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

aspiehd@gmail.com

SUBJECT LINE: PPT