April is Autism Acceptance Month! Formerly known as Autism Awareness Month, the shift from awareness to acceptance is recent. Check out the announcement from the Autism Society of America here https://www.autism-society.org/releases/media-urged-to-recognize-shift-from-autism-awareness-month-to-autism-acceptance-month-this-april/
According to their announcement, “The shift in the use of terminology aims to foster acceptance to ignite change through improved support and opportunities in education, employment, accessible housing, affordable health care and comprehensive long-term services.”
How can we at Forbes AAC support those with autism spectrum disorder (ASD)?Approximately 30-40% of individuals with ASD do not develop functional speech or have limited speech skills and would benefit from AAC (Howlin et al., 2014; Iacono et al., 2016; Pickles et al., 2014). Research has found that individuals with ASD can benefit from both low-tech AAC, such as picture cards or communication boards, and high-tech AAC such as a speech-generating device (SGD), for functional communication. There are several strategies clinicians, teachers, and parents can use for fostering language development for individuals with ASD who use AAC. Below are a few of those strategies:
Aided language stimulation is a language approach in which the communication partner provides spoken words while pointing to AAC symbols during communication opportunities (ASHA, n.d.). Research on the use of this strategy has shown to have a positive impact on language for individuals with ASD. Drager et al. (2006) found that aided language modeling increased symbol comprehension and symbol production skills in two individuals with ASD. A systematic review by O’Neill and colleagues (2018) found empirical evidence to support the use of this intervention strategy by various communication partners to improve expressive and receptive language in individuals with ASD who use AAC.
Prompting is a way to introduce a new language concept and to elicit use of that concept. Using a least-to-most prompting paradigm has been found to increase multi-symbol message production (Finke et al., 2014) and multistep requesting and generic small talk (Chavers et al., 2021). If a user is provided with too much prompting they can become prompt dependent, meaning they rely on prompting instead of learning to independently communicate.
Milieu therapy includes a range of methods, such as incidental teaching or time delay, incorporated into a child's natural environment to expand their language production for various communicative functions (ASHA, n.d.). In a single-subject design with four children with ASD as participants, the study found that this intervention strategy increased the children's linguistic complexity and social communication skills (Hancock & Kaiser, 2002). These methods are great for implementing in a child's immediate environment, such as at home or in the school setting, as they are meant for use in the individual's natural environment.
These strategies are meant to allow individuals with ASD who use AAC to learn and develop language, however they aren't meant to "force" these individuals to use "normal language". Honor all communication by those with ASD while utilizing these strategies to foster language learning!
Join us in celebrating all involved in the autism community this April! #CelebrateDifferences
American Speech-Language-Hearing Association (n.d.). Augmentative and Alternative Communication (Practice Portal). www.asha.org/Practice-Portal/Professional-Issues/Augmentative-and-Alternative-Communication/
Chavers, T. N., Morris, M., Schlosser, R. W., & Koul, R. (2021). Effects of a Systematic Augmentative and Alternative Communication Intervention Using a Speech-Generating Device on Multistep Requesting and Generic Small Talk for Children with Severe Autism Spectrum Disorder. American Journal of Speech-Language Pathology, 30(6), 2476–2491. https://doi.org/10.1044/2021_AJSLP-20-00353
Drager, K. D. R., Postal, V. J., Carrolus, L., Castellano, M., Gagliano, C., & Glynn, J. (2006). The effect of aided language modeling on symbol comprehension and production in 2 preschoolers with autism. American journal of speech-language pathology, 15(2), 112-125. https://doi.org/10.1044/1058-0360(2006/012)
Finke, E., Davis, J., Benedict, M., Goga, L., Kelly, J., Palumbo, L., . . . Waters, S. (2017). Effects of a least-to-most prompting procedure on multisymbol message production in children with autism spectrum disorder who use augmentative and alternative communication. American Journal of Speech-Language Pathology, 26, 81–98. https://doi.org/10.1044/201
Hancock, T. B., & Kaiser, A. P. (2002). The Effects of Trainer-Implemented Enhanced Milieu Teaching on the Social Communication of Children with Autism. Topics in Early Childhood Special Education, 22(1), 39–54. https://doi.org/10.1177/027112140202200104
Howlin, P., Savage, S., Moss, P., Tempier, A., & Rutter, M. (2014). Cognitive and language skills in adults with autism: A 40-year follow-up. Journal of Child Psychology and Psychiatry, 55, 49–58. https://doi.org/10.1111/jcpp.12115
Iacono, T., Trembath, D., & Erickson, S. (2016). The role of augmentative and alternative communication for children with autism: current status and future trends. Neuropsychiatric Disease and Treatment, 12, 2349. https://doi.org/10.2147/NDT.S95967
Media urged to recognize shift from “Autism Awareness Month” to “Autism Acceptance Month” this April. (n.d.). Autism Society. https://www.autism-society.org/releases/media-urged-to-recognize-shift-from-autism-awareness-month-to-autism-acceptance-month-this-april/
O'Neill, T., Light, J., & Pope, L. (2018). Effects of Interventions That Include Aided Augmentative and Alternative Communication Input on the Communication of Individuals with Complex Communication Needs: A Meta-Analysis. Journal of Speech, Language, and Hearing Research, 61(7), 1743–1765. https://doi.org/10.1044/2018_JSLHR-L-17-0132
Pickles, A., Anderson, D. K., & Lord, C. (2014). Heterogeneity and plasticity in the development of language: A 17-year follow-up of children referred early for possible autism. Journal of Child Psychology and Psychiatry, 55(12), 1354–1362. https://doi.org/10.1111/jcpp.12269
Katie Threlkeld, M.S., CCC-SLP is a Doctoral Candidate at the University of Missouri and the Educational Program Developer at Forbes AAC. She has over 8 years of experience in AT and AAC assessment and treatment across the lifespan. Her goal is to provide all AAC users and those around them with evidence-based information for best practice in AAC.