The two main communication deficits in ASD, according to Wetherby (2006), are what?
- Capacity for symbol use - difficulty in learning shared or
conventional meanings for symbols (evident in words,
gestures and play) - Capacity for joint attention - difficulty coordinating
attention between people and objects
In a typically developing child, within the first year, what 3 achievements lead to the broader capacity to share experiences?
- Sharing attention
- Sharing affect
- Sharing Intentions: behavioural regulation, affiliation,
joint attention
In a typically developing child, what developments in symbol use would have occurred by the age of 2?
- Repertoire of conventional sounds/gestures
- Imitate new behaviours
- Pretend play with objects
- Understand and use words to refer to things
What level of communication would you expect in a child with ASD in their first year?
- Lack of pointing (to show)
- Limited social responsiveness
- Less social smiling and initiating eye contact
- Less communicative vocalisation
- Less engagement in social sequence (e.g. peekaboo)
- May use adults hand as a “tool” to acquire objects
- Communication is more for regulation (getting others to
do or not do)
What level of communication would you expect to see in a child with ASD, aged 1 to 2?
- possible regression
- Language comprehension worse than expression
- Limited spoken language development
- Less responsive to words
- Unusual prosody and pragmatics
- Possible precocious language development
What level of communication would you expect to see in a child with ASD, aged 3 to 5 year? Give some examples of content and form use?
- Lots of variation from one child to another
- 10% are non verbal
- 40-50% have only a few single words only (not
functional) - Some will use AAC to offer basic means of expression
and to reduce frustration (picture based or symbol
based)
Content and Form: - Pronoun reversal - Echolalia - Unusual prosody: mono or exaggerated intonation, nasal voice quality
How would a child with ASD (aged 3-5) use language compared to a typically developing child?
- Language is used for regulatory purposes rather than
social purposes. - Fewer : comments, initiation of social interaction, social
sharing information, requesting information,
listener acknowledgements
What communicative traits might you expect to see in a school aged speaker with ASD?
- May have a formal or pedantic style of speaking
- Relatively lower rates of social communication
- Difficulty with pragmatics
What are examples of Pragmatic difficulties (in both using and understanding) that a school aged speaker with ASD might experience?
Using:
- Turn taking: might dominate
- Rules of politeness
- Topic maintenance and flow
- Relevance rules
- Prosody (unusual)
Understanding:
- Listener’s non-verbal signals
- Conversation ambiguity: slang, jokes, sarcasm
- Inference and implicit meaning
What key aspects of communication need to be assessed in an pre-verbal child with ASD?
- The ‘whys’ and ‘hows’ of communication
2. The understanding of others communication
Which approach to assessment is considered good practise? What would it involve?
A Mixed Method Approach
- Parent report checklists and questionnaires
- Observation: e.g. parent-child interaction and child- peer
interaction - Tools: using communicative ‘temptations’ and prompts
What method of assessment is a good example of a mixed-method approach?
Communication and Symbolic, Behaviour Scales- Developmental Profile. (CSBS-DP)
- Standardised, norm-referenced screening and evaluation tool)
- Administered at functional communication age (6 to 24 months)
- Administered by SLT’s
What does the CSBS-DP consist of?
- 1 page checklist (completed by caregiver)
- 4 page questionnaire (completed by caregiver)
- Behaviour sample
- Perception check (Is the sample typical for the child?)
What areas of communication does the CSBS-DP asses?
- LANGUAGE: sounds and words
- SYMBOLIC: Object use and verbal understanding
- SOCIAL: emotion & eye gaze, gestures
What does the CSBS-DP behavioural sample involve?
- 30 minuits video taped
- interaction between clinician and child (Caregiver is also present)
- Communicative temptations (book sharing, play etc…)
- Systematic probes in social, speech and symbolic skills
- Does child have present or absent behaviour?
- Caregiver completes 1 page “Was that typical” check
What is the CSBS-DP useful for?
- Good starting point for planning intervention
- Identify areas for further assessment
- Measure changes over time
- Monitor if intervention is working
What assessment should/can be preformed on ASD children at a speaking level?
- Discussion with their communication partners
- Discussion in communicative contexts
- Standardised language tests
- Checklists of pragmatic functioning (e.g. Children’s Communication Checklist 2)
- Tests of pragmatics language, figurative language and ambiguity.
- Probe responses to ‘conversational challenges’
According to Paul, R (2007) in his journal on “Communication and its development in autism spectrum disorders”, what core defecit in the ASD population “serves as major impediments to successful social adaptation and acceptance”? And what can be helpful in reducing this?
Defects in the use of language for social purposes.
- Explicit training in social use of language.
What can increase the ability to communicate for non verbal ASD children? Give examples.
What will the child then need to learn to do with this?
AAC (alternative augmentative communication)
- Signs
- Pictures
- Electronic aids
- Children will then need help learning how to use their personal AAC to engage in spontaneous, meaningful social interactions
what can “significantly improve the outlook for individuals on the spectrum”?
According to National Research Council (2001), early intervention focused on communication and social skills.
