Augmentative Communication and LiteracyChapter 14By Pat Mirenda and Karen A. Erickson

Autism and Augmentative Communication 1988 summary article stated no firm

conclusion on the efficacy of AAC interventions with ASD population

No current summary article completed between 1988- the 2000 printing of this book

This chapter examines the 1990’s as an up-to-date summary of AAC and Autism

Function vs. Form In typical development early forms of

communication are gradually improved upon by new forms and result in an integrated multimodal system

In intervention, promoting the use of early forms of communication in natural contexts is a good starting point for those who are “preintentional”

Function vs. Form The goal is the development of natural speech

and language, However, if this does not occur, a foundation

for later AAC intervention has been developed.

Comprehensive intervention supports concurrent development of both form and function of language

Function vs. FormInitial communication goals:1. Building intentionality, turn-taking, joint

attention, and initiation skills using unaided AAC techniques (gestures, vocalizations, and speech)

2. Expanding the individual’s repertoire of communicative functions beyond instrumental

Brief History of Symbol Use in Autism Symbol- something

that stands for something else

Two types:1. Unaided symbols2. Aided symbols

Referent- the “something else”

Symbols Unaided*gestures*vocalizations*facial expressions*body languageUsed by beginning

communicators often thought of as “preintentional”

Aided*requires some type of

external device for production (communication book, board, or computer)

Chimps, Chips, Signs, and Lexigrams Premack & Premack (1974 book chapter)

taught chimp to associate plastic shapes with words and she used them to communicate

Gardner & Gardner (1969, 1975) taught chimp to use sign language

Rumbaugh, Savage-Rumbaugh, & Boysen (1977, 1978) taught chimps to communicate using abstract lexigrams

Letters and Words Operant conditioning interventions

demonstrated that some individuals with autism could learn to associate words with their referents (1970’s)

Hyperlexia spurred interest in using orthographic symbols to help those with autism communicate (1980’s)

Visuospatial Symbols A natural match for the visuospatial strengths

demonstrated in autistic individuals-line drawings-photographs Widespread utilization of this approach by the

late 1980’s

Manual Signs and Visual-Graphic Symbol Research All people, regardless of the apparent extent of

their disability, can learn to communicate Both manual signs and visual-graphic symbols

hold particular promise for individuals with autism (Fay & Schuler, 1980)

Shift from use of manual signs to visual-graphic symbols occurred as a result of research in imitation, iconicity, and intelligibility

Imitation Research shows that the development of

expressive speech in children with autism is dependent on the mastery of imitation at the time of intervention (using manual signs)

Generalized imitation deficit in autism Motor coordination difficulties (apraxia)

correlated to the acquisition and use of signs by autistic individuals

Iconicity “Symbols having strong resemblance (visual

relationship)to referents are easier to learn” hypothesis (Fuller & Stratton, 1991)

Support in the literature Many of the most basic need and functional signs

fail the iconicity test Visual-graphic symbols capitalize on the

visuospatial strengths commonly seen in people with autism

Intelligibility Research supports the use of visual-graphic

symbols as opposed to manual signs Untrained communication partners are more

likely to be able to interpret meaning from pictures than from manual signs

Relationship between AAC and Speech Development Research shows communication transfers

from sign to spoken language when individual has mastered approximately 200 signs and begins chaining them together

Research also shows that some individuals remain mute and acquire only a few signs

There is potential for speech development in conjunction with manual signing ( it does not inhibit speech production)

Continued… Research on Picture Exchange

Communication System Research on VOCAs/System for Augmenting

Language Together results suggest that aided symbol

use does not inhibit development of speech in individuals with autism

The Role of Voice-Output Communication Aids and Computers Single level devices- deliver a limited number of

messages and are simple to operate Multi-level devices- deliver more than 20 messages

on two or more levels and are more difficult to program

Comprehensive devices-deliver multiple messages and have additional features including printers, calculators, large memory capacity, and the ability to interface with computers

Computer Software Used to support communication and literacy

development Research showed computer use also has a

positive effect on peer interactions and verbalizations (Panyan, 1984), problem-solving strategies (Jordan & Powell, 1990), motivation and behavior (Chen & Bernard-Opitz, 1993) and reading individual words (Hiemann, Neslon, Tjus, & Gillberg, 1995)

AAC interventions for Challenging Behavior Many empirical studies that show providing

receptive/expressive communication supports decreases occurrence of challenging behavior in individuals with autism

Augmentative Input StrategiesUsed to either communicate more effectively

with others or to understand communication from others.

1. Pictorial or written schedule*within-task*between-task*rules

Functional Communication Training Using AAC Functional Communication Training- teaching

individuals to use manual signs or other AAC techniques as “substitutes” for the “messages” underlying challenging behaviors

Research shows 3 basic messages:1. Attention (Pay attention to me)2. Tangibles ( I want _____)3. Escape (I don’t want to do this) FCT teaches use of more functional messages and

provides a positive alternative to challenging behaviors

Clinical and Educational Implications: AAC Interventions and Autism Complex task considering not only form but

function of language Careful assessment of types of symbols Instructional and facilitator supports May use electronic devices Communication opportunities must be

provided

Directions for Future Research: What strategies are most successful for developing natural

gestures and vocalizations for preintentional communicators? How much incidental modeling is needed for efficient

symbol learning? What are comparative outcomes of PECS and SAL

approaches with young children with autism How does use of augmented input strategies for behavioral

support affect communication and social development How much does availability of voice output technology

contribute to symbol learning, speech development, and receptive language development as compared with visual-graphic symbol use without

Autism and Literacy Facilitated communication created renewed

interest in the literacy learning potential of people with autism

Hyperlexia Appears most often in children with autism as

compared to other disability groups Specific characteristics:1. Word reading skills that exceed what is predicted or

expected2. Compulsive or indiscriminate reading of words3. Onset of ability between 2 and 5 years of age4. Onset of ability in the absence of direct instruction

Hyperlexia Evidence supports that hyperlexia stems

from a problem with general receptive language comprehension coupled with strong word recognition skills

Children with autism and hyperlexia do not differ dramatically from readers without disabilities: they both require background knowledge and language understanding to comprehend text

What is Literacy? Skill usually acquired through numerous

opportunities to interact with print in meaningful ways and receive appropriate instruction

Involves the interaction of several processes Defined as the combination of reading and writing Reading- silent reading comprehension Writing- translation of thoughts and words into

written text

Emergent Literacy and Readiness Perspectives Emergent Literacy Perspective-the ability to read

and write is acquired in much the same way as spoken language

Readiness Perspective-a within child characteristic; they are ready for reading and writing instruction when they have mastered the following set of skills:

1. shape, number, and color recognition2. Letter identification3. Pincer grasp

Children with Autism Research shows they can learn readiness skills They can learn to recognize and use isolated words No research regarding ability to comprehend

paragraph-length or longer text Research provides evidence that an intervention can

be used effectively to increase clause length, phrase length, and frequency of adjective and gerund use in both students without disabilities and those with autism

Center for Literacy and Disability Studies Preschool Project Comprehensive example of the potential for

Emergent Literacy Perspective Intervention in two phases: writing and

reading as focus Results suggest that children with autism

develop emergent reading and writing skills in much the same way as their typically developing peers

Sociocultural Model of Literacy Learning Multiple contexts influence literacy learning Individual’s abilities and disabilities are only one of

the contributing factors Attitudes and expectations of people in child’s

environment a factor Availability of accessible reading and writing

materials a factor Nature of the interactions between individual and

his/her literacy instructor a factor

Clinical and Educational Implications: Autism and Literacy What we do know is that we really don’t

know what type of intervention is best Should incorporate many aspects of

interventions that are known to work for literacy learning (Four Block Model)

Directions for Future Research How does Early literacy development according to

emergent literacy model apply to individuals with autism

Relationship between literacy learning and communication development?

To what extent can recommended practices in literacy instruction apply to autism?

Can people with autism be taught using a comprehensive approach?

How does the use of AAC graphic symbols impact literacy learning in people with autism?

Conclusion Social context is important both for communication

and learning Instruction must be embedded in relevant,

motivating social contexts AAC intervention should provide both receptive and

expressive supports Literacy supports should incorporate both decoding

and comprehension skills that are developmentally appropriate