Evidence-Based Practices for Effective Communication and Social Intervention
Contributed by Kristie Brown Lofland, MS, CCC-A
Differences in communication are the hallmark for individuals on the Autism Spectrum (ASD). These differences in communication and language development include absence or delay in spoken language, impairment in conversational abilities, stereotyped and repetitive language, inappropriate use of pronouns, and difficulties with play and imitation. Some students with ASD will have a specific language impairment. Others may have limited comprehension in verbal and gestural forms of communication. In addition, some individuals will exhibit difficulty in generalization. The National Professional Development Center for Autism Spectrum Disorders has identified 24 evidence-based practices that have proven effective in educating students on the autism spectrum. Many of those evidence-based practices can be utilized when addressing communication and social issues.
Practices for promoting social and communication/language skills for individuals with ASD are as follows:
• Discrete Trial Teaching (DTT)*: is a one-to-one instructional approach used to teach skills in a planned, controlled, and systematic manner. It is used when a learner needs to learn a skill best taught in small repeated steps.
• Functional Communication Training (FCT)*: FCT is used to decrease the incidence of interfering behaviors and to those behaviors with clearer communicative forms. Children with ASD are taught alternative ways to communicate that serve the same function as the interfering behavior.
• Imitation and Modeling: Imitation and modeling are prerequisite skills for the development of various skills including communication.
• Joint Action Routine (JAR)*: JAR is a strategy used to encourage communication skills. Following a predictable and logical sequence of events, the activity relies on routine verbal exchanges by those involved.
• Naturalistic Language Strategies*: Naturalistic Language Strategies are child-centered and take place during naturally occurring routines and activities. The approach promotes communication and language development through environmental arrangement, responsive communication partners, and prompting, modeling, and reinforcement.
• Social Narratives*: Social narratives are interventions that describe social situations in some detail by highlighting relevant cues, and offering examples of appropriate responding.
• Peer Mediated Instruction and Intervention (PMII)*: PMII teaches peers to interact and support students with ASD in acquiring new social skills in natural environments.
• Picture Exchange Communication System (PECS)*: PECS is a behaviorally based, alternative communication system based on the principals of Applied Behavior Analysis (ABA) and B.F.Skinner’s Verbal Behavior. PECS teaches the child to become an initiator of communication by exchanging a picture symbol for a desired object, etc.
• Pivotal Response Training (PRT)*: PRT uses the principals of ABA. PRT is effective for developing communication, language, play, and social skills. Interventions enhance 4 pivotal skills: motivation, responding to multiple cues, self-management, and self-initiations.
• Video Modeling (VM)*: VM is a mode of teaching that uses video recording and display equipment to provide a visual model of the targeted behavior or skill.
• Voice Output Communication Aids (VOCA)*: VOCAs are portable electronic devices that provide computer generated or digitized speech output.
Many individuals with ASD develop verbal language; however, the skills needed to sustain conversation with others are often impaired. Elements of conversation include turn-taking, choosing appropriate topics, and perspective taking. The evidence-based practices (EBP) that help promote conversation skills include naturalistic language strategies, social narratives, and video modeling.
Individuals with ASD often use spoken language in non-communicative ways including repetitive language, echolalia, or idiosyncratic language. EBPs that may help promote appropriate language use include functional communication training, Picture Exchange Communication System (PECS), and Voice Output Communication Aids (VOCA).
In order to have conversational skills, we need to have reciprocity. Reciprocity describes the back-and-forth exchanges that comprise social interaction. Individuals with ASD have difficulty with reciprocity. Practices that may be helpful in promoting reciprocity include imitation and modeling, joint action routines, naturalistic language strategies, Peer Mediated Instruction and Intervention (PMII), Pivotal Response Intervention (PRT), social narratives, and video modeling. For more detailed information on these evidence-based practices, visit the NPDC website at http://autismpdc.fpg.unc.edu/.
American Speech-Language-Hearing Association. (2006c). Roles and responsibilities of speech-language pathologists in diagnosis, assessment, and treatment of autism spectrum disorders across the life span: Position statement. Available from http://www.asha.org/policy.