Transcript Static Scene Cues

‘Teaching Language Concepts’ (TLC):
Language Instruction
For Persons on the Autism Spectrum
Created in:
Autism Language Program,
Children’s Hospital Boston
Howard Shane, Ph.D.
James Sorce, Ph.D.
Meghan O’Brien, M.S., CCC-SLP
Marie Duggan
Anna Hutt Fredman
Sharon Weiss-Kapp, M.S., CCC-SLP
www.aac-rerc.com
This work is funded by the National Institute on Disability and Rehabilitation
Research of the U.S. Department of Education, under grant number
H133E030018. The opinions contained in this presentation are those of
the grantee and do not necessarily reflect those of the U.S. Department of
Education.
Acknowledgement
Contributors to this presentation
• Patients and parents in the Autism Language Program
• Monarch School students, parents, and staff
• Model Autism Program, Boston Public Schools
• Sharon Shaham (Augmentative Communication Program,
Children’s Hospital Boston)
• John Costello (Augmentative Communication Program,
Children’s Hospital Boston)
Today’s Agenda
1. Overview of Teaching Language Concepts
Program (TLC)
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Why is learning language concepts difficult for some persons
with ASD?
Why are visuals needed?
2. Three Phases of Instruction
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Dynamic Scene Cues
Static Scene Cues
Element Cues
3. Developing Effective and Efficient Implementation
Procedures for Teaching Element Cues
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Using typically developing children
Adapting and applying findings to individuals with autism
Overview of Teaching Language
Concepts Program (TLC)
Why Teach Language Concepts?
Autism Language Program (ALP):
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Population: Primarily individuals with moderate to severe autism (from initial
diagnosis to adulthood)
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Core deficit: Difficulties with language comprehension and expression, in
addition to pragmatic language skills
– Comprehension:
• Children on the spectrum often experience difficulty comprehending
spoken language and/or auditory processing impairment (Novick et al.,
1980; Boddaert et al., 2003).
• Many children are able to follow routine-based, familiar directives, but
have not yet demonstrated comprehension of more abstract linguistic
concepts (e.g., verbs, prepositions, attributes)
– Expression:
• 50% of individuals with autism spectrum disorders do not use speech
functionally (Wetherby and Prizant, 2005; Lord & Paul, 1997; Rutter, 1978)
• Many children are able to reliably use PECS to request and label, but have
not yet developed the ability to describe, comment, or ask questions
Model of Language Comprehension
(Typical Development)
Spoken
Language
Short-Term
Memory
Language
Processor
Comprehension
Model of Language Comprehension
(Moderate-Severe ASD)
Verbal
Information
Short-Term
Memory
Language
Processor
Comprehension
= Clinical insight suggests these impairments are due to:
•Attention to auditory stimuli
•Not understanding language as meaningful/symbolic
•Fleeting nature of spoken language
•Language processor ‘broken’
•Combination of these
Language comprehension is often compromised
• Occasional comprehension of noun labels and familiar directives (in context)
• Impaired comprehension of relational linguistic concepts (e.g., verbs, prepositions,
attributes)
Current Intervention Practices
The importance of visuals:
• Providing communication via an alternative modality/channel (visual)
takes advantage of an area of relative strength -- visual processing -to extract the intended meaning (supported by research and
considerable clinical observation)
• Sustained presence -- while spoken language is ephemeral, visual
symbols remain present, providing an extended period of time for
additional rehearsal and processing.
However:
•
Many programs targeting individuals with ASD use visuals, yet the
focus is typically on
– Developing expressive language skills (particularly requesting
and labeling)
– Scheduling
•
Few communication programs (spoken or visual) focus on developing
language comprehension
‘Teaching Language Concepts’ (TLC)
Program
• A visual instruction system for teaching language concepts
that tend to be difficult for people with moderate to severe
autism (e.g., verbs, prepositions and attributes).
• TLC is a closed visual language, limited to the essential
vocabulary and syntax needed to support the comprehension
and expression of practical, everyday communication
exchanges.
• Instruction typically begins in the virtual environment (video
clips) and the tabletop environment (photographs, toy
figurines and miniature objects), then extends to the natural
environment to enable functional communication at home,
school and community.
Key Ingredients of TLC
•
Visual language for both language
comprehension and expression
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Both mentors and learners use the same visual
symbols to communicate with each other
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Targets language comprehension: viewed as
foundation for expression
•
Advanced computer and video technologies
attract and maintain children’s attention, provide
compelling multimedia language instruction, and
enable the use of dynamic visual symbols
What TLC Does Not Target
•
TLC is not intended to teach advanced communicative
operations:
– Abstract concepts: “…with liberty and justice for all.”
– Passive voice: “The book was read by the boy.”
– Complex syntactic structures: “If he hadn’t checked
the weather in the morning, then he would have
forgotten to bring his umbrella.”
– Figurative language: “She flew to the bookstore.”
– Humor : “Why did the chicken cross the road?”
•
TLC provides a solid foundation for launching languagebased intervention programs that target the more advanced
communicative operations listed above.
Three Phases of TLC Instruction
TLC Instructional Phases:
•
Learner progresses through all/some of three phases of
visual language symbols, from concrete to abstract
representations:
1. Dynamic Scene Cues: full-motion video clips of
action scenes
Bypassing Spoken Language Comprehension
Using Dynamic Scene Cues
(Moderate-Severe ASD)
Verbal
Information
Short-Term
Memory
Imitation
(as inferred from
dynamic scene cues)
Visual
Information
(dynamic scene cues)
*Note: No involvement of language processor required
for comprehension of dynamic scene cues
TLC Instructional Phases:
•
Learner progresses through all/some of three phases of
visual language symbols, from concrete to abstract
representations:
1. Dynamic Scene Cues: full-motion video clips of
action scenes
2. Static Scene Cues: photographs that capture a
prototypical moment in the action scene
Bypassing Spoken Language
Comprehension Using Static Scene Cues
(Moderate-Severe ASD)
Verbal
Information
Short-Term
Memory
Imitation
(as inferred from
static scene cues)
Visual
Information
(static scene cues)
*Note: No involvement of language processor required
for comprehension of static scene cues
Implications of Static Scene Cue Mastery
Use of dynamic and static cues bypasses language
processor
– Due to load on language processor when using
elements, some children may use static scenes as their
communication system
Mastery of static scene cues is a significant
accomplishment
– Can be used to promote general understanding and
communication related to:
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Daily Living Skills
Play
Transitions
Requesting
Commenting
Clarifying
Directives
TLC Instructional Phases:
•
Learner progresses through all/some of three phases of
visual language symbols, from concrete to abstract
representations:
1. Dynamic Scene Cues: full-motion video clips of
action scenes
2. Static Scene Cues: photographs that capture a
prototypical moment in the action scene
3. Language Element Cues: graphic icons
representing each of the individual linguistic
components that comprise an action scene (e.g.,
subject, object, verb, preposition, adjective, etc.)
TLC Phase 3: Element Cues
Model of Visual and Spoken Language
Comprehension
(Moderate-Severe ASD)
Comprehension of
Verbal
Representation
Verbal
Information
Short-Term
Memory
Visual
Information
(element cues)
Language
Processor
Comprehension of
Visual
Representation
(element cues)
Symbolate:
Language Comprehension?
• Stringing symbols together does not automatically result in
comprehension.
• Learners must first have a knowledge of language
elements and semantic relationships, as provided in VIP.
• Paradoxically, stringing symbols together may actually
interfere with comprehension.
Clinical Observations About
Element Understanding
• Some label elements without meaning attached (echolalic-like)
• Some comprehend agent and object elements -- struggle with relational
elements
• Some comprehend isolated elements -- difficulty interpreting element
strings
What improves element comprehension?
• Immersion in symbol-rich environment
• Mass trials across multiple settings and communication partners
• Computer-based instruction
• Persistence over extended period
Bottom line: A more effective, efficient way of teaching language
elements must be developed.
TLC 3 Phases: Clinical Observations
• Progressing from
– Dynamic Scene Cues to Static Scene Cues -- is easy
• No involvement of language processor required
– Static Scene Cues to Element Cues -- is difficult
• Requires involvement of language processor
But
• The payoff is worth it -- foundation for generative
language
– Goal: Combine language element cue vocabulary with
their understanding of semantic relationships to generate
novel sentences for expressing requests, comments,
replies, etc. in natural settings.
The Empirical Challenge
• Can we better understand the process?
• Can we expedite the process?
Developing Effective and Efficient
Implementation Procedures for
Teaching Element Cues
The TLC Approach
Strategy: First study typical children, then apply findings to children with
autism
Rationale:
– Not yet literate
– Able to verbalize thought process
– Compliance
Subjects: Ages 3 yrs, 11 mos to 6 yrs, 4 mos
Procedure: General task - sequence three linguistic elements: left-toright reading order
– agent + action + object
– agent + preposition + object
– Experimenter provides no spoken language to label elements
– Learner demonstrates comprehension of element string by acting
out directives
Multiple design-prototype-test cycles to refine TLC instructional
approach
Iteration 1: Top-Down Approach - Sequentially
Through Three Instructional Phases
Iteration 1 Procedure
• Learner presented with
– Dynamic scene cues; imitate action
– Static scene cues; imitate action
– Element cues; demonstrate comprehension by
acting out directives
•
For each instructional phase, learner viewed the
visual cues and was provided with spoken
prompt, “Now you do it!”
Iteration 1: Top-Down Approach Sequentially
Through Three Instructional Phases
Outcome:
– Able to accurately imitate dynamic and static cues
– Difficulty understanding task when presented with
element cues (often attempted to match objects to
elements rather than carry out directive)
– Difficulty comprehending left-to-right sequence of
‘reading’ elements
– Difficulty understanding meaning of verb/preposition
(abstract) symbols
– Difficulty comprehending de-contextualized element
strings.
– Tendency to act on objects in a familiar manner (e.g.,
‘man climbs ladder’ rather than ‘ladder on man’)
Iteration 2: Modified
Top-Down Approach
Modifications to Iteration 1 Procedure:
– Introduced visual template to focus attention on leftto-right order of elements, and presented elements
in left-to-right sequence
– Introduced Mixed Display (Static scene cue along
with Element cues) and demonstrated association
between scene cue and its elements
– To enhance understanding of task expectation:
• Presented task as ‘game’ to discover meaning of
the relational (verb or preposition) symbol
• Experimenter modeled the task
Iteration 2: Visual Template
Iteration 2: Modified
Top-Down Approach
Outcome:
– Initially learners did not appear to attend to the
relational element -- verb or preposition (e.g., “You
don’t need that one”)
– Still initially attempted to match the agent and
object elements to their physical objects
– Given repeated trials, demonstrated
comprehension of the individual elements, but
continued to experience difficulty with the left-toright ‘reading’ order for elements
Iteration 3: Bottom-Up Approach
Modifications to Iteration 2 Procedure
Instruction started at element rather than dynamic phase
• Presented elements on computer monitor
– Experimenter modeled the task
– Guided discovery to select combination of element
strings to play corresponding video clip
• Then moved to tabletop
– Presented non-electronic task with identical element
cues and physical objects;
– Experimenter modeled the task
– Learner encouraged to create element strings to direct
the actions of communication partners
Iteration 3: Bottom-Up Approach
Outcome:
– Older learners were able to execute each directive
presented and label each element
– Younger learners had difficulty attending to screen and
task; more likely to engage in their own independent
play with the materials
Iteration 4: Modified Bottom-Up
Approach with Compelling Scenes
• Modifications to Iteration 3 Procedure:
– Created ‘fun’ scenes depicting engaging, motivating
activities using human models and life-sized objects
– Clicked on message window to activate video clip of
corresponding element string (in hopes of enhancing
attention to relational element)
– Presented learner with an ‘agent’ element cue
representing him/herself
– Encouraged learner to use elements to direct his/her
own play and actions of communication partners
Iteration 4: Modified Bottom-Up
Approach with Compelling Scenes
Outcome:
– Actively engaged
– Successfully combined elements - although still initial
tendency not to attend to relational element (verb or
preposition)
– Prepositions more difficult than verbs
Iteration 5
Modifications to Iteration 4 Procedure:
– Focus attention to relational element (verb or
preposition):
• Animated relational element
• Click on relational element to play video
Key Ingredients to Teaching
Element Cues
• Present elements electronically
• Guided discovery with element combinations (to play
video)
• Provide children with symbols representing themselves
and familiar communication partners to allow them to
direct the activity
• Begin instruction with fun, motivating tasks. Gradually
expand to language-arts activities.
• Animate center elements to direct attention to element and
enhance likelihood of comprehension
Directions for future TLC research
• Improve symbols
– Animated symbols (verbs, preposition, attributes)
• Generalization of language skills targeted in TLC to natural
setting
• Facilitating generative language