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Augmentative Communication for Autistic Children

By Dr. Deborah Cutter

For any child the ability to communicate is an important part of learning. For autistic children this can prove to be a unique challenge. Using augmentative communication tools even a non-verbal child can learn how to reach their full potential.

For years educators have been aware of the advantages of introducing children to enriched learning environments that reinforce a child’s primary learning style whether they are an auditory, kinesthetic or visual learner. An auditory learner interprets the underlying meaning of speech through tone, pitch and voice speed. A kinesthetic learner absorbs information by physically interacting with their environment through movement, drawing or taking notes. The majority of children with Autism are visual learners who often think in pictures and more readily comprehend a lesson if provided with visual cues. Verbal instructions alone are usually not a sufficient form of communication for these children. It is easier for a child with Autism to understand the teacher’s intended communications by visual facial cues, hand gestures and body language. However, one of the challenges faced by Autistic children is the common problematic behavior of making eye contact and socializing which directly interferes with the ability to optimize a visual learning style face-to-face with people.

Visual Learning with Augmentative Communication

One way to improve these children’s lives is to introduce learning tools called Augmentative Communication. This assistive technology provides visual information in a creative format to improve a child’s ability to complete activities of daily living both in the home and at school. Depending on the situation, various visual systems can be introduced to turn up the volume on learning. For example, an Activity Schedule can be created to remind the child what they have to do when they wake up to get ready for school. The morning routine can be represented using various photographs, drawings or words placed chronologically in a three ring binder as follows:

Page 1: a toilet

Page 2: a toothbrush and toothpaste

Page 3: a hairbrush

Page 4: a shirt, underwear, pants, socks, and shoes

Page 5: a bowl of cereal and milk

Page 6: a backpack

After completing each action it’s important for the child to cross off the item or place the picture in an “all done” envelope. When the information is presented in this way it helps the child understand the sequence of daily events.

All children have an easier time of moving from one activity to another when given a verbal two-minute warning that a change is coming. However, since children with Autism are more visual than auditory, the transition time can be made easier by introducing Forewarning Cards. Each card tells the child what is going to happen next. When a child is going to start an activity, a green circle card is placed on their desk with the word “go” smack dab in the middle of the circle and they are told to begin the activity. When there are approximately 1-2 minutes left for the child to continue the activity, an "almost done" yellow circle is placed in front of the child, followed by a verbal message that they are going to need to stop in two minutes. When the time comes for the child to stop the activity, a red stop sign card with the word "stop" is placed on their desk and they are verbally told to stop the activity.

Communicating with Picture Cards

It is not unusual for children with Autism to have a difficult time communicating or speaking. In these cases, the Picture Exchange Communication System (PECS) can be an indispensable tool. One example of a PECS is a stack of individual picture cards with the word of the item written at the top of the card. The cards are whole punched and attached with a metal ring. If the child wants a banana, they can show their caregiver or teacher the drawing of the banana. This provides a way for the child to communicate without frustration and enables them to be the one initiating the communication exchange. There are other types of PECS cards that can help to reduce frustration, acting out, and tantrums. “Break cards” can be used when the child is feeling stressed and needs some down time; “choice cards” give the child independence by allowing them to choose from pre-determined options; and “all done cards” give the child an avenue to communicate that they are finished with a task.

Other Tools

The examples of assistive technology presented here are low-tech tools that are low-cost and relatively easy to create. There are many other kinds of augmentative communication tools that can help to improve an Autistic child’s independent functioning skills. In Part 2 we’ll examine the motivating mid-tech options such as the Voice Output Communication Aids and in Part 3 we’ll look at the benefits of using high-tech tools such as video taping and computers to improve comprehension, social skills and self-control.