Presented by Vicky Roy, Ph.D. CCC-SLP and Amy Cameron, MA.CCC-SLP Strategies for facilitating spontaneous communication with students diagnosed with autism. Presented by Vicky Roy, Ph.D. CCC-SLP and Amy Cameron, MA.CCC-SLP Mid-South Autism Conference, Memphis, TN April 1, 2017

Amy Cameron, MA, CCC-SP Vicky Roy, PhD, CCC-SP Amy Cameron, MA, CCC-SP has been a Speech-Language Pathologist for over 25 years, specializing in Autism Spectrum Disorders. Amy is the owner of Pathways Treatment Center near Raleigh, NC. Amy is a Core Specialist in the Masgutova Neuro-Sensory-Motor Reflex Integration (MNRI) Program, and a Certified Relationship Development Intervention (RDI) Consultant. Vicky Roy, PhD, CCC-SP is a Speech-Language Pathologist has over a decade of specialized experience working with children with neurological and developmental difficulties. She graduated from UNC-Chapel Hill with a Doctorate in language and literacy. She is co-owner of Dynamic Therapy Specialists, LLC in Baton Rouge, LA. Vicky is an MNRI Core Specialist and a Certified RDI Consultant

Objectives Participants will: Better understand the process that leads to prompt dependency in nonverbal, low verbal, and “response only” verbal students. Recognize the importance of their own communication use and the impact that it has on the communication of their students. Learn three specific strategies to facilitate spontaneous, independent contributions during reciprocal communication with their students.

Traditional Communication Therapy Goals Focus on: Requesting Labeling Following Directions Responding

Clinical Practice: Areas of concern Prompt Dependency Limited Spontaneous Communication Limited Reciprocity

How did we get here? Language and Cognition are inter-related The majority of what is SAID to many children with the label of autism is in an attempt to GET the child to respond, not to allow the child to generate their own input. Focus on isolated, measurable goals Imperative (Directive) Communication vs. Declarative (Experience Sharing) Communication

Static VS Dynamic Communication Measurable Reliable Logical Predictable Rule based Facts Rules Contextually dependent Unclear Grey areas Integrated Evolving Emotional Collaborative

Abilities included in reciprocal communication Engagement Competency Attention/focus Experience matching Curiosity Tolerance for breakdowns/repairing Social referencing Reading context Understanding Inhibition Ideation Formulation Auditory processing Articulation Co-regulation Co-ordination Collaboration Self Regulation

TRUE Reciprocal Conversation Joint attention Mutual topic with central coherence (ability to derive overall meaning from a mass of details) An unspoken “agreement” on the topic with flexibility around novel ideas Individual contributions that are unique and related and integrated with partner’s ideas Back and forth participation, timing, monitoring, adjusting and repairing Shifting attention based on the movement of the conversation Ability to integrate all of the above

Communicative Intent The purpose or meaning behind why people are communicating with others The “why” behind communication, language functions What kind of communicative environment are we creating? People with Special Needs, especially individuals with Autism Spectrum Disorders often have limited communicative intent More importantly, these same students are exposed to limited communicative intent (Primary purpose for communicating with a student with autism is to GET…)

Why? As a Speaker, we expect and rely on feedback from our Listener. So much so that when we do not receive it, we will “make it easier” for the child by using Questions, Commands and Prompts. We create an “imperative environment”. We facilitate a dependency on prompting.

Recognize Your Intent Keep the goal in mind, Be aware that what you say is influencing the BRAIN Expect your job to be challenging because you might receive little feedback initially Declarative vs Imperative Getting something vs creating opportunity Directing vs Communicating/Collaborating

Directive/Imperative Communication Questions with definite answers Commands with actions that can be deemed “right or wrong” Prompts or fill in the blank statements All require minimal thought and input from the Listener All have the intent of GETTING the child to respond

Experience Sharing/Declarative Communication Early communication functions that are non-directive are things like: Making actual choices Expressing opinions Calling for attention Noticing things Commenting

Take an assessment of YOUR communication What is the child doing? What are YOU doing? How is your language impacting the child’s opportunity to grow as a reciprocal communicator How are you feeling about this interaction – check your own regulation

Systematic Opportunities Must have systematic opportunities for STUDENTS to make progress as thinkers How to think vs How to know

Strategy #1 Identify a time frame or a specific activity where you will practice creating thinking and sharing opportunities for your students What percentage of the child’s day can be devoted to thinking opportunities?

Strategy #2 Decrease the amount of talking, specifically the amount of questions and commands you use. By asking a questions and giving commands, you ONLY provide an opportunity for your students to RESPOND. Comment, think out loud, invite, notice, share, expand, make real decisions

Strategy #3 SLOW DOWN Give your child time to think, organize themselves and make a contribution. Pause for a minimum of 5 seconds before scaffolding, repeating, or rephrasing. Use the “anticipatory gaze” and “pregnant pausing”

Implications for Future Research

Thank You! Amy Cameron, MS, CCC-SLP Pathways Treatment Center Apex, NC www.pathwaystreatmentcenter.org AECameron@aol.com Vicky Poston Roy, PhD, CCC-SLP Interactive Communication, LLC Baton Rouge LA, 70809 www.interactivecommunicationbr.com vposton22@gmail.com vickyroy@dtsbr.com