Transcript Enhancing communication: what can we do?

Enhancing communication:
what can we do?
Dr Glenys Jones
Autism Cymru
May 2006
Carol Gray (2000)
‘We hold more than half the solution’
• It’s unfair and misleading to state that those
with ASD have a communication impairment
• Alter our communication, so that they can
understand us
• Teach the person how to communicate and
give them a means and incentive to
communicate
Differences in communication
in ASD
• Difficulties in taking part in early carer-infant
dialogue (Hobson, 2002)
• May not develop speech, or this may be
delayed
• Limited use of non-verbal means
• Functional, rather than social
• Often INITIATE far less contact
• Limited range of communicative functions
• Sensory issues (Bogdashina, 2003)
Our communication
• Our behaviour can be very difficult to interpret
and understand
• Our social signals and intent via our facial
expressions; gesture; intonation; body
language may not be noticed or understood
Our communication
• Our words may be taken literally (Welton,
2003)
• Different intonation can make the same words
have different meanings
• Our rate of speaking might be too fast
• There are often competing sounds and other
stimuli
Adults’ language
(advice from Potter and Whitaker, 2000)
• Reduce speech to single words or two word phrases
supported by pictures or objects (eg tidy; story;snack)
• Map single words onto the most meaningful aspect of
the situation/activity
• Use long pauses (10 seconds or more) to allow time
to process and respond
• Use physical prompts for new task– delay use of
speech
• Engage in interactive games, leaving pauses
Developing communication:
prerequisites
• Must have a reason
• Must have the opportunity
• Must have a system
• Must feel enabled
Three main elements to consider:
• Means: eg language – spoken , written or
signed; gesture, eye contact; facial
expression; touch; behaviour; drawings,
volume, tone, intonation, email, poetry
• Reasons: request; negate; affirm; tease;
inform; share comment; greet; chat; express
choice
• Opportunities: where:classroom; canteen;
home; leisure areas / when: time, duration,
frequency/with whom – adults, peers, other
staff, parents
Communication in ASDs
• Some (33-50%) do not develop spoken
language and so will need to be taught other
forms with which to communicate (eg
signs;photos; objects)
• Some with ASDs develop very good spoken
language skills, in terms of vocabulary and
grammatical structure BUT they need support
to communicate effectively
Comments made:
• ‘He never communicates with me.’
• ‘He can’t communicate.’
• This is highly UNLIKELY as we communicate
in many different ways
• These comments usually mean that the
person does not communicate in the ways
expected or in ways we notice or can
understand
Challenging behaviour as
communication
• treat CB as a form of communication
• Zarkowska has suggested we see CB as a
‘gift’– it prompts us to try to identify what the
person is feeling or ‘saying’
• Teach an acceptable alternative behaviour to
get the same result
• Communicate with the person in a way which
is likely to avoid challenging behaviour
Assessment – person and setting
• Observe when and how s/he communicates
and why?
• Pragmatics profile useful (Dewart and
Summers, 1988)
• Factors which promote communication (eg
setting/ activity/ sensory/people)
• Learn their ‘language’ (Caldwell)
Alternative forms to speech
Choice of system - need to consider:
• intelligibility to general public
• portability and convenience
• compatibility with cognitive, linguistic, sensory
and physical level of functioning
• usability within present and future
environments
Types of intervention to enhance
communication
• Interactive work (intensive interaction;
musical interaction; Option approach)
• Developing play and role play (Sherratt and
Peter, 2001)
• Changing parent/staff style (eg Child’s talk,
Aldred, 2001)
• Object,picture, symbol or photo exchange
• Computers (email; written work)
• Social stories and Circles of friends
Interactive approaches
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Mimic early infant-carer dialogue
Work on social timing
Person-centred and enjoyable
Shows benefits of human company – basis of
friendships
• Negotiation and turn-taking
Create opportunities:
Circle of friends/buddies
• To promote the inclusion of the person in
work and play activities
• To facilitate discussion and negotiation with
others
• Allows adults to gain insights into their
understanding
Communicate through a Passport
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My name is Adam.
I am happy when…..
I don’t like it when teachers….
If I am upset, it helps to…..
Email opportunities
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This avoids face to face contact
Can be done when the person feels ready
Provides a permanent record
Can create a wide network of contacts, with
no travel involved
Sharing the diagnosis with the
child/adult (Jones, 2001): why?
• Can better understand themselves
• Can develop their own strategies
• Can avoid or invite interaction (eg Autscape
strategy)
• Can meet others with ASD
Extract from Gunilla Gerland’s book
• Eye contact
• Some of us with AS think it is easier to listen if
we don’t have to look in the eyes of the
person we are listening to.
• When you don’t look in the eyes of the person
you are listening to, they may think you are
not listening.
• It may help if you explain that you are
listening even though you are not looking at
them
Gain the individual’s views: why?
• A reason to communicate
• Guides interventions (Bullock, 2005)
• Can gauge their self esteem (Moran,
2001)
• Enhances their emotional awareness
and vocabulary
• An indication of how well something is
working or not
Build self esteem to prevent
withdrawal/depression
• Often can not think of anything they are
good at
• Told many times they are wrong
• Use applauding stories
• Put positive statements within Social
Stories
• Create permanent records of success
and refer to these
Wendy Lawson’s poem: an extract
The future
‘My future may not depend on my stock
So much as it does upon sources
Sources of warmth, sources of care
I depend on the nurture to be for me there.’