Communication Interventions

Providers use communication interventions to promote communication skills for children with ASD and other delays and disabilities.

Alternative and Augmentative Communication (AAC)

AAC systems are personalized methods or devices that supplement an individual’s ability to communicate. Some strategies that require no devices or pieces of equipment include:

• Manual signing
• Gestures
• Facial expressions
• Pantomime
• Pointing
• Eye gaze

Aided systems use an external device that can be low technology (such as picture boards) or high technology devices (electronic communication devices with sound output). If children can use speech, providers encourage them to continue to talk while using the AAC system.

• Finke, E., McNaughton, D., Drager, K. (2009). “All children can and should have the opportunity to learn”: General education teachers perspectives on including children with autism spectrum disorder who require AAC. Augmentative and Alternative Communication, 25, 110-122.

Picture Exchange Communication System (PECS)

PECS provides a means of communication for all ages of individuals with ASD and other developmental disabilities. In this system, the individual indicates a need or want by exchanging picture cards of a desired item with a communicative partner. There are six phases of the system that progressively teach the individual to:

• Discriminate picture items
• Learn and use sentence structures to make requests
• Expand on sentence requests
• Answer the questions “what do you want?”
• Comment on other questions such as “what do you see?”, “what do you hear?” and “what is it?”.

Young children with ASD need to understand the symbolic representation of pictures for objects to use this intervention.

• Preston, D., & Carter, M. (2009). A review of the efficacy of the picture exchange communication system intervention. Journal of Autism and Developmental Disorders, 39, 1471-1486.
• Howlin, P., Gordon, R., Pasco, G., Wade, A., & Charman, T. (2007). The effectiveness of Picture Exchange Communication System training for teachers of children with autism: a pragmatic, group randomized controlled trial. Journal of Child Psychology and Psychiatry, 48, 473-481.

Hanen Method

The Hanen method includes six primary interventions that provide early language intervention for young children who have or who are at risk for developing language and communication delays. The program provides parents tools that they can use to help develop a child’s language in the context of everyday home and community activities.

Parents of children with ASD are trained in group sessions composed of three major elements:

• Pre-program assessment and baseline video taping of the parent-child interactions
• Group training for parents
• Individual feedback sessions

Two of the six interventions are designed specifically for children with ASD. “More than Words” is intended for verbal and non-verbal children with ASD under age five, and “Talkability” is intended for children ages 3-7 with mild ASD.

• Baxendale, J., Frankham, J., & Hesketh, A. (2001). The Hanen parent programme: A parent’s perspective. International Journal of Language and Communication Disorders, 36, 511-516.
• Coulter, L., & Gallagher, C. (2001). Evaluation of the Hanen early childhood educators programme. International Journal of Language and Communication Disorders, 36, 264-269.
  

Total Communication

Total communication incorporates a variety of modes of communication (including signing, verbalization, and written and visual aids) to best suit the needs of a particular child. This method was originally used for children who are deaf, but has since been generalized to all children with communication disorders, including children with ASD. If using sign language with a child with an ASD, it can be beneficial to use a total communication approach which uses both speech and sign so that the same language structure is modeled for the child in two modalities. Using speech and sign helps to highlight key word meanings and help language comprehension.

• Assistive Technology for Children with Autism
  
• Hands & Voices: Communication Considerations
• Goldstein, H. (2002). Communication Intervention for Children with Autism: A Review of Treatment Efficacy. Journal of Autism and Developmental Disorders, 32, 373-396.

Facilitated Communication

Providers use facilitated communication with children who have several communication difficulties. In this strategy, a facilitator physically supports the child’s hand or arm and guides them to use a key board or other augmentative communication device. This support helps the child to develop pointing skills and communicate. Facilitated communication is not supported by evidence, and research has shown that the communication output is more strongly driven by the facilitator then the child.

• Mostert, M. (2001). Facilitated communication since 1995: A review of published studies. Journal of Autism and Developmental Disorders, 31, 287-313.