Sarah Choss' More Here Page
AAC & Facilitated Communication with Persons with Autism
Research by Sarah Choss & Sara Cook
CSD823x Augmentative & Alternative Communication
Michigan State University

What are Autism Spectrum Disorders (ASD)?

Autism and Autism spectrum disorder are terms to describe a group of disorders that affect brain development. These can range from an incredibly severe form to a very high functioning form where it is very difficult to tell if someone has ASD. Typically, it is those with more severe forms of ASD who use alternative communication. ASD includes the following disorders: autistic disorder, Rett syndrome, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrom. The following characteristics apply to certain disorders on the autism spectrum.

Characteristics of ASD:
1) Impairments in social interaction
2) Impairments in Communication
3) Restricted and repetitive patterns behaviors, communication, activities, and interests
4) Attention and motor difficulties
5) Physical health problem

At this time, there are no know causes of autism, but it is not caused by family background, emotional states, or environmental factors. Recently, the Center for Disease Control released that 1 in 88 children are diagnosed with autism.

Augmentative & Alternative Communication (AAC)

Alternative & Alternative Communication (AAC) is frequently used with individuals with autism. Many persons with autism cannot physically speak so, oftentimes, some sort of device with a speech output is used to provide a form of communication. These devices can be used to teach literary skills, ask questions and respond to others, teach vocabulary words, and even teach natural speech production. The following are examples of AAC for individuals with autism:

iPad Assistive Chat
Speech Output Technologies

Speech output technologies, or talking computers, can be used to communicate with others. The individual types in to the device or selects a symbol on the device. Then, the computer will "speak" out loud so others can hear and understand the message.  There are many speech output programs available for the Apple iPad, as shown in the picture. Many can be installed on computers.



Picture Communication Exchange System (PECS)

In PECS, individuals with autism are taught to exchange a picture for a desired item. The individual receives prompts and feedback to give the picture to the facilitator in exchange for the item. Over time, these prompts are phased out and the individual learns that these pictures must be given to the facilitator in order to receive the object. Eventually, more symbols and pictures are given to the student include verbs and descriptors. The student will learn to make sentences to ask questions and label items.

Benefits to AAC

Facilitated Communication (FC)

Facilitated Communication (FC) is a way of communication for a person with autism who cannot verbally speak. The person with autism has a FC facilitator who holds his hand while he looks for letters and moves his hand around a keyboard or letter board. Many people who use this form of communication eventually learn to speak independently. The facilitator does not type or guide the person's hand, but provides physical support for the person's forearm, wrist, or fingers and providing positive feedback for correct responses. Eventually, the person will learn to move his hand on his own and will no longer need feedback of support. However, FC is controversial because many believe the facilitator is controlling the person's hand and speaking for him. There have been studies done that show this to be the case. On the contrary, though, many individuals have learned to speak independently with a communication board after practicing FC.

Facilitated Communication

Benefits to FC
Determining the Right Type of Alternative Communication

        Obviously not any device can be handed to a person with autism. Is FC or AAC more appropriate? Which AAC device should be used? Depending on the physical and cognitive capabilities of an individual, there might be some aspects of a certain communication method that is too difficult for a certain person to use. Therefore, it is very important to assess a person before determining a specific type of alternative communication. First, a clinician must identify what the person needs and the capabilities of a person by conducting interviews, filling out communication needs surveys, and observing the person in his or her natural environment. Then, he or she must assess the skills of the individual. This includes motor skills, if verbal speech is present, literacy, sensory feedback, motivation to use communication, and supports by family and friends, to name a few. The environment that the person will use this is also important to note. For example,a person in a wheelchair might need a communication device to be portable or able to be mounted on the chair. For others, they might need a communication system for a work setting while another person might just need a way to answer yes or no questions. Next, it is important to determine if and how the person will be taught the skills to use the alternative communication. If a person has low cognitive capabilities, an easier system will probably need to be used. Finally, teach the individual as well as those who assist him to use the device.
    Additionally, there are some considerations that need be addressed when working specifically with autism. Many of these individuals have motor issues and struggle to push buttons or even sit still. Many devices require a lot of precision, so this might not be good for an individual with autism who struggles with this. Additionally, individuals with autism might have an easier time using pictures to communicate instead of words as the pictures help them to understand the message better. Both pictures and words are good tools for learning as well. One of the big characteristics of ASD is difficulties with social interaction. This is important to keep in mind as this communication method is going to be the prime way of socializing. Many AAC device make it easy to communicate and help teach the person how to properly socialize and plan sentences. As we've seen this semester, many devices also have activities built into them to practice these skills. Finally, computer-based devices often work well as it is easy to socialize and does not require any interpretation of social cues. The computer will also always look the same and have some consistency to it, which is something many people with autism need. 

See our AAC & FC Presentation!

Sources: Beukelman, David & Mirenda, Pat (2005). Alugmentative & Alternative Communication. Pittsburgh: Paul H. Brooks Publishing

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