Module 3: Social Communication PDF

Module 3: Social Communication What will we cover today? 1) Quiz 2 Review 2) Communication Differences continued: 3) Social Communication Differences a) Social Developmental Milestones b) Early Signs of Social Challenges c) Differences in Play and Peer Relationships d) Teaching Joint Attention and...

Module 3: Social Communication What will we cover today? 1) Quiz 2 Review 2) Communication Differences continued: 3) Social Communication Differences a) Social Developmental Milestones b) Early Signs of Social Challenges c) Differences in Play and Peer Relationships d) Teaching Joint Attention and Social Skills e) Teaching Play Skills with peers f) Social Skills Curriculums for Adolescents/Young Adults/ High Functioning individuals with ASD g) Other Strategies for teaching Social skills 2) Communication Differences Continued 7c). Focus on Oral Language ● Strategies employing behavior analysis have been utilized extensively to teach speech and language skills to learners with autism spectrum disorders, including discrete trial teaching for communication skills (Brunner & Seung, 2009; Wong et al., 2015). ● Incidental teaching, another evidence-based intervention, has shown success in developing vocal language skills in children with ASD by following the child's lead and setting up communication opportunities (McGee & Morrier, 2005). ● Pivotal response treatment (PRT), similar to incidental teaching, focuses on child-initiated activities, varied tasks, and natural reinforcers, claiming significant success in acquiring words for young children with autism (Koegel & Koegel, 2006). ● Despite a scarcity of research, evidence suggests that teaching in a child's native language can be beneficial, leading to increased correct responses and reduced challenging behaviors for children with ASD (Kayser, Lang et al., 2011). ● Stimulus-equivalence procedures have demonstrated potential in teaching second-language skills to individuals with autism, indicating promising outcomes that could address second-language learning challenges for learners with ASD (Fragoso & Hall, 2006). 7d). Using Augmentative and Alternative Communication (AAC)and Speech Generating Devices ● Augmentative systems are frequently used alongside speech goals for individuals with ASD to supplement or substitute language development delays (Wendt, Ogletree & Oren, 2006; Charlop et al., 2011). ● Speech-generating devices (SGDs) are effective augmentative systems for ASD students lacking functional speech or with limited articulation and vocabulary (Ogletree & Oren, 2006). ● Research supports that augmentative systems don't hinder speech development if educators continue targeting vocal language (Schlosser et al., 2009; Charlop et al., 2011). ● There's no superior form of augmentative system identified for promoting spontaneous and generative communication in ASD individuals (Wendt, 2009). ● Some individuals with ASD may require intentional communication training to fulfill their needs, as they might have learned to communicate through nonverbal behaviors rather than using a formal communication system. 7e) Picture Exchange Communication System (PECS) ● The Picture Exchange Communication System (PECS) is an evidence-based practice for ASD individuals with minimal speech, focusing on picture or 3D item exchanges (Bondy & Frost, 2002; Wong et al., 2015). ● It involves initial phases of exchanging pictures for desired items and progresses to sentence requests and environmental observations (Bondy & Frost, 2009). ● PECS can lead to improved spontaneous speech, reduced problem behaviors, and enhanced social behaviors (Bondy & Frost, 2009; Greenberg, Erickson, Tomaino, & Charlop, 2014). ● Understanding the relationship between the symbol and its referent is crucial for learners (Quill, 2000). ● Environmental arrangements and motivation play a role in reinforcing and enhancing communication skills (Quill, 2000). 7f) Sign and Gestural Communication ● Sign language, such as Makaton and American Sign Language (ASL), is found to be effective for communication in individuals with ASD, aiding their language development (Wendt, 2009; Creedon, 1973). ● Creedon's (1973) early research showed that using sign systems increased vocabulary and language skills in nonverbal learners with ASD (Creedon, 1973). ● Makaton, used in England and Australia, facilitated increased sign use and enhanced enjoyment and interaction in communication sessions (Hooper & Walker, 2002). ● Introducing signs alongside music showed significantly more sign and word imitation compared to rhythm and sign alone, suggesting music enhances attention and recall (Buday, 1995). ● Transition from PECS to an SGD should occur once the learner is proficient with PECS and the selected device supports further growth (Frost & McGowan, 2011, 2012). 7h)Teaching Non-Verbal Communication ● Educators aim to model nonverbal behaviors, but direct teaching might be necessary for effective learning in individuals with autism (Prizant et al, 2006b; Taylor & McDonough, 1996). ● Teaching functional gestures like pointing has been successful using prompting and reinforcement techniques (McClannahan & Krantz, 1999; Buffington, Krantz, McClannahan, & Poulson, 1998). ● Children with ASD might display facial expressions unrelated to context, such as laughing when a peer is hurt (Feldman, McGee, & Mann, 1993). ● Teaching programs using behavioral analysis strategies enabled students to match facial expressions to emotions depicted in videos, and this skill generalized to recognizing emotions in their teachers (Hall & Russell, 2000). ● While research has shown individuals with autism can discern vocal prosody, dedicated studies focused on teaching appropriate vocal tones were not found (Lamers & Hall, 2003). 7i) Strategies to teach non-verbal language ● Applied behavior analysis is effective in teaching complex language to children with autism. ● Studies showcase success in teaching adjectives as descriptors and improving language skills. ● Home-school communication programs can enhance children's linguistic abilities and recall. ● Case studies illustrate improvement in recalling past events and using complex sentences. ● ABA strategies aid in conversation skills, topic management, and assertive responses. 8. Social Communication Differences ● Individuals with autism spectrum disorder (ASD) often experience various challenges in social communication. Some key differences include: 1. Difficulty in Social Interaction: Challenges in understanding and interpreting social cues, which can involve facial expressions, gestures, tone of voice, and body language. This difficulty can make it hard to engage in reciprocal conversations or understand social nuances. 2. Impaired Social-Emotional Reciprocity: Difficulty in developing and maintaining relationships, sharing interests or emotions, and engaging in back-and-forth interactions. This might lead to challenges in making friends or establishing connections. 8. Social Communication Differences 3. Nonverbal Communication Challenges: Difficulty in using and understanding nonverbal communication such as gestures, facial expressions, and body language, which can lead to misinterpretations or communication breakdowns. 4. Literal Understanding: A tendency to process language literally, which can cause challenges in understanding sarcasm, idioms, or abstract meanings in conversation. 5. Repetitive Behaviors and Routines: Engaging in repetitive behaviors or adherence to specific routines might hinder social communication by limiting flexibility in social situations. These differences can vary significantly among individuals with ASD, impacting their social interactions, relationships, and overall communication experiences. Understanding and accommodating these differences are vital for effectively supporting individuals with ASD in social settings. 8. Social Communication Differences 3. Nonverbal Communication Challenges: Difficulty in using and understanding nonverbal communication such as gestures, facial expressions, and body language, which can lead to misinterpretations or communication breakdowns. 4. Literal Understanding: A tendency to process language literally, which can cause challenges in understanding sarcasm, idioms, or abstract meanings in conversation. 5. Repetitive Behaviors and Routines: Engaging in repetitive behaviors or adherence to specific routines might hinder social communication by limiting flexibility in social situations. These differences can vary significantly among individuals with ASD, impacting their social interactions, relationships, and overall communication experiences. Understanding and accommodating these differences are vital for effectively supporting individuals with ASD in social settings. 9. Sensory Needs ● Individuals with autism spectrum disorder (ASD) often experience differences in sensory processing. These variances can manifest in several ways: 1. Sensory Sensitivities: Some individuals with ASD can be hypersensitive or hyposensitive to sensory stimuli. They might be extremely sensitive to sounds, touch, tastes, smells, or sights, experiencing discomfort or distress with seemingly ordinary sensory input. Conversely, some individuals might show reduced responsiveness to sensory input, seeking intense sensory experiences. 2. Sensory Overload: The surrounding environment can easily overwhelm individuals with ASD due to difficulties in filtering and processing sensory information. In crowded or noisy environments, they may experience sensory overload, leading to stress, anxiety, or meltdowns. 9. Sensory Needs 3. Sensory-Seeking Behaviors: Some individuals may actively seek sensory stimulation. They might engage in repetitive behaviors or seek out specific sensory experiences like spinning, flapping, or seeking pressure. 4. Difficulty in Sensory Integration: Difficulty integrating and organizing sensory information might affect their motor skills, coordination, and spatial awareness. This can lead to challenges in various tasks requiring coordination or interacting with the environment. These differences can significantly impact how individuals with ASD experience the world around them. Understanding and addressing these sensory processing differences are vital for supporting their comfort and well-being. 3) Social Communication Differences L A) Social Development Milestones 72 Hours and Beyond: ● Infants as young as 72 hours old can mimic caregiver behaviors like tongue protrusion and mouth opening. ● Mimicry of mouth and tongue movements declines between 2 and 4 months of age. 3-6 Months: ● Sharing of emotions in face-to-face interactions contributes to interpersonal development. ● Infants initially focus on social partners but later shift attention to objects and events. 6-18 Months: ● Coordinated joint attention emerges around 6-18 months, allowing infants to focus on both people and objects. ● Play behavior starts with exploring and manipulating toys. ● Infants engage in mouthing objects and kicking mobiles. ● Infants as young as 8 weeks smile during object interactions. A) Social Development Milestones Around 12 Months: Social games like turn-taking during pat-a-cake begin, involving observing others and imitating actions. ● Infants start responding to bids for joint attention by following social partners' gaze or point, known as social referencing. 9 months-2 years: ● Infants initiate joint attention by pointing or coordinating eye contact and gestures for various functions like seeking help or information. ● 18-24 Months: Infants engage in meaningful joint attention activities, and language acquisition is influenced by culture. ○ Infants engage in functional play, like rolling a car or placing pegs, by the end of their first year. ○ Babies learn cause and effect through repeated actions with objects. ○ Exploring object properties by twisting knobs or banging objects together is observed. ● By 2 years: Children begin asking questions like "What's that?" or "Where's that?" ● They start differentiating between various emotions in others, like anger and joy. ● Symbolic pretend play emerges, involving substituting objects, attributing false properties, or using imaginary items. By Age 3: ● Children respond to distress in others and offer appropriate comfort to meet others' needs. B) Early Signs of Social Challenges in ASD Review: Diagnostic Characteristics: ● Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and interaction across various contexts (American Psychiatric Association, 2013). ● These deficits include impairments in social-emotional reciprocity, nonverbal communicative behaviors, and difficulties in relationship development, including symbolic play and making friends. B) Early Signs of Social Challenges in ASD Early Signs and Joint Attention Deficits: ● Early signs of ASD involve deficits in joint attention, such as lack of responding to bids for joint attention, responding to nam, and initiating joint attention skills (Baron-Cohen, Allen, & Gillberg, 1992). ● Research shows that infants with ASD demonstrate lower joint attention gestures compared to typically developing children (Watson et al., 2013). ● Joint attention difficulties, including sharing attention and responding to shifts in attention, contribute to social referencing challenges (Bedford et al., 2012; Van Hecke et al., 2012). Predictive Nature and Later Outcomes: ● Early delays in joint attention predict developmental delays in various areas as children grow older, including language, imitation, self-regulatory behaviors, and severity of ASD symptoms (Xoder et al., 2009; Ibanez et al., 2013; Van Hecke et al., 2012). ● Better joint attention skills at age 3 correlate with closer friendships and fewer conflicts reported by children with ASD at 8 years old (Freeman et al., 2015). B) Early Signs of Social Challenges in ASD Underlying Mechanisms: ● The social motivation hypothesis suggests that reduced attention to people and increased focus on objects might hinder the specialization of brain regions involved in social cognition (Dawson, 2008). ● Challenges in switching and sharing attention contribute to deficits in joint attention (Perryman et al., 2013; Schietecatte et al., 2012). Facial Expressions and Social Skills: ● Children with ASD display facial expressions similar in duration to their peers, but these expressions might not match the context, indicating challenges in understanding social cues (McGee et al., 1986, 1991; Mundy et al., 1986). ● They may exhibit less empathy responses and demonstrate preferences for non-facial details in photographs (Weeks & Hobson, 1987; Sigman & Ruskin, 1999). ● Students with ASD often struggle with attending to nonverbal cues, taking turns, interpreting facial expressions, and understanding voice tone (Koegel, Koegel, & Carter, 1999; Taylor & McDonough, 1996; Lamers & Hall, 2003). C) Differences in Play and Peer Relationships Play and Social Behavior: ● Children with ASD often engage in solitary play, lacking imaginative and creative aspects in their play (Sigman & Mundy, 1989; Faja et al., 2016). ● They may exhibit repetitive behaviors, such as arranging toys in a particular order or using toys in a repetitive manner (Schuler & Wolfberg, 2000). ● Key behaviors like imitation, object play, and joint attention during infancy predict later communication and intellectual outcomes for children with ASD (Poon et al., 2012). ● Executive function skills in preschoolers with ASD predict their symbolic play abilities at age 6 (Faja et al., 2016). ● For older and more vocal children, conversational difficulties include challenges in initiating, maintaining, and diversifying topics during conversations (Mesibov, Shea, & Schopler, 2004). C) Differences in Play and Peer Relationships Social Acceptance and Friendships: ● Individuals with ASD may face challenges in social acceptance, with gender differences observed in how they are treated, with girls often being ignored or overlooked (Dean et al., 2014). ● During group activities, children with ASD demonstrate fewer instances of sharing, positive affect, social conversation, and collaboration compared to typically developing peers (Bauminger-Zviely & Agam-Ben-Artzi, 2014). ● Adolescents and adults with ASD may struggle with understanding subtle social cues necessary for successful dating, romantic relationships, and intimacy. D) Teaching Joint Attention and Social Skills ● Research underscores the significance of addressing joint attention deficits early in Autism Spectrum Disorder (ASD) as they serve as foundational skills tied to language development and social interaction. Behavior-Based Strategies: ● Klein et al. (2009) employed behavior analysis techniques, like discrimination training, to teach joint attention responses in children with autism. ● McClannahan and Krantz (2005) arranged environmental cues and used natural reinforcement to initiate joint attention, employing audio prompts that led to generalized improvements in children's skills. ● Taylor and Harris (1995) employed time delay strategies to enhance joint attention skills in children with ASD, leading to significant gains in joint attention, imitation, language, and play (MacDonald et al., 2014). D) Teaching Joint Attention and Social Skills Combination Behavioral and Developmental Approaches: ● Kasari et al. (2010) conducted coaching sessions with caregivers, incorporating direct instruction and guided practice, resulting in significant differences in joint attention responses. ● Lawton and Kasari (2012) and Kaale, Smith, & Sponheim (2012) implemented interventions targeting joint attention, yielding increased joint attention initiations in preschoolers with ASD. Parent-Directed Interventions: ● Schertz and Odom (2007) utilized joint attention mediated learning (JAMI) principles, leading to increased joint attention skills in toddlers with autism when implemented by parents. ● Gutstein and Sheely (2002a, 2002b) designed a curriculum focusing on social and emotional development, revealing increased joint attention initiation, especially when transitioning from perseverative to nonperseverative objects. E) Teaching Play Skills with Peers Behavioral Strategies for Social Skills: ● Reinforcement based approaches: pair activities to interest with other novel activities to increase repertoire of play ● Antecedent based interventions- give exposure to variety of activities that children client’s age engage in at home or during 1:1 therapy so as to increase success with peers ● Imitation training- start with imitating motor movements of adults and then eventually they will imitate their peers with opportunities ● Parent-implemented home-based strategies for social and communicative behavior in young children with ASD ● Practice with pretend play/symbolic play Peer-Mediated Interventions: ● Structured play groups ● Play dates F) Social Skills Curriculums for Adolescents/Young Adults/ High Functioning individuals with ASD Two most popular Social skills training programs for adolescents and individuals with high functioning Autism are: ● Social Competence Intervention (SCI) ● Program for Evaluation and Enrichment of Relational Skills (PEERS) Both are curriculum based interventions which involve guided lesson on conversations, initiating in-person and electronic communication with peers, sustaining interactions, social problem solving (dealing with teasing and bullying) etc. The PEERS manual also has lessons on understanding cross gender relationships, love and marriage Cognitive Behavioral Therapy (CBT) ● Is an approach that works with understanding how our thoughts and influence our feelings and how our feelings influence emotions ● often used with individuals who face anxiety-especially social anxiety G) Other Strategies to Teach Social Skills ● Scripts- teach conversation or interaction starters as well as what to say to change conversational topics or play activities ● Video Modeling ● Social Stories ● Role play Any Questions? 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