AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 1
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC with ABA for ASD:Easy as 1, 2, 3
Christina Martin, M.S., CCC-SLP, BCBARacheal Montgomery-Garba, M.S., CCC-SLP
Christina Martin, M.S., CCC-SLP, BCBARacheal Montgomery-Garba, M.S., CCC-SLP
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
Handouts
Updated handouts are available on our website at:
OSHA Conference 2017
www.therapyandbeyond.com/presentations
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 2
Executive Director: Regina Crone, Ph.D., BCBA-D
Disclosures
Racheal Montgomery-Garba, M.S., CCC-SLP
Relevant Financial Disclosures• Receives payment for employment at Therapy and Beyond. This
organization provides ABA and speech therapy to individuals with autismand other developmental disabilities.
Relevant Non-Financial Disclosures• None
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
Disclosures
Christina Martin, M.S., CCC-SLP, BCBA
Relevant Financial Disclosures• Receives a salary for employment at Therapy and Beyond. This
organization provides ABA and speech therapy to individuals with autismand other developmental disabilities.
Relevant Non-Financial Disclosures• Is dually credentialed as a Board Certified Behavior Analyst.
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 3
Executive Director: Regina Crone, Ph.D., BCBA-D
Objectives
• Describe how individuals with Autism Spectrum Disorder (ASD)could benefit from Augmentative and Alternative Communication(AAC)
• Explain the potential benefits of AAC on the development ofnatural speech with individuals with ASD
• Recognize the myths about AAC and distinguish scientific frompseudoscientific treatment claims
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
What is Autism?
• Autism, or autism spectrum disorder (ASD), refers to a range ofconditions characterized by challenges with social skills, repetitivebehaviors, speech and nonverbal communication, as well as byunique strengths and differences. We now know that there is notone autism but many types, caused by different combinations ofgenetic and environmental influences.
OSHA Conference 2017
Autism Speaks. (2017). What is Autism? Retrieved from: https://www.autismspeaks.org/what-autism
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 4
Executive Director: Regina Crone, Ph.D., BCBA-D
What is Autism?• About 1 in 68 children has been identified with autism spectrum
disorder (ASD).• ASD is reported to occur in all racial, ethnic, and socioeconomic
groups.• ASD is about 4.5 times more common among boys (1 in 42) than
among girls (1 in 189).• About 1 in 6 children in the United States had a developmental
disability in 2006-2008, ranging from mild disabilities such asspeech and language impairments to serious developmentaldisabilities, such as intellectual disabilities, cerebral palsy, andautism.
OSHA Conference 2017
Centers for Disease Control. (2017). Autism Spectrum Disorder: Data and Statistics. Retrievedfrom: https://www.cdc.gov/ncbddd/autism/data.html
Executive Director: Regina Crone, Ph.D., BCBA-D
Need for AAC with ASD
Approximately ofindividuals with autism present with little or nofunctional speech and may be candidates forAAC to replace or supplement natural speech.
Approximately ofindividuals with autism present with little or nofunctional speech and may be candidates forAAC to replace or supplement natural speech.
Weitz, C., Dexter, M., Moore, J., Glennen, S., & Decoste, D. (1997). AAC and children withdevelopmental disabilities. Handbook of augmentative and alternative communication, 395-431.
Lloyd, L. L., Fuller, D. R., & Arvidson, H. H. (1997). Augmentative and alternative communication: Ahandbook of principles and practices. Needham Heights, MA Allyn & Bacon
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 5
Executive Director: Regina Crone, Ph.D., BCBA-D
What is AAC?
Augmentative and Alternative Communicationincludes(other than oral speech) that are used toexpress thoughts, needs, wants, and ideas.
Augmentative and Alternative Communicationincludes(other than oral speech) that are used toexpress thoughts, needs, wants, and ideas.
American Speech-Language-Hearing Association. (2002). Augmentative and alternativecommunication: knowledge and skills for service delivery [Knowledge and Skills]. Available fromwww.asha.org/policy.
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
Augmentative vs. Alternative
OSHA Conference 2017
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of speech-language pathologists with respect to augmentative and alternative communication: Technicalreport [Technical Report]. Available from www.asha.org/policy.
Supplement to currentcommunication
Supplement to currentcommunication
Replacement of currentcommunication
Replacement of currentcommunication
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 6
Executive Director: Regina Crone, Ph.D., BCBA-D
Key Terms
Act of giving orreceiving information
in any form
Act of giving orreceiving information
in any form
System ofconveying thoughtwith shared rules
System ofconveying thoughtwith shared rules
Communicationby vocal
production
Communicationby vocal
production
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Forms
Sign LanguageCommunication Boards
PECSAnd many, many more
Sign LanguageCommunication Boards
PECSAnd many, many more
Speech GeneratingDevices
Electronic CommunicationSystems
Speech GeneratingDevices
Electronic CommunicationSystems
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 7
Executive Director: Regina Crone, Ph.D., BCBA-D
No Tech Example
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
Low Tech Example
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 8
Executive Director: Regina Crone, Ph.D., BCBA-D
High Tech Example
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
Which AAC is best?
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 9
Executive Director: Regina Crone, Ph.D., BCBA-D
Which AAC is best?
The best method supportsthe development of spontaneous, meaningfulcommunication that generalizes to allenvironments. There is no such thing as onesize fits all.
The best method supportsthe development of spontaneous, meaningfulcommunication that generalizes to allenvironments. There is no such thing as onesize fits all.
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
Feature Matching
OSHA Conference 2017
Caron, J. (2013) Feature Match Table. Retrieved from http://www.childrenshospital.org/centers-and-services/augmentative-communication-program/downloads/app-and-clinical-feature-matching-handouts
an individual’savailable or potentially available augmentative andalternative communication
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 10
Executive Director: Regina Crone, Ph.D., BCBA-D
Feature Matching Table
OSHA Conference 2017
Caron, J. (2013) Feature Match Table. Retrieved from http://www.childrenshospital.org/centers-and-services/augmentative-communication-program/downloads/app-and-clinical-feature-matching-handouts
Executive Director: Regina Crone, Ph.D., BCBA-D
Pseudoscientific ClaimsPseudoscience refers to claims that appear to be based on the scientific method
but are not.
Finn, P., Bothe, A.K., & Bramlett, R.E. (2005). Science and Pseudoscience in Communication Disorders.American Journal of Speech-Language Pathology, 14, 172-186.
OSHA Conference 2017
1. Untested2. Unchanged3. Confirming evidence4. Anecdotal evidence5. Inadequate evidence6. Avoiding peer review7. Disconnected8. New terms9. Grandiose outcomes10.Holistic
Russell’s Orbiting Teapot
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 11
Executive Director: Regina Crone, Ph.D., BCBA-D
Scientific Claims
“ASD is a medical/ neurodevelopmental condition with behavioral symptoms that are directly addressed by appliedbehavior analysis methods. ABA has proven effective in addressing the core symptoms of autism as well asdeveloping skills and improving and enhancing functioning in numerous areas that affect the health and well-beingof people with ASD.”
“The effectiveness of ABA-based interventions in ASDs has been well documented through a long history of research inuniversity and community settings. Children who receive early intensive behavioral treatment have been shown to makesubstantial gains in cognition, language, academic performance, and adaptive behavior as well as somemeasures of social behavior, and their outcomes have been significantly better than those of children in control groups.”
“ABA has both long-term empirical and research data to demonstrate its effectiveness inhelping children who are diagnosed with ASD, and AAP has endorsed the use of ABAtreatments when determined appropriate by physicians within a medical home, in closeconsultation with families.”
Applied Behavior Analysis as an Evidence-Based Practice
American Academy of Pediatrics. (2012) Statement on the Use of ABA to Treat Individuals with ASDs.Retrieved from http://www.armed-services.senate.gov/statemnt/2012/06%20June/Tait%2006-21-12.pdf
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
Applied Behavior Analysis
“The in which procedures derived fromthe are systematicallyapplied to improve behaviorto a meaningful degree and to demonstrateexperimentally that the procedures employed wereresponsible for the improvement in behavior." (p.14)
“The in which procedures derived fromthe are systematicallyapplied to improve behaviorto a meaningful degree and to demonstrateexperimentally that the procedures employed wereresponsible for the improvement in behavior." (p.14)
OSHA Conference 2017
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis, 2nd ed. Upper Saddle River,N.J.: Pearson Prentice Hall.
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 12
Executive Director: Regina Crone, Ph.D., BCBA-D
Applied Behavior Analysis
Some individuals may rely on socially inappropriate,or maladaptive behaviors (i.e. hitting) tocommunicate their needs to others. In these cases,
can serve as an method ofcommunication through
.
Some individuals may rely on socially inappropriate,or maladaptive behaviors (i.e. hitting) tocommunicate their needs to others. In these cases,
can serve as an method ofcommunication through
.
OSHA Conference 2017
Danov, S.E., Hartmann, E., McComas, J.J., & Symons, F.J. (2010). Evaluation of two communicative responsemodalities for a child with autism and self-injury. The Journal of Speech and Language Pathology- Applied BehaviorAnalysis, 5(1), 70-79.
Wacker D. P, Berg W. K, Harding J. W, Derby K. M, Asmus J. M, & Healy A. (1998). Evaluation and long-term treatmentof aberrant behavior displayed by young children with disabilities. Developmental and Behavioral Pediatrics, 19, 260–266.
Executive Director: Regina Crone, Ph.D., BCBA-D
Functional Communication Training
A differential reinforcement procedure inwhich an individual is taught an
that results in the same class ofreinforcement identified as maintainingproblem behaviorFor example, instead of screaming for an orange, anindividual is taught to exchange a picture to gain access.
A differential reinforcement procedure inwhich an individual is taught an
that results in the same class ofreinforcement identified as maintainingproblem behaviorFor example, instead of screaming for an orange, anindividual is taught to exchange a picture to gain access.
OSHA Conference 2017
Carr, E.G. & Durand, V. (1985). Reducing behavior problems through functional communication training. Journalof Applied Behavior Analysis, 18, 111–126.
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 13
Executive Director: Regina Crone, Ph.D., BCBA-D
Functional Communication Training
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
AAC is speechintervention strategy.
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 14
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
“AAC interventions on the failure to developspeech skills or considered a last resort because AAC can play many roles inearly communication development.”
“AAC devices and strategies are a tool, a means to an end — language and
communication skills — .”
“AAC interventions on the failure to developspeech skills or considered a last resort because AAC can play many roles inearly communication development.”
“AAC devices and strategies are a tool, a means to an end — language and
communication skills — .”
AAC is a last resort speech intervention strategy.
Romski, M. & Sevcik, R. (2005). Augmentative communication and early intervention: Myths andrealities. Infants and Young Children, 18(3), 174-185.
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
AAC is speechintervention strategy.
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 15
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
There areskills needed for AAC.
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
individuals are considered potential candidates for AAC. There is a
policy with respect to determining individuals' eligibility for AAC
services. There is arbitrary list of (i.e. matchpictures, level of cognitive ability, etc.)
" . . . breathing is the only prerequisite that is relevant to communication.Breathing equals life, and life equals communication. It is that simple."
There are pre-requisite skills needed for AAC.
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of speech-language pathologists with respect to augmentative and alternative communication: Technicalreport [Technical Report]. Available from www.asha.org/policy.
Kangas, K. & Lloyd, L. (1988). Early cognitive skills as prerequisites to augmentative andalternative communication use: What are we waiting for? Augmentative and AlternativeCommunication, 4(4), 211-221.
Mirenda, P. (1993). Bonding the uncertain mosaic. Augmentative and Alternative Communication,9(1), 3-9.
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 16
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
There areskills needed for AAC.
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
Only benefitfrom AAC.
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 17
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
The comprehensive study of AAC intervention by Millar, D., et. al, (2006)indicated that the positive effects of AAC intervention on speech production were
observed across children and adults, ranging in age from
.
It is too early or too late to start teaching AAC.
Only certain ages benefit from AAC.
Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternativecommunication intervention on the speech production of individuals with developmental disabilities:A research review. Journal of Speech, Language, and Hearing Research, 49, 248-264.
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
Only benefitfrom AAC.
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 18
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
AAC willspeech and language
development.
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
There have been published studies that show decreased speechproduction as a result of AAC. Two articles reviewed all of the previously-published research that had investigated speech production before, during, and
after AAC intervention. of the individuals involved in any of the studiesdemonstrated decreases in speech production as a result of AAC intervention.
The majority demonstrated at least modest .
AAC will inhibit or impede speech and language development.
Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternativecommunication intervention on the speech production of individuals with developmental disabilities:A research review. Journal of Speech, Language, and Hearing Research, 49, 248-264.
Schlosser, R., & Wendt, O. (2008). Effects of augmentative and alternative communicationintervention on speech production in children with autism: A systematic review. American Journal ofSpeech-Language Pathology, 17(3), 212–230.
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 19
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
According to the study by Millar, D., et. al, (2006)investigating speech production before, during, andafter AAC intervention, participants with:
• Decreases in speech production- 0%• No change in speech production- 11%
OSHA Conference 2017
Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternativecommunication intervention on the speech production of individuals with developmental disabilities:A research review. Journal of Speech, Language, and Hearing Research, 49, 248-264.
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
According to Mirenda (2003), if AAC (e.g., the manualsign or graphic symbol for cookie) is presented alongwith the spoken word (as is typically the case in AACintervention), and these are followed by a reinforcer(e.g., a chocolate chip cookie),
.
Mirenda, P. (2003). Toward functional augmentative and alternative communication for studentswith autism: Manual signs, graphic symbols, and voice output communication aids. Language,Speech, and Hearing Services in Schools. 34 203–216
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 20
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Myths
AAC willspeech and language
development.
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
AAC Competence Takes Time
OSHA Conference 2017
AAC with ABA for ASD: Easy as 1, 2, 3Christina Martin, CCC-SLP, BCBARacheal Montgomery-Garba, CCC-SLP
09.16.2017
Therapy & Beyondwww.therapyandbeyond.com539.777.0940 21
Executive Director: Regina Crone, Ph.D., BCBA-D
Credit for Images Used• http://www-tc.pbs.org/parents/education/files/2012/06/Sign-
Language.jpg• http://www.asha.org/events/convention/handouts/2011/frost-horton-
matteo-waegenaere&psig=AFQjCNFK9cWXI5-AENpCEH_08LAT5fH2CA&ust=1454480315243447
• https://shaivalinisingh.files.wordpress.com/2011/12/footwear-big.jpg• https://hobi.com/myth-busters-itad/myth-busters-itad/• https://itunes.apple.com/us/app/touchchat-hd-aac/id398860728?mt=8
• http://www-tc.pbs.org/parents/education/files/2012/06/Sign-Language.jpg
• http://www.asha.org/events/convention/handouts/2011/frost-horton-matteo-waegenaere&psig=AFQjCNFK9cWXI5-AENpCEH_08LAT5fH2CA&ust=1454480315243447
• https://shaivalinisingh.files.wordpress.com/2011/12/footwear-big.jpg• https://hobi.com/myth-busters-itad/myth-busters-itad/• https://itunes.apple.com/us/app/touchchat-hd-aac/id398860728?mt=8
OSHA Conference 2017
Executive Director: Regina Crone, Ph.D., BCBA-D
Questions
OSHA Conference 2017
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Executive Director: Regina Crone, Ph.D., BCBA-D
Contact Information
www.mytherapyandbeyond.comwww.mytherapyandbeyond.com
539.777.0940539.777.0940
OSHA Conference 2017