Teaching Nonverbal and Less Verbal People - Adam paints a self portrait

"Live as if you were to die tomorrow. Learn as if you were to live forever." 

~ Mahatma Gandhi

Adam writes and draws about our portrait painting class

Adam is an intelligent young adult on the autism spectrum who is less verbal and uses drawing and other art forms for communication. I first met Adam when he was just 3 years old and profoundly nonverbal. My job as a speech-language pathologist was to help him learn to connect and communicate with the world around him. What actually happened over the next couple of decades was more interesting - as much as I taught him, he taught me more. So at this point, I'll say that together Adam and I have discovered some effective ways to get around the barrier of imperfect verbal communication and give voice to the intellect and creative soul within. With Adam's permission, we now share some of what we've learned.


In the Art Studio:

Portrait teaching setup (Adam's easel on the left, my instructional model on the right, iPad photo reference and painting materials in the center)

You need a space that is friendly and comfortable for the student. The art studio we are working in is one that Adam's dad set up for Adam and his mom (who is also learning to paint). We have a generous work surface so that materials can be visually set out in an organized way. There is room for Adam (a tall guy) to step back and move around. Also important to consider lighting (need to see clearly, but not aggravate sensory sensitivies), sound environment (reduce background noise) and air quality (allergies, eg. free from mold & mildew).


Below are links to the two instructional videos that we made from our recent portrait painting sessions (posted on our YouTube channel AUTISMartCOMMUNICATE). These videos highlight and demonstrate some effective teaching strategies when working with less verbal individuals, including:

• use of visual demonstrations
• working from visual models
• effective use of the iPad as a visual tool (takes & displays photos, allows zooming in on specific details)
• verbal language should be clear, slow-paced and match demonstrated actions
• back up verbal language with visual supports (to improve comprehension)
• allow time for processing of verbal questions and instructions
• repetition and rephrasing (of key information) can be helpful
• resist "chattering" (remind yourself to leave quiet spaces)
• SHOW more than TELL
• gentle "hand over hand" can sometimes be useful when teaching a new motor skill
• simplify language without "talking down"
• allow the student to work at their own pace (don't rush)
• student should be mostly calm, relaxed and enjoying the experience
• okay for students to talk to themselves as they work
• specific to portrait painting, be aware that autism can affect the individual's ability to process the human face
• balance direct instruction with developing the student's artistic expression & style
• art activities are a good context for language learning 
• assume competence (and that all of your words are received and understood)

Part 1 (from the first hour-long painting session):

(if the video won't play click this link: Adam paints a self portrait - part 1 )

And Part 2 (from our second one-hour portrait painting session):

(if the video won't play click this link: Adam paints a self portrait - part 2 )

We hope you find these videos helpful and that you try out some of the methods in your own classes and studios. There is a lot of untapped artistic potential in the autism population, and many new artists waiting to learn new ways to express themselves. We would love to hear about your experiences.

We'll end this post by sharing Adam's completed self portrait. He has a bold and expressive artistic style that comes through in all of his art work, and is all his own. I love it:

Self Portrait by the artist, Adam V

Drawing to Communicate: making sure your message is received!

This morning I received the kind of message that totally recharges my "therapist batteries".

In a recent post (click here to read "Drawing for Communication: how to get things started"), I wrote about Kieran, a young boy on the autism spectrum, who was beginning to use his newly developed drawing skills to communicate. Earlier today, his mom sent me an update by e-mail:

"We were chatting about having an outing ... either to Carp Market or the beach at Fitzroy Harbour Provincial Park. Kieran was in the room when we were talking and said that he wanted to go to the beach. We acknowledged his input, but I think he wanted to make really sure that we understood - he got a piece of paper and a pencil and drew this for us!"

Yay, triple yay for Kieran! He used his new drawing communication skills to make sure that his important message was received by his family (who were happy to accommodate his wishes in the family schedule for the day).

Being able to clearly communicate your thoughts and wishes to others (who will listen to and respect that communication) is the strongest strategy for short-circuiting difficult behaviour and melt-downs - knowing that you're "heard" makes all the difference.

Thanks so much to Kieran and his family for allowing us to share this story .... Sheila B


Posted using BlogPress from my iPad

Drawing Together for Communication: how to get things started

Drawing can be a useful tool for developing communication skills in young children, and in older children (and teens and adults) with communication delays.

One of the techniques I commonly use in therapy is "collaborative drawing", where each person contributes to the larger drawing, and the drawing itself acts as a visual record of the conversation or story. Take a look at this video (made with my typically developing nephew Will when he was 4 years old) for a short demonstration of this technique:

click this link if video does not automatically appear in your browser

 

 

Today I want to share with you some interesting developments from one of my young friends on the autism spectrum. Kieran is a bright active young boy (in grade 4) with delays in the development of his verbal language. He is very visual and is a whiz at math and putting together complicated building toys using diagram instructions. For the past two years, his family and I have been drawing things for him, making visual representations of what happens in our toy play and also of situations and interactions from the larger world around him.

During our early sessions, he was happy to have others do the drawing. The drawing was a good anchor for our conversations during play and this helped his focus, his comprehension and his verbal language development. Following our drawing/play sessions he liked to have the big drawings posted on the walls at home so he could look at them, think about them and talk about them with his family.


Then, at the beginning of this calendar year, Kieran started to take a more active role in the drawing process.


He began to frequently tell me what to draw and how to draw it. For example, this "portrait" of him and his cat was drawn in January according to his very detailed instructions:

portrait of Kieran in cowboy hat & tractor pyjamas (drawn by me, directed verbally by him)

He started drawing spontaneously to express himself - here is a picture, also from January, that he drew when his mom was drawing out some challenges from the school day (his suggestion ... how about going to Monster University?):

"I want to go to Monster University"

He has begun to draw collaboratively, adding details and figures to our large drawings (that we do beside our toy play), so now those drawings include his direct visual thoughts as well as his play ideas and what he has verbally directed me to add.

Here's a drawing from February where we explored the difficulty of loud noises and emotional responses to various situations - at the end of our session, he spontaneously added his two cats:



this "big picture" is done on 2 ft x 3 ft paper beside our toy play area
(this day we were playing with trains & plasticine figures)

Kieran's cat Ginger

Keiran's cat Spooky

 

Then at our last session in April, he added multiple details to our picture about Thomas the Tank Engine and friends:

 

Kieran added tracks and faces and smokestacks and many other details

What are the benefits of going after communication in this context?

 

First and foremost, it's fun and relaxed, and it makes formidably difficult skills (communication and social interaction) more approachable and accessible.

 

Second, it stimulates communication development in a very natural context, so the language learned is already generalized to where it's functional and fits.

 

Third, it lets the individual (who is the target of the therapy) set the pace - you can be certain that the information is going in, and they will show you when they have enough information and confidence to give the new skills a try.

 

 

 

 

Because we have never forced the issue, Kieran continues to willingly taking steps forward, trying new things and gaining confidence daily.

 

I leave you with his latest creation, a plasticine cat modeled after the many little plasticine animals I have made for him during our play over the last year - as you can see, it's a great cat with lots of personality and a happy disposition ... just like the young artist who made it.

 

Kieran's clay creation

 

 

iLanguage: creative language teaching using the iPad

The visual touch screen interface of the iPad brings many possibilities for creative language teaching - today I'd like to share with you a few of the ideas (and apps) that I've been trying out in recent therapy sessions with ASD individuals:


1. Action verbs:

Concrete nouns are relatively easy to teach using objects and static pictures. But action verbs are more complicated because they (by their nature) involve movement - so it's hard to be certain that what the therapist thinks they're teaching is what the student is actually learning.

Here's a short video showing Adam creating sentences using Word Mover (a creative writing app that works like magnetic fridge poetry). I would give Adam one or two words, he would add more and put a sentence together. Then we used Stop Motion Studio Pro HD (an iPad animation app) and small clay figures to "illustrate" the sentence meaning - because the end product was a film clip, rather than a static picture, it was easier to see what Adam understood and where he might have gaps in his interpretation of the language meaning:

CLICK HERE: Using iPad apps for Language Teaching

Here's another video showing Kevin using Word Mover, traditional pen-paper drawing and FlipBoom Cartoon (a different iPad animation app) to illustrate the meaning of a short story he wrote (using one of the words he had just spelled in Montessori Crossword, another app I really like for the structured way it connects written letter patterns to the word sound patterns):

CLICK HERE: Kevin's Jogging Story

And here's one more video (from Kevin's session today) where I would give Kevin a verb (in Word Mover) and then he would write a complete sentence using that verb. He uses both pen-paper drawing and the FlipBoom Cartoon animation app to illustrate the meaning of the sentences he's written. (note: I am a big fan of grammatical errors - they show me that I'm getting original generative language rather than rote language chunks):

 

CLICK HERE: Kevin Writes & Illustrates

2. Creative Writing:

The Word Mover app is also useful for writing "starters" and inspiration. You write one or more words and then let your student write additional words and arrange the words into a sentence. I'm finding that the "puzzle" nature of the exercise and the ability to modify (add/delete/rewrite) without visible "errors" at the end is encouraging more risk-taking (trying out words that are not well-known, trying to write sentences that are more grammatically complex).

I gave Michael the words "boy" and "horse" - he changed "boy" to "cowboy", and added some more words to make the sentence "A cowboy needs a horse". He drew an illustration by hand (marker on paper) and then he made an entertaining animated short (using FlipBoom Cartoon) of a cowboy unwillingly transforming into a horse. He was calm and focused and expressed a complete (and funny) original idea. Watch the video:

CLICK HERE: Cowboy & Horse by Michael

So go ahead, get creative, use the iPad technology to its best advantage - it is a wonderful direct visual interface that can help you make the world of verbal communication less mysterious and more accessible to your students with autism.

Blending hi-tech and low-tech for optimal learning

The world of technology is developing at the speed of light, and the advent of good touch screens and affordable well-written software that takes advantage of the direct visual interface brings new and wonderful possibilities into classrooms, therapy rooms and family homes. Putting an iPad (or android tablet) into the hands of every child seems like a great idea. But there are challenges: how do you choose good apps? how do you integrate the use of a touch-screen device into your current programming? how do you develop practical aptitude on devices that only existed in the imagination when you were growing up?

Today's post addresses the second challenge: "How do you integrate the use of a touch-screen device into your current programming?" I will give some examples (with illustrations from recent therapy sessions with Kevin and Adam) of how you can use both iPad apps and "real world" tasks together in language learning activities.

First a little background:

Comic Strip stories allow a visual person to create coherent narratives (see blog post ... it's all about stories ). As my students become adept at drawing stories, we use the visual story format as a "scaffold" to teach traditional written language (initially the picture is drawn first and then a sentence is written to go with it, some students have moved on to writing a simple sentence first then adding extra details in the comic illustration).

Scrambled Sentences is another general type of learning activity that I use to teach grammar without the extra challenges of spelling and fine motor (see blog post Scrambled Sentences - using drawing to support language development and teaching video Drawing as Communication - Scrambled Sentences ).

Recently, I broadened both of these learning contexts by adding in some iPad apps.

Comic Strip Story:

Word Wizard is a spelling to speech app by l'Escapadou. On the "movable alphabet" function, you can drag letters to the board and the program will sound out both the individual letters (as you select them) and the letter combinations that you spell. You have the choice of several voices, and you can have the entire phrase/sentence read aloud when you touch the speech bubble icon:

I started Kevin out with the words "mister bean" and he wrote the rest of the sentence (his own words and ideas). Then we switched from high-tech to low-tech, and Kevin drew out the meaning of the sentence to start his Mr. Bean story. Subsequent story events came from sentences spontaneously written by Kevin using the Word Wizard app:

 

 

 

all pictures drawn by Kevin 2013

I'm not concerned about the grammatical errors in Kevin's written sentences, since the point of the activity is for Kevin to express his own ideas using a combination of written language and drawing (I actually like to see grammatical errors - it's an indication that I'm getting novel generative language rather than phrases and sentences copied verbatim from another context)

(and on another note, this looks like a pretty good plan for a post-secondary learning program!)

Scrambled Sentences:

Word Mover is a creative writing app by ReadWriteThink (National Council of Teachers of English). It works on the same premise as magnetic poetry for your fridge. You have the choice of starting with a pre-existing "word bank" that provides you with a collection of words that you can use in your writing, or you can start from a blank screen ("My Own Words"). Additional words are added with the "+" function.

During the same session as Kevin wrote his Mr. Bean story, I set up a traditional "scrambled sentence" using the Word Mover app (I selected and wrote the words, Kevin unscrambled them into a sentence):

 

 

Then Kevin drew out the meaning of the sentence using markers and big paper. (the second sentence "Kevin and Raymond are making an art project" was independently written by Kevin, using the Word Mover app, based on the structure of my initial sentence):

drawn by Kevin 2013

The benefit of adding the apps into both of these language activities was an increased ease and flexibility in the writing process for Kevin. I'm hoping that this will stimulate further development in his functional expressive written language.


Two more quick examples of "Scrambled Sentences" from Adam's recent work:

1. Adam's mom gave him the words "boy", "girl" and "snowball" on a Word Mover screen. Adam added more words and unscrambled the sentence to read "The boy and girl is fighting in the snowball.", then he illustrated his meaning using markers on paper. With the picture making his meaning clear, his mom was able to show him (using Word Mover) some minor changes that made the sentence grammatically correct.

drawn by Adam 2013

2. Adam's mom started him off with the words "baby", "dragon" and "fire" on Word Mover. Adam added more words and created the sentence "The baby this is fire the dragon". With the support of the picture Adam drew to illustrate his intended sentence meaning, his mom was able to help Adam modify his sentence (on the Word Mover screen) so that his written words matched what he meant to say.

drawn by Adam 2013

(love the expression on the baby's face)


Technology is a great tool that can be used to enhance the learning environment - it works best when you use it to augment your current effective techniques, rather than using it to replace traditional play and hands-on learning.

What is Autism Anyway?

Ever heard the Indian fable of the blind men and the elephant?


A king asks a group of blind scholars to tell him what an elephant is like. Each defines the elephant based on his limited contact with the animal - the one at the tail describes the elephant as a rope, the one at the leg says "no, it's like a pillar", the one at the belly argues that clearly an elephant is like a wall, the one at the ear says "it's like a fan!", the one at the tusk thinks an elephant is just like a sword, and the one at the trunk would stake his life on the fact that an elephant is the same as a tree branch. In some versions of the story a big melee follows with each scholar willing to fight to the death to defend their learned viewpoint.

Sound familiar?

The field of autism is plagued with arguments over definitions, diagnosis, treatment and philosophy - and for the most part, this has not been helpful to ASD individuals and their families. The constant conflict causes discussions to go around in circles, as each faction searches for an elusive all-encompassing theory that explains "autism".

But what if the blind men listened to each other? In some versions of the story, this happens. What if we recognized that different perceptions and perspectives could illuminate pieces of a larger truth? One that could only be understood by looking at all of the information, all together, without bias and preconceptions? What if we stopped arguing and started listening?

For what it's worth, to start the discussion, I'll share my perspective:

My practice is unusual, in that I work with individuals over a long stretch of time. The 2-yr-old that comes through my door stays with me through preschool, elementary school, high school and beyond. This has challenged all of my original "learned" viewpoints and changed my view of what autism is. I'm not sure that a single one of my preconceptions about the diagnosis has survived.

In my practice I bring the best that I have to each person that I see, and therapy never looks exactly the same for any two of them - I match the intervention to the individual. Some are very verbal (note: the first time language "suddenly" appeared in one of my clients, I thought my therapy and I had caused it; the next time it happened, I realized that some individuals are just "set" to do this language burst), some are moderately verbal and some are very low verbal. The difference in outcomes reflects differences in the individuals from the start - no "one size fits all" treatment or developmental path.

What am I left with in terms of answers? One thing. The question is wrong. The question "What is autism?" and the related question "What is the one definitive standard treatment for autism that will result in a 'successful' outcome for all?" are misguided and misleading. Autism is not just one thing. Defining autism as a "spectrum" is a good start, but the next step is realizing that members of that spectrum are the most "individual" of individuals, and that one approach, one definition, one philosophy or theory is never going to define, treat or educate them all.

Real life and real people are messier (and more interesting) than neat diagnostic boxes. Maybe if we all recognize our own blindness, the limitations of our knowledge and the complexity of the question, we could work together and do better for the people we are seeking to help.

- Posted using BlogPress from my iPad