Tuesday, December 16, 2014

Kieran's Communication

Often times those with autism have difficulties with verbal communication. This is not always the case but certainly it's very common. The abilities vary greatly, as with all other characteristics.

When people ask me if Kieran is verbal or non verbal, I have to explain rather than just give a quick answer. Kieran is very verbal, though he is not conversational and often times his communication is only understandable by our family. He does a lot of repeating what other people say, which can be interesting and is a good start for teaching him to use the words on his own. For example, if you ask him a question he will often just repeat the last word or two of your question. Other times you may get a yes or no answer, depending on the question. Both of those are very inconsistent though the repetion of words, or echolalia, is happening very frequently now. Echolalia is the automated repetition of things others have said, which is very common among those with autism. 

Kieran has little difficulty understanding what we're saying, that's very obvious, as responds appropriately to commands. He's also very vocal in general and can name objects or flash cards for his therapists but his overall verbal communication is not that of your "typical" three year old. A lot of what he CAN say, is not used in an unprompted manner on his own. He often babbles and it appears to be random and incoherent (sometimes it is) but once you know him well, you can pick up on him reciting things he's heard before, such as from TV shows. He tends to do this when he's anxious or overstimulated. Great progress has been made, that is certain, but communication continues to be a barrier for him.

PECS or Picture Exchange Communication System is a very common system for assisting those on the spectrum with communication. It involves photos or symbols being used as a way to communicate wants or needs. Educators or parents often use this method for visual cues, which help those on the spectrum to follow a daily routine or make choices. We haven't exactly implemented this full time, but have used imagery to assist Kieran in a couple ways. 

The first time we used any PECS related supports was during his Speech therapy sessions with Early Intervention, back in the spring of 2014. The sessions are play based, which initially was a struggle because Kieran has difficulty with typical play, transitions between activities, and focus. In order to remedy this, she began using a FIRST/THEN card. 

A FIRST/THEN card is literally that. You place a photo of the first activity under FIRST and the next activity under NEXT. This allows the individual to see what is going to happen. They can learn to associate that image with the activity and also learn to follow along in order to finish tasks. It also seemed to decrease his frustration with each session.

When we first implemented this, he wasn't interested, but as time went on it became a motivator. He may not like the first task but he would gladly complete it in order to get to a task that was preferred. Using the photos as cues taught him an immense amount of patience, focus, and communication skills. By the end of his Early Intervention run, his therapist only had to verbally say FIRST/THEN. When she did use the card, Kieran was able to place photos on it by himself. Basically trying to show his therapist what he wished to do during that specific session. I still use those cues/prompts to this day when explaining tasks at home. The cards aren't necessary any longer. They truly served their purpose.

Kieran attends preschool, where they also use PECS related tools for things such as transitions from one activity to another. As far as they've told me, it's helping him there, as well.

Another photo related tool was something I created - family photo cards. Kieran doesn't care for these but I still bring them out and show him the cards with family members photos every now and then. He can say mommy, daddy, Cameron (timmie or cammie), Connor (Nonnor), Memaw, Pappy, and Pop Pop. 

The future may hold some more PECS related tools for Kieran. We struggle with balance for him, as we don't want to throw a million and one supports at him and hope they all stick. With him just finishing Early Intervention and starting preschool, we are letting the dust settle. We will see how he progresses and go from there, as with anything! He continues with his multiple support therapies at school and outpatient, and we see so much progress and the willingness to learn from him. 

If you're new to Autism, please know that as simple as these tools seem, they aren't simple for the autistic person. These things can truly change a persons quality of life. 


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  1. He is a doll. I love his glasses. Great post. Lisa from Quirks and Chaos