When we are called upon to support individuals with Autism Spectrum Disorder, we often find that a key area of focus is communication. Communication can mean many things, and it is not characterized only by what an individual expresses or tries to express verbally. Communication is primarily composed of nonverbal behaviors such as gestures, facial expressions, and body language, and these nonverbal communication behaviors, perhaps more so than what an individual can actually say, moderate the quality and functionality of their communication.
Joint attention is also a vital building block of communication. Joint attention occurs when two people share interest in an object or event at the same time, and there is understanding between the two people that they are interested in the same object or event. For instance, when you point to a big dinosaur in the book and exclaim, “Look at those scary teeth!,” we want the child to look at the dinosaur, and then look to you with similar affect, such as interest or excitement, to share in this social experience. Another example of joint attention is when an adolescent attends to a peer who is telling a funny story, and then the adolescent looks to others in the group to get more information about their reactions to the peer’s story.
We know that many individuals with autism struggle to display these communication and social behaviors. Thus, it is important to focus on the development of these nonverbal behaviors, because they are foundations to communication and socialization. In many cases, the strategies we use to target communication draw from developmental and behavior analytic approaches such as the Early Start Denver Model (ESDM) and Pivotal Response Treatment (PRT). Such approaches hinge on the understanding that the fundamental deficit of social motivation should be addressed through joint activity routines that build reciprocity and sustained engagement with another person. We believe that many of the principles and strategies derived from these models are highly applicable across the lifespan.
Start with what interests the individual
Focusing on these pivotal communication and social behaviors does not mean sitting an individual down at a table for extensive practice drills. Rather, these important communication behaviors are most effectively and appropriately targeted in the context of naturalistic, highly motivating sensory and play- or leisure-based routines that you expand over time. We start with what is interesting and motivating to the individual. For example, if a young learner has an interest in stacking and knocking down blocks, a routine might start like this: 1. Build a block tower, taking turns. 2. You slowly drive a toy car toward the tower, as if you will crash it. 3. Crash the car if the child expresses any sign of interest, such as smiling or looking at you or the car. 4. Repeat the routine, assessing motivation along the way.
Another routine might go like this: 1. The individual is sifting mulch outside, so you do so as well. 2. Then, you lift your hand up, pause and wait to capture attention, and then pour mulch onto the ground again. 3. If the individual shows any signs of interest, try pouring mulch into the individual’s hand. 4. Repeat if the individual shows any motivation to continue. Within such routines, we can begin to create opportunities to target joint attention and communication behaviors because the individual is motivated to communicate. In addition, we are working to add a social component to these primarily sensory-based routines.
The key is to start simple and recognize that with some individuals with autism, we might make very slow, incremental progress. A few more seconds of engagement with the individual or any small sign of interest, such as a glance toward you or the activity, is still progress.
Tips for targeting communication behaviors
Here are a few basic guidelines when targeting communication behaviors within leisure and sensory-based routines:
- Start with the individual’s interests. What does he do in his free time, what materials does he use, and how does he use them? If it’s a train set, start there. If it’s jumping and spinning, start there. If it’s talking about Pokémon, start there. To learn the power of communication, the individual has to be motivated to engage and to communicate something.
- Arrange the environment to control access to highly preferred items or materials so that the individual must communicate with you in some way – not necessarily through words – that she wants the item. Otherwise, if she can freely access the things she wants, what does she need you for?
- If possible, break up delivery of the item or activity into parts, to allow more opportunities to target a nonverbal behavioral request. For example, if the individual is motivated to sift through LEGOs, don’t give him all of the pieces at once. Give a piece or two and then pause and look in anticipation. Immediately reinforce any gesture, look, or action that might mean “I want more” by giving the individual more of the item.
- Once the activity has started, imitate the individual’s actions to capture her attention. Look for any sign of shared affect and engagement, even if it is fleeting.
- Playfully add one action or item to the routine that might interest the individual. Examples might include swirling the string, fingers moving to tickle the child, dropping a figurine into water to create the motivating splash, and singing as the individual jumps on a trampoline. Then after a moment or two, pause, wait, and look in anticipation to see whether the individual expresses any motivation for you to continue or repeat the action. Reinforce any nonverbal communication behavior by immediately continuing the action with lots of enthusiasm. This is how we begin to shape communication behaviors in these motivating contexts and this is how we expand upon an existing routine.
Learn more
Want to learn more about promoting social motivation and enhancing play skills in young children with autism? Join us for the Autism Society of North Carolina’s annual conference March 22-23 in Charlotte and attend the session titled: “Let’s Play! Getting Kids with Autism Engaged.” The ASNC Clinical team will provide practical strategies for parents, teachers, and caregivers to teach play skills and shared attention. Attendees will leave with techniques that can be used at home, school, and beyond. Register online now.
ASNC’s Clinical Department staff is composed of PhD and master’s-level licensed psychologists, Board Certified Behavior Analysts, and former special education teachers. We provide individualized intensive consultation using evidence-based practices to support children and adults across the spectrum in home, school, employment, residential and other community-based contexts. We also deliver workshops to professionals on a wide range of topics including but not limited to, strategies to prevent and respond to challenging behaviors, best practices in early intervention, functional communication training, and evidence-based practices in instruction for K-12 students with autism.
To find out more, contact us at 919-390-7242 or clinical@autismsociety-nc.org.
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