Assistive Communication Devices for Children with Autism
If you are wondering, “How can assistive technology help a child with autism?” you are not alone. Using different types of alternative forms of communication for autism has been proven to improve communication outcomes in children with language delays. The benefits of assistive technology for autism are widely recognized by speech-language pathologists. This article will explore augmentative and alternative communication methods for autism, assistive technology for students with autism, and communication devices for autism to help you find one that will work best for your child’s needs.
Communication issues and autism
Communication issues are one of the first signs of autism spectrum disorder (ASD). Autism covers a spectrum of challenges; each child can present communication issues differently. Some children might have a large vocabulary and learn to read at a young age. This same child might also struggle to contextualize what they have read. Answering who, what, where, when, why, and how questions could present a huge challenge. Other children may be able to carry conversations but struggle with non-verbal communication.
Gestures, facial expressions, and body language might be particularly hard to read. And then some children with autism may be entirely non-verbal.
The Diagnostic and Statistical Manual of Mental Disorders v.5 (DSM-5) determines the criteria for ASD. The first criterion is listed as:
“A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text):
- Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
- Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
- Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.”
The National Institute of Deafness and Other Communication Disorders (NIDCD), states that children with autism generally display one of the following patterns of language and use of behaviors: (“Autism Spectrum Disorder: Communication Problems in Children,” 2017)
Repetitive or rigid language
- Sing-song tone, robot-like, or high pitched speech
- Responding to questions with questions
- Narrow interests and exceptional abilities
- Delivering in-depth monologues about a topic that holds their interest
- Inability to hold a two-way conversation about the same topic
Uneven language development
- May develop a strong vocabulary in a particular area of interest very quickly
- May be able to read words before age five but may not comprehend what they have read
- Often do not respond to the speech of others and may not respond to their names
Poor nonverbal conversation skills
- Unable to use gestures—such as pointing to an object—to give meaning to their speech
- Avoid eye contact
Another child may be entirely non-verbal. According to Bev Long of the Diagnostic Center of Central California, “As many as 50% of individuals with autism are non-verbal, and up to 80% are intellectually challenged.” (Long)
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The success of assistive communication devices and strategies
A variety of assistive communication devices and strategies have proven successful in assisting many children develop methods of communicating and even speech. These devices are usually prescribed by a speech-language pathologist and are a part of augmentative and alternative communication interventions (AAC).
This comprehensive research summary by Débora R. P. Nunes for the International Journal of Special Education discusses 56 studies that took place from 1980-2007. Nunes concludes:
“Some of the advantages of using sign language included (a) its portability; (b) its characteristic of being a true language system and, (c) the possibility of communication occurring at a faster pace. Among the positive aspects of using a visual-graphic system were: (a) its iconicity; (b) its nontransient nature; and (c) the limited motor requirements for its use. SGDs were considered advantageous for (a) they allowed communication to occur at larger distances; (b) they permitted messages to be easily deciphered, and (c) required limited cognitive and motor demands.” (Nunes, 2008).
In an article written by speech-language pathologist Jessica Lenden-Holt and special education teacher Forrest Holt, two case studies of high school aged teenagers with autismare reviewed. These teenagers were given instruction on high-tech communication devices for the first time, three times a week for an hour each session. Both students were able to use their devices to communicate their needs and give spontaneous answers and utterances. Additionally, this article proves high school students have not necessarily met their full language potential by their teenage years, and the appropriate AAC interventions can help them improve and develop communication skills. (Holt, 2017).
Available assistive communication devices and strategies
A variety of assistive communication devices and strategies are available. The most commonly used devices and strategies are:
- Visual boards
- Picture exchange communication system (PECS)
- Sign language
- Low technology interventions
- High technology electronic devices
Visual boards help children with autism express their preferences and emotions. They also help children understand rules and schedules. Visual boards usually consist of a series of pictures children can point to or arrange in order. Visual boards can grow with your child’s skill level. As he/she learns you can adjust the board to include more complex images. Often times, images are attached to the board with Velcro or other adhesives so children can arrange them into their desired schedule or place the appropriate image after a question (e.g., What do you want to eat?).
Picture Exchange Communication System
PECS are broken down into six progressive phases:
- How to communicate
- Distance and persistence
- Picture discrimination
- Sentence structure
- Responsive requesting
These buildable skills teach functional communication and even help some children develop speech. Children begin at stage one by showing their partner a picture of something they desire. Their requests are immediately honored. As students progress, they arrange pictures into sentences. From there, they learn to use modifiers, start conversations, and answer questions. Pictures can be bought in a set or made at home to customize them to your child’s exact needs.
Sign language is a practical and functional way for children with autism to communicate. A variety of communities recognize sign language as a form of language. Children with autism often use Signing Exact English (SEE). SEE follows the speech pattern and sentence structure of spoken English. This makes transferring their signs to speech as their language develops much easier. A variety of methods are available to help a child with autism learn sign language. Flashcards and videos or taking lessons from an instructor are common ways to learn. Visual or tactile learners may pick up sign language easier than auditory learners.
As with all communication methods, different children will do better with different interventions. For some children with autism, gestures can be difficult to associate with language. Other children will more easily connect gestures to phrases and desires. Children with some speech skills might do better with gestures than their nonverbal peers by pairing speech with gestures to fill in gaps of their spoken language. Gestures may be supplementary to sign language or of the child’s invention. It is important for caregivers and parents to be aware of these gestures’ meanings.
Low technology AAC interventions
Low technology AAC interventions are generally “parts of a whole.” These may include the Velcro for visual boards, adaptive writing tools, or manipulatives. Low technology interventions help children use the language skills they already have.
High technology electron devices
High technology electronic devices are rising in popularity as they become more obtainable. These devices can vocalize speech for children who can type or identify pictures. Apps are available for children to try before trying more intricate devices. These devices will not stop children from talking. Many even develop speech after using AAC devices. It is important to note that it may take months or even years for a child to master a device.
How to access the best assistive devices for your child
Choosing the best assistive device for your child can be a daunting task for many families. A great first step is to find a speech-language pathologist (SLP) who connects well with your child. A pediatrician, occupational therapist, psychologist, or psychiatrist can make referrals. Children with individualized education plans (IEP) will have access to a SLP through their school district. The SLP will be able to conduct an AAC evaluation to match your child with the best methods and devices. He/she will take your child’s learning style and skill level into consideration. Rebecca Eisenberg, MS CCC-SLP wrote a comprehensive article on this process. You can find in Autism Parenting Magazine.
As Eisenberg notes, there is a zero reject policy for AAC. Children who need the devices are not rejected based on their abilities. She also notes that private insurance or Medicaid can fund your child’s evaluation. Your child’s school district might also offer funding. Including your child’s teacher in the AAC evaluation can be invaluable. He/she can offer his/her observations to ensure your child’s SLP has a full picture of his/her needs and skills.
Teachers and caregivers need to learn alongside the children with whom they work. The learning curve can be frustrating, but participation is key. Children who have support while learning how to use their AAC device are more likely to succeed. Participating in your child’s sessions with the SLP can ensure you are on the same page as your child. It also puts you in a better position to help him/her during moments of frustration. As children develop better communication skills, they often experience lower levels of frustration. This will lead to them gaining further confidence in their abilities.
N. (2017, December 12). Autism Spectrum Disorder: Communication Problems in Children. Retrieved February 02, 2018, from https://www.nidcd.nih.gov/health/autism-spectrum-disorder-communication-problems-children#3“As many as 50% of individuals with autism are non-verbal and up to 80% are intellectually challenged.”
Long, B. (n.d.). Autism Basics. Retrieved February 02, 2018, from http://www.dcc-cde.ca.gov/af/afbasic.htm
Nunes, D. R. (2008). AAC Interventions for Autism: A Research Summary. International Journal of Special Education, 23(2), 17-26. Retrieved February, 2018, from https://files.eric.ed.gov/fulltext/EJ814395.pdf.
Holt, J. L. (2017, December 01). Has My Child Reached Full Communicative Potential? Retrieved February, 2018, from https://www.autismparentingmagazine.com/has-my-child-reach-full-communicative-potential/
Katherine G. Hobbs is a freelance journalist and university student studying English, with an emphasis on journalism, and psychology. She is interested in the impact of having a special needs child on the family dynamic. Katherine is dedicated to bringing awareness of resources to families and providing help to those who love their autistic children. You can find her online at katherineghobbs.com.
Autism Parenting Magazine tries to deliver honest, unbiased reviews, resources, and advice, but please note that due to the variety of capabilities of people on the spectrum, information cannot be guaranteed by the magazine or its writers. Medical content, including but not limited to, text, graphics, images and other material contained within is never intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician with any questions you may have regarding a medical condition and never disregard professional medical advice or delay in seeking it because of something you have read within.