TLC: A Comprehensive Approach to Teaching Communication Julie Martin M.A. CCC-SLP/L Kathryn Anthony M.S. CFY-SLP/L Elim Christian Services ACE Program

TLC: A Comprehensive Approach to Teaching Communication

Julie Martin M.A. CCC-SLP/LKathryn Anthony M.S. CFY-SLP/L

Elim Christian ServicesACE Program

K. Anthony, J. Martin Elim Christian Services

What to expect

Communication philosophy What is TLC? How does it work for me? The concept of written language as a viable

form of communication Questions and answers


Three cornerstones of communication

The ability to attend to another individual

The ability to understand another individual

The ability to produce an effective message


Cornerstone of CommunicationAbility to attend to another individual Autism Spectrum Disorder is defined as (DSM IV Classification)

Qualitative impairment in social interaction, as manifested by at least two of the following:

a. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures, to regulate social interaction

b. failure to develop peer relationships appropriate to developmental level

c. a lack of spontaneous seeking to share enjoyment, interests or achievements with other people e.g., by a lack of showing, bringing or pointing out objects of interest

d. lack of social or emotional reciprocity


Cornerstone of CommunicationAbility to produce an effective message Autism Spectrum Disorder is defined as (DSM IV Classification)

Qualitative impairments in communication as manifested by at least one of the following:

a. delay in, or total lack of, the development of spoken language not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime

b. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others

c. lack of varied, spontaneous, make-believe play or social imitative play appropriate to developmental level


Cornerstone of Communication:Ability to understand another individual Autism Spectrum Disorder is defined as (DSM IV Classification)

Restricted, repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

a. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.

b. apparently inflexible adherence to specific nonfunctional routines or rituals.

c. stereotyped and repetitive motor mannerisms, e.g.: hand or finger flapping or twisting, or complex whole-body movements.

d. persistent preoccupation with parts of objects.

• Receptive language skills tend to commiserate with cognitive level

• Deficits in receptive language skills are not part of defining characteristics of Autism

• Receptive skills tend to splinter

• Presence of echolalia may be perceived as higher receptive skills


Communication

Brings order to an otherwise chaotic world Is the foundation of building relationships Is the tool used to effect one’s own well-being


Communication bringing order to an otherwise chaotic world

OR

RD E



ORDER



What does chaos look like? What am I trying to communicate? Video clip – student is expecting “go home” to be the next thing on

his schedule. He is trying to find out why this is not happening and when he is going home.

What does order look like? I can communicate my message effectively! Video clip – the same student (2 years later) wants to go home and is

asking “when is it time to go home?”


Communicationthe foundation of building relationships You cannot build a relationship without some

form of communication.


CommunicationIs the tool used to effect my own well-being. This is how I … ask for things I want initiate conversations with people ask questions for clarification express feelings learn new things


So what do we do ?

What is the best way to teach communication ?


Let’s go back to the basics

Bringing order A room designated to learning language and building

communication skills in an autism friendly environment Building relationships

A method that focuses on building the students, not just the skills

Find out what’s important to the student and what’s important for them to be able to communicate to others

Don’t just teach skills for the sake of teaching skills or filling in milestones


Bringing OrderTLC structure Space built with three adjoining rooms

Group room Play/social communication room Reading room

Students come as a class (6 students) 2 students per room (some exceptions are

made if warranted for behavior reasons) Rotate around the rooms approximately

every 10 minutes (picture of schedule)


Bringing OrderTLC frequency and duration Students come for 1 hour, 3 times a week

2 sessions are devoted to IEP goals 1 session is devoted to reading skills


TLC Themeslessons are taught following a yearly theme schedule These themes are carried out

throughout the entire program Students are focused on vocabulary

in a variety of settings: various academic activities books field trips

Allows students to experience vocabulary in a variety of forms

Back to school Around the house Fall Thanksgiving Clothing Christmas Winter Food Animals Around town Community helpers Transportation Spring/nature/Mother’s Day Health/hygiene Safety awareness Fun and games


Group Room

Follows principles of ABA Works directly on IEP goals Allows for peer modeling opportunities

Video clip – students working at group table


Play/Social Communication Room Follows floor time model Teach students

Joint attention Parallel play Interactive play

Teach students to talk to and listen to one another Video clip – students at snack time, requesting from each other

Picture of room and video of working in room


Reading Room

Immerse students in language through books Deliberate bombardment of language through

structure of books Shared book reading (targeting joint

attention) like a parent might read with their child Video clip – student and staff reading adapted book


Building Relationshipscreating a safe place There is a different set of rules in TLC The rules we always stick to:

number one priority is keeping students and staff safe

consistent with student behavior plans students are being productive at all times

As for all of the other rules ……


Building Relationshipsas for the other rules …. The goal is for students to feel safe and comfortable

communicating Given opportunity to talk about what interests them

might be plungers might be dinosaurs

Opportunity to communicate how they want to might be on a chair might be on their head

Remember: “If you’re happy, you’ll want to come” – Make it a positive place and experience Video clip – students arriving in TLC


Building Relationshipsrelationships with staff are just as important Close relationship with OT:

proper positioning (tables and chairs) alternative work environments/approaches (ball chairs,

standing, wheelbarrow walks, student positioned over ball) Sensory suggestions for transitions, needed breaks and

play Video clip – students working in different rooms with various

accommodations

Paraeducators attend TLC with students allows for modeling and generalization to classroom behavior management


TLC was NOT created to be implemented ALONE

It WAS created to be a TEAM approach


Building Relationshipscreating a safe place Open the door and let them come in It is our job

to listen to interpret to respond to encourage to provide a communication path that they can follow to teach the most effective and appropriate way that allows them

to be true to who they are It is NOT our job

to teach them words for the sake of words to strip them of who they are by making their communication

generic to silence their voice when it sounds like nonsense – they are

always saying something - figure it out


Building Relationshipsit is our job to listen Communication is an innate urge People will find the most effective and quickest way

to communicate A baby learns that if he cries, a parent comes. Once a child learns to talk, they discover that words are

more effective to meet specific needs. If a child does not have the words they will revert to what is

most effective. scream (video clip - student screaming vs saying “bugging me”) hit (video clip – student hitting vs saying “I don’t want to”) familiar phrases/scripts (video clip - student saying “what’s so

funny vs “Hi”)


Building Relationshipsit is our job to interpret If you think they said it, they probably did If you think there is a reason, there probably is They are trying to tell you something – what is it? Interpreting can only be done by focusing on the student and not the

goals If you are so focused on what you want them to say – you will miss what

they are trying to say !! “Let me say it in a song” Video clip – description of student below

14 year old student No purposeful verbilizations Loved to listen to music “randomly” sing parts of songs Songs were NOT random

Greetings Specific songs for different people


Building Relationshipsit is our job to respond The best way to continue communication is to

respond to the first attempt A correction is not an effective response If I attempt to communicate and no one responds

I will stop communicating and may try something else (negative behaviors)

If I attempt to communicate and I am wrong I will stop communicating and may try something else

(negative behaviors) If I attempt to communicate and you “hear” me

I will keep communicating


Building Relationshipit is our job to encourage Some students are so content with their

worlds that they really have no need to communicate with others outside

So it is our job to invite students into conversations about what is interesting to them Video clip – student being engaged in conversation


Building Relationshipsto teach the most effective and appropriate way that allows them to be true to who they are How Corey says “hi”

Video clip – student using personal approach to communicate

Pairing hand gesture with saying hi on device How we say things reflects who we are We do not want communication to become so

regimented and structured that there is no room for our students to express who they are


Building Relationshipsto provide a communication path they can follow Providing multiple forms of communication Teaching students to become proficient with

different ways to communicate We want students to have a personal

communication “toolbox” at their disposal what works in one situation won’t necessarily work

in the next… each student may practice multiple types of

communication in TLC (e.g., verbal, pictures, device, print)


TLC and Reading Speech therapy team has committed time and effort

teaching reading skills Reading is taught in an effort to provide students

with the ability to use print as a viable form of communication

Students do not follow typical pattern of development learn to talk learn to read learn to write

All students have some reading ability to be expanded upon

Many students have been exposed to pictures paired with words throughout their lives (Boardmaker pictures)


TLC and Reading

Print as a viable form of communication looks something like this…

Do you want to go to Grandma’s or McDonald’s? no speech no pictures

How do you tell me ?


TLC and Reading

But if you can read – then I can write it down Most accessible form of communication other than

speech There’s always pen and paper around

Grandma’s McDonald’s


Traditional therapy Was it tried and did it work ? Yes, it was tried

students were pulled out in one-one sessions 30 minute sessions (twice a week) therapy focused only on specific goals

No, it did not work improved splinter skills but did not address underlying

communication skills behaviors caused by communication deficits did not

improve no noticeable changes in communication skills or strategies


TLC – things we’ve triedWe definitely didn’t get it right the first time break area

computer station one-one station

All were too independent and did not promote communication growth

Remember: Students should be doing something “productive” for their personal communication growth at all times

This looks different for every student


How does it work for me? Can be implemented in a classroom through

stations may be a temporary set-up

Does not need to be implemented by a speech therapist teachers, para-educators, and other therapists

can do this too language arts goals can be addressed at group

station/room The communication philosophy is not only for

structured teaching but should be embraced throughout the day

Documents

TLC: A Comprehensive Approach to Teaching Communication Julie Martin M.A. CCC-SLP/L Kathryn Anthony M.S. CFY-SLP/L Elim Christian Services ACE Program