COMMUNICATION PROBLEMS

AND INTERVENTION FOR

CHILDREN WITH AUTISM
Presented by
MS. Fouzia Saleemi
Speech Language Pathologist
M.Phil. Speech Language Pathology,M.A.Sed (Special Education),
PGD(SLT),CD Applied Behavior (USF) CMH,Lahore
 Allah(GOD) has not sent
down a disease except that
he has also sent down its
cure.

Quoted by
Prophet Muhammad
(P.b.u.h)
 WORD AUTISM MEANING

A mental condition,
present from early
childhood, characterized
by great difficulty in
communicating and
forming relationships
with other people and in
using language and
abstract concepts.
 AUTISM

 Autism is a lifelong disability

 Autism Spectrum Disorders (ASD) are a
collection of developmental disorders that are
characterized by impairments in social
interaction and communication, as well as the
presence of restricted and repetitive behaviors
and interests.it occurs primarily in males. The
ratio is 4:1
Autism impairs one’s ability to
 Communicate

 Receptive Language

 Expressive Language

 Pragmatic or Social Language abilities

 Autism affects socialization.

 Autism affects the sensory system.

 Autism can impact cognitive skills where

brain is wired differently.
 COMMUNICATION
Communication is when someone sends a
message to another person and the message is
received and understood.
Everyone Communicates!
• Communication is not just speech.
• Communication may occur through behaviors,
signs, gestures, pictures, pointing, nonverbal
body language, symbols, vocalizations,etc.
• Communication often relies on language.
• Language is a system of symbols and rules that
govern the use of the symbols to convey meaning.
 DSM- IV CRITERIA
COMMUNICATION IMPAIRMENT
 Delay in, or total lack of development of spoken
language
 Failure to compensate with non-verbal gestures
 Marked impairment in ability to initiate or
sustain conversation in children with speech.
 Stereotyped, repetitive use of idiosyncratic
language
 Echolalia, scripting, unusual prosody
 Lack of spontaneous, varied, spontaneous make
believe play or social imitative play appropriate
to developmental level.
 DSM-IV CRITERIA
SOCIAL COMMUNICATION IMPAIRMENT
 Impairment in use of non-verbal behaviors to
regulate social interaction
 Eye contact, facial expressions, gestures
 Failure to develop developmentally-appropriate
peer relationships
 Lack of spontaneous seeking to share enjoyment
with others
 Lack of showing or pointing out objects of interest
 Lack of social or emotional reciprocity
SOCIAL / COMMUNICATION ISSUES
BIZARRE / REPETITIVE BEHAVIORS
SAFETY ISSUES
MOTOR ABNORMALITIES IN SOME AREAS
 Communication is broad
concept consisting of language
(linguistic, paralinguistic and
pragmatics aspects of
functioning).
INTEGRATION OF COMPONENTS OF
LANGUAGE
LEVELS OF LANGUAGE
 WHAT COMMUNICATION PROBLEMS ARE
ASSOCIATED WITH ASD
 Limited inclination to share enjoyment, interests,
or achievements with other people

 Primary purposes for communication to be:

- requests (get someone to do
something)
- protests (get someone/something to stop)
 GENERAL COMPREHENSION AND
EXPRESSION PROBLEMS

 Difficulty with language comprehension

 High- pitched, monotonous speech

 Echolalia

 Sterotypic,meanigful speech

 Asocial monologues

 Preference for mechanical sounds over human

voice
 Reduced interest in communication

 Errors in recognizing face.

 Poor use of environmental cues.

 Poor response to commands.

 SEMANTIC/PRAGMATIC BEHAVIORS
PROBLEMS

 Lack of responsive to others.

 Use of only few communication stratgies

 Minimal use of gestural communication

 Lack of eye contact

 Slow acquisition of speech

 Word findings difficulties

 Poor categorization abilities

 Poor understanding of related words

 COMMUNICATION AND BEHAVIOR

 Parents need to understand the behavior – look

deeper to try to understand the communication that is
occurring

 Behavior may communicate:

- Frustration
- Fear or other emotional upset
- Discomfort – need to escape noise, light,
sensory,irritation, etc.
- Boredom
- Physical needs – thirst, hunger, bathroom
- Protest
- A request
- Many other things…
 Language
Assessment and Evaluation
 RECEPTIVE LANGUAGE SAMPLE
Subjective Assessment Objective Assessment

 LevelOf  TROG test

Functioning Brown
Stages
 ICW levels

 PEEP

 ABLLS
 EXPRESSIVE LANGUAGE SAMPLE
Subjective Assessment Objective Assessment

 Renfrew Test
 Pragmatics Checklist Action Picture
Bus Story Test
Word finding
Vocabulary test
 CELF 4

 PLS 5

 SALT
 RDLS
Treatment Approaches
The diagnosis of an Autism Spectrum Disorder
presents parents and clinicians with a veritable
maze of programs and therapies.
 What is out there?

 Which programs are best for my child/student?

TREATMENT APPROACHES FOR
PROFESSIONAL WORKING WITH
ASD CHILDREN
 PECCS

TEECH Biomedics ABLLS

ABA
 BIOMEDICS APPROACH

 Biomedics approach is commonly known as food

therapy. Gluten is a unique type of protein that is
generally discovered in our day-to-day meals
items. while it is an essential items of our diet,
the body of an Autistic kid responds in a different
way than a normal child. It is vital for the
parents to plan gluten free diet for their child
experiencing Autism.
THE ASSESSMENT OF
BASIC LANGUAGE AND
LEARNING SKILLS

ABLLS
 The Assessment of Basic Language and
Learning Skills (ABLLS, often pronounced
“ABLLS") is an educational tool used frequently
to measure the basic linguistic and functional
skills of an individual with developmental delays
or disabilities.
 OVERVIEW OF ABLLS CURRICULUM

Syntax and Grammar

Reinforce Requests
effectiveness Play and Leisure
Labeling
Visual performance Social Interaction
Intraverbal
Receptive Language Group Instruction
Spontaneous
Imitation vocalization Classroom Routines
Vocal imitation Reading Skills Generalized
Responding
Gross Motor Skills Math skills
Dressing
Fine Motor Skills Writing Skills
Eating
Spelling Skills
Grooming
Toileting
 PECS FOR
CHILDREN WITH
AUTISM
Lori Frost, a certified Speech-Language Pathologist,
Andrew Bondy, PhD., at the Delaware Autistic
Program.
 WHAT IS PECS

 PECS was developed by Lori Frost, a certified

Speech-Language Pathologist, and Andrew Bondy,
PhD., at the Delaware Autistic Program.
 Using the PECS, with nonverbal ASD children.
Children learns to spontaneously initiate
communicative exchanges. Using PECS, children
learn to gain the attention of the communication
partner in order to make a request.
 TEECH FOR
CHILDREN WITH
AUTISM

Eric Schopler,Margaret Lansing, PhD, BCBA,

TEECH PROGRAMME BASED ON THESE
FACTORS

Chronological
Age

Developmental
Age

Functional
Level
CURRICULUM OF TEECH

Imitation Perception Cognition

Gross Motor
Self Help
Eye-Hand
Fine Motor Coordination

Verbal
Social
Performance
 APPLIED BEHAVIOR
ANALYSIS FOR
CHILDREN WITH
AUTISM

Jonathan Tarbox, PhD, BCBA, & Bill Roth, PhD,

 ABA
 Applied Behavior Analysis (ABA) is the only
scientifically validated treatment for autism and
is recommended by the U.S. Surgeon General.
 Antecedent--Behavior--Consequences

A—B—C
 Applied Behavior Analysis (ABA) given in early
then it is called Early intensive behavior analysis
(EIBI)
 COMPREHENSIVE ABA PROGRAMS

 DTT
 Natural Environment Training (NET)
 Verbal Behavior
 Challenging behavior
 Fluency based instruction Programme
 Programming for generalization
 VERBAL BEHAVIOR
 B.F. Skinner, Verbal Behavior (1957): Applied principles of
behavior analysis to language
 Separates language into categories by function

 Some incorrectly say that “Verbal behavior is not ABA” or

“We don’t do ABA, we do verbal behavior”
 COMMON TERMS FOR THE
VERBAL OPERANTS

 Echoic
 Mand
 Tact
 Intraverbal
 Receptive or Listener Responding
Verbal Antecedent Behavior Consequence
Operant
Mand Motivative Verbal behavior Direct reinforcement
Operation (says “cookie”) (gets cookie)
(wants cookie)

Tact Sensory Stimuli Verbal behavior Non-specific

(sees or smells (says “cookie”) reinforcement
cookie) (gets praised, for
instance)

Intraverbal Verbal stimulus Verbal behavior Non-specific

(someone (says “cookie”) reinforcement
says:”What do (gets praised, for
you eat?” instance)

Echoic Verbal Stimulus Verbal behavior: Non-specific

(someone says repeats all or part reinforcement
“cookie”) of antecedent (gets praised, for
(says “cookie”) instance)

Receptive Verbal stimulus Non-verbal Non-specific

(actually not (someone says behavior reinforcement
a verbal “touch cooke”)* (child touches (gets praised, for
operant) cookie) instance)
 OTHER TREATMENTS AND COMMUNICATION
METHODS
 Sensory Integration Therapy
 SIT should be administered by, or need for SIT should be assessed
by, an Occupational Therapist.
 Auditory Integration Therapy
 AIT generally consists of a prescribed amount of time spent each
day listening to a recording that uses particular combinations of
sound waves to retrain the ear mechanisms.
 Music Therapy
 Music Therapy can be an excellent addition to a treatment
program, but the therapist should be well-versed in your method of
choice (in other words, if you are running an ABA program, your
music therapist should have some experience working as an ABA
therapist).
 TREATMENT APPROACH FOR
TEACHERS WORKING WITH ASD
CHILDREN
SCERTS MODEL
SCERTS can be classified as a
combined intervention as it
blends elements of behavioral
and developmental models to
better support children on the
autism spectrum as they
develop.

SCERTS stands for Social-

Communication, Emotional
Regulation, and Transactional
Support. These are seen as the
principal dimensions for
intervention planning.
 KEY COMPONENTS OF THE SCERTS
MODEL

 Communication and language deficits

These are addressed through social-pragmatic language therapy, which
emphasizes the functional use of pre-verbal and verbal communication skills
in natural and semi-structured interactions. The model includes the use of
validated and effective strategies to support the use of non-speech
communication systems such as picture symbols. Social-pragmatic
approaches are now practiced in both contemporary Applied Behavior
Analysis programs as well as developmentally-based programs.
 Deficits in social relatedness and social-emotional reciprocity
These are addressed through strategies developed as part of the Floor Time
approach. The basic premise of Floor Time is that children learn skills from
the relationships which they have with their caregivers and other people
significant in their lives.

 Sensory processing deficits

These are addressed through sensory integration therapy and environmental
adaptations and supports. Many children with autism also have motor
planning issues affecting daily living skills, which are also addressed.
TREATMENT APPROACH FOR
PARENTS WORKING WITH
CHILDREN
 PARENTS-CHILD VERBAL THERAPY
 This therapy are based on three stages with
following guidelines
 Beginning stage

 Middle stage

 Advanced stage
 Sitting Subtle Social Skills
Attending Compliance Higher Level Play
Communication skills Skills
Remaining on task
Play skills Advanced
How to Process Feed
Back Self-help communication
Social skills &cognitive skills
Understanding Cause
and effect Integration of skills to
everyday environment
 Academic
Skills

Executive Social
Cognition
Functions Skills

Adaptive Motor
Language Play
Skills Skills
 LANGUAGE CURRICULUM Language

31 Lessons by Emerging Age and Function:

0-12 mos. 1 - 2 yrs. 2 - 3 yrs. 3 - 4 yrs.
• Body Parts • Actions • Adverbs • Describe
• Echoics • Basic Mands • Attributes • Sequences
• Following • Categories • Features • Statement -
Instructions • Choices • Gender Statement
• Gestures • Functions • Manding for 4 - 5 yrs.
• Sound • Negation Information • Same / Different
Discriminati • Objects • Opposites 5 - 6 yrs.
on • Pronouns • Ask & Tell
• People &
Relationships • Wh- Discrimination
• Prepositions Discriminatio • Statement –
• Yes / No n Question
• Locations • Syntax
• Plurals 6 - 7 yrs.
• What Goes With
 Language Curriculum Language

Function Instruction Behavior Consequence

or Setting (Reinforcer)
Matching “Put with same” apple is matched
with apple Praise
Listening “Touch apple” Selects apple Praise
Vocal Someone says “apple” Praise
Imitation “apple”
Request Hungry and no “apple” Child gets an
apple present apple
Labeling Apple is present “apple” Praise
“What is your “apple” Praise
Conversation favorite fruit?”
 PLAY CURRICULUM Play
Sensorimotor Play
Independent
Task Play
Completion Play
Play Stations

Early Social Games

Block Constructions
Constructive Read-to-Me Books & Nursery Rhyme
Structure Building Interactive
Music and Movement
Play
and and Water Constructions Play Hunt
Treasure
Clay Constructions Card and Board Games
Arts and Crafts Locomotor Play
Peer Play

Functional Pretend Play

Pretend
Audio and Video Play Symbolic Play
Electronic Play
Computer Play Play
Imaginary Play
Video Games Sociodramatic Play
 ADAPTIVE (SELF
HELP)CURRICULUM
Adaptive
Personal Domestic
Feeding
Pet Care
Toileting
Setting & Clearing Table
Undressing
Telephone Skills
Unfastening
Tidying
Dressing
Meal Preparation
Preventing Spread of Germs
Cleaning
Bathing
Gardening
Fastening
Laundry
Teeth Care
School Backpack Prep
Hair Care
Making a Bed
Nail Care
Health Care

Safety
Safety Awareness
Community Safety Equipment
Shopping
Restaurant Readiness
 Motor Curriculum
Motor

Oral Motor

Oral
Ocular Motility
Binocular Vision Skills

Visual Visual Perception

Fine Hand Skills

Coloring
Finger Skills
Drawing
Pre-Handwriting
Cutting with Scissors

Gross
Sitting Crawling / Creeping Riding Foot-Propelled Vehicles
Standing Rolling Over Rolling / Throwing / Dribbling
Walking Stairs and Climbing Riding a Tricycle / Bicycle
Running Balance Beam Swinging a Bat / Racquet / Paddle
Jumping Kicking Physical Education Readiness
Hopping Catching
 Language Arts
Colors
A S
CADEMIC KILLS C URRICULUMAcademic
Community Helpers
Handwriting and Penmanship
Math Writing Skills
Shapes Letters
Spelling
Money
Print Concepts
Patterning
Literary Genres
Calendar
Decoding & Word Recognition:
Addition Phonics
Subtraction Sight Reading
Statistics and Data Analysis
Comprehension:
Oral Story Comprehension
Number Concepts:
Numbers Reading Comprehension
Phonological Awareness:
Counting & Quantities
Phoneme Isolation
Quantitative Concepts
Phoneme Blending & Segmentation
Ordering Numbers & GroupsMatching
Phoneme
ComparisonsPhoneme Manipulation
Number Patterns
Word Discrimination & Segmentation
Time: Rhyming
Syllables
Time of Day & Daily Activities
Telling Time
 REFERENCES
 Perry, A., Condillac, R. A., Freeman N. L., Dunn-Geier, J., &
Belair J. (2005). Mulit-site study of the Childhood Autism
Rating Scale (CARS) in five clinical groups of young children.
Journal of Autism and Developmental Disorders, 35, 625-634.
 Rellini, E., Tortolani, D., Trillo, S., Carbone, S., & Montecchi, F.
(2004). Childhood Autism Rating Scale (CARS) and
Autism Behavior Checklist correspondence and conflicts
with DSM-IV criteria in diagnosis of autism. Journal of
Autism and Developmental Disorders, 34, 703-708.
 Stella, J., Mundy, P., & Tuchman R. (1999). Social and nonsocial
factors in the Childhood Autism Rating Scale. Journal of
Autism and Developmental Disorders, 29, 307-317.
 New York State Department of Health. (1999). Autism/Pervasive
Developmental Disorders. Clinical practice guideline
technical report. New York: Author.
I HAVE AUTISM.AUTSIM IS NOT BAD
BEHAVIOR
 DON’T CRITICISE MY
DISABILITY,PLZ TRY TO EXPLORE
MY ABILITIES