Developing Language and Communication Skills with Children with ASD Rita Dubé, PhD, R.SLP (C) Brianne Rayment, MSc, SLP, R.SLP (C) Portions of this presentation is based on information from More Than Words The Hanen Program for Parents of Children with Autism Spectrum Disorder. The content of the More Than Words Program is drawn from the guidebook More Than Words a Guide to Helping Parents Promote Communication and Social Skills in Children with Autism Spectrum Disorder ( Sussman, 1999 ). For more information on The Hanen Centre's resources and programs, please visit www.hanen.org. Overview 4 Stages of Communication Strategies to Facilitate Communication Follow your child s lead 4 I s OWL 4S s Communication Temptations Turn Taking Social Communication What is it? How does it relate to play? Deficits in Children with ASD How to promote social interactions
Stages of Communication Own Agenda Requester Early Communicator Partner Social/Expressive/Receptive Language Characteristics at Stages Own Agenda Requester Early Communicator Partner Social o Minimal interest in others o No initiation/ responding o Pays some attention to you o Shares enjoyment o Pays attention to you and activity at same time o Initiates and responds o Initiates and responds o Some play with children Expressive o Cries, looks, sounds, smiles, reaches o Hand leading o Reaching o Gives, looks, signs, gestures, sounds, words, echoes o Spontaneous o Echoes o Gestures Receptive (Understands) o Almost nothing o Routines with cues o Words, some gestures and easy questions o Sentences o Many words Own Agenda Characteristics: Socially: Minimal interest in others No initiation/limited responding Expressive: Cries, looks, sounds, smiles, reaches Receptive: Hard to tell (very little understanding of verbal language)
Own Agenda Video Requester Characteristics: Socially: Pays some attention to you Shares enjoyment Expressive: Hand leading Reaching, body movements May use a few words/picture exchanges Receptive: Routines with cues Requester Video
Early Communicator Characteristics: Socially: Pays attention to you and activity at same time Initiates, responds, takes turns Expressive: Uses signs, gestures, sounds, words, echoes and/or pictures to protest, request, greet, comment, etc. Receptive: Words, gestures, easy questions (i.e. Yes/No questions, What s that?, etc.) Early Communicator Video Partner Characteristics: Socially: Initiates and responds (longer interactions) Use of social language and play with other children Expressive: Asks/answers questions (spontaneous) Starts to use words or another method of communication to: talk about the past and the future, express feelings, and pretend Receptive: Beginning to understand more complex language and concepts
Partner Video Get Them to Pay Attention.How??? Think about where child is at adjust your expectations accordingly Think about the child s communication/interaction/sensory level and adjust accordingly Give them a reason to communicate.and WAIT Follow Your Child s Lead How? Get down to their level Encourage your child to communicate by letting him start more interactions with you Make learning fun for them OWL. Use the 4 I s.
Follow Your Child s Lead Why? No demands to shift attention = less arguments More motivating for the child Allows for a better connection and creates a shared focus More sociable increases child initiation Child feels important Follow Your Child s Lead When you let your child lead, then respond to him, you give him information about things that interest him This information will help him to improve his communication Children who lead get the language they need The 4 I s - Include Include your child s interests: Notice what they re doing (even if it s unusual) Join in and do what they re doing (Meeting them where they are at increases the chance of engaging with the child!)
The 4 I s - Interpret Say it as your child would if he could (provide a verbal model for them) Say/do at his level (think back to the different stages of communication) Say it from their point of view get down to their level so they can hear you The 4 I s - Imitate Children learn through imitation however, some children do not know HOW to imitate (therefore a skill that must be taught separately) How to teach imitation? Imitate them! Imitating the child = less pressure, more playful, provides important feedback The 4 I s - Intrude Get close to the child Insist on joining in even if you get rejected this is okay! Be persistent (while keeping their sensory needs in mind)
Following Your Child s Lead Requires You To Observe Wait Listen Help Your Child Understand What You Say -The 4 S s Say Less Simplify Short clear labels and sentences (i.e. You re drawing with red! vs. I see that you re drawing a red strawberry! Use good English Stress Exaggerate key words Put key words at the end Use animated voice Go Slow PAUSE to allow time to process Show Use visuals, real objects and gestures Communication Temptations Do not anticipate all of your child s wants and needs let them initiate! What are some ways we can motivate, or tempt our kids to communicate? Examples of communication temptations: o Hard to operate toys o Put favourite things in view, but out of reach o Bit-by-bit o Give choices o Do the unexpected o Use creative stupidity o Put favourite toys/foods in a sealed container/bag o Most importantly.wait we need to give children a chance to communicate! Count to 5 in your head before jumping in to help or prompt.
Taking a Turn It is important to help our child take turns so that they can stay in an interaction longer The longer an interaction, the more opportunities the child has to learn how to communicate Taking a Turn (cont d) Turns look different at different stages: Own Agenda a sound, a look, a smile, a slight movement Requester a look, an action, gesture, sound, single word or combination of these Early Communicator single words, signs, pictures, actions, gestures, sounds Partner single words, or words in combination (sentences, phrases) Take a Turn (cont d) Match your turns to your child s turns to create balanced conversations This means that you take an equal number of turns and that your turns are not much longer than his Match the: -Length of your Child s turns -Child s pace -Child s interest
Cue your Child to Take a Turn We can support a child in learning how to take turns: Pause or change a familiar routine, then wait Ask a question, then wait Use changes in facial expression and body language, then wait Give a visual helper, then wait Give hand-over-hand help, then wait Any time is language learning time. People games (e.g. tickles, chase, Ring- Around- the-rosie)- You be the toy! Songs (e.g. Itsy Bitsy Spider, Wheels on the Bus, Old Macdonald) Toy play (e.g. blocks, cars) Book sharing Routines (e.g. snack, dressing, bedtime, dinner time) Anywhere, anytime! Conversation Stoppers Things to Avoid Asking too many questions Asking questions that: -your child doesn t have time to answer -test your child s knowledge -are too hard for your child to answer -don t have anything to do with what your child is interested in -you obviously know the answer to
Do s & Don'ts of Communication Do: - Know your child s language level - Match your expectations/interaction style to your child s language/interaction style - Give them a reason to communicate and wait - Follow their lead (Use 4 I s and OWL) -Use the 4 S s - Take turns - Use communication temptations - Stimulate language ANYWHERE, ANYTIME! (HAVE FUN!) Don t: - Use conversation stoppers - Overwhelm the child with language - Control all aspects of interactions - Get upset if strategies don t work right away they take practice!!!! Consider As an adult What do you like in a conversation partner? Physically at your level, discussing things you re interested in, giving you time to state your opinion, etc. What do you not like in a conversation partner? Interruptions, too many questions, one-sided conversation, etc. If it s not something you like it s likely NOT something they would like either! Face-to-Face Communication What do you find most comfortable as an adult when you communicate with others? Proximity? Eye contact/body language? Tone of voice, etc? Conversation topics?
Social Communication What is it? How & what we communicate in our social interactions Social Thinking Social Communication Team approach to facilitating social communication and interaction Communication development relative to development of play skills Stages of Play Non-social activity: solitary play tends to watch other children or play alone Parallel play: plays alongside others, often with similar materials; does not actively influence the play or behaviour of others Associative play: play becomes more social; children may be engaged in separate activities, interaction in the exchange of materials or language Cooperative play: social interaction between the children; usually involves working towards a common goal Social Communication Deficits in ASD May not have appropriate words to initiate interactions May have very specific and sometimes unusual interests not shared by others Rigidity around how play and interactions happen Sensory issues challenges with personal space difficulty being in close proximity to groups need for movement difficulties with noise sensitivities to touch On own agenda, may be unaware of other s needs/desires
Why is it harder to communicate with peers than with adults?? Who is more predictable?? Who provides more support?? Who gives children time to think about what they want to say?? Who lets the child finish their thoughts?? What do social communication deficits look like? What you say Missing um, that thing, what do you call it...vocabulary Not able to understand sarcasm or subtleties of language May use scripted language/memorized phrases May speak off topic Difficulty using appropriate volume of speech What you do Unable to read/adjust body position relative to the person you are talking to Difficulty with eye contact Difficulty reading facial expressions Social Interactions what do we need to do Getting them started, keeping them going, making them end How to approach a friend/how to approach a stranger What to say to keep a friend interested in playing with you How to tell others you re done playing or ready to go I asked, they said no, now what? Need to teach the kids how to react and what to do when their approach of another child is not successful I don t want to! I don t know how! Need to teach the children that it s okay to say no, but to do it appropriately Also need to recognize that a child s refusal to play may be based on lack of knowledge of how to play rather than lack of desire
Social Interactions (con t) Look at me! Look at me! Children with ASD don t always show that they want others to be interested in what they are doing This is a skill that we need to help them to develop in order to improve interactions with other children Who, Where, When, What do I ask you???? Teach children how to use questions to keep a conversation going - ask questions that relate to other people s interests Use questions to gain useful information I can t talk but I want to play! How do we help non-verbal children engage in peer interactions? What supports can we provide to help them interact? What types of games can we play? What modifications should we make? Be Aware Looks can be deceiving a verbal child may have very limited play skills while a child with limited verbal skills may have a great imagination and strong ability to play. Be sure to look at play skills and communication separately & target these skills at the child s level.
It s very important to do this (work on peer play) in the beginning so the skills generalize into the peer world quickly. If we wait until the child is older, then it is much harder for him to learn to relate spontaneously to peers with humour and joy. Engaging Autism, Stanley Greenspan & Serena Wieder. Da Capo Press 2006 Questions? Contact information: ritadube@renfreweducation.org briannerayment@renfreweducation.org Community Education Service To register for notification or an upcoming education session go to: www.fcrc.sacyhn.ca For general CES enquiries Email: ces@sacyhn.ca Call: 403-955-7420