Expressive Communication Skills:
"Low-tech" strategies designed to focus on a child's expressive communication skills include the following:
- Picture point communication board system: In order to communicate the child points to various visual representations (e.g., photos, PCS, objects, etc.) located on a "communication board" . Numerous communication boards can be created that are child, task, or environmentally specific.
Example: Placemat communication board to be used during snacks and meals with PCS around the edge of the placemat; communication board created for the "play" area.
- Picture Exchange Communication System (PECS): The child approaches and gives a picture of a desired item (photo, PCS, object, etc.) to a communicative partner in exchange for that item (7). The use of this type of communication system provides the child with a way to communicate and most importantly, teaches the child to spontaneously initiate a functional communicative exchange (7).
Numerous adaptations can be made when using a PECS program to meet the individual needs of a child. For example, placing the visual representation system on frozen juice can lids or other hard discs or squares (counter top samples) allows the visual representation system to become more prominent to the child by giving him more tactile input (weight and hardness). He may tend to "crumple" up lightweight paper type items (pictures on plain paper) as a possible sensory need.
- Break cards: This is to help the child communicate that he needs some "down time" or a "break". Break cards should be easily accessible to the child and could be located in a consistent spot in the classroom, such as on the child's communication board or book, on the child's desk, etc. The purpose of the break card is for the child to communicate the message that he needs a break by using an appropriate communicative mode (visual representation system) rather than having to become increasingly anxious and frustrated, which may result in the occurrence of challenging behaviors.
- Choice cards: Choice cards (again using any type of visual representation system) allow the child a degree of independence by indicating a choice from a pre-determined set of possibilities. (e.g. a "work time" choice card could be presented to the child with several choices of activities for the child to choose from). When presented in this manner, the child is less likely to act out because he is allowed to make a "choice" of what he wants to do.
"All Done" Card
- "All done" cards: Many non-verbal children exhibit challenging behaviors to indicate that they are "all done" with something, as they typically have no other way to communicate this concept. Therefore, teaching a more appropriate way to indicate "all done" through a visual representation system will lessen both the child's and adult's stress and frustration. "All done" cards can be taped to the child's work area and taught to the child by stopping an activity prior to reaching the child's attention/frustration level, then pointing to the "all done" card. The child's hand can be physically prompted to point to the "all done" card if needed. "All done" cards can also be placed on the child's communication board, or book, for him to use.
- Topic ring/topic wallet: These are designed for children who are verbal, yet have difficulty initiating a topic with others or, have difficulty initiating various topics with others, particularly when these topics are not related to their high interest areas. The "topic wallet/ring" can have various topics visually illustrated (e.g., written words, PCS) to prompt the child to initiate a topic.
Example: The following topics are illustrated individually on small 3" by 3" laminated cards using both PCS and written words. They are either attached by a metal ring in the corner (for the child to hook on a belt loop) or placed in a small "communication wallet" to be kept in his pocket. The topics include "What did you do over the weekend"? "What is your favorite movie?" "Do you have any pets?" "What books do you like to read?"
- Relating past events: Many children with autism, both verbal and non-verbal, have significant difficulty relating past events. Using a visual representation system, which the child readily understands, can help to bridge this gap, at least between home and school. General templates are developed, which can be easily circled or filled out each day and sent to the respective location (home or school), to aid the child in relating past information through this visual representation system. Please click to see the samples "Last Night at Home" and "Today At School".
Children with autism need to be directly taught various social skills in one-to-one and/or small group settings. Numerous low-tech strategies can be used for this purpose. Social skills training will also be needed to consider the child's possible difficulties in generalizing this information different social situations, which may be supported through the following visual strategies:
- Social Stories: The use of Social Stories, developed by Carol Gray, provides the child with the use of visual information/strategies that will improve his understanding of various social situations and teach him specific behaviors to use when interacting with others (9). Social Stories are written in first person and are individually written for each child for various difficult social situations (for example, staying in assigned seat on the bus). The Social Story should be visually represented in a mode which the child can most readily understand (such as written words, line drawings and written words, photos and written words).
The repetitious "reading" of the Social Story, when the child is calm, is what leads to the success of this strategy. Two 3-ring binders of identical Social Stories, kept in page protectors, could be made, one for home and one for school, so the child can read them at his leisure. This strategy has proven to be very successful for many students in learning to recognize, interpret and interact appropriately in different social situations.
A software program from Slater Software Company (23) which converts text to a graphic symbol, is called "Picture It",. This software program is ideal for adding line drawing graphics above written words to increase the child's understanding of Social Stories.
- Social Scripts: Social scripts are similar to Social Stories; however, an actual script is developed for a specific social situation (it is specific to the child and the social situation).
Example: A child has difficulty asking peers if he can join in their "ball-tag" game at recess. He typically runs in the midst of the game, takes the ball and then runs away. The script would read: Joey - "Hi guys. Can I play 'ball-tag' with you?" Guys - "Sure you can, Joey, but you will have to wait over there until it's your turn to throw the ball." Joey - "O.K. I'll wait until you tell me it's my turn."
Use of social scripts also readily helps in role playing these various social situations with peers, puppets, etc. Social scripts can also be used to visually, and thus clearly indicate what went "wrong" in a social situation.
- Comic Strip Conversations: The use of simple drawings to visually clarify the elements of social interactions and emotional relations. Comic Strip Conversations are used to visually "work through" a problem situation and identify solutions (8).
- Turn-taking cards: Turn taking cards are used to visually represent and mark whose turn it is. This use of turn-taking cards through a visual representation mode (PCS, object, written word, etc) is very effective in teaching this social skills concept.
- "Wait" cards: Wait cards visually represent the abstract concept of "waiting" through the use of a large orange colored oval card printed with the word "wait". These cards can be used at any time to teach the abstract concept of "waiting".
Example: Place the "wait" card on the computer monitor while waiting for the computer or a program to boot up; have the child hold the "wait" card while waiting in line.
- "Help" cards: "Help" cards are used to teach the child the abstract concept of raising his hand in order to indicate that he needs help. Initially it is necessary to provide a concrete reason for the child to raise his hand by using the "help" card. An "I need help" visual representation (PCS, photograph, written word - taped to a Popsicle stick, or object) is used for the child to raise up in the air to indicate that he needs help. The item that he raises in the air can gradually be eliminated until the child is readily raising only his hand to seek assistance.
- "Waiting hands" card: An outline of a person's open hands on colored paper is used as a guideline as to where the child should place his hands while waiting (either for his turn, or for a chance to perform an action, etc.).
- Social "rule" cards: These cards are taped to the child's desk in the classroom (e.g., "I will raise my hand and wait for the teacher to call on me"). Social "rule" cards can be made for other environments than just the classroom. A "rule" card per environment can be written on an index card, laminated, and then given to the child to carry along as a visual reminder of the social "rules" for that particular situation.
Example: Library social rules cards: "I will sit at a table with at least one other student". "I will discuss my book with one other student". "I will discuss another student's book".
The visual symbols "go", "almost done" and "stop" can also be used to increase a child's attending skills. Data will need to be initially obtained to get a general idea of how long a child attends to a particular task.
Example: The child attends to a particular task for approximately 45 seconds and then throws all of his materials to indicate that he is "all done". To teach the significance of the "go" , "almost done" and "stop" cards, the "go" card is given at the start of the activity, the "almost done" card is given after approximately 30 seconds (as we already know the child will throw the materials after 45 seconds) and the "stop" card is given at approximately 40 seconds, with the activity immediately ceasing. It is critical to initially use the cards to "stop" the activity prior to the child throwing the materials, so that the child realizes the significance of the cards in relaying the messages of being "almost done" and "stopping". Gradually, the length of time for giving the child the "almost done" card and the "stop" card is increased, thus increasing the child's attending skills. It is important to note that the "almost done" card is always given to the child within a short time frame of giving him the "stop" card. Consistency is important in using these cards to increase the child's attention.
- File Folder Activities: The use of file folder activities can assist the child to independently focus on numerous academic tasks. Long strips of Velcro are placed on the inside pages of a laminated file folder. Matching tasks focusing on colors, shapes, alphabet letters, common nouns, familiar people, categories, relations (e.g., shoes and socks) etc. can be developed for the child, as well as focusing on reading comprehension skills, math skills, generalization skills, etc.
- Highlighter Tape: Many children with autism possess relative strengths in their reading recognition skills (decoding), but experience significant difficulty understanding what they have read (comprehension). Highlighter tape is an economical, non-destructive way to highlight text wherever needed via a removable transparent tape (25). The tape can be used in such ways as highlighting key words pertaining to a reading comprehension question. Different colors of highlight tape can be used to encode different significant concepts (e.g., blue highlighter to mark dates, yellow highlight tape to mark people, etc.).