Communication Intervention

Intervention
Planned Ignoring

Once you have established that there is not a medical reason for the behaviour the first step is to:

Ignore the inappropriate behaviour. (It is important to understand that you are ignoring the behaviour and not the child).
Ignoring the behaviour means not giving any attention to it. This includes even looking in the child’s direction. Giving attention to the behaviour can cause the behaviour to escalate.
Sometimes the behaviour may get worse as the child will try to get your attention by the only means they know. When you do not respond they may try a little harder!!!
Once the child has calmed you can then begin to teach the child to communicate appropriately.

Communication Tools
There are many ways to teach a child to communicate using a variety of methods and tools. The following are some of the most commonly used and effective methods of teaching communication skills to children with autism.

Visual supports
Sign language
Gesture
Reduced language

Visual Supports
Many children with ASD are visual learners. Visual supports can help to encourage basic communication interaction. They are constant and predictable and can help children to understand complex language and social rules by breaking the concepts into smaller more understandable segments of information.

Visual supports should be ideally:

Portable
Easily accessible
Simple to use
An app on a tablet or a folder with symbols/pictures that the child can carry around are ideal. The visual support should also be durable so pictures should be laminated and photographs and symbols on a tablet should be backed up.

Examples of Visual Supports
Basic symbols: allows a child to communicate needs or wants e.g. food, drink, toilet

Choice boards: a variety of pictures on a board gives the child a choice

First-then sequences: helps the child to visualise the concept of ‘first we ___then we____’

Key phrase symbols: ‘I want__’ ‘I see a __’

Daily schedule: helps the child to visualise the sequence of the day and allows some control over what they do

Calendar: helps to prepare the child for any activities outside of the normal routine e.g. Christmas
Task analysis strip: breaks more difficult tasks down into smaller steps that the child can visualise and achieve more easily

Social stories: help to develop self-help skills, explain how to respond to particular social situations and help with change in routine

Reward chart:  used to motivate and encourage the child to do well

Sign Language
Sign language can be a very effective way to encourage non-verbal children with ASD to communicate. Teaching simple signs can help to reduce the pressure and frustration a child feels by not being able to express his needs and wants. Start with basic signs such as:

Yes

No

Eat

Drink

More

Bathroom/toilet

All don/finished

A good sign language program will give you the tools required to take the first step in effective communication.

Gesture
Gestures: Simple gestures such as pointing and nodding for yes or shaking head for no can encourage the child to communicate his needs in a simple way.  The child can learn to gesture by the parent modelling, or in the case of pointing physically prompting him to do so. Present the child with the item so they can see what you are offering.
Ask the child questions that they need to reply to: for example, ‘Do you want a drink? If you know the child wants a drink you can model nodding for them.
If you are unsure of what the child wants give them choices. When they reach for the desired item shape their finger into a point. Do this each time until they starts to point themselves

Reduced Language
Reduced language involves changing the way we speak by reducing the amount of information we are providing the child. Vital information is provided whilst unnecessary link words are eliminated. This will help the child to understand what is being said as they will only have to focus on the key words. For example; ‘Open door’ instead of ‘It’s time to open the door’ or ‘Feet down’ instead of ‘Take your feet off the table’.

Key things to remember when using reduced language
Speak to your child at their level of understanding.
Emphasise the important words to keep attention.
Use objects or pictures where possible to demonstrate what you are speaking about.
Show actions and gestures where appropriate for example show a happy face to demonstrate happy, or drink from a cup to demonstrate drinking.
Always use consistent language, for example, do not use ‘pants’ one day and ‘trousers’ the next.

Behaviour: Crying
Example:

John is non verbal and he has very limited communication skills. He cries a lot.
When John cries his mother offers him a variety of things. John stops crying when he is offered a drink.
The next time John wants something he cries again.
He does this because he knows that he will gain access to what he wants by crying.
The behaviour (crying) is maintained because John has learned that crying gets him what he wants. The crying will continue until John is taught to communicate his needs effectively.

It is important that John learns that crying is not an effective way to get what he wants but communicating appropriately is.
The use of visual cues, basic sign language and gestures can be very successful in teaching a non verbal child like John, how to communicate.

Intervention
Ignore the behaviour (crying)
When John is calm he is offered a choice of items
When he reaches for a drink his finger is shaped into a point
The process is repeated each time John cries for something.
John finally learns that he does not get what he wants by crying but by pointing to it.

Teaching Communication
Children like John can be taught to use

Visual tools such as basic laminated symbols or symbols on a visual support app to communicate their needs. They can also be taught to
Gesture or to use
Sign language
Teach when the child is relaxed
All children learn at different paces so it is important to teach communication skills

At a pace and level that are suitable to the individual child.
Set aside a one to one learning period of up to 15 minutes at a time to teach communication skills.

Initially a child may need to be physically prompted but in time the prompting can be faded out as they become more independent.