4 Key Take Home Strategies

I have covered so much material in the course of making this blog and we have discussed many aspects of communication in our discussions. It is a key factor for those with ASD and how they function.

4 Strategies I would focus on include:

1. Co-treating with SLPs and Educators/Families:
It is important to all use the same key words. You and the SLP can help others understand some commonality in the speech of those with ASD including:
-oral sensitivities
-motor impairments
-low tone
-prosody
-sound/syllable repetition
-word repetition
-word revisions
-slow articulation
-pause time
-misplaced stress in words
-monotonous tome
-loud high pitch
-nasality
-sing-song voice
Once the verbal expectations are known/understood by listeners, they may more more willing to interact with the child with ASD.

Motivation and interest and attention should be primary focuses of interactions. Co-treatment sessions such as making and using puppets seem to be one example that is good. We have also discussed using Sponge Bob to help teach idioms and expression sayings. Homographs also need to be taught.

The rationale for co-treating is that many things can be worked on at the same time in a naturalistic setting and motivation will be present. Also, it helps generalize skills if all team members are on the same page.

2. Context:
Consider auditory and visual distractions, social complexity, and of course motivation to communicate! Use high contrast and boundaries to establish work and play areas and help with expectations/predictions. Materials used should also be considered. We have discussed using their choices/interests such as Thomas and trampolines to expand communication skills as well as motor skills and social/play skills. Another example is using repetitive stories and songs and leaving out parts they need to fill in. Also you can leave a key piece of a task out so they have to ask for it.

The rationale for the use of context is to not overwhelm the child from the start but to motivate them to communicate. It will be a more efficient use of time and be more meaningful to the student.

3. Consider Interventions:
Remember feeding and speech use different muscles and that oral motor techniques may not necessarily lead to speech. Joint attention and imitation should be developed first. Consider random or blocked techniques (or a combination). Consider continuous or discrete interventions (or both). Find the best fit for the child. Random has better transfer and continuous allows you to use the natural environment and incidental teaching which I feel is important. Consider body awareness and postural cues and facial interpretation ability when planning communication, socialization and play. Know that the above techniques may vary depending on the skill desired. Social Stories are good for preparation for a multitude of experiences and flip videos are good visual feedback as only 2 examples. Remember sensory desires such as proprioception too.

My Rationale for using a variety of interventions is to focus on the individual and the skill being developed. Task analysis can help you decide what might be the best way to proceed. Don't forget reinforcement, interest and motivation. DTT may be better for difficult skills as there is immediate reinforcement but the long term goal is continuous random interactions in the natural environment so the child can generalize skills learned in many different settings and the interaction is the reinforcement.

4. Total Communication:
It is important to be aware of the numerous ways to facilitate communication especially for those who are nonverbal or show no intent. Many items below use the visual strengths of this population. Consider that communication involves a listener and a speaker.
-PECS
-Sign language
-augmentative devices
-PROMPT
-NSOMEs
-Integration Stimulation
-Verbal Behavior
-The Denver Mode
-building on echolalia

It is important to know various programs or strategies to empower those working with the child with ASD and enabling educated choices or alterations to best meet the child's needs.

My rationale for this is to reduce the frustration and increase the desire for the child to want to communicate. Many of the above also use the visual strengths of this population. They an be used together or variations such as photos or transitional objects can be used. Again, the best fit is important. I like to allow the child with ASD to have as many avenues and opportunities as possible to communicate.

Finally, I encourage you to combine communication, play and social skills. You can build communication and social skills (hidden curriculum) during physical tasks and basically during any intervention. Remember your speech as well and gear it toward your goals. Remember sensory needs and motivate the child. Enjoy yourself and teach other professionals and families how to engage the child for optimal communication.