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Augmentative and Alternative Communication (AAC) 

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Augmentative and Alternative Communication (AAC) 

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Augmentative and Alternative Communication (AAC) is a high-tech device that aims at generating speech among nonverbal or low verbal students with ASD. https://www.autismspeaks.org/technology-and-autism

AAC supports students with ASD by giving them a voice; allowing their needs, wants, and thoughts to leave them and come out into the open. It reduces frustration. I was volunteering for a Turkey Trot run on Thanksgiving in Fountain Hills, Arizona. My job was to hand out tee-shirts for the race. A middle school student approached me in a wheelchair with his family. I recognized he used an AAC device and, before his parents could tell me what was needed, I bent down to his level and asked him how I could help. I patiently waited while he typed out what size tee-shirt he needed and made eye contact with him the entire time. He beamed with happiness/confidence (as did his parents) that he was acknowledged without the help of an adult; he had a voice and I had taken the time to hear him. Effectiveness of the device is evident; can communication happen?  Receiver input is crucial with understanding and patience a requirement.

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Social Skills Training (SST) is a low-tech strategy involves the teaching of social skills such as taking turns in peer conversations and eye contact. https://www.autismspeaks.org/tool-kit-excerpt/autism-and-social-skills-development

SST aids in establishing and maintaining peer relationships. Examples include students with ASD having a conversation with a peer at lunch, recess, or in the hallway between classes. Social stories can be utilized to teach students with ASD to initiate conversations, appropriate pauses in conversation, and the art of back-and-forth communication. Social stories can also encourage eye contact. Effectiveness, like other therapies, is measured by how well the student is able to interact with other people. In training, consistent teaching should occur and positive reinforcement given when goal achieved.

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Joint Attention Interventions (JA) is a low-tech strategy that teaches the skill of coordinating focus with that of another person so that both people are paying attention to the same thing. https://www.autismspeaks.org/expert-opinion/joint-attention-and-autism

JA interventions are crucial so students with ASD do not come off as aloof and uncaring. Teaching the social skill in real-time might look something like, in a self-contained special education classroom, a student with ASD might notice a sparkly pillow in a calm-down corner and point to it.  The adult might mirror his movement, name it, and ask about his interest.  For example, “I see the shiny pillow. Would you like to touch it?”  Effectiveness is measured by how the JA interaction works. Does the student walk toward the pillow to look at it closer or touch it? Teaching the skill of directing attention to a shared object or activity between the individual and another person to facilitate interaction and communication is a skill that can be learned.

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Discrete Trial Instruction (DTI) is a low-tech strategy to teaching specific communication skills by breaking them down into smaller steps and providing reinforcement for correct responses. https://www.autismspeaks.org/expert-opinion/what-discrete-trial-training

DTI supports by dividing skills into smaller parts, teaching students with ASD through repetition and continuous encouragement. My five-year-old son has ASD and I have used DTI to teach him to wash his hands after using the restroom. After task analysis is performed, visual cues were created to break the task down step-by-step. Effectiveness of the strategy is measured by frequency of prompts which were necessary for some time and consistent positive reinforcement was given when the task was completed correctly. Finally, it clicked that every time he finishes using the restroom, he must wash his hands.  The scaffold was then removed.

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Mobile apps are a high-tech system (tool used within a device to execute a strategy). In showing picture boards and providing voice prompts, these visual schedules aid students with ASD to communicate. https://www.autismspeaks.org/apps-and-technology

Mobile apps allow students with ASD to learn tools for communication. An example is a student with difficulty communicating being provided with voice prompts in order to prompt him to finish a sentence. Effectiveness is measured with communication improvement.

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Speech-generating devices (SGDs) are a high-tech solution to allow students with ASD to express themselves. They come loaded with pre-recorded language or text-to-speak capabilities which allow students with ASD to communicate. https://www.autismspeaks.org/technology-and-autism

SGDs speak out messages as a user types words or selects pictures/symbols. It is good to think of SGDs as a mechanism to enable students with ASD and other nearly nonverbal students to communicate. Examples include someone in a wheelchair with ASD and cerebral palsy. In this example, the student has ASD and other health issues not assisting with communication. SGDs are able to bridge the gap if someone has trouble making eye contact, talking, pushing buttons, etc. Effectiveness of this device can come if someone immediately asks for it and communication efforts improve.

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Video modeling is a high-tech strategy that helps students with ASD understand generally accepted desired behavior by watching pre-recorded videos which demonstrate expectations. https://www.autismspeaks.org/expert-opinion/mr-rogers-and-video-modeling

Video modeling allows students with ASD to watch and reflect social norms. It improves listening and speaking skills and increases attention for learning new tasks and encouraging imaginative play. An example of this is a student watch an episode of decreasing anxiety and excitability on Mr. Rogers’ Neighborhood. Effectiveness of the strategy is measured via student response.

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Picture Exchange Communication System (PECS)

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Picture Exchange Communication System (PECS)

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Picture Exchange Communication System (PECS) is a low-tech strategy which helps individuals with limited speaking abilities to communicate by exchanging picture cards with a communication partner. https://www.autismspeaks.org/picture-exchange-communication-system-pecs

PECS reduces frustration and opens nonverbal or low verbal students up to the world of communication. A common places to see this is in a self-contained special education classroom. A Speech Language Pathologist, working with a nonverbal student with ASD, could sit across a table from the student and show him picture cards which relate to a word. The student could choose one that best expresses his desire and communication is occurring. Effectiveness is measured by how well the student matches the picture cards to his communication desires. Positive reinforcement is given when each communication is performed.

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Picture communication boards (PCBs) are a low-tech device composed of boards with pictures representing something that students with ASD can point to in order to communicate. https://www.autismspeaks.org/blog/video-diy-autism-communication-cards

PCBs allow communication skills to build. I have used on with my own son with ASD when he was two years old.  At the time, I did not understand these scaffolds assist with language and I worried they would be a forever crutch, not permitting to gain skills.  I took it upon myself to use the tool to push beyond words and put two to five pictures together.  He quickly picked up on each “sentence” I was making and we both beamed. Effectiveness can be measured; is the student with ASD, verbal or low verbal, progressing with their timetable of communication?

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Visual schedules are a low-tech strategy with pictures of daily to dos or optional activities to help students with ASD in communication understanding and transitions. https://www.autismspeaks.org/visual-supports?topic[1861]=1861&topic[2031]=2031&topic[1861]=1861&state[176]=176

Visual schedules aid in communication but my experience with them, at the middle school level, has primarily been in aiding in transitions from classroom to classroom and from different tasks done in one classroom.  Effectiveness is measured by how well the student likes the strategy and if it helps with their individual communication efforts.