The Autism Society Event and Education Recordings Archive

Approximately 50% of individuals with autism do not develop effective spoken language and require the use of augmentative and alternative communication (AAC). Symbols are a common element in AAC systems for individuals with autism. A review of the literature reveals effective symbol-based communication interventions. This session will provide participants with an understanding of a range of symbol-based intervention options that are supported by current research. User-stories will be provided to demonstrate these empirically validated strategies in action. The prevalence of autism continues to rise, with the current statistics indicating that as many as 1:150 children will be diagnosed with autism (CDC, 2007).  Given this, it is imperative that clinicians are adequately trained and informed to serve this population. The field of autism intervention is quite diverse, with approaches ranging from scientifically-based to not recommended, because some are potentially harmful and limit access to more appropriate intervention options (Simpson, 2005).  Individuals with autism and their families are desperate to identify interventions that will work, and rely on the support and information they receive from professionals, other parents, the autism community and the media. This presentation will provide participants with an overview of research-based intervention options that use symbols to represent language to create AAC supports.  The information will be organized in three categories, including the use of symbols to manage challenging behavior, to communicate requests, and to support following a schedule and transitioning between activities. Information will also be shared about how learners with autism learn and generalize the use of symbols.

Approximately 50% of individuals with autism do not develop spoken language (Alpert & Rogers-Warren, 1985). Augmentative and alternative communication is necessary to meet their communication needs.  Several studies have demonstrated that individuals with autism have relative strengths in processing visuo-spatial input with concurrent difficulties in processing auditory input (Hermelin & O'Connor, 1970; Harris, Handelman, & Burton, 1990). The utilization of symbol-based communication utilizes the visuo-spatial strengths of individuals with autism to promote successful communication.  Each of the following methods/practices will be described with a brief review of the literature and user stories to illustrate effective application of these strategies in clinical practice.

Challenging Behavior:

Challenging behaviors are common among individuals who have autism.  This behavior significantly impacts an individual’s ability to fully access their learning environment and community.  Given the use of behaviors to communicate needs and desires; providing AAC supports to meet communication needs, which in turn works towards extinguishing inappropriate behaviors, is an appropriate focus for speech and language intervention (Bopp, Brown, & Mirenda, 2004). The use of symbolic communication embedded within functional communication training has resulted in success for people with autism who exhibit challenging behavior. Cafiero (2001) utilized natural aided language to promote instructional understanding from a participant with autism.  This instructional modality resulted in a decrease in challenging behavior and an increase in engagement in activities. Additionally, preschool students were given access to symbol-based communication to request preferred activities within the typical classroom routine which resulted in a decrease in highly aggressive behavior (Frea, Arnold, Vittimberga, & Koegel, 2001). Moreover, functional communication training has a long-history of success for individuals with autism (Mirenda, 1997). The use of symbols within functional communication training takes advantage of individuals’ visual-spatial strengths and ultimately increases the likelihood of a decrease in aberrant behavior. 

Requesting:

The instruction of manding (i.e., requesting) behavior frequently utilizes symbols for people with autism.  The Picture Exchange Communication System (PECS) developed by Bondy & Frost (1994) is one of the most frequently used symbol-based intervention strategies for people with autism. This highly successful intervention demonstrates the successful use of symbols by individuals with autism to gain access to preferred items and activities. PECS also expands the use of symbols from manding to tacting (i.e., labeling) as the learner advances. Similarly, Reichle, McComas, Dahl, Solberg, Pierce, & Smith (2005) demonstrated the use of symbol-based communication for an adult with autism to conditionally request help. Social deficits are one of the core challenges for people with autism (DSM IV, 1994).  This deficit paired with an inability to communicate verbally provides significant challenges in peer relationships.  Johnston, Nelson, Evans, Palazolo (2003) successfully utilized a symbol to promote peer interaction in preschool children with autism.

Scheduling and Transitions:

Symbol-based schedules have also demonstrated success in promoting on-task behavior for individuals with autism.  One of the unique aspects of symbol schedules is the use across the wide spectrum of individuals with autism, including those with co-occurring mental retardation and those without. Bryan & Gast (2000) demonstrated that the use of a picture book was successful to promote on-task behavior with high-functioning school-aged students with autism.  Macduff (1993) used a visual schedule to increase on-task behavior for individuals with autism who were perceived to have limited skills.

Teaching Symbol Use:

The use of symbols promotes successful communication for individuals with autism. Individuals with autism may have a preferred disposition to the use of visual modalities for communication; however, instruction in the use of symbols is required, with several instructional practices have proving successful.  Aided language modeling (Drager, Postal, Carrolus, Castellano, Gagliano, & Glynn, 2006) successfully increased the comprehension and production of symbol-based communication with preschoolers. Preis (2006) demonstrated that pairing verbal commands with symbols leads to increased generalization.  The ability to generalize across learning environments is also a core challenge for individuals with autism.  The use of symbols may provide a method to increase the ability to generalize verbal communications. 

Symbol-based language representation to promote effective communication is of critical importance for individuals with autism.  Professionals and caregivers that work with individuals with autism must stay abreast of empirically valid strategies in the field of autism.  This presentation will provide a review of research-based interventions that have been successful in promoting communication success.  User stories will provide an entry-level understanding of these strategies.

Learning Objectives: