Effective communication is a key that opens doors for children with autism. When kids can communicate their wants, needs and preferences, dangerous behavior and frustration tend to decline, says Molly Scott, a Board Certified Behavior Analyst and Assistant Clinical Director with Gateway Pediatric Therapy in Grosse Pointe Woods, one of 13 Gateway locations in Michigan.
Not all children with autism spectrum disorder can access verbal communication, but many can learn to communicate using alternative augmentative communication (AAC). “AAC is basically a means of communication,” says Scott. “For individuals who are unable to communicate using vocal speech, AAC provides them with a voice to get their wants and needs met.”
There are many types of AAC. “A common method is sign using American Sign Language, and while ASL is an option, it’s not easily understood by every listener,” she says. To communicate, children would need to seek out those with training in ASL.
A second type of AAC is Picture Exchange Communication System (PECS). “This is a low-tech option that looks like a small binder with different icons of preferred activities, people, locations, items, food and snacks. They’re sorted into categories and we teach children to take out the picture of the item they want and hand it to a caregiver or listener to get those needs met,” explains Scott.
A higher-tech version of PECS uses a tablet or other device in conjunction with an app. “This can have hundreds of icons on it and different pages to scroll through. It also includes a keyboard to type a message and even pre-made buttons that say ‘I want’ or ‘I need’ or ‘help,’” says Scott.
Commonly used apps are Proloquo and LAMP Words for Life, which are similar functionally, Scott says. Typically, apps can be tailored to the individual and start out with just a few icons and increase as the child develops skills.
In ABA therapy, kids also learn AAC combinations, for instance, using a device combined with pointing to the desired object. An AAC can also be used with children with difficult-to-understand speech. “Parents may understand their children and can even anticipate their wants and needs, but if they go to school and the listener can’t figure out what they are saying, with an AAC they can get their needs met, too,” Scott says.
Importance of effective communication
Sometimes parents are concerned that using an AAC can deter children from learning vocal communication, but the opposite is actually true, Scott says.
“Research shows that a communication device or other means of AAC can actually lead to vocal speech. For example, through the use of PECS, once a learner can make picture exchanges with an adult and we are also working on vocalizations separately, we can marry the two skills,” she says. “We can encourage the child to emit vocalization while making the exchange.”
For every child, effective communication is a matter of safety. In an emergency situation, will a child be able to provide answers to get them to safety? Will they be able to report if someone hurts them or if they witness danger?
“For many families, the ultimate goal is for their child to have verbal communication,” Scott says. “We are honest and transparent that the use of an AAC comes down to client safety.”
For many kids on the autism spectrum, effective communication can be life changing. “Some apps can even be customized to have a voice that matches your child,” Scott says. “I worked with a child who had a buddy who was verbal, so he used his voice to record the buttons and that was really nice.”
Gateway Pediatric Therapy offers best-in-class ABA therapy services at 13 locations in Michigan. Learn more at gatewaypediatrictherapy.com.