Transcript Supporting Children with ASD Presentation

Julie Mullis
Clinical Lead Specialist Speech &
Language Therapist (ASD)
Cardiff & Vale UHB
Flying Start Conference 15/1/16
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A neuro-developmental disorder
A medical diagnosis, made by a multidisciplinary team, by observing a pattern of
behaviours which affect:
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social interaction
social communication
social imagination/flexible thinking
repetitive and restricted behaviours and interests
90% also have sensory processing difficulties
A spectrum condition meaning there is a
huge variety of presentation
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Used to be thought of as a rare
condition
Now thought to occur in about 1 in
100
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Broader defining characteristics
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Better diagnosis
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Better knowledge in the general public
Early identification leads to early
intervention
 Record observations
 Discuss your concerns with the
parents
 Do not use medical terminology
 Gain consent to refer to other
agencies as appropriate
 Include comments about positive skills
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You do not have to wait for a child to
receive a diagnosis to start providing
support
All pre-school children with ASD will
have difficulties with communication
Visual strategies can be used to
support them to understand us and to
support them to communicate with us
 Calendar?
 Diary?
 To
do lists?
 Electronic
devices/apps?
 Visual
 Concrete
 Repetitive
 Predictable
 Consistent
 Processing
 Unambiguous
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Develops symbolic understanding through a
hierarchy
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Objects
Photos
Symbols
Writing
Develops independence
◦ Communication
◦ Planning
 Signs
are a visual means of
communication but…
 Like speech, signs are transient
 Like speech, signs rely on recall
rather than recognition
 Motor difficulties
 Difficulties with imitation
 Echopraxia
 Visual
 Cue
Schedules
Cards
 ‘Traffic
 Timers
 Writing
Lights’
 Objects
of Reference
 Picture
Exchange Communication
System (PECS)
 Communication
 Voice
Books
Output Communication Aids
 Writing
 Aids
independence
 Represents
 Helps
the order of activities
to organise our time
 Reduces
anxiety
 De-personalises
 Ensures
instructions
flexibility not rigidity
 What
is the level of the child’s
symbolic understanding?
 Can the child understand
◦ Objects?
◦ Photos?
◦ Symbols?
◦ Written words?
 One
at a time?
 First X, then Y?
 Longer schedule?
 Half-day or whole day?
 Weekly calendar ?
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Some children will not
yet understand pictures
Label object if possible
Use single word
consistently with the
object
Later show OOR with
photo or symbol
 Ensures
that everyone calls an
item by the same label
 Aids
language development
 Develops
word recognition preliteracy skills
 Ensure
items are easily accessible
– box or shelf
 Present
 Say
two objects as a choice
what is on the label as item is
given
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The child needs to
engage with the
schedule by removing
the picture or ticking
the item, etc, or at
least looking at the
item
‘Finished’ box or
pocket
Reflecting on activities
at the end of the day
Copy to take home
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Simple ‘one message’
instructions or reminders about
specific rules or behaviours to
be remembered
Backs up verbal instructions that
are not on the visual schedule
toilet
De-personalises
Asocial and removes emotional
engagement
Reduces need for repeated
verbal instructions
no light
A type of cue card
 Can be used individually or with
groups
 Helps individuals to understand
transitions
 Prompts children to start and finish
activities
 Warns children that activities are
going to finish
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“X activity is
starting now”
“Go”
“Start X”
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Teaches concept of
waiting
“X activity is nearly
finished”
“X activity is
starting soon”
Can be paired with
a verbal countdown
or use of visual
timer such as eggtimer
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“X activity is
finished now”
“X items are
finished/all gone
now”
“Stop/Finish”
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What kinds of
timers are
there?
◦ Egg timers
◦ Clocks and
watches
◦ Sundials
◦ On computer
◦ On phone
◦ On TV
Why do you use
clocks or timers?
For cooking
 To record a programme
 To remind us to take medication
 To know how long before the bus is
coming
 To get to an appointment on time
 To know how long it is before we can
have a break?
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Help us to
◦ plan and organise our time
◦ be productive
◦ be where we need to be when we need to
be there
Represents an abstract concept in a more
visual and concrete way – provides
information that otherwise would be hard to
explain
Reduces anxiety
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Picture Exchange
Communication System
A structured
programme developed
specifically for children
with ASD
Develops
communicative intent
Teaches that two
people are needed for
communication to be
effective
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Provides a functional
appropriate means of
communicating
requests which reduces
inappropriate
behaviours
Uses pictures to
request desired items
Builds up gradually to
longer sentences and
more functions
(comments,
responding to
questions)
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For children who
◦ know how to get
someone’s attention
◦ have a large vocabulary
(PECS no longer userfriendly)
◦ can scan a selection of
pictures
Photos, symbols or written
words can be used
Child communicates by
pointing to one or more
pictures
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VOCAs are hightech battery
powered AAC
Use symbols that
are already familiar
Looks like PECS
book
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Portable
Motivating
Easy to add new vocabulary
Can break down, run out of battery, get
broken
Needs low-tech back-up
Technology developing fast – new apps
cheaper and easier to individualise – iPads
and iPods increasingly being used as
communication aids
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Writing is a visual
means of
communication
Can be used to
communicate with
individuals with ASD
Some individuals need
longer to process
verbal information
Some non-verbal
individuals can read
and write and can use
written systems to
communicate
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