Len Levin, Ph.D. Kara Lee, M.A., BCBA Jessica Ann Korneder, M.A., BCBA Tiffany Bauer, M.A., BCBA
PROMOTING COMMUNICATIVE DEVELOPMENT Merlin L. Taylor, Jr., Ph.D., CCC-SLP, BCBA-D Speech-Language...
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Transcript of PROMOTING COMMUNICATIVE DEVELOPMENT Merlin L. Taylor, Jr., Ph.D., CCC-SLP, BCBA-D Speech-Language...
PROMOTING COMMUNICATIVE DEVELOPMENT
Merlin L. Taylor, Jr., Ph.D., CCC-SLP, BCBA-DSpeech-Language Pathologist
Behavior AnalystAspie
THE TRAIN SLOWS DOWNA Mathematical Model of Central Nervous System (CNS) Development
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Bottom-Up (Receptive) and Top-Down (Expressive)
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Bottom-Up
ReceptionExteroceptionProprioception
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Bottom-Up
ExteroceptionPicking up external stimuli (e.g.: sound, touch) as sensations through specialized
receptors (e.g.: ears, sensory nerve endings)
MANAGE THE SENSORY ENVIRONMENT
Balanced sensory input, a.k.a. “sensory diet”
Prevent overstimulation
Prevent understimulation
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Bottom-Up
ProprioceptionSense of body
Sense of relationship between body parts
Sense of body in space
PROMOTE PROPRIOCEPTION
Possibly the most fundamental deficit in autism!
PROMOTE PROPRIOCEPTION
Possibly the most fundamental deficit in autism!Where is me?
PROMOTE PROPRIOCEPTION
Possibly the most fundamental deficit in autism!Where is me?
Stimulate body awareness through
PROMOTE PROPRIOCEPTION
Possibly the most fundamental deficit in autism!Where is me?
Stimulate body awareness throughPhysical activity (e.g.: gymnastics, horse riding, tai chi)
PROMOTE PROPRIOCEPTION
Possibly the most fundamental deficit in autism!Where is me?
Stimulate body awareness throughPhysical activity (e.g.: gymnastics, horse riding, tai chi)
Specialized clothing (e.g., pressure vests)
PROMOTE PROPRIOCEPTION
Possibly the most fundamental deficit in autism!Where is me?
Stimulate body awareness throughPhysical activity (e.g.: gymnastics, horse riding, tai chi)
Specialized clothing (e.g., pressure vests)Other aspects of “sensory diet”
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Bottom-Up
PerceptionAssessment of sensations processed through the CNS for• timing• quality• intensity• novelty.
Facilitate Sensory Processing
Facilitate Sensory Processing
Minimize competing and distracting inputs Figure/groundSignal/noise
Facilitate Sensory Processing
Minimize competing and distracting inputs Figure/groundSignal/noise
Optimize desired inputse.g.: use of FM systems to facilitate auditory processing
Facilitate Sensory Processing
Minimize competing and distracting inputs Figure/groundSignal/noise
Optimize desired inputse.g.: use of FM systems to facilitate auditory processing
Provide patterns of sensory input where possibleVisual-spatial patternsTactile patternsTemporal patterns
Facilitate Sensory Processing
Minimize competing and distracting inputs Figure/groundSignal/noise
Optimize desired inputse.g.: use of FM systems to facilitate auditory processing
Provide patterns of sensory input where possibleVisual-spatial patternsTactile patternsTemporal patterns
Promote proprioception
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Bottom-Up
MemoryThe final processing
and storage of present and past sensory
experiences
Facilitate Memory
Facilitate Memory
Utilize repetitionBe mindful of threshold for cognitive overload
Facilitate Memory
Utilize repetitionBe mindful of threshold for cognitive overload
Utilize sensory associationsEmploy multiple media—being mindful of threshold for sensory overloadAvoid noxious associations as much as is possible
Facilitate Memory
Utilize repetitionBe mindful of threshold for cognitive overload
Utilize sensory associationsEmploy multiple media—being mindful of threshold for sensory overloadAvoid noxious associations as much as is possible
Utilize semantic associations“Chunking” units of similar meaning
Facilitate Memory
Utilize repetitionBe mindful of threshold for cognitive overload
Utilize sensory associationsEmploy multiple media—being mindful of threshold for sensory overloadAvoid noxious associations as much as is possible
Utilize semantic associations“Chunking” units of similar meaning
Provide patterns of sensory input
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Rote Learning
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Goal of Applied Behavior Analysis (ABA)?
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
NOT WHERE COMMUNICATION IS CONCERNED
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
THE TOP
IdeationUltimately
making sense of sensations
Making Sense of Sensations
Making Sense of Sensations
Comparing present sensory inputs with sensory memories
Making Sense of Sensations
Comparing present sensory inputs with sensory memoriesIntegrating these into consciousness and determining meaning
Making Sense of Sensations
Comparing present sensory inputs with sensory memoriesIntegrating these into consciousness and determining meaningBuilding concepts from those meanings, and symbolizing these concepts in language
THE SENSE WE MAKE OF SENSATIONS—FROM OUTSIDE AND ESPECIALLY INSIDE THE BODY—LARGELY FORMS THE BASIS FOR THE
DEVELOPMENT OF IDEAS—CONSCIOUS AND UNCONSCIOUS.(Parvizi and Damasio, 2000)
MOST FUNDAMENTAL OF ALL IDEAS
“I”
THREE FUNCTIONS OF SELF(Taylor and Randolph, 2005)
Self-Construction
Self-Actualization
Self-Conservation
Development of Self in the Mind of a Child with Autism
Self-Construction
Self-Actualization
Self-Conservation
Development of Self in the Mind of a Child with Autism
Self-Construction
Self-Actualization
Self-Conservation
Development of Self in the Mind of a Child with Autism
Self-Construction
Self-Actualization
Self-Conservation
Development of Self in the Mind of a Child with Autism
Self-Construction
Self-Actualization
Self-Conservation
Development of Self in the Mind of a Child with Autism
Self-Construction
Self-Actualization
Self-Conservation
Development of Self in the Mind of a Child with Autism
Self-Construction
Self-Actualization
Self-Conservation
Development of Self in the Mind of a Child with Autism
Self-Construction
Self-Actualization
Self-Conservation
Helping the Self Develop
Self-Construction• Promote proprioception• Use names frequently• Use personal pronouns with visual cues
• e.g.: pictures, pointing
Helping the Self Develop
Self-Actualization• Find personal strengths and promote these• Provide safe opportunities for interpersonal communication • Provide positive feedback using specifics
• not just “good job” or “awesome”• e.g.: “What a colorful picture,” “What a happy song!”
Helping the Self Develop
Self-Conservation• Make the environment friendly
• Identify and minimize* threatening or noxious stimuli• (*As much as is possible)
• Progressively desensitize
Developing the Self
“I”
Developing the Communicative Self
“I”
Developing the Communicative Self
as in…
Developing the Communicative Self
“I AM”“I FEEL”
“I THINK”“I NEED”“I WANT”“I CAN”“I WILL”“I DO”“I ASK”
“I DECLARE”
Developing a Mind for Communication
Help the child to find a self
Allow the child to find things to talk about
Assure the child that self-expression is safe
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Top-Down
IntentionDesire to communicate a feeling, idea, need or
want
Optimizing Communicative Intent
Encourage appropriate self-expression
to any degree
in any form
Consider the possibility of communicative intent driving inappropriate behaviors
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Top-Down
PlanningUnconscious and rapid selection of muscles and sequencing of
reflexes to produce a pattern of efficient and
precise intentional movement
Facilitating Motor Programming
• Promote proprioception
• Optimize sensory processing
• Teach and reteach motor behavior
• Be mindful of threshold for cognitive overload
• Model both part and whole
• TEACH MORE THAN TEST
• Provide temporal patterns
• e.g.: music, melodic intonation
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Top-Down
ExpressionIntentional and
patterned motor response that enables
communication
Expression
Expression
Proximity
Expression
Proximity
FacialExpressio
n
Expression
Proximity
Gaze
FacialExpressio
n
Expression
Proximity
Gesture
Gaze
FacialExpressio
n
Expression
Proximity
Gesture
Vocalizing
Gaze
FacialExpressio
n
Expression
Speech
Proximity
Gesture
Vocalizing
Gaze
FacialExpressio
n
Expression
Speech
Sign
Proximity
Gesture
Vocalizing
Gaze
FacialExpressio
n
Expression
Writing
Speech
Sign
Proximity
Gesture
Vocalizing
Gaze
FacialExpressio
n
Speech
Speech
SoundProductio
n
Speech
SoundProducti
on
MeaningfulSegme
nts
Speech Words
SoundProducti
on
MeaningfulSegme
nts
Speech Words
SoundProducti
on
MeaningfulSegme
nts
BuildingPhrases
Speech Words
SoundProducti
on
MeaningfulSegme
nts
BuildingPhrases
Social Usage
Social Usage
THE BIG ONE
Awareness of boundaries
Concrete
Abstract
Situational insight
Appropriate word choice
Interpersonal insight or…
EMPATHYCOUNSELMODEL
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Two Special Considerations
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Reflexive Response
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
“Feed-Forward”
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
What About “Stimming?”
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
A Closed Circuit
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
A Closed Circuit
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
A Closed Circuit
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
A Closed Circuit
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
A Closed Circuit
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
A Closed Circuit
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
A Closed Circuit
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
A Closed Circuit
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Three of its Main Purposes
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Three of its Main Purposes
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Three of its Main Purposes
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Three of its Main Purposes
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Three of its Main Purposes
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Three of its Main Purposes
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Three of its Main Purposes
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Find Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Find Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Find Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Find Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Find Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Shield Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Shield Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Shield Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Shield Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Shield Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Build Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Build Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Build Me
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
Build Me
Development of Self in the Mind of a Child with Autism
Self-Construction
Self-Actualization
Self-Conservation
Reception
Perception
Memory
Ideation
Intention
Planning
Expression
The Open Circuit
“Stimming” is not without communicative significance or value
Analogous to watching a closed-circuit broadcast through
a window into a room you otherwise cannot enter…
“Stimming” is not without communicative significance or value
…until you are let in.
(Keep knocking.)
“Stimming” is not without communicative significance or value
Some self-stimulation patterns do indicate level of readiness for interpersonal
communication
“Stimming” is not without communicative significance or value
Some self-stimulation patterns represent a frustrated attempt
at interpersonal communicationSo do some instances of self-injurious and/or aggressive
behavior
“Stimming” is not without communicative significance or value
• Especially verbal self-stimulation• Echolalia• Imitative
• Egocentric speech, self-talk• (Vygotsky, 1986)• Intrapersonal rather than
interpersonal communication
Taylor (2012): Single-Case Study
This study yielded two findings that
are worthy of note:
Finding I
Significant (p<0.05) positive correlations were measurable between self-stimulatory and frankly communicative behaviors, specifically…
Correlation A
Passive withdrawal and mutual gaze (p=0.037)
Correlation B
Echolalia and spontaneous utterance (p=0.022)
Finding II
In the aftermath of behavioral crises, the emergence of empathy and related aspects of social cognition was noted
(The above finding was serendipitous).
By the way…
…he is one really neat guy to hang out with, and I miss him a lot.
IN SUMMARY
We want to communicate
With help, we can communicate
There are ways to help us communicate
There are various ways in which we can communicate
Keep trying!
THANK YOU