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Social Communication: Initiating is as Important as Responding


Many students with ASD and verbal challenges are taught to communicate using a variety of augmentative or alternative communication systems to supplement any speech they do have. These systems can include sign language, picture symbols (such as PECS), low-tech voice output devices (Big-Mac recording devices), or computer-based electronic voice output devices (iPad with Proloquo2Go, Vantage, Dynavox’s V, etc.).

Regardless of which system a student is using (including any speech), teams are encouraged to think about how the child will initiate requests and social interactions. Too often, students with verbal challenges who use augmentative communication systems learn to use their system only in response to a question from someone else (e.g., “What do you want?”), and fail to understand that they can use their system to get social attention, to initiate greetings, to ask questions, or to make requests without waiting to be asked.

This month’s tip will provide a few ideas for creating opportunities that will stimulate a child to use their communication system to initiate.

Set up routines in which the expected behaviour is to initiate.

For example, have the student take the attendance down to the office with his communication system. Have him greet the secretary: ”Hi, Mrs. Jones. Here’s the attendance.” (A Big Mac switch can be used to record this message.) Teach the secretary to wait until she hears the message before she responds to the student.

Set up situations to tempt communication.

For example, give the child something he wants in a difficult to open container. Make sure he has a communication system available that can allow him to ask for help: “I need help, please”. Or leave a necessary item out of a routine, e.g., provide the yogurt, but not the spoon. Make sure he has the appropriate vocabulary available to request: “I need a spoon, please.” or “Where’s my spoon?” You can also give the child just a little of anything he requests, providing an opportunity for him to practice using the system to ask for more: “I want more, please.” or “Let’s do that again!”

Whenever you want the student to initiate, it is very important to be aware of the prompts you provide.

In the long run, we want the child to know he can initiate communication without being directly told what to say or when to say it. In other words, we want him to respond to natural cues in the environment. It’s critical to provide “wait time” in the situations you set up to teach initiation. Once the child is taught the expected response (e.g., hitting the Big Mac switch to initiate a greeting), the individuals supporting the student need to provide prompting in a “least to most” fashion. Ensure the communication system is available and set up the situation. Wait expectantly. If the child does not initiate, gesture towards the communication system or device. Wait expectantly. If the child still does not initiate, gesture towards the system again and provide a generic verbal prompt e.g. What do you need to say? Wait expectantly. You can model the expected response and/or provide hand over hand support only when lesser forms of prompting have failed to elicit the expected communication.
For more information on developing communicative initiations in children with ASD the reader may wish to check out the following resources:

The TEACCH Approach to Autism Spectrum Disorders (Issues in Clinical Child Psychology S) 2004th Edition
Teaching Children with Autism: Strategies for Initiating Positive Interactions and Improving Learning Opportunities 1st Edition

The webcast, A Clear Picture: The Use and Benefits of PECS , provides information on the picture exchange communication system designed to teach functional communication with a focus on
initiation: http://www.pecs.com/webcasts/overview.php
The manual for PECS is an important teaching resource for teams using this system.

Websites that support specific augmentative communication devices also provide good information. A downloadable handout from DynaVox called “Chain of Cues” provides a helpful summary of the least to most prompting hierarchy:

http://tdvox.web-downloads.s3.amazonaws.com/MyTobiiDynavox/dagg%202%20-%20writable.pdf .