Assistive Communication

Devices for Children with

Autism
Assistive Communication Devices for Children
with Autism

Communication issues and autism

For many children with autism, communication issues are one of the rst
telltale signs of autism spectrum disorder (ASD). As autism covers a
spectrum of challenges, children can present communication issues
di erently from one another. Some children might have a large vocabulary
and learn to read at a young age but struggle to contextualize what they
have read or answer who, what, where, when, why, and how questions.

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism
Other children may be able to carry conversations but have trouble
understanding non-verbal aspects of communication such as gestures,
facial expressions, and body language. And then some children with
autism may be entirely non-verbal.

T h e Diagnostic and Statistical Manual of Mental Disorders v.5 (DSM-5)

determines the diagnostic criteria for ASD with the first criterion listed as:

“A. Persistent de cits in social communication and social interaction across

multiple contexts, as manifested by the following, currently or by history
(examples are illustrative, not exhaustive, see text):

1. De cits in social-emotional reciprocity, ranging, for example, from

abnormal social approach and failure of normal back-and-forth
conversation; to reduced sharing of interests, emotions, or a ect; to
failure to initiate or respond to social interactions.
2. De cits in nonverbal communicative behaviors used for social
interaction, ranging, for example, from poorly integrated verbal and
nonverbal communication; to abnormalities in eye contact and body
language or de cits in understanding and use of gestures; to a total
lack of facial expressions and nonverbal communication.
3. De cits in developing, maintaining, and understanding relationships,
ranging, for example, from di culties adjusting behavior to suit
various social contexts; to di culties in sharing imaginative play or in
making friends; to absence of interest in peers.”

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism
According to the National Institute of Deafness and Other Communication
Disorders (NIDCD), children with autism generally display one of the
following patterns of language and use of behaviors: (“Autism Spectrum
Disorder: Communication Problems in Children,” 2017)

Repetitive or rigid language

Sing-song tone or robot-like or high pitched speech

Echolalia
Responding to questions with questions
Narrow interests and exceptional abilities
Delivering in-depth monologue about a topic that holds their interest
Inability to hold a two-way conversation about the same topic
Uneven language development
May develop a strong vocabulary in a particular area of interest very
quickly
May be able to read words before age ve but may not comprehend
what they have read
Often do not respond to the speech of others and may not respond to
their names
Poor nonverbal conversation skills
Unable to use gestures—such as pointing to an object—to give
meaning to their speech
Avoid eye contact
Another child may be entirely non-verbal. According to Bev Long of the
Diagnostic Center of Central California , “As many as 50% of individuals with
autism are non-verbal, and up to 80% are intellectually challenged.” (Long)

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism

The success of assistive communication

devices and strategies
A variety of assistive communication devices and strategies have proven
successful in assisting many children to develop methods of
communicating and even developing speech. These devices are usually
prescribed by a speech-language pathologist and are a part of
augmentative and alternative communication interventions (AAC).

Th is comprehensive research summary by Débora R. P. Nunes for the

International Journal of Special Education discusses 56 studies that took
place from 1980-2007. Nunes concludes:

“Some of the advantages of using sign language included (a) its portability;
(b) its characteristic of being a true language system and, (c) the possibility
of communication occurring at a faster pace. Among the positive aspects
of using a visual-graphic system were: (a) its iconicity; (b) its nontransient
nature; and (c) the limited motor requirements for its use. SGDs were
considered advantageous for (a) they allowed communication to occur at
larger distances; (b) they permitted messages to be easily deciphered, and
(c) required limited cognitive and motor demands.” (Nunes, 2008).

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism
In an article written by speech-language pathologist Jessica Lenden-Holt
and special education teacher Forrest Holt, two case studies are reviewed
of high school aged teenagers with autism. These teenagers were given
instruction on high-tech communication devices for the rst time, three
times a week for an hour each session. Both students were able to use
their devices to communicate their needs give spontaneous answers and
utterances. Additionally, this article proves that high school students have
not necessarily met their full language potential by their teenage years,
and the appropriate AAC interventions can help them improve and
develop communication skills. (Holt, 2017).

Available assistive communication

devices and strategies
A variety of assistive communication devices and strategies are available.
The most common are visual boards, a picture exchange communication
system (PECS), sign language, gestures, and low technology interventions,
and high technology electronic devices.

Visual Boards
Visual boards help children with autism express their preferences,
emotions, understand rules, and schedules. Visual boards usually consist
of a series of pictures, sometimes with words labeling each picture that
children can point to or arrange in order to express their needs or desires.
Visual boards can be modi ed to an individual child’s needs by showing
simple or more complex images. Often times, the images are attached to
the board with Velcro or other adhesives so that children can arrange
them into their desired schedule or place the appropriate image after a
question (e.g., What do you want to eat?).

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism
Picture Exchange Communication System
PECS are broken down into six progressive phases: how to communicate,
distance and persistence, picture discrimination, sentence structure,
responsive requesting and commenting. These buildable skills teach
functional communication and even help some children develop speech.
Children begin at stage one showing their teacher or communication
partner a picture of something they desire—a cookie or juice, for example,
and their requests are immediately honored. As students progress, they
arrange pictures into sentences and then use to learn modi ers, initiate
conversation, and answer questions. Pictures can be bought in a set or
made at home to customize them to your child’s exact needs.

Sign Language
Sign language is considered one of the most practical and functional forms
of communication for children with autism. Sign language is widely
recognized by a variety of communities including the deaf and hearing
impaired community and is a formally recognized form of language.
Children with autism often bene t from Signing Exact English (SEE) as
opposed to American or British Sign Language. SEE follows the speech
pattern and sentence structure of spoken English making transferring their
signs to speech as their language develops much easier. A variety of
methods are available to help a child with autism learn sign language
ranging from ashcards to videos or taking lessons from a certi ed sign
language instructor. Children who are visual or tactile learners may pick up
sign language easier than auditory learners do.

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism
As with all communication methods, di erent children will do better with
di erent interventions. For some children with autism, gestures can be
particularly di cult to associate with language, while others will more
easily connect gestures to phrases and desires. Children with some
speech skills might do better with gestures than their nonverbal peers. By
pairing speech with gestures to ll in gaps of their spoken language.
Gestures may be supplementary to sign language or of the child’s
invention. It is important for caregivers and parents to be aware of these
gestures and their meaning so that the child’s needs can be met.

Low technology AAC interventions

Low technology AAC interventions are generally “parts of a whole.” These
may include the Velcro for visual boards, adaptive writing tools including
weighted pencils, large ruled paper, stress balls, or other manipulatives.
These low technology interventions usually assist children in accessing
language and speech skills they already have.

High technology electron devices

High technology electron devices are quickly rising in popularity as they
become more obtainable. These devices can vocalize speech for children
who can either type or identify pictures. Apps are available for
smartphones and tablets for children to try to see if the technology works
for them before trying more intricate devices. These devices will not
necessarily stop children from talking, and many even develop speech
after using AAC devices. It is important to note that it may take months or
even years for a child to master a device.

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism

How to access the best assistive devices

for your child
Choosing the best assistive device for your child and ensuring he or she
has consistent access to a chosen device or communication method can
be a daunting task for many families. A great rst step is to nd a speech-
language pathologist (SLP) who connects well with your child. Referrals
can be made by a pediatrician, occupational therapist, psychologist, or
psychiatrist. Children with individualized education plans (IEP) will have
access to a SLP through their school district. The SLP will be able to
conduct an AAC evaluation to match your child with the best methods or
devices for his or her learning style and skill level. Rebecca Eisenberg, MS
CCC-SLP wrote a comprehensive article on this process that you can nd
in Autism Parenting Magazine.

As Eisenberg notes, there is a zero reject policy for AAC. Children who
need the devices will not be rejected based on their abilities. She also
notes that an ACC evaluation can be funded through private insurance,
Medicaid, or your child’s school district. Including your child’s teacher and
his or her observations of your child in the AAC evaluation can be
invaluable in ensuring your child’s SLP has the fullest picture possible of
his or her needs and skills.

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism
As children develop their communication and speech skills, it is important
that caregivers and teachers learn along with them. This learning curve
can be frustrating and nonlinear, but patience is key to ensuring your child
gets the most out of his or her AAC device. Sitting in on your child’s
sessions with the SLP can ensure you are on the same page as your child
and help him or her during technology glitches or moments of frustration.
As children gain a greater understanding of speech and language and
develop greater communication skills, they often experience lower levels
of frustration and gain further confidence in their abilities.

Resources:
N. (2017, December 12). Autism Spectrum Disorder: Communication
Problems in Children. Retrieved February 02, 2018, from
https://www.nidcd.nih.gov/health/autism-spectrum-disorder-
communication-problems-children#3“A s many as 50% of individuals with
autism are non-verbal and up to 80% are intellectually challenged.”

Long, B. (n.d.). Autism Basics. Retrieved February 02, 2018, from

http://www.dcc-cde.ca.gov/af/afbasic.htm

Nunes, D. R. (2008). AAC Interventions for Autism: A Research Summary.

International Journal of Special Education, 23(2), 17-26. Retrieved February,
2018, from https://files.eric.ed.gov/fulltext/EJ814395.pdf.

Holt, J. L. (2017, December 01). Has My Child Reached Full Communicative

Potential? Retrieved February, 2018, from
https://www.autismparentingmagazine.com/has-my-child-reach-full-
communicative-potential/

Assistive Communication Devices for Children with Autism

Assistive Communication Devices for Children
with Autism
Katherine G. Hobbs is a freelance journalist and university student
studying English, with an emphasis on journalism, and psychology. She is
interested in the impact of having a special needs child on the family
dynamic. Katherine is dedicated to bringing awareness of resources to
families and providing help to those who love their autistic children. You
can find her online at katherineghobbs.com.

Assistive Communication Devices for Children with Autism