Expressive+Communication

Expressive Communication We know that students with ASD have difficulty with expressive as well as receptive communication. Not only do they struggle to understand the words used by others in their environments, they struggle to communicate their thoughts and emotions to people in those same environments. Expressively, they are challenged by difficulties with word retrieval and the complexities of person-to-person communication. On the plus side, students with ASD often have strong visual processing skills. Augmentative & alternative communication, or AAC, falls under the umbrella of assistive technology. AAC is any tool, device, picture, word, symbol, or gesture that compensates for expressive (outgoing) and receptive (incoming) communication deficits. The tools, technology, and strategies of AAC serve to "increase, maintain, or improve" a person's ability to communicate by augmenting the skills he or she already possesses and providing alternative means when that degree of support is required. So, AAC is any type of assistive technology that helps a person with disabilities communicate. Because AAC is a visual communication medium, it's an ideal match for the specific skills and deficits common to students with ASD.
 * Be sure to visit R4ATandAutism wikispace for additional information and strategies to support expressive communication for individuals with ASD.**

No Tech Tools and Strategies

 * **pausing**- the same effective receptive communication strategy is equally effective for expressive communication as well. Parents and educators can increase expressive communication and especially the initiation of expressive communication using a "pause." Pausing gives the student more time to understand that it is his or her turn to communicate, to process what may have been asked, and to formulate an answer.
 * **gesturing, eye gaze, and sign language** - these communication strategies are usually specific to the student and may require a familiar person such as a caregiver to "interpret" what is being communicated. That being said, honor, as much as possible, the "intent" of these communications. These expressive communication strategies used by the student can be shaped into something more widely understood as teaching and interventions continue.

Lite Tech Tools and Strategies

 * **tangible or tactile symbol strategies**- some students are very dependent on tactile information even though they have usable vision.
 * Tangible Symbol Systems from Design to Learn. [[image:keys_object_symbol.jpg align="right"]]
 * Tactile symbol systems from the Texas School for the Blind and Visually Impaired.
 * **picture point communication board system -**The student points to various visual representations (e.g., photos, PCS, objects, etc.) located on a communication “board” in order to communicate wants, needs, comments, choices, etc. Many communication boards can be created, which are both context-specific and individual-specific (e.g., a place mat communication board to be used during snack and meals, with PCS surrounding the perimeter of the place mat; a communication board created for the “play” area, etc.).
 * **Picture Exchange Communication System (PECS)**- PECS is a specific program that requires training and consistency for quality implementation. A wide variety of adaptations may be made when using a PECS program to meet the specific student’s individual needs. For example, some students find it useful to place the visual representation system on a frozen juice can lid or another hard material, such as a small rectangular sample of counter top (laminate) material. In this example, the visual representation system becomes more salient to the student by giving him or her more tactile input (weight and hardness). This also increases the durability and functionality of the visual representation symbol for students who tend to “crumple” up lightweight paper type items in response to what may possibly be a sensory need.
 * **Break cards**- “Time out” or “I need a break” cards can be used by the student to communicate to another individual that a break is needed. The purpose is for the student to communicate the message that he or she needs a break via a more appropriate communicative mode (visual representation system), rather than having to become increasingly anxious and frustrated resulting in the appearance of challenging behaviors. They should be
 * easily accessible to the student
 * located in a consistent place in the classroom, work environment, day care, or home (e.g., on the student’s communication board or book, on the student’s desk, etc.)
 * **Choice cards**- Choice cards (again using any type of visual representation system) allow the student a degree of independence by making a choice. Of course, the adult determines the choices presented to the student (e.g., a “work time” choice card can be presented to the student with several activities from which to choose). When presented in this manner, the individual may more readily participate in less desirable activities because he or she was allowed to make a “choice” regarding that specific activity.
 * **“All done”/ “Finished” cards -**Many individuals with ASD exhibit seemingly challenging behaviors to indicate that they are “all done” or “finished” with an activity. Typically, this tends to be because they may not have a more appropriate way to communicate this concept. Teaching the student a more appropriate way to indicate “all done” via a visual representation system, therefore, may lessen both the student’s and the adult’s stress and frustration. “All done” or “finished” cards can be taped to the student’s work area and the appropriate use should be directly taught to the individual. First, terminate the activity prior to reaching the student’s attention/frustration level. Then, point to the “all done” card. The student’s hand can be physically prompted to point to the “all done” card if needed. “All done” cards can also be placed on the student’s communication board or book for them to readily access via a picture point or physical communication exchange.
 * **Topic ring/topic wallet -** This strategy is designed for individuals who are verbal, yet have difficulty initiating topics with others.[[image:atconsiderations-asd/Long-Wallet.jpg width="127" height="116" align="right"]]It is also useful for those who have difficulty initiating a variety of topics with others; that is, not those just related to his or her areas of particularly high interest. The “topic wallet/ring” can have various topics visually depicted via written words, pictures, or PCS for the student to reference. For example, topics may be depicted individually on small 3” x 3” laminated cards using both PCS and written words. Then they can either be attached by a metal ring in the corner (for the student to hook on a belt loop) or, placed in a small “communication wallet” to be kept in his or her pocket. Topics might include: “What did you do over the weekend?” “What is your favorite movie?” “Do you have any pets?” “What books do you like to read?” The topics will initially need to be trained on an individual basis, followed by a small group setting. This will provide the student with practice using this visual support system. It can also provide ways to expand on the topics once they have been initiated. This strategy will help to ensure successful generalization of this system beyond the classroom setting. Be sure that you have some type of organization system for the student to find communication topics without flipping through unorganized pages.
 * **Past event cards -** A large number of individuals with ASD, both verbal and non-verbal, have significant difficulty relating past events. Using a visual representation system that the individual readily comprehends can help to bridge this gap, at least between home and school or the work place. Staff members can create generic templates that can be easily circled [[image:atconsiderations-asd/Topic_Card.png width="284" height="99" align="right"]]or filled out each day and sent to the respective location (home or school) to aid the individual in relating information about what occurred. For example, a card might look like this:

Only the activities that actually occurred would be circled.

Mid Tech Tools and Strategies
Listed below are descriptions of a few mid-tech devices that may be used to address various skill areas including expressive communication. Most of these devices are very appealing to students with ASD and, thus, provide them with motivation to successfully participate in various classroom activities.
 * **Voice Output Communication Aids (VOCAs)**- These are called Speech Generating Devices or SGDs in the field of rehabilitation. Any type of visual representation system can be placed on simple speech-generating device that students can easily access by a simple push of a “button.” Most of these devices are battery-operated and are easy to update with new messages. It is important to note that these devices were created to provide an augmentative means for individuals to communicate. However, as noted above, many individuals with autism spectrum disorders find these devices to be motivating. Therefore, their use can expand beyond expressive communication and into use for practice in many different skill areas.
 * Examples for types of VOCAs. This is not an inclusive list as there are many devices and many vendors.
 * One-Message Devices
 * BIGmack - Ablenet
 * Memo Talker - Attainment
 * One Message Hip Talk - Enabling Devices
 * Portable Talking ID - Enabling Devices
 * One-Step Communicator - Ablenet
 * Voice Recording Pen - Attainment
 * Talking picture frames (various types, from single message to 24 messages)
 * Multiple-Message Devices (one level)
 * 5 Talker - Attainment
 * Cheap Talk 4, 8 - Enabling Devices
 * Communication Builder - Enabling Devices
 * Four Frame Talker - Attainment
 * Hip Talk Plus Enabling Devices
 * Partner Plus AMDI
 * Devices with Levels
 * Go:Talk - Attainment
 * Chat Box - Saltillo
 * 32 Message Communicator - Enabling Devices
 * 6, 12 Level Communicator - Enabling Devices
 * Step by Step Communicator with Levels - Ablenet
 * Tech/Speak (32)—AMDi
 * Devices that use typing [[image:atconsiderations-asd/text_speak.jpg width="182" height="96" align="right" caption="Text Speak keyboard"]]
 * Speaking Speller - Franklin Products
 * Text Speak series from Text Speak
 * Lightwriters Toby-Churchill
 * Allora Talk To Me Technologies
 * Devices must be accessible to individuals at all times because initiation of communication can be challenging for some individuals with ASD. Mounting a single-message device near a block play area programmed for “Let’s play blocks” encourages the student with ASD to initiate communication with a peer or adult. One-message devices can be programmed to assist the older student to ask for help, request a break, or comment on activities (e.g., “Awesome.”)

High Tech Tools and Strategies

 * **Video taping**: Expressive vocabulary skills (being able to name items, people, places) can be taught in much the same way as receptive vocabulary skills through the use of video taping. Categorization skills and concepts can also be taught through this medium. As mentioned previously, a variety of language skills (communicative social interaction skills) can also be taught via videotaping.
 * **Devices with Icon Sequencing or Dynamic Display**: For the student whose preferred communication method is not verbal, and responds well to the use of simple speech generating devices, it may be reasonable to utilize a more complex device with dynamic display, or icon sequencing. These products allow for a large numbers of messages (Reed, 2000). A speech pathologist with knowledge about augmentative communication or an AT/AAC specialist can help determine which, if any, of these types of devices might be helpful.
 * Prentke Romich
 * Dynavox
 * Tobii ATI
 * Saltillo
 * and others...
 * **Devices with Visual Scene Display**: Some high tech devices are now utilizing visual scene displays (VSDs) to more easily bridge the gap between cognition and communication. These devices include a full screen that looks like a child’s room, a [[image:atconsiderations-asd/freestyleBIG.jpg width="180" height="135" align="right"]]classroom, an office, or one of any myriad of age-appropriate “scenes.” “Hot spots” are then programmed into the appropriate place on the screen. When Joe wants to watch television, he simply touches the picture of the television on the touch screen of his device and his message is spoken. Low-tech visual scene display options are also available.
 * Dynavox
 * Low tech print-based communication books using VSD are available here. You must have Microsoft Publisher installed on your computer to open them.
 * **Devices that Use Typing**
 * Zygo Industries
 * Persona Mobile
 * Spok 21
 * Lightwriter by Tobii ATI
 * SpeakOut from Saltillo