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Friday, March 4, 2011

Expressive drawing as "augmentative" communication for verbal ASD individuals

Drawing for communication is also a very effective technique for more verbal ASD individuals (Asperger's and PDD-NOS), especially when dealing with emotional and social concepts (a general area of weakness for any ASD person). When emotions run high and life falls apart, the high distress frequently causes language skills to retreat, and words become a poor tool for working through the challenging situation. In this context, drawing is used as an "augmentative" communication tool (where the drawing "augments" or adds to verbal language to provide more detailed and complete information).

Published research has shown the effectiveness of putting social and emotional information into a visual format for individuals on the autism spectrum (eg. Carol Gray's "Social Stories", Tony Attwood's emotional "thermometers" and "toolboxes"). Expressive drawing adds another dimension to this teaching mode, because the ASD individual processes and acts on the information: presenting their own point of view, generating their own strategies and solutions, and predicting potential outcomes. This type of active problem-solving leads to integrated and flexible social learning, building a skill set which allows the individual to apply the information to novel social situations.

Let me introduce you to another young man on my caseload who has been using expressive drawing to solve difficult social situations for many years now. His name is Brett, he has Asperger's Syndrome, and he has very kindly given me permission to share some of his work with you. Here is an example of his drawing about a tricky upset that happened at school:

Solving the problem started with the green square - this was the event that was visible to others - a loud angry upset at school when the teacher tells him the final copy was supposed to be typed - we went back in time visually to see what the real problem was. Square 1 shows the night before, where Brett is trying to get his homework done, but is having great difficulty understanding the details. He wants his dad to come and stand by the computer while he works, so he'll be available for questions. Dad says "no", so Brett comes up with a strategy where he prints out multiple versions of his written work and brings them out to his dad for editing. Meanwhile, his older sister takes issue with the fact that he's wasting paper doing this ("You're killing all the trees!"). Square 2 shows how "happy" he is to be doing his homework. Square 3, the torture continues as dad edits and changes are required. In square 4, he gives up and simply hand-writes his last version. The circled numbers included in the pictures represent how "hot" Brett reported himself to be on his "angrymometer" (from Tony Attwood's techniques) as the incident evolves. In square 6, Brett comments that "Dad screws everything up". Once we knew in detail what was behind the outburst in class, it was possible to make effective strategies for "next time".

Brett is currently finishing high school, and these techniques have helped him to become an effective and flexible social problem-solver (with an excellent "dark" sense of humour that helps to counteract his angry reactions to social mis-steps). His perspective on everyday social interactions is often surprising and always enlightening.

When I spent a lot of time in the schools, I used this type of problem-solving on an almost daily basis. It's something that can be developed with any ASD student, whether they know how to draw or not. All you need is some paper (or a chalkboard) and practice at rendering key parts of a social situation in simple line drawings (it's not "great art", it's visual information - stick figures are good). I have presented these techniques at many teacher workshops over the years, and a lot of the teachers who attended those sessions have since incorporated the drawing techniques into their "bag of tricks". Let me end with an excerpt from an e-mail I got a few days ago from a long-time teaching colleague and friend (after she took a look at the website and blog):

"I use cartooning all the time ... daily in my job as High Needs Coordinator .... This method works every time for me as we attempt to uncover the truth about 'what really happened when you lunged across the table and squeezed the living daylights out of that kids arm!' It's amazing what we learn ... and we always do the Next time .... which does really prove to work over time."

It's not rocket science, and it does work - take a chance and give it a try!

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