The Autism Society Event and Education Recordings Archive

Providing speech therapy services for children with ASD that are nonverbal can be challenging. This session will provide practical tips and strategies to support language and skill development for children on the autism spectrum with limited verbal skills. Addressing challenging behaviors, writing appropriate goals, and creating fun therapy/classroom activities will be discussed. This session will be beneficial for speech therapists, other professionals, and parents of children with limited verbal skills. Speech Language Pathologists are often the first professionals to work with students on the autism spectrum with limited verbal skills. Often these children have overt behaviors that impact their learning.  To begin working with children on the autism spectrum with limited verbal skills, the speech language pathologist needs to build a relationship with the parent and the child.  This begins by talking with the family and observing the child to determine the child’s interests including the child’s favorite items, activities, and people.  This information is critical to begin to develop the child’s functional communication skills.
A total communication approach is utilized to teach a child functional communication skills.  Sign language, pictures, spoken words, and augmentative communication are all modeled for the child to provide multiple communication modalities.  To begin, develop a list with the parents of the child’s most highly reinforcing items/activities.  Take digital pictures of these items/activities and learn the manual signs corresponding to these words.  The following website provides video clips of manual signs (http://commtechlab.msu.edu/sites/aslweb/browser.htm ).  “More”, “all done”, and “please” should not be taught as first signs.  These words do not provide the child with the skills necessary to request specific desired items and will lead to frustration for both the child and others around him.  Instead, we want the child to be able to initiate communication, not just respond to presented items by signing “more”. A total communication approach exposes the child to various communication modalities to see what the child responds best to.  The ultimate goal is for the child to communicate spontaneously, even if he is unable to speak.
Typically a child who is nonverbal exhibits behaviors as his/her form of communication. It is necessary to examine the function of these behaviors to be able to shape them into more appropriate forms of communication.  When teaching a child to communicate using signs, words, pictures, and/or assistive technology, it is important that this new communication modality is effective to receive the desired items and the challenging behaviors are no longer effective.  For example, if a child cries and then is given his milk, the replacement communication of giving a picture to request milk replaces the crying.  The crying in this situation, can no longer serve as a means to get milk.  In looking at communication, speech language pathologists need to familiar with the process of a functional behavioral assessment to understand the function of the behavior in relation to communication.
To promote a child’s language learning, expressive and receptive language skills need to be targeted.  To address receptive language skills, incorporate visuals (digital pictures, line drawings, box packaging) into activities.  For example, to teach the child the direction “go put it in  the trash”, show him a picture of a trash can or a picture of the child throwing an item in the trash.  Children with autism spectrum disorder benefit from visual supports to help during transitions.  Limit the amount of words you say to the child (I know this is difficult for SLPs) and just point to the picture.  Visuals provide static references for the child to follow directions more independently.
To help develop a child’s language, incorporate the child’s favorite interests into activities.  This will motivate the child to want to play with you. Reinforcing items are used throughout activities to promote skill development.  For example, if a child is encouraged to play with a typical Mr. Potato Head toy (this may mean initially putting one piece in or taking one piece out of the Potato Head), once the task is completed, he is handed his highly reinforcing item.  The item is removed by saying “1,2,3…my turn”.  Reinforcers are constantly changing for each child. It is valuable to complete a reinforcer inventory to see what will motivate each child.
When working with students that are nonverbal and have immense communication needs, it is difficult to know where to begin.  Often there are so many things the child cannot do that is may be difficult to see what the child can do.  It is important to use a functional assessment that tells you both what the child can and cannot do.  The following are potential goal areas for children with limited verbal and language skills:  responding to his name, tracking items by following a point to an item, imitating motor movements, pointing to a desired item, requesting highly motivating items, requesting basic wants and needs (objects, actions, assistance, refusal), identifying common vocabulary, labeling reinforcing items, filling in the last word of a phrase, following routine directions, and matching pictures to pictures.  These targeted areas provide an initial guide to provide services for children with limited verbal and classroom readiness skills.
In the classroom, therapy or home setting, interactive engaging activities promote language learning for children that have difficulties with classroom readiness skills.  Examples include bubbles, jumping together on a trampoline, bouncing the child on a ball, swinging the child in a sheet, playing in water, playing with a ball drop toy, and using a pop-up toy.  The exploding volcano (baking soda and vinegar) is a highly engaging activity for students. This activity is great for language skills as well as encouraging sitting at a table.  To incorporate language into the volcano, the children use a visual recipe that indicates the steps to create the experiment.  The children complete intraverbals (fill-ins) to participate in the activity (ready, set…go!; 1, 2…3;  Pour it…in) and request to make it explode again.  Visuals, assistive technology, and manual signs are integrated into activities to support the child’s expressive and receptive language skills.
To promote interactions in classroom and home activities, interactive books have been created to target labeling and identifying common and thematic vocabulary.  These books (which samples will be shared with the audience) are created using Microsoft Publisher ® and pictures from Google Images (www.images.google.com).  Creating personalized books and materials helps to engage the child on the autism spectrum with therapy activities.  It is critical to remember that a child needs to be engaged to be learning.
As a speech language pathologist, I know the challenges and rewards that are associated with working with children that are nonverbal or have limited verbal skills. Those first attempts of appropriate communication are so rewarding.  As professionals, we need to help support children as they learn to communicate and understand the world around them.    To provide effective speech and language therapy for the child on the autism spectrum, it is imperative to integrate a total communication approach, teach functional communication skills, involve parents in programming, and make learning interactive and fun.

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