by Susan Stokes Autism Consultant
If you reprint or use this article, or parts of it, please include the following citation:"Written by Susan Stokes under a contract with CESA 7 and funded by a discretionary grant from the Wisconsin Department of Public Instruction. "
The two-fold purpose of this article is to provide:
|I||Key questions to consider in order to determine the child's current communication abilities;|
|II||Information regarding the development of a communication intervention program based on the child's communication needs.|
In order to develop an appropriate communication intervention program for the non-verbal child with autism, it is essential to determine the child's current communication abilities. The following are important questions to consider in order to make this determination:
It is important to determine if the child is exhibiting communicative intent. Intent to convey a message distinguishes communication from non-communicative speech, verbalizations and gestures. When the child anticipates an outcome from his communication, regardless of the form (i.e.: speech, gesture, etc.), he demonstrates intent.
Communicative intent is indicative of the child's desire to communicate. In turn, the desire to communicate is inextricably tied to the development of social relationships, an area of significant difficulty for children with autism. Because these children are often unaware of, or may be uninterested in, others, communicative desire or intent is often absent. They do not understand that they can use communication to get something, or to get someone to do something for them. They attempt to get their needs and wants met by themselves in any way possible, and may exhibit distress when unsuccessful. When interacting with a child with autism, it is important to be able to distinguish this distress from a desire to communicate, in order to determine if the child is exhibiting communicative intent.
A child with autism, who demonstrates intentional communication, can do so using various forms or modes. It is important to consider which of the following communication forms are used by the child:
In addition it is important to determine if the form of communication used by the child varies, depending upon the context and situation or the type of communication desired. For example, the child may use a motoric mode of communication (taking a person's hand and pushing it towards a desired item) to request an object. However the same child may use a vocalization (crying) to reject an item, or to protest.
Research has shown that the child with autism uses his language to communicate for a narrow or restricted range of purposes or functions (7). There are three primary functions or purposes of language: behavioral regulation, social interaction and joint attention (7). It is important to note that all three communicative functions are developed by approximately age 12 months in typically developing children, and are listed in hiearchical order from least social to most social (6):
This is the most difficult communicative function for children with autism spectrum disorder to develop (6). These communicative acts are used to direct another's attention to an object, event, or topic of a communicative act. Joint attention communication acts include:
It is important to determine what motivates the child before developing a language intervention plan. As in typical child language development, children with autism will generally not engage in communicative interactions unless they are motivated to do so. Therefore, if the child loves swinging, or jumping or playing with string or particular foods, then these are the actions/objects that should be part of an intervention plan. Incorporating motivating activities and objects is vital when helping children develop communicative intent / desire. Teaching a core of early developing vocabulary words is merely teaching the child with autism to label and does not constitute teaching him to communicate. By initially using motivating actions and objects, the child will truly learn the purposes or functions of communication. Once the child has learned this, vocabulary can then be expanded through a variety of teaching strategies.
Communication implies being both an initiator of, and a responder to information while engaged in a social situation (4). Therefore it is important to determine if the child with autism is able to understand, as well as participate in, both roles in communicative interactions.
Children with autism typically have difficulty initiating communicative interactions with others, and tend to be better at learning to respond (4). When determining if the child initiates or responds to any communicative interactions, it is important to ascertain the particular contexts/settings, the manner or form of communication and the communicative purpose or function.
Due to their significant difficulties in successfully communicating, children with autism may experience frequent occurrences of communication breakdowns as both speakers (expressively communicating) and listeners (when asked to respond). Therefore it is important to determine if the child has developed, or is able to use, any communication repair strategies for both receiving and expressing communicative messages.
Repeating the same communicative attempt: Being persistent. For example the child repeatedly points to a shelf out of reach, as the adult takes each item off of the shelf and shows it to the child to see if it is the desired item.
Showing the person what they are trying to communicate: a child might take an adult to the refrigerator, for example, open the door and reach towards a shelf where the milk is located, demonstrating that he wants milk.
Use of an alternative way to communicate the same message: In the above example, if the child points to the shelf several times, but the adult still does not understand (a breakdown in communication), the child might then choose a picture from his communication book to clarify his communicative request, thus repairing the breakdown in communication.