This issue of NASET’s Autism Spectrum Disorder series was written by Maeghan Johnson and will focus on strategies for non-verbal and minimally verbal students. Diagnosis of autism is rapidly increasing. Forty percent of those diagnosed with ASD are non-verbal. Those students and parents do not always have access to strategies available that can help ease frustration and increase communication skills. Visual supports, using pictures or objects as a replacement for activity or to enhance understanding of requested activity. The PECS system teaches children to use pictures and symbols in place of words to request items, answer questions and formulate simple sentences. Modeling can be done either by adults or most receptively by peers, as they learn to ask questions, answer appropriately and take turns to have a meaningful exchange.
ABSTRACT
Diagnosis of Autism is rapidly increasing. Forty percent of those diagnosed with ASD are non-verbal. Those students and parents do not always have access to strategies available that can help ease frustration and increase communication skills. Visual supports, using pictures or objects as a replacement for activity or to enhance understanding of requested activity. The PECS system teaches children to use pictures and symbols in place of words to request items, answer questions and formulate simple sentences. Modeling can be done either by adults or most receptively by peers, as they learn to ask questions, answer appropriately and take turns to have a meaningful exchange.
INTRODUCTION
Two years ago, I had my first non-verbal student. Within a month, I had two non-verbal students. The first student was older, 5th grade, but his mother was an SLP by trade and had worked extensively with him and he had learned the PECS system and carried around his own Tobi DynaVox iPad with him and used it effectively to communicate with teachers and peers. The second student, a first grader, had no such training and no way to communicate other than to scream, hit or yell “Shup Up!” Conversely, his mother was raising him alone, uneducated and had enrolled him in school because she was at her wits end. The difference was astounding. Knowledge + resources = better communication. I took it upon myself to help bridge the gap because I realized in that moment that so many of my parents do not have the knowledge or resources to help their non-verbal child.
Fast forward to now, I have a classroom full of non-verbal students. Eight to be exact and not at all by design, completely by happenstance. However, it makes sense this is becoming increasingly more prevalent. Students whose IQs (Intelligence Quotient) are within normal range but are non-verbal. My goal is to empower these students and give them the tools to at least become minimally verbal, but able to fully communicate, whether it be signs, PECS, writing or drawing. Mostly, I hope to compile strategies and interventions to use in the classroom and reach each child at their specific level but give parents the tools needed to reinforce and empower as well.
STATISTICS
The rate of children diagnosed with Autism (ASD) has increased drastically over the last 20 years. In fact, studies show 1 out of every 44 children is affected by Autism and 40% of these children are non-verbal (National Autism Association). Some children may even speak words by 12-18 months but lose them later. While these facts are heart wrenching, ASD is treatable and there are interventions that can assist in language development and the ability to help establish and cultivate communication, even if the words never come.
VISUAL SUPPORTS
Visual supports are concrete cues paired with, or used in place of, a verbal cue to give the learner information about a routine, activity, behavioral expectation, or skill demonstration. Visual supports might include: pictures, written words, objects, arrangement of the environment, visual boundaries, schedules, maps, labels, organization systems, timelines, and scripts. (Sam 2015) These supports are often used in early childhood settings with typically developing children. Visual supports can be used to improve a number of outcomes, including social, communication, behavior, school readiness, play, and cognitive. (The IRIS Center 2016) Visuals can promote appropriate, positive ways to communicate, decrease frustration and may help decrease problem behaviors that result from difficulty communicating. (Loring, et al 2011)
PECS (PICTURE EXCHANGE COMMUNICATION SYSTEM)
PECS is an augmentative and alternative communication (AAC) system. AAC systems are used to help individuals who do not have typical verbal skills to communicate with others. PECS is a behavior-based intervention that teaches the learner to use visual-graphic symbols to communicate with others. (Sam 2015) PECS is a six-phase process. In phase one, the child learns to exchange the picture for a desired item or activity. Phase two: the child becomes more comfortable using the PECS and can use it throughout the natural setting, including with siblings and peers. During phase three, the child can discriminate and choose between two or more pictures. Phase four: the child begins to use two picture cards to make simple sentences. For instance, “I want…pizza.” During phase five, the child can respond to the question “What do you want?” by creating a simple sentence with their strips “I want…” followed by a picture. Lastly in phase six, the child expands their sentence structure to “I see…” and uses the system to initiate conversation with others. (IRIS Center 2016) The IRIS Center also describes PECS as a type of AAC in which children and youth with limited verbal skills learn to communicate and interact with others through the exchange or presentation of visual cues.
PEER MODELING
While adults, parents and teachers model language and speech for ASD students, it is not as impactful as peer modeling. Research showed an improvement in social skills and language development of ASD students when tutored by peers. (Alshurman et al 2015) Children’s language develops through interactions with more knowledgeable peers. When you model more complex language, children start to imitate and learn the syntax of language. (Kosanovich et al 2020) Peer modeling is best experienced in the natural setting, play time, small group settings, transitions, and social settings (free time or recess). When utilizing peer modeling in the natural setting it allows for more opportunities to practice communication patterns, how to ask for help, identifying and expressing feelings appropriately and overall social development, which most ASD students struggle with. It is not enough to only model language for children’s language to grow. You must also talk with children and provide opportunities for them to talk as much as possible. (Alshurman et al 2015)
CONCLUSION
Communication is a vital component to a successful life. It is used to express emotions, wants, and needs. Communication is essential in learning and growing academically and socially. It is how relationships are developed and maintained, and how academic information is obtained and implemented. As noted by the data from these studies and personal experience teaching students with ASD, early implementation of these strategies to assist non-verbal ASD students can reduce frustration and increase social confidence and even more, further academic growth and knowledge.
REFERENCES
Alshurman, W. & Alsreaa, I. (2015) The Efficiency of Peer Teaching of Developing NonVerbal Communication to Children with Autism Spectrum Disorder (ASD). Journal of Education and Practice, Vol 6 n29 p 33-38
Kosanovich, M., Phillips, B., & Willis, K. (2020). Professional Learning Community: Emergent Literacy: Participant Guide—Module 4: Oral Language (Sessions 10–12) (REL 2021-045). Washington, DC: U.S. Department of Education, Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance, Regional Educational Laboratory Southeast. Retrieved from http://ies.ed.gov/ncee/edlabs.
Loring, W., & Hamilton, M. (2011) Visual Supports and Autism. Treatment and Research Institute for Autism Spectrum Disorders (TRIAD) www.autismspeaks.org
National Autism Association. (2023) Autism FACT SHEET. https://nationalautismassociation.org/resources/autism-fact-sheet/
Sam, A., & AFIRM Team. (2015). Picture exchange communication system. Chapel Hill, NC:National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from afirm.fpg.unc.edu/picture-exchange- communication-system
Sam, A., & AFIRM Team. (2015). Visual supports. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/visual-supports
The IRIS Center. (2016). Autism spectrum disorder (part 2): Evidence-based practices. Retrieved from iris.peabody.vanderbilt.edu/module/asd2/
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