Communication problems and intervention for children with autism

informative material

1. COMMUNICATION PROBLEMS
AND INTERVENTION FOR
CHILDREN WITH AUTISM
Presented by
MS. Fouzia Saleemi
Speech Language Pathologist
M.Phil. Speech Language Pathology,M.A.Sed (Special Education),
PGD(SLT),CD Applied Behavior (USF) CMH,Lahore

2. Allah(GOD) has not sent
down a disease except that
he has also sent down its
cure.



Quoted by
Prophet Muhammad
(P.b.u.h)

3. WORD AUTISM MEANING

A mental condition,
present from early
childhood, characterized
by great difficulty in
communicating and
forming relationships
with other people and in
using language and
abstract concepts.

4. AUTISM

Autism is a lifelong disability
Autism Spectrum Disorders (ASD) are a
collection of developmental disorders that are
characterized by impairments in social
interaction and communication, as well as the
presence of restricted and repetitive behaviors
and interests.it occurs primarily in males. The
ratio is 4:1

5. Autism impairs one’s ability to
 Communicate
 Receptive Language
 Expressive Language
 Pragmatic or Social Language abilities
Autism affects socialization.
Autism affects the sensory system.
Autism can impact cognitive skills where
brain is wired differently.

6. COMMUNICATION
Communication is when someone sends a
message to another person and the message is
received and understood.

Everyone Communicates!

•Communication is not just speech.

•Communication may occur through behaviors,
signs, gestures, pictures, pointing, nonverbal
body language, symbols, vocalizations,etc.

•Communication often relies on language.

•Language is a system of symbols and rules that
govern the use of the symbols to convey meaning.

7. DSM- IV CRITERIA
COMMUNICATION IMPAIRMENT
Delay in, or total lack of development of spoken
language
Failure to compensate with non-verbal gestures
Marked impairment in ability to initiate or
sustain conversation in children with speech.
Stereotyped, repetitive use of idiosyncratic
language
Echolalia, scripting, unusual prosody
Lack of spontaneous, varied, spontaneous make
believe play or social imitative play appropriate
to developmental level.

8. DSM-IV CRITERIA
SOCIAL COMMUNICATION IMPAIRMENT
Impairment in use of non-verbal behaviors to
regulate social interaction
Eye contact, facial expressions, gestures
Failure to develop developmentally-appropriate
peer relationships
Lack of spontaneous seeking to share enjoyment
with others
Lack of showing or pointing out objects of interest
Lack of social or emotional reciprocity

9. SOCIAL / COMMUNICATION ISSUES

10. BIZARRE / REPETITIVE BEHAVIORS

12. SAFETY ISSUES

14. MOTOR ABNORMALITIES IN SOME AREAS

15. Communication is broad
concept consisting of language
(linguistic, paralinguistic and
pragmatics aspects of
functioning).

16. INTEGRATION OF COMPONENTS OF
LANGUAGE

17. LEVELS OF LANGUAGE

18. WHAT COMMUNICATION PROBLEMS ARE
ASSOCIATED WITH ASD
Limited inclination to share enjoyment, interests,
or achievements with other people

Primary purposes for communication to be:
- requests (get someone to do
something)
- protests (get someone/something to stop)

19. GENERAL COMPREHENSION AND
EXPRESSION PROBLEMS
Difficulty with language comprehension
High- pitched, monotonous speech
Echolalia
Sterotypic,meanigful speech
Asocial monologues
Preference for mechanical sounds over human
voice
Reduced interest in communication
Errors in recognizing face.
Poor use of environmental cues.
Poor response to commands.

20. SEMANTIC/PRAGMATIC BEHAVIORS
PROBLEMS
Lack of responsive to others.
Use of only few communication stratgies
Minimal use of gestural communication
Lack of eye contact
Slow acquisition of speech
Word findings difficulties
Poor categorization abilities
Poor understanding of related words

21. COMMUNICATION AND BEHAVIOR

Parents need to understand the behavior – look
deeper to try to understand the communication that is
occurring

Behavior may communicate:
- Frustration
- Fear or other emotional upset
- Discomfort – need to escape noise, light,
sensory,irritation, etc.
- Boredom
- Physical needs – thirst, hunger, bathroom
- Protest
- A request
- Many other things…

22. Language
Assessment and Evaluation

23. RECEPTIVE LANGUAGE SAMPLE
Level Of
Functioning Brown
Stages
ICW levels
PEEP
ABLLS
TROG test
Subjective Assessment Objective Assessment

24. EXPRESSIVE LANGUAGE SAMPLE

Pragmatics Checklist
Renfrew Test
Action Picture
Bus Story Test
Word finding
Vocabulary test
CELF 4
PLS 5
SALT
RDLS
Subjective Assessment Objective Assessment

25. Treatment Approaches

26. The diagnosis of an Autism Spectrum Disorder
presents parents and clinicians with a veritable
maze of programs and therapies.
 What is out there?
 Which programs are best for my child/student?

27. TREATMENT APPROACHES FOR
PROFESSIONAL WORKING WITH
ASD CHILDREN

28. Biomedics
PECCS
ABLLS
ABA
TEECH

29. BIOMEDICS APPROACH


 Biomedics approach is commonly known as food
therapy. Gluten is a unique type of protein that is
generally discovered in our day-to-day meals
items. while it is an essential items of our diet,
the body of an Autistic kid responds in a different
way than a normal child. It is vital for the
parents to plan gluten free diet for their child
experiencing Autism.

31. THE ASSESSMENT OF
BASIC LANGUAGE AND
LEARNING SKILLS
ABLLS

32. The Assessment of Basic Language and
Learning Skills (ABLLS, often pronounced
“ABLLS") is an educational tool used frequently
to measure the basic linguistic and functional
skills of an individual with developmental delays
or disabilities.

33. OVERVIEW OF ABLLS CURRICULUM

Reinforce
effectiveness
Visual performance
Receptive Language
Imitation
Vocal imitation
Gross Motor Skills
Fine Motor Skills

Requests
Labeling
Intraverbal
Spontaneous
vocalization
Reading Skills
Math skills
Writing Skills
Spelling Skills



Syntax and Grammar
Play and Leisure
Social Interaction
Group Instruction
Classroom Routines
Generalized
Responding
Dressing
Eating
Grooming
Toileting

34. PECS FOR
CHILDREN WITH
AUTISM

Lori Frost, a certified Speech-Language Pathologist,
Andrew Bondy, PhD., at the Delaware Autistic
Program.

35. WHAT IS PECS

PECS was developed by Lori Frost, a certified
Speech-Language Pathologist, and Andrew Bondy,
PhD., at the Delaware Autistic Program.
Using the PECS, with nonverbal ASD children.
Children learns to spontaneously initiate
communicative exchanges. Using PECS, children
learn to gain the attention of the communication
partner in order to make a request.

36. TEECH FOR
CHILDREN WITH
AUTISM
Eric Schopler,Margaret Lansing, PhD, BCBA,

37. TEECH PROGRAMME BASED ON THESE
FACTORS
Chronological
Age
Developmental
Age
Functional
Level

38. CURRICULUM OF TEECH
Cognition Perception Imitation
Fine Motor
Self Help
Gross Motor
Eye-Hand
Coordination
Social
Verbal
Performance

39. APPLIED BEHAVIOR
ANALYSIS FOR
CHILDREN WITH
AUTISM
Jonathan Tarbox, PhD, BCBA, & Bill Roth, PhD,

40. ABA
Applied Behavior Analysis (ABA) is the only
scientifically validated treatment for autism and
is recommended by the U.S. Surgeon General.
Antecedent--Behavior--Consequences
A—B—C

Applied Behavior Analysis (ABA) given in early
then it is called Early intensive behavior analysis
(EIBI)

41. COMPREHENSIVE ABA PROGRAMS
DTT
Natural Environment Training (NET)
Verbal Behavior
Challenging behavior
Fluency based instruction Programme
Programming for generalization

42. VERBAL BEHAVIOR
B.F. Skinner, Verbal Behavior (1957): Applied principles of
behavior analysis to language
Separates language into categories by function
Some incorrectly say that “Verbal behavior is not ABA” or
“We don’t do ABA, we do verbal behavior”

43. COMMON TERMS FOR THE
VERBAL OPERANTS

Echoic
Mand
Tact
Intraverbal
Receptive or Listener Responding

44. Verbal
Operant
Antecedent Behavior Consequence
Mand Motivative
Operation
(wants cookie)
Verbal behavior
(says “cookie”)
Direct reinforcement
(gets cookie)
Tact Sensory Stimuli
(sees or smells
cookie)
Verbal behavior
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Intraverbal Verbal stimulus
(someone
says:”What do
you eat?”
Verbal behavior
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Echoic Verbal Stimulus
(someone says
“cookie”)
Verbal behavior:
repeats all or part
of antecedent
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Receptive
(actually not
a verbal
operant)
Verbal stimulus
(someone says
“touch cooke”)*
Non-verbal
behavior
(child touches
cookie)
Non-specific
reinforcement
(gets praised, for
instance)

45. OTHER TREATMENTS AND COMMUNICATION
METHODS
Sensory Integration Therapy
SIT should be administered by, or need for SIT should be assessed
by, an Occupational Therapist.
Auditory Integration Therapy
AIT generally consists of a prescribed amount of time spent each
day listening to a recording that uses particular combinations of
sound waves to retrain the ear mechanisms.
Music Therapy
Music Therapy can be an excellent addition to a treatment
program, but the therapist should be well-versed in your method of
choice (in other words, if you are running an ABA program, your
music therapist should have some experience working as an ABA
therapist).

46. TREATMENT APPROACH FOR
TEACHERS WORKING WITH ASD
CHILDREN

47. SCERTS MODEL
SCERTS can be classified as a
combined intervention as it
blends elements of behavioral
and developmental models to
better support children on the
autism spectrum as they
develop.

SCERTS stands for Social-
Communication, Emotional
Regulation, and Transactional
Support. These are seen as the
principal dimensions for
intervention planning.

48. KEY COMPONENTS OF THE SCERTS
MODEL

Communication and language deficits
These are addressed through social-pragmatic language therapy, which
emphasizes the functional use of pre-verbal and verbal communication skills
in natural and semi-structured interactions. The model includes the use of
validated and effective strategies to support the use of non-speech
communication systems such as picture symbols. Social-pragmatic
approaches are now practiced in both contemporary Applied Behavior
Analysis programs as well as developmentally-based programs.
Deficits in social relatedness and social-emotional reciprocity
These are addressed through strategies developed as part of the Floor Time
approach. The basic premise of Floor Time is that children learn skills from
the relationships which they have with their caregivers and other people
significant in their lives.

Sensory processing deficits
These are addressed through sensory integration therapy and environmental
adaptations and supports. Many children with autism also have motor
planning issues affecting daily living skills, which are also addressed.

49. TREATMENT APPROACH FOR
PARENTS WORKING WITH
CHILDREN

50. PARENTS-CHILD VERBAL THERAPY
This therapy are based on three stages with
following guidelines
Beginning stage
Middle stage
Advanced stage

51. Sitting
Attending Compliance
Remaining on task
How to Process Feed
Back
Understanding Cause
and effect

Communication skills
Play skills
Self-help
Social skills
Subtle Social Skills
Higher Level Play
Skills
Advanced
communication
&cognitive skills
Integration of skills to
everyday environment

52. Language Play
Adaptive
Skills
Motor
Skills
Executive
Functions
Cognition
Academic
Skills
Social
Skills

53. LANGUAGE CURRICULUM





0-12 mos.
•Body Parts
•Echoics
•Following
Instructions
•Gestures
•Sound
Discriminati
on

1 - 2 yrs.
•Actions
•Basic Mands
•Categories
•Choices
•Functions
•Negation
•Objects
•People &
Relationships
•Prepositions
•Yes / No
2 - 3 yrs.
•Adverbs
•Attributes
•Features
•Gender
•Manding for
Information
•Opposites
•Pronouns
•Wh-
Discriminatio
n
•Locations
•Plurals
3 - 4 yrs.
•Describe
•Sequences
•Statement -
Statement
4 - 5 yrs.
•Same / Different
5 - 6 yrs.
•Ask & Tell
Discrimination
•Statement –
Question
•Syntax
6 - 7 yrs.
•What Goes With



31 Lessons by Emerging Age and Function:
Language

54. Language Curriculum
Behavior Instruction
or Setting
Function Consequence
(Reinforcer)
Vocal
Imitation
Someone says
“apple”
“apple” Praise
Praise
Praise
Request Hungry and no
apple present
Labeling

Conversation
“apple”
“apple”
“apple”
Child gets an
apple
Apple is present
“What is your
favorite fruit?”
Language
Matching “Put with same”
apple is matched
with apple
Praise
“Touch apple” Selects apple Praise Listening

55. PLAY CURRICULUM Play


Electronic Play
Independent Play
Interactive
Play

Pretend
Play

Constructive
Play
Sensorimotor Play
Task Completion Play
Play Stations
Early Social Games
Read-to-Me Books & Nursery Rhymes
Music and Movement
Treasure Hunt
Card and Board Games
Locomotor Play
Peer Play
Functional Pretend Play
Symbolic Play
Imaginary Play
Sociodramatic Play
Block Constructions
Structure Building
Sand and Water Constructions
Clay Constructions
Arts and Crafts

Audio and Video Play
Computer Play
Video Games

56. ADAPTIVE (SELF
HELP)CURRICULUM
Adaptive

Safety
Safety Awareness
Safety Equipment


Domestic
Pet Care
Setting & Clearing Table
Telephone Skills
Tidying
Meal Preparation
Cleaning
Gardening
Laundry
School Backpack Prep
Making a Bed



Community
Shopping
Restaurant Readiness
Personal
Feeding
Toileting
Undressing
Unfastening
Dressing
Preventing Spread of Germs
Bathing
Fastening
Teeth Care
Hair Care
Nail Care
Health Care

57. Motor Curriculum
Motor



Oral Motor

Ocular Motility
Binocular Vision Skills
Visual Perception

Hand Skills
Coloring
Finger Skills
Drawing
Pre-Handwriting
Cutting with Scissors

Sitting Crawling / Creeping Riding Foot-Propelled Vehicles
Standing Rolling Over Rolling / Throwing / Dribbling
Walking Stairs and Climbing Riding a Tricycle / Bicycle
Running Balance Beam Swinging a Bat / Racquet / Paddle
Jumping Kicking Physical Education Readiness
Hopping Catching
Gross
Fine
Oral
Visual

58. ACADEMIC SKILLS CURRICULUM Academic
Skills Math
Shapes
Money
Patterning
Calendar
Addition
Subtraction
Statistics and Data Analysis
Number Concepts:
Numbers
Counting & Quantities
Quantitative Concepts
Ordering Numbers & Groups
Comparisons
Number Patterns
Time:
Time of Day & Daily Activities
Telling Time
Language Arts
Colors
Community Helpers
Handwriting and Penmanship
Writing
Letters
Spelling
Print Concepts
Literary Genres
Decoding & Word Recognition:
Phonics
Sight Reading
Comprehension:
Oral Story Comprehension
Reading Comprehension
Phonological Awareness:
Phoneme Isolation
Phoneme Blending & Segmentation
Phoneme Matching
Phoneme Manipulation
Word Discrimination & Segmentation
Rhyming
Syllables

59. REFERENCES
Perry, A., Condillac, R. A., Freeman N. L., Dunn-Geier, J., &
Belair J. (2005). Mulit-site study of the Childhood Autism
Rating Scale (CARS) in five clinical groups of young children.
Journal of Autism and Developmental Disorders, 35, 625-634.
Rellini, E., Tortolani, D., Trillo, S., Carbone, S., & Montecchi, F.
(2004). Childhood Autism Rating Scale (CARS) and
Autism Behavior Checklist correspondence and conflicts
with DSM-IV criteria in diagnosis of autism. Journal of
Autism and Developmental Disorders, 34, 703-708.
Stella, J., Mundy, P., & Tuchman R. (1999). Social and nonsocial
factors in the Childhood Autism Rating Scale. Journal of
Autism and Developmental Disorders, 29, 307-317.
New York State Department of Health. (1999). Autism/Pervasive
Developmental Disorders. Clinical practice guideline
technical report. New York: Author.

60. I HAVE AUTISM.AUTSIM IS NOT BAD
BEHAVIOR

61. DON’T CRITICISE MY
DISABILITY,PLZ TRY TO EXPLORE
MY ABILITIES