Non-Verbal Autism: Discovering ways to Effectively Communicate

Guest Blog Post by Amber DeVine-Stinson, MS, CCC-SLP, University of Louisville Autism Center

 

“I just wish he could tell me what he wants.”

“It’s so hard when she is crying and we know something is wrong, but she can’t tell us what it is.”

These words echo true for so many caregivers of individuals with autism. Communication is what sets us apart from the rest of the animal kingdom. Our ability to use complex language to send and receive messages is what makes us human. Communication, both verbal and nonverbal, allows us to form connections with other people, have meaningful relationships, and be part of a community. Often though, the inability to communicate is given far less attention than other deficits that are often present with autism. It seems there is still some lack of awareness of the available options for helping children with autism learn to communicate and a lack of providers in many rural areas. So, when I was asked if I would like to be part of Project Lifesaver’s Autism Awareness campaign, I thought, what a great opportunity to reach caregivers, educators, and therapists and talk about communication!

First, let’s just quickly establish what is NOT communication. Communication is NOT drilling an individual on their ability to point and name colors, numbers, letters, words, and other concepts. All of those things are certainly important, but let’s not confuse rote identification and naming for communication. Communication is also NOT requiring an individual to try to say words or sounds when they clearly struggle to speak. This can often increase frustration. Communication is NOT an individual repeating everything they hear (echolalia). Although some individuals are able to use echolalia to functionally communicate simple wants, it is not a reliable means of communication. Most importantly, communication is NOT denying access to pictures, symbols, and speech generating devices because “speech” is the ultimate goal.

So, what IS communication? Communication IS an individual having access to words, pictures, or objects in order to request items and activities they like, reject things they do not want or like, ask questions about their environment and the people around them, answer questions about themselves and their experiences, direct the actions of others, and to comment on things that happen. As a speech-language pathologist working with individuals with autism, my goal is always to find a way for the individual to communicate to the greatest extent. If you are a caregiver of an individual with autism who is minimally verbal or nonverbal, the speech therapist working with the individual should have the same goal. Even if the individual is verbal, if they are not communicating everything that would be expected of a same-age peer, they may benefit from the use of an alternative communication system or other visual systems.

How exactly can we help individuals with autism learn to communicate to their fullest potential? There are many evidence-based practices for providing individuals with autism a more effective means to communicate. These include the use of printed communication boards, voice output devices with recorded speech, the Picture Exchange Communication System (PECS), and speech generating devices. The term we use to describe all of these is Augmentative & Alternative Communication (AAC). An AAC evaluation conducted by a licensed Speech-Language Pathologist is essential to provide the individual with the most appropriate mode of communication. The AAC evaluation assesses the whole child and should include receptive and expressive language, mobility, vision, hearing, literacy, and fine motor skills.

Augmentative and alternative communication, regardless of the modality, requires explicit teaching of the vocabulary available on the individuals’ system for them to use it effectively for expressive communication. This teaching should be provided to children during early intervention if deemed necessary. Individuals using AAC must be taught how to use a variety of single words in different contexts, for many purposes. “Having a communication device doesn’t make you an effective communicator any more than having a piano makes you a musician” (Beukelman, 1991). If you are the caregiver of an individual with autism that has not been provided with an AAC evaluation, please talk to your speech-language pathologist to discuss if an AAC evaluation would be appropriate. I have included links to several articles and websites as well.

Common Questions about AAC Services in Early Intervention

Augmentative communication and early intervention: Myths and realities

Early Intervention and AAC: What a Difference 30 Years Makes

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