enhancing communication: what can we do? dr glenys jones autism cymru may 2006
TRANSCRIPT
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Enhancing communication: what can we do?
Dr Glenys JonesAutism Cymru
May 2006
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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
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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)
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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
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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
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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
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Developing communication: prerequisites
• Must have a reason • Must have the opportunity • Must have a system
• Must feel enabled
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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
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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
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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
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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
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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)
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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
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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
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Interactive approaches
• 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
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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
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Communicate through a Passport
• My name is Adam.• I am happy when…..• I don’t like it when teachers….• If I am upset, it helps to…..
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Email opportunities
• 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
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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
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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
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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
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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
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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.’