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FUNCTIONAL COMMUNICATION
Evaluation and Support
Geni Moots Plotnick, M.A., SLP / Regional Autism Specialist SOESD
Geni_Moots-Plotnick@soesd.k12.or.us
Today
• Defining Functional Communication
• Evaluation Components
• Characteristic of ASD?
• Goal-Setting
• Service
SLP Opportunities….
• Team collaboration to determine eligibility
• IEP Crafting
• Direct Service for Communication,
Social Cognition and Behavior
• Train, rehearse, facilitate generalization
• Consultation to parents and staff and
peers
-analysis -modeling -graphic supports
ASHA SAYS:
“ Due to the pervasive nature of social
communication impairment,
individuals with ASD should be
eligible for services from a
speech/language pathologist.”
www.asha.org/docs/html/GL2006-0049.html
The ASD Story
• Prevelance 1/150 or higher
• Neurologic disorder of perception and
thought
• Etiology?? Genetic predisposition with
biochemical insult triggers??
• Can reliably be diagnosed as early as 18
months by experienced diagnosticians
ASD
• COMMUNICATION
• SOCIAL
• SENSORY PROCESSING
• PATTENRS OF BEHAVIOR / INTEREST
Social Competence, Independence,
Self-Regulation
ELIGIBILITY COMPONENTS
• Developmental history/
Parent interview
• File Review
• Observations
• Direct Interaction
• Medical Statement
• Assessment of Educ
• Impact
• Behavioral Rating Scales
TOOLS
• Adult reporting • Orchestrated or
• Checklists Analog Interactions
• Student Interview • Peer Probes
• Observations • Developmental
• Rating Scales comparisons
• Standardized • FBA
Assessments • Sampling/Analysis
1. Social Communication
• Orienting
• Shared focus and emotion
• Reciprocity-initiating bids to
interact/maintain
• Considering partners‟s communications
• Rapid shifting of attention (can they do it?)
2. Language and Cognition
• Comprehension
• Verbal skills
• Nonverbal comprehension and expression
• Symbolic play
• Literacy
• Executive Functioning (problem-solving,
planning, organization, flexibility)
3. Behavior and Emotion
• Assist team in acknowledging relationship
between challenging behavior and
communication
• Regulating self in midst of bombarding
environment and/or social challenges
• Express a variety of recognizable
emotions
• Recognize and respond to emotions of
others
4. Augmentative/Assistive
Technology
• Recognition of,response to, use of various
tools and symbols
(object, photo, drawing, print etc)
• Potentially augment input / output
5. Contextual Engineering
• Visual support and structure
-picture schedules and work systems
-social stories and scripts
Self-determination/advocacy tools;
individuals w/ASD seem to have been
taught to depend on
excessive prompting from others.
What‟s In Place?
Find and describe the embedded supports
that are in place…those that seem to be
working
for the individual.
• Fitting adult communication style
• Assistive Technology (high or low tech)
• Augmentative Communication (high or low
tech)
• Contextual Engineering (organization, clarity
of room, schedules)
Watch carefully!
Standardized Assessment
Receptive / Expressive Levels usually
based upon individual‟s response to
graphic stimuli or adult action. Tests
assess knowledge better
than performance which involves rapid,
multi-modal processing and response.
FORM appear adequate but socially-
based USE (requiring
inference and prediction) may be skewed.
Evaluating Communication
Development
*CHAT *PPVT/EOWPVT
*PLS *CELF
*Social Comm *Test of Narrative
Language
Questionnaire *Test of Lang Competence
Evidenced-Based Assessment Studies by
1) Sally Ozonoff and 2) Geralyn Timler 3) ASHA report
ADOS (autism diagnostic observation schedule)
LANGUAGE AND SOCIAL
COMMUNICATION (what we do to stay
(How we take in or connected)
put out language)
-Comprehension -Quality of rapport
-Offering information -Shared enjoyment
-Reporting events -Joint attention
-Use of body -Shared gaze/focus
-Frequency of bids directed -Balance
to others -Repair
Social Development
Ages 1-3 interactions with caregivers and
proximal, parallel play with peers
Ages 3-5 mutual engagement in play
activities.
Preschool play is an avenue for fantasy
-lost/found -danger/rescue -death/rebirth
Heavy demands on perspective-taking,
negotiation, roles, agree, disagree etc.
Intermed.Great sensitivity. Need to avoid
rejection. Use gossip, teasing, negative
evaluation
M.S. Need more than group exceptance;
need close relationship with other(s) as
transfer parent-child bond
H.S. Desire personal intimacy, self-
disclosure, trust, commitment
Social Competence
Abilility to relate effectively to people
Ability to be accepted by others (Guay ’93)
• SKILLS
• INTERACTIONS
• RELATIONSHIPS and FRIENDSHIPS
•Evaluating Social Competence
• Test of Problem Solving?
• Test of Pragmatic Language?
• CELF-IV Pragmatic Language subtest?
Must have additional venues to assess the
demands of authentic, spontaneous
(unscripted) interpersonal communication.
The „Album‟ vs. the „Snapshot‟
CONTEXTS PARTNERS
• Quiet simple space
• Free choice • 1-1 w/familiar adult
• Playground /break • 1-1 w/unfamiliar adult
• Cafeteria • w/peer in familiar setting
• As group member • w/small group
responding to teacher • w/parent
• instruction
• New / unexpected /
upsetting events
Differential Diagnosis
Co-occurrence with other physical, learning
and/or mental health disorders is common.
Scattered ASD traits may be indicative of
other disorders rather than fulfilling an
ASD
picture. As a team member specializing in
communication and social development it
is critical that SLPs be knowledgeable.
PLAY ANYONE??
Research supports that ASD-to-NTD
children displayed comparable use of
communication to -request -protest -
engage in constructive play
-engage in nonsocial constructive play
(puzzles)
LESS use of social gaze, social
responsiveness, shared affect, gestures,
joint attention, symbolic/make-believe play
SHARING
SPACE
TURNS
JOINT ATTENTION
EMOTION/AFFECT
-JOY -ANTICIPATION -DISAPPOINTMENT
ACTIVITY/MOVEMENT
OBJECTS
TALK
MOST CRITICAL
Geralyn Timler, U Baltimore
• PEER ENTRY
-persistance (typical average=10 tries)
-flexibility (need 3 strategies/alernates)
-relevance („off-topic‟=penalty)
• Sustaining and maintaining collaboration
• Conflict Resolution
• Replace penalizing behaviors
Atypical Social Behaviors
Lead to…….
• NEGLECT = • REJECTION =
-solitary play -Hostility
-hover and wait -Aggressiveness
-non-responsiveness -Self-focused
-irrelevant behavior or -Superiority
talk -Defensiveness
-adult dependency
SAMPLES AND ANALYSIS
Most Common Communicative
FUNCTIONS for
• To obtain desired objects
• To obtain desired actions
-do this -go away -stop this
• Verify facts (encyclopedia/dictionary/rules)
• Complete scripted loops (reduce anxiety)
Intent of Vocal/Verbalizations?
Two? One is the loneliest #...
• Reciprocity and • Self-guidance
Balance • Script stimming
• Referencing • Rule review
• Persistence/Repair
• Proximity and
Orientation
Talk is Overrated
We can teach and learn articulation,
grammar and expression
However…….
Words are neither social
nor communicative
without a partner.
Key Probes for FC Evals:
How does Student Student Output =
……..
• Freq of Initiations
-use peers as • Rate of Responses
teaching/learning bud?
-as a source of • Verbal
pleasure? • Nonverbal (action,
-initiate / enter ? gesture, expression)
-maintain and repair?
The Student‟s Partners
PEERS ADULTS
1-1, Small/ Large Group Parent(s)
Sibling(s)
Familiar Routine Teacher
Setting
Initiations Paraeducator
Responses
Balance
HOW WE TALK
Considering how adult
communication influences atypical
language and thought
Interaction / Interview
Younger / More Fragile
Give some time w/objects alone first
Use Communicative Temptations
Engage in imaginative 2-role skits w/props
Have class photos
Play w/ only two (identical) objects
Play with only two (lock-key) objects
Use of more phatives may encourage more
S talk
Communicative Temptations
Wetherby, Prutting, Prizant
Ways to engage a reluctant
communicator –
1.Create a problem that requires comm
2.Make a statement (non-
confrontational)
3.Set forth a complaint or puzzle (to
self)
4. Request information (“I want to
hear..”)
Older / More Competent
• Sit side-by-side vs. across table
• Avoid question strings
• Watch at lunch/break
• Leave pauses and voids
• Disagree or surprise at least once (act like a
peer!)
• Peruse yearbook
• Refer to ADOS / RDI interview ideas
• Seek assistance “I don‟t know where the library
is”
• May bring a peer (part-time?)
Input from General Educators
• Teacher Survey:
“__is being evaluated for ASD. We are
looking as strengths and challenges in the
areas of
social/communication skills, unusual
behaviors and interests. Given this focus,
please send a brief description of this
student from your perspective. Specific
events you recall will be helpful but are not
necessary. Thank you!”
Potential Inhibitors
• INSTRUMENTAL • Student as
-getting needs met RESPONDENT
-passivity
vs -compliance
-focus on performance
• SOCIAL Vs.
-pleasurable interaction • RECIPRICAL PARTNER
-interactive
-connected
-initiating
So, we will need to
answer……………
are the social and communication
behaviors characteristic of ASD
??
IMPACT ON EDUCATION
• Comprehension • Expression
-vocab -intelligibility and prosody
-following directions -relevance and range
-of verbal/nonverbal -clarity and repair
-use of body/face
• Processing -quantity and organization
-Orientation
-Shifting attention/thought • Connection w/Peers as
-Cognitive Flexibility -playmates/buddies
-learning partners
The SLP, The FCE and
Curriculum
Advocate for careful evaluation and „filling the
gaps.‟ As splinter skills are so prevalent in the
neuro-atypical population, make sure core
understanding is present. As these individuals
often „learn‟ structured, visual skills such as
reading/math it is easy to move forth using
grade-level benchmarks.
Math (BOEHM space/quantity/time using
realia,reality)
Reading: Comp=MORE than recall! Check social
savvy of inference and prediction.Don‟t let
fluency go beyond authentic comp! Vary genres
at all levels.
Impact=Access and
Participation
• Orienting and Attending to environment
and
• main event or speaker(s)
• Executive Functioning/goal-directed
behavior
• -Problem solving /self planning
(variables/options/persistence)
• -Initiation and Momentum
(stop/start/inhibit)
If eligible, then the goals…
Should reflect:
1) The child
2) The core of the disability
-present impact
-projected impact
SLP can assist casemanager in crafting these
Key Considerations
• Language Processing and Comprehension
• Functional, spontaneous communication
• Play and Leisure
• Social Interaction and Relationships
across settings
• Self-Regulation / Self-Advocacy
• Functional academic skills
NCLB/Evidenced-Based
Practice
focus on Autism and other DD Vol 20#3
*Individualizes supports and services –
intensity and level based upon
strengths/weaknesses
*Systematic Instruction-desirable outcomes
*Specific Content –must include and
emphasize language and social interaction
(as primary)
*Functional Approach to Problem Behavior-
away from punishment/compliance to
useful skill development
Getting Started
• Replace most penalizing behaviors
• Start and maintaing interaction
• To support:
-remain aware of own difficulties
-practice ways to overcome these
-apply to activities w/peers
Goal Priorities for ASD
• Socio-Relational
Communication/reciprocity
• Independence; freedom from constant
verbal prompting by adults
• Cognitive Flexibility
• Self-Regulation and Self-Advocacy: (know
self and use support
systems/communicate)
• Problem Solving (beyond math!)
ADJUSTING THE IMAGE
• Great planning and support tool.
Willamette ESD and Columbia Regional Programs
gford@pps.k12.or.us
• Beg / Inter /Adv:
• Play and Leisure
• Self-Advocacy
• Relationships
INCREASE
• FREQUENCY OF INITIATION
• FREQUENCY OF RESPONSE
• MAINTAINANCE OF INTERACTION
• VARIETY AND RANGE OF PARTNERS
PLAY TO ASD STRENGTHS
• Memory for information
(rules, scripts, people info)
• Visual Strengths
• Reading Fluency
SPECIALIZED INSTRUCTION
SKILLS / APPLICATION/
KNOWLEDGE PRACTICE
-scripts and rules -adding in bits of „reality‟
(Do/Watch/Say/Listen, -partners who are not (as
Hidden Curriculum, social stories)
kind or predictable as)
-contextual variations adults
for scrips/rules
-dyads/small groups/
-gathering personal
classroom
information about
generalization
others (people files)
-collaborate=talk
-cooperate=action
SLP Role in Behavioral
Supports
FBA (mini or maxi) used to construct:
-Prevention strategies
(environment/tasks/visual supports)
-Graduated rehearsal replacement skills
-Reinforcement
Classroom Trainings - Elem
„I study how students learn, play and talk
with one another.”
“Tell me what YOU do” (call on individuals)
“Tell me about (point to a peer) SHE does.”
“Now tell me about, hmm,Fred. Oh, he‟s not
here.”
“I‟m interested in this.” (make notes)
List student ideas, and yours. Role play.
List.
Buddy Sign Ups
• Create choice board
• Recess -teach specific game skill or
assign „buddy task‟ (collections,
inventories etc)
• Role play / rehearse. Have teacher, staff
note
and give positive reinforcement to peer.
• Take / send home photo 1x/wk
• Assign one student to a role for 1
Hints for young Buddies….
TELL. Happily give the play idea. “Come
on!”
DO. Move quickly. “Here, let‟s____”)
GIVE. Give a roll (“You be__” “You hold__”)
PERSIST. “We‟re gonna do it once more.”
TRANSITION PLANNING
Self-reflection and projection/imagination are
difficult for individuals with ASD
• Long-term goals
• Nature of disability
• Public services
• Family and community supports
“WHO ya gonna call on?”
Adolescents
• In addition to understanding and
implementing “The Hidden Curriculum”
(Smith-Myles)…
• Keep monitoring/attending to ADAPTIVE
skills that are often discrepant
• Self-Determination is critical. Teens have
a right to know about themselves, about
their rights.
PROJECT TO THE FUTURE…
Personal Health / Employability
“…humans need social interaction and input
such as companionship and acceptance to
obtain and sustain physical and mental
well-being”.
Acceptance= extent to which one is liked
Friendship=mutual liking between two
individuals
Ziggurat Model
Barry Grossman and Ruth Aspie
TASKS
MODIFICATIONS AND ACCOMODATIONS
VISUAL SUPPORTS
REINFORCEMENT
BIOL / COG / SENSORY ISSUES
