What is the role of the SLT within ASD services?
according to RCSLT, 2015
- Key member of ASD specialist team
- Contribute to differential diagnosis and planning of intervention
- Promoting an autism & communication friendly environment
- Reduce risks associated with ASD: communication and mental health difficulties
- Establish effective, acceptable, and accessible means of communication (e.g. AAC)
What are the key principles of intervention?
according to NICE, 2013
- Family and person centred approach
- Focus on function and participation
- Adapt environment (social and physical)
- Preventative (anticipate transitions)
- Adjustments to the way care is delivered (e.g. scheduled apt. to minimise waiting times)
What makes an “autism-friendly” environment?
NICE, 2013
- Visual supports (pictures, symbols, printed words)
- Consideration for personal sensitivities: lighting, noise, distractions, over stimulation
- Routine and structure, personal space, time out
How can an SLT make a communication-friendly environment?
- Adjust to the families preferences and the settings resources
- Increase the understanding and responsiveness of the key communication partners
- Encourage parent-, teacher-, and peer- mediation
- Employ evidence based strategies: e.g. therapist modelling, video-interaction feedback etc.
When a child has ‘behaviour that challenges’ what is important for the SLT to consider before planning intervention?
- How frequent/ persisting is the behaviour?
- How does the behaviour impact family/ relationships/ education/ opportunities
- Is this behaviour a result of difficulty understanding or expressing a need or want?
- Is it a response to changes, pain or physical disorder, mental health problems?
- Is there an aspect of the physical or social environment that is causing difficulties
What would intervention for these ‘behaviours that challenge’ include?
- Anticipate and prevent these behaviours where possible
- Understand the underlying functions which the behaviour may serve?
- Facilitate an alternative and more acceptable way for the child to meet that function
- Assess factors which may contribute to or increase risk?
What specific intervention approaches are there for ASD?
- FCT (functional communication training)
- Social Stories
- PECS
- Video-feedback
- Peer Mediation
What is Functional Communication Training?
- Replacing a problem behaviour with an alternative
- Asses the function the behaviour currently serves (any
possible triggers, unintended and intended
consequences and reinforcers) - Select appropriate alternative (Must fufill exact same
function, be hassle free, and be accessable and
recognisable by others) - Teach alternative and fade out prompts
What are some considerations for the FCT approach?
- Requires optimism (from families carers: believe they’re making a difference)
- Hard to introduce new behaviour while old one persists
- Can be seen as ‘giving in’
- Needs skills to engineer/teach new responses
- Demands of new response may seem excessive
What is PECS?
Picture Exchange Communication System (1994)
- A picture/ icon based AAC system, for people with limited, or no, verbal abilities
- Person with ASD initiates self motivated requests
- Requires training
What are some of the Expressive and Receptive targets of PECS?
Expressive:
- Requesting help
- Requesting a break
- Requesting an item or activity
- Affirming offers for desired items/activities
- Rejecting undesired items or activities
Receptive:
- Following a direction to wait
- Responding to directions
- Following visual scehdules
What are the 6 stages of PECS?
- Exchange icon for item, 2 teachers, close proximity
- Wider number of icons/items, more partners, shorter distance
- Child must now choose from an array of icons (Some undesired)
- Requests in complete sentences (e.g. saying “I want raisins”)
- Answer questions using the icons (e.g. answering “What do you want?”)
- Expanding usage. Using PECS to comment.
What are Social Stories? What can they be used to target?
A carefully written, personalised story, usually accompanied by visual support (e.g. pictures).
Focus on how person with ASD thinks and feels.
Designed to facilitate social understanding or to target a specific challenging situation.
Used to:
- Promote positive behaviours
- Promote social skills (e.g. sharing)
- Target a behaviour that challenges
- Target mood (anxiety)
- Introduce planned changes (Transitions)
- Address pragmatic impairments (interrupting)
What is video modelling? What are the benefits?
Video of someone demonstrating a targeted behaviour/skill. The person demonstrating the skill can be a friend or family member of the individual, an animation or the individual themselves.
Benefits:
- plays on the fact that people with ASD typically have an interest in video
- can be used to develop any skill
- Readily available and easy to use
What is peer mediation?
Equipping one or more peer(s) without disabilities to provide ongoing social and academic support.
(under staff guidance)
Social:
- Peer interacts with individual
- The peer will network to establishing a social group around the focus student with ASD
academic:
- Peer tutoring (direct academic support)
- Peer will work with individual within a cooperative learning group (small group, shared goals, assigned roles, collaborative achievement)
What does the chosen peer in peer-mediation need to be?
- Be competent communicators
- Have strong interpersonal skills
- Have high social status
- Be keen to do it
- Be able to implement the training
