Transcript Stephen N. Calculator, Ph.D., Professor Dept. of

Communication in People
With Angelman Syndrome
Stephen N. Calculator, Ph.D., Professor
Dept. of Communication Sciences and Disorders
University of New Hampshire
Durham, NH 03824-3563
<[email protected]>
Defining Characteristics of AS
(Deletion Positive)
Severe to profound
mental retardation
•Tremulous movement of
limbs
None or minimal
use of words
•Easily excitable
Receptive language
exceeds expressive
language
Ataxic gait
•Hypermotoric
•Short attention span
•Apparent happy
demeanor and frequent
laughing/smiling
Other Characteristics Significant to
Communication
Protruding tongue
Frequent drooling and excessive
chewing/mouthing
Sleep disturbance
Communication Profile of AS
Problems first noted in early
infancy.
•
Fail to develop any functional speech.
One group identified on REEL with receptive
language skills in 9-22 month range and
expressive skills in 9-14 month range (Joleff &
Ryan, 1993).
May use one or more words indiscriminately
early on. Often drop out of lexicon.
Communication Profile of AS (cont.)
Typically rely on multimodal communication (Calculator,
1997).
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Marginal success with VOCAs in terms of spontaneous use.
All required prompting to use AAC systems.
Minimal initiations.
Self-selected simple means of communication:
(natural gestures – actions on people and objects, eye gaze, and
reaching).
*Majority of gestures required physical contact with referent or
interactant – contact gestures.
Use of Gestures by Children with AS
Frequent reliance on gestures
(Alvares & Downing, 1998; Clayton-Smith, 1993).
Those using manual sign (about 20% of population) use signs
difficult to understand – motor problems
(Clayton-Smith, 1993).
Manual communication is preferred modality for most individuals
(Alvares & Downing, 1998).
Difficulty imitating gestures, including those already in
communication repertoire
(Joleff & Ryan, 1992; Penner et al., 1993).
What Other Communicative Behaviors
Should I Be Looking For?
Vocalizations
AAC
Challenging Behavior:
(socially unacceptable and perhaps harmful
behavior).
Vocalizations
Often limited – vowels, consonants and
syllable shapes
Goal – expand phonetic and phonemic
inventories
AAC
Principle of Zero Exclusion
Moving away from cognitive prerequisites
Cognitive skills that ARE important
(Rowland & Schweigert, 2003)
– Awareness (theory of mind, social awareness.
AAC
– Communicative intent (importance of parents’
responsiveness and contingency).
– World knowledge (general experience)
– Memory (sensory, working, long-term)
– Symbolic representation (levels of abstraction)
AAC
Cognitive and Related Requisites to Use
Different AAC Systems?
Consider child’s language skills when
introducing (immediate needs) and
planning future uses of AAC systems.
AAC to foster communication growth.
Challenging Behavior
Functional alternatives to socially unacceptable
behavior
– Self-injury
– Aggression
Must identify function (impact on environment) of
behavior.
Functional communication training (Carr &
Durand, 1985).
Challenging Behavior
Functional communication training (FCT)
1.
Identify function of the unacceptable behavior. (what are the
reinforcers?)
–
ABC paradigm (escape, attention, gain item or activity, sensory.
2.
Make certain the communicative response is as efficient or
more efficient than the unacceptable behavior (effort,
frequency of reinforcement, and delay).
3.
Evaluate reinforcers provided for unacceptable and
communicative responses.
Communication Stages
Perlocutionary Stage
– Lack communicative intent.
– Not goal directed per se.
– Adults ascribe meaning.
– Include responses to internal states.
– Might teach adults to read and interpret children’s
behaviors, gaze patterns.
Communication Development
Perlocutionary Stage – Intervention
– Alter partners’ perceptions of children as
communication partners.
– Replace children’s unintentional behaviors with
voluntary communicative behaviors (BIGmack)
– Increase children’s responsiveness to others, as well
as to objects and events. Means-end behavior.
– Move toward functional uses of objects. ENGs
Communication Development
Illocutionary Stage
– Intentional communicative acts.
– Usually gestures and vocalizations
Often to request attention or request objects and
actions (protodeclaratives and protoimperatives)
Communication Development
Illocutionary Intervention
– In late stage may be taught to use symbols to
request, reject, share information, and engage in
conversations.
– Scripting & embedding communication within routines
Partial participation
Backward chaining
– Communication dictionary?
Communication Development
Locutionary Stage
– Emergence of symbolic communication
– Expansion of communicative functions,
vocabulary, and conversational skills.
– Reciprocal social exchanges
Communication Development
Locutionary Stage Intervention
– Stress conventional methods of communication.
– Topic initiation and turn taking.
Home-school coordination – VOCA journal
– Expansion of vocabulary.
General case instruction.
Fast mapping (Rice, 1989; Wilson & McIlvane, 2002).
What do we mean by
‘Success’ of Communication’?
Success – adult acknowledges (“okay”, “I see”,
“mmhmm”), interprets (oh, you’re telling me…; you’re still
thirsty, huh?), or complies with child’s message.
Rejections are also successes since they are contingent
replies.
Non-success – adult ignores, fails to respond, requests
clarification, or responds non-contingently.
Circle of Conversational Partners