aac with aba for asd: easy as 1, 2, 3 - therapy and beyond · 2017-09-16 · aac with aba for asd:...

AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP

09.16.2017

Therapy & Beyondwww.therapyandbeyond.com539.777.0940 1

Executive Director: Regina Crone, Ph.D., BCBA-D

AAC with ABA for ASD:Easy as 1, 2, 3

Christina Martin, M.S., CCC-SLP, BCBARacheal Montgomery-Garba, M.S., CCC-SLP

Christina Martin, M.S., CCC-SLP, BCBARacheal Montgomery-Garba, M.S., CCC-SLP

OSHA Conference 2017


Handouts

Updated handouts are available on our website at:


www.therapyandbeyond.com/presentations


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Disclosures

Racheal Montgomery-Garba, M.S., CCC-SLP

Relevant Financial Disclosures• Receives payment for employment at Therapy and Beyond. This

organization provides ABA and speech therapy to individuals with autismand other developmental disabilities.

Relevant Non-Financial Disclosures• None



Disclosures

Christina Martin, M.S., CCC-SLP, BCBA

Relevant Financial Disclosures• Receives a salary for employment at Therapy and Beyond. This

organization provides ABA and speech therapy to individuals with autismand other developmental disabilities.

Relevant Non-Financial Disclosures• Is dually credentialed as a Board Certified Behavior Analyst.



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Objectives

• Describe how individuals with Autism Spectrum Disorder (ASD)could benefit from Augmentative and Alternative Communication(AAC)

• Explain the potential benefits of AAC on the development ofnatural speech with individuals with ASD

• Recognize the myths about AAC and distinguish scientific frompseudoscientific treatment claims



What is Autism?

• Autism, or autism spectrum disorder (ASD), refers to a range ofconditions characterized by challenges with social skills, repetitivebehaviors, speech and nonverbal communication, as well as byunique strengths and differences. We now know that there is notone autism but many types, caused by different combinations ofgenetic and environmental influences.


Autism Speaks. (2017). What is Autism? Retrieved from: https://www.autismspeaks.org/what-autism


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What is Autism?• About 1 in 68 children has been identified with autism spectrum

disorder (ASD).• ASD is reported to occur in all racial, ethnic, and socioeconomic

groups.• ASD is about 4.5 times more common among boys (1 in 42) than

among girls (1 in 189).• About 1 in 6 children in the United States had a developmental

disability in 2006-2008, ranging from mild disabilities such asspeech and language impairments to serious developmentaldisabilities, such as intellectual disabilities, cerebral palsy, andautism.


Centers for Disease Control. (2017). Autism Spectrum Disorder: Data and Statistics. Retrievedfrom: https://www.cdc.gov/ncbddd/autism/data.html


Need for AAC with ASD

Approximately ofindividuals with autism present with little or nofunctional speech and may be candidates forAAC to replace or supplement natural speech.

Approximately ofindividuals with autism present with little or nofunctional speech and may be candidates forAAC to replace or supplement natural speech.

Weitz, C., Dexter, M., Moore, J., Glennen, S., & Decoste, D. (1997). AAC and children withdevelopmental disabilities. Handbook of augmentative and alternative communication, 395-431.

Lloyd, L. L., Fuller, D. R., & Arvidson, H. H. (1997). Augmentative and alternative communication: Ahandbook of principles and practices. Needham Heights, MA Allyn & Bacon



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What is AAC?

Augmentative and Alternative Communicationincludes(other than oral speech) that are used toexpress thoughts, needs, wants, and ideas.

Augmentative and Alternative Communicationincludes(other than oral speech) that are used toexpress thoughts, needs, wants, and ideas.

American Speech-Language-Hearing Association. (2002). Augmentative and alternativecommunication: knowledge and skills for service delivery [Knowledge and Skills]. Available fromwww.asha.org/policy.



Augmentative vs. Alternative


American Speech-Language-Hearing Association. (2004). Roles and responsibilities of speech-language pathologists with respect to augmentative and alternative communication: Technicalreport [Technical Report]. Available from www.asha.org/policy.

Supplement to currentcommunication

Supplement to currentcommunication

Replacement of currentcommunication

Replacement of currentcommunication


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Key Terms

Act of giving orreceiving information

in any form

Act of giving orreceiving information

in any form

System ofconveying thoughtwith shared rules

System ofconveying thoughtwith shared rules

Communicationby vocal

production

Communicationby vocal

production



AAC Forms

Sign LanguageCommunication Boards

PECSAnd many, many more

Sign LanguageCommunication Boards

PECSAnd many, many more

Speech GeneratingDevices

Electronic CommunicationSystems

Speech GeneratingDevices

Electronic CommunicationSystems



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No Tech Example



Low Tech Example



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High Tech Example



Which AAC is best?



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Which AAC is best?

The best method supportsthe development of spontaneous, meaningfulcommunication that generalizes to allenvironments. There is no such thing as onesize fits all.

The best method supportsthe development of spontaneous, meaningfulcommunication that generalizes to allenvironments. There is no such thing as onesize fits all.



Feature Matching


Caron, J. (2013) Feature Match Table. Retrieved from http://www.childrenshospital.org/centers-and-services/augmentative-communication-program/downloads/app-and-clinical-feature-matching-handouts

an individual’savailable or potentially available augmentative andalternative communication


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Feature Matching Table


Caron, J. (2013) Feature Match Table. Retrieved from http://www.childrenshospital.org/centers-and-services/augmentative-communication-program/downloads/app-and-clinical-feature-matching-handouts


Pseudoscientific ClaimsPseudoscience refers to claims that appear to be based on the scientific method

but are not.

Finn, P., Bothe, A.K., & Bramlett, R.E. (2005). Science and Pseudoscience in Communication Disorders.American Journal of Speech-Language Pathology, 14, 172-186.


1. Untested2. Unchanged3. Confirming evidence4. Anecdotal evidence5. Inadequate evidence6. Avoiding peer review7. Disconnected8. New terms9. Grandiose outcomes10.Holistic

Russell’s Orbiting Teapot


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Scientific Claims

“ASD is a medical/ neurodevelopmental condition with behavioral symptoms that are directly addressed by appliedbehavior analysis methods. ABA has proven effective in addressing the core symptoms of autism as well asdeveloping skills and improving and enhancing functioning in numerous areas that affect the health and well-beingof people with ASD.”

“The effectiveness of ABA-based interventions in ASDs has been well documented through a long history of research inuniversity and community settings. Children who receive early intensive behavioral treatment have been shown to makesubstantial gains in cognition, language, academic performance, and adaptive behavior as well as somemeasures of social behavior, and their outcomes have been significantly better than those of children in control groups.”

“ABA has both long-term empirical and research data to demonstrate its effectiveness inhelping children who are diagnosed with ASD, and AAP has endorsed the use of ABAtreatments when determined appropriate by physicians within a medical home, in closeconsultation with families.”

Applied Behavior Analysis as an Evidence-Based Practice

American Academy of Pediatrics. (2012) Statement on the Use of ABA to Treat Individuals with ASDs.Retrieved from http://www.armed-services.senate.gov/statemnt/2012/06%20June/Tait%2006-21-12.pdf



Applied Behavior Analysis

“The in which procedures derived fromthe are systematicallyapplied to improve behaviorto a meaningful degree and to demonstrateexperimentally that the procedures employed wereresponsible for the improvement in behavior." (p.14)

“The in which procedures derived fromthe are systematicallyapplied to improve behaviorto a meaningful degree and to demonstrateexperimentally that the procedures employed wereresponsible for the improvement in behavior." (p.14)


Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis, 2nd ed. Upper Saddle River,N.J.: Pearson Prentice Hall.


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Applied Behavior Analysis

Some individuals may rely on socially inappropriate,or maladaptive behaviors (i.e. hitting) tocommunicate their needs to others. In these cases,

can serve as an method ofcommunication through

.

Some individuals may rely on socially inappropriate,or maladaptive behaviors (i.e. hitting) tocommunicate their needs to others. In these cases,

can serve as an method ofcommunication through

.


Danov, S.E., Hartmann, E., McComas, J.J., & Symons, F.J. (2010). Evaluation of two communicative responsemodalities for a child with autism and self-injury. The Journal of Speech and Language Pathology- Applied BehaviorAnalysis, 5(1), 70-79.

Wacker D. P, Berg W. K, Harding J. W, Derby K. M, Asmus J. M, & Healy A. (1998). Evaluation and long-term treatmentof aberrant behavior displayed by young children with disabilities. Developmental and Behavioral Pediatrics, 19, 260–266.


Functional Communication Training

A differential reinforcement procedure inwhich an individual is taught an

that results in the same class ofreinforcement identified as maintainingproblem behaviorFor example, instead of screaming for an orange, anindividual is taught to exchange a picture to gain access.

A differential reinforcement procedure inwhich an individual is taught an

that results in the same class ofreinforcement identified as maintainingproblem behaviorFor example, instead of screaming for an orange, anindividual is taught to exchange a picture to gain access.


Carr, E.G. & Durand, V. (1985). Reducing behavior problems through functional communication training. Journalof Applied Behavior Analysis, 18, 111–126.


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Functional Communication Training



AAC Myths

AAC is speechintervention strategy.



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AAC Myths

“AAC interventions on the failure to developspeech skills or considered a last resort because AAC can play many roles inearly communication development.”

“AAC devices and strategies are a tool, a means to an end — language and

communication skills — .”

“AAC interventions on the failure to developspeech skills or considered a last resort because AAC can play many roles inearly communication development.”

“AAC devices and strategies are a tool, a means to an end — language and

communication skills — .”

AAC is a last resort speech intervention strategy.

Romski, M. & Sevcik, R. (2005). Augmentative communication and early intervention: Myths andrealities. Infants and Young Children, 18(3), 174-185.



AAC Myths

AAC is speechintervention strategy.



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AAC Myths

There areskills needed for AAC.



AAC Myths

individuals are considered potential candidates for AAC. There is a

policy with respect to determining individuals' eligibility for AAC

services. There is arbitrary list of (i.e. matchpictures, level of cognitive ability, etc.)

" . . . breathing is the only prerequisite that is relevant to communication.Breathing equals life, and life equals communication. It is that simple."

There are pre-requisite skills needed for AAC.

American Speech-Language-Hearing Association. (2004). Roles and responsibilities of speech-language pathologists with respect to augmentative and alternative communication: Technicalreport [Technical Report]. Available from www.asha.org/policy.

Kangas, K. & Lloyd, L. (1988). Early cognitive skills as prerequisites to augmentative andalternative communication use: What are we waiting for? Augmentative and AlternativeCommunication, 4(4), 211-221.

Mirenda, P. (1993). Bonding the uncertain mosaic. Augmentative and Alternative Communication,9(1), 3-9.



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AAC Myths

There areskills needed for AAC.



AAC Myths

Only benefitfrom AAC.



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AAC Myths

The comprehensive study of AAC intervention by Millar, D., et. al, (2006)indicated that the positive effects of AAC intervention on speech production were

observed across children and adults, ranging in age from

.

It is too early or too late to start teaching AAC.

Only certain ages benefit from AAC.

Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternativecommunication intervention on the speech production of individuals with developmental disabilities:A research review. Journal of Speech, Language, and Hearing Research, 49, 248-264.



AAC Myths

Only benefitfrom AAC.



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AAC Myths

AAC willspeech and language

development.



AAC Myths

There have been published studies that show decreased speechproduction as a result of AAC. Two articles reviewed all of the previously-published research that had investigated speech production before, during, and

after AAC intervention. of the individuals involved in any of the studiesdemonstrated decreases in speech production as a result of AAC intervention.

The majority demonstrated at least modest .

AAC will inhibit or impede speech and language development.


Schlosser, R., & Wendt, O. (2008). Effects of augmentative and alternative communicationintervention on speech production in children with autism: A systematic review. American Journal ofSpeech-Language Pathology, 17(3), 212–230.



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AAC Myths

According to the study by Millar, D., et. al, (2006)investigating speech production before, during, andafter AAC intervention, participants with:

• Decreases in speech production- 0%• No change in speech production- 11%




AAC Myths

According to Mirenda (2003), if AAC (e.g., the manualsign or graphic symbol for cookie) is presented alongwith the spoken word (as is typically the case in AACintervention), and these are followed by a reinforcer(e.g., a chocolate chip cookie),

.

Mirenda, P. (2003). Toward functional augmentative and alternative communication for studentswith autism: Manual signs, graphic symbols, and voice output communication aids. Language,Speech, and Hearing Services in Schools. 34 203–216



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AAC Myths

AAC willspeech and language

development.



AAC Competence Takes Time



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Credit for Images Used• http://www-tc.pbs.org/parents/education/files/2012/06/Sign-

Language.jpg• http://www.asha.org/events/convention/handouts/2011/frost-horton-

matteo-waegenaere&psig=AFQjCNFK9cWXI5-AENpCEH_08LAT5fH2CA&ust=1454480315243447

• https://shaivalinisingh.files.wordpress.com/2011/12/footwear-big.jpg• https://hobi.com/myth-busters-itad/myth-busters-itad/• https://itunes.apple.com/us/app/touchchat-hd-aac/id398860728?mt=8

• http://www-tc.pbs.org/parents/education/files/2012/06/Sign-Language.jpg

• http://www.asha.org/events/convention/handouts/2011/frost-horton-matteo-waegenaere&psig=AFQjCNFK9cWXI5-AENpCEH_08LAT5fH2CA&ust=1454480315243447

• https://shaivalinisingh.files.wordpress.com/2011/12/footwear-big.jpg• https://hobi.com/myth-busters-itad/myth-busters-itad/• https://itunes.apple.com/us/app/touchchat-hd-aac/id398860728?mt=8



Questions



09.16.2017



Contact Information

www.mytherapyandbeyond.comwww.mytherapyandbeyond.com

539.777.0940539.777.0940


aac with aba for asd: easy as 1, 2, 3 - therapy and beyond · 2017-09-16 · aac with aba for asd:...

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