Communication

The uncertainty due to the current coronavirus pandemic can be very overwhelming and confusing, especially for children with Autism and other developmental disabilities. Parents may be wondering how to talk to their child about COVID-19 and the changes it has caused in their daily routines, such as:

Why do I have to wear a mask? Why are you wearing a mask?

Why do I need to wash my hands more frequently?

Why can’t I play with my friends?

Why am I home from school?

Why are you working at home? Why are you unable to work at all?

Social Stories are a great way to communicate this information with your child in a safe and comforting way. They can help manage emotions and challenges due to these changes, and encourage appropriate behavior and responses.

The following social stories have been compiled to help support you and your child due to this challenging and unknown time.

Little Puddins – The Autism Educator

Hello I Am A Virus – Also available in Spanish and Italian

Why Do I Have To Stay At Home? Autism Little Learners

Seeing Other People Wearing Masks

This month’s Autism 200 series class is Autism 203:  The Visual Pathway in ASD: Explicit Teaching Methods to Promote Social Communication

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Welcome to the February edition of Ask Dr. Emily!

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Neuhaus, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format.

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Swimming is such an iconic and fun activity for the summer, but can be overwhelming for some with autism because of all of the unfamiliar sensations, actions and directions.

We’re accustomed to using visual supports to help with novel experiences and this is no exception.

You can think “visual” in the pool – you just have to think visual and waterproof!

Here are five ways you can make the pool a success this year:

1. Swimming lessons for children with disabilities

2. Brush up on water safety

3. Visual schedules: Take pictures of each step: getting ready, swimming, playing.  Use them before getting in the water  or waterproof them by laminating and sticking to a pool noodle, or consider getting a floating, waterproof iPad case:

   The Waterproof Store

   Amazon

4. Social stories: Think about social encounters that may happen at the pool. You may want to involve motivating special interests such as favorite characters (anyone from Nemo to Thomas the Train can enjoy the water). Describe what to do if the situation gets overwhelming (ask for help, wear earplugs or goggles to decrease sensory overload)

5. Video modeling: To increase new skills and establish routine, consider videotaping a day at the pool for your child to review ahead of time. This doesn’t have to be your child, but can be you, a sibling, a friend or even a video on swimming on YouTube.

More Resources:

 Swimming with Autism

Visual Supports For Summer Swims

Resolve to Get Visual: Five Tips on Augmentative and Alternative Communication (AAC) for Speech Language Pathologists (SLPs).

It’s the beginning of a new year and a great time to resolve to kick off 2016 by implementing visual supports for all kinds of learners, particularly those with ASD. It takes a little elbow grease but the outcome is worth the investment. Plus, it doesn’t have to be any more complex than getting your own day planner ready for the start of a new year. Here are five can-do reminders that address common barriers to diving in to AAC from Jo Ristow, SLP at Seattle Children’s Autism Center.

AAC is NOT always high-tech (such as the iPad). It’s true, high-tech AAC can be an investment of dollars and time but AAC can be as cheap as pencil and paper or a good printer. You already have all the tools you need to start. While iPads and apps have revolutionized the field, AAC predates iPads by many years. Plus, there are some advantages to low-tech AAC – nothing needs to be charged, it’s more portable, less expensive, can go with you to the pool, and no one wants to steal picture symbols! Not every kid needs an iPad but every kid needs a means of communicating. One child I work with uses a portable dry-erase board. It can be that easy.

 AAC doesn’t have to be difficult to learn. AAC runs the gamut from high-tech, cutting edge programs to extremely simple and accessible picture and written supports. Just think visual. Can you draw smiley and frowny faces to talk about feelings? Can you print out three clip art pictures to offer choices? Can you use visuals that you already use in your own life such as a calendar or planner to support your students’ communication and understanding? If so, you’re on your way to using AAC! The most important thing is to just start trying to use visuals in your lessons and expand from there. Aim for a robust language system, but starting small is better than not starting at all.

Also, remember that our students benefit from our mistakes. I rarely have to directly teach a child to use the backspace button on a high-tech AAC device because they see me doing it so frequently that they learn from my mistakes. And searching fruitlessly for a vocabulary word is a nice way to naturally demonstrate behavior-regulation strategies such as taking a deep breath, modeling self-talk, and being persistent. Or sometimes it is a great way to model words like “Whoopsie!” “This is hard!” or “I’m frustrated!”

AAC is not that different from traditional therapy. Good therapy skills transcend the tools you’re already using.Techniques such as modeling, expanding utterances, and providing communication temptations are all at play in AAC. You basically have to remember to point to visuals while using the traditional techniques.

More students than you might think benefit from AAC.We all use AAC in our lives. When’s the last time you picked up a phone and called someone? Today we tweet, text, IM, email. Think how emojis enhance your message! Studies show that kids who don’t talk benefit from using AAC and AAC may jumpstart verbal ability. For those who are verbal, AAC can increase the quality of their communication whether it’s speaking in longer sentences or communicating for different purposes such as asking questions or sharing ideas.

AAC doesn’t have to be a lot of work to implement. It’s true that the success of the AAC user depends a lot on the adults in their environment using and modeling but you don’t have to reinvent the wheel. In this age of technology, accessing pre-made AAC is as simple as running a Google search and hitting the PRINT button. The high-tech devices are more and more robust and evidence-based in their organization of vocabulary, so it is often a matter of creating a few buttons and trying it out.

Like all New Year’s resolutions, it’s ok to start small and measureable and work your way towards something that could make life a lot easier. Who knows where you’ll be this time next year!

Some handy websites for AAC:

For tons of resources and ideas: http://praacticalaac.org/

For lesson plans and activities: https://aaclanguagelab.com/

For recommendations from an AAC master: http://janefarrall.com/

Let me start with a spoiler, in a good way.

I want to stand up on my little SLP soapbox and say first and foremost:

Using two or more languages with a child with autism spectrum disorder (ASD) will not:

1. Make it harder for them to learn one language or
2. Cause them to have “worse” language than monolingual (one-language) children with ASD

In fact, it may provide some benefits to their language and social development!

Ok, so now that we have that up front, I will say this: Learning a language is an astounding feat. Learning two seems twice as hard, especially for kids who may be struggling with one language already. I have had many families report that their well-meaning medical providers told them that they should only talk to their child with autism in one language, usually English. Read full post »

To date, our most popular blog is Why Do Kids with Autism Do That? Not surprising I suppose, as we are always trying to figure out why our kids do what they do. We gathered more puzzling questions for our panel of providers and invite those of you who offered your own insight and perspective last time to join in. This time we asked Brandi Chew, PhD, Jo Ristow, MS, CCC-SLP, and Soo Kim, MD to share their thoughts and this is what they had to say . . .

Why do some kids with autism . . .

Learn unevenly – seem to take one step forward and then one back

Jo: The answer to this question could fill a book! In my practice, I see a lot of this unevenness when kids have difficulty translating (or generalizing) learned skills to different people, environments and items/activities. For instance, I’ve seen kids learn that they can touch a photo on the iPad to activate voice output and request a Skittle, but then not be able apply that learning to touching different photos Read full post »

Most people have heard of Autism Spectrum Disorder (ASD) and Down syndrome (DS) but many do not know that a child can have both. Today we discuss this dual diagnosis in an interview with providers and parents of children with both ASD and DS. 

Lynn: What do we know about the genetics of ASD and DS? Are kids with DS any more at risk for ASD than others? How common is the dual diagnosis? 

Raphael Bernier, PhD: You know, Lynn, I think what gets tricky when we talk about the genetics of ASD and DS is that the DS diagnosis is made (or can be confirmed) by genetic testing which reveals the presence of the third chromosome 21. In contrast, the ASD diagnosis is made strictly on behavioral observation. There are currently no genetic tests for ASD. 

However, we’ve made massive gains in our understanding of the genetics of ASD in just the past 10 years so this does provide some insight into the relationship between ASD and DS. For example, a couple of genes that keep popping up as ASD risk genes are located on chromosome 21 in the DS critical region suggesting a genetic connection between ASD and Read full post »

Dr. Mendy Minjarez

Researcher and clinical psychologist at Seattle Children’s Autism Center, Dr. Mendy Minjarez, along with researchers at Lucile Packard Children’s Hospital Stanford, show in a recent study that parents, in a group setting, can learn Pivotal Response Training (PRT) to effectively increase motivation and language skills for their child with autism. Typically, PRT has been taught to parents in individual therapy sessions, but this research demonstrates that it can be just as effective when taught in a group setting.

In a previous blog, Minjarez describes PRT as a naturalistic behavioral intervention. She explains, “PRT utilizes the principles of ABA (Applied Behavioral Analysis), such as reinforcement, but also incorporates developmental principles, such as following the child’s lead in intervention. Rather than applying ABA principles in a highly structured way, as in discrete trial training, in PRT parents are taught to embed ABA teaching principles into interactions with their child to enhance learning.”

To read more about the study and PRT, please see Seattle Children’s blog On the Pulse.

Communication deficit is a key feature of autism, and we see children who have communication strengths and challenges of all types. Some children benefit from the use of alternative/augmentative communication, known as AAC.  AAC includes any type of communication that is not speech in order to replace or supplement talking. Parents frequently and understandably have questions and concerns when a clinician starts talking about AAC for their child – it certainly is a new, different and unfamiliar way to communicate. Or is it? If you think about it, we all use AAC every day – we point, gesture, click on icons, text or email. This is all nonverbal communication! Not so unfamiliar after all. Read full post »