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

Karaoke as Curriculum: teaching through musical passion

It's December already! ... and what better way to start off this festive month than with a gift of music. I'd like to welcome back my guest blogger Carole (Kevin's mom) who has been using Kevin's love of music to happily teach language and literacy:

Picture drawn by Kevin

And now, here's Carole:

"When you raise a child on the ASD spectrum, a child who doesn’t just pick up skills, and learn naturally like other children, you become painfully aware of how incredible those early years of learning really are. You see other children learn to mimic, speak, understand, read cues, watch and follow. It’s phenomenal how much is learned in such a short space of time, and apparently so effortlessly. For the rest of us, there is an overwhelming void, and we have to decide what to teach, when to teach it, what is the priority, and figure out how so much can be taught without overwhelming our little ones. For my adult son, I still find myself deciding on his behalf, what, when and how to teach. If you’re anything like me, this can be a little overwhelming at times, and the responsibility of deciding for another adult what they need, or should know feels a little like making choices that shouldn’t be mine. I recently wrote to someone, and I shared that my middle aged brain prefers the KISS method, (keep it simple stupid) because frankly that’s about all it can handle. Then it occurred to me, that’s exactly the approach I use when teaching my son.

Teaching an unwilling student is painful at best, so I have always taken the things he loves, and tried to incorporate as much curriculum as I can in them, so that it never feels like work. It also allows me to teach skills that don’t necessarily fit his development at that moment, but hopefully will be there at the ready when the time comes. So for example, my guy has very limited speech, he reads but comprehension is very limited, and his auditory processing has always been a huge issue. So the question becomes, how do you get him to make more utterances, and practice the motor part of speech, and do you put the effort into improving his reading ability when the comprehension is not there? What if miracle of miracles, one day that comprehension kicks in and his reading is lacking, or suddenly he finds his words but has a hard time getting them out there, because he’s never practiced? I still believe that anything is possible for him, and I don’t want to think I didn’t raise the bar in expectation of that. So this is one example of how we took one of Kev’s delights and although he didn’t know it, turned it into curriculum.

Kevin loves music, and always has. As soon as I realized that, I had him listening to every genre of music I could find, and often you would hear me singing conversations to him (never in public!) So when we decided to hire a worker for a couple of mornings a week, how serendipitous was it, to discover she was a singer with the most beautiful voice – and karaoke began. It began slowly, he would cough a lot, unused to using that voice. He could only sing in the key of the song, and so we had to find songs in his register only. He couldn’t read, and vocalize quickly enough to sing along, so we had to start with very slow songs, and he had trouble with the reading.

Video of Kevin doing Karaoke:

Click this link to see video on YouTube (if your browser won't automatically play the inserted video clip)

Today, it’s his favourite activity, and we’re all kitted out with microphones for the computer, and a huge playlist from youtube. He can harmonize, it doesn’t need to be in his register anymore. He reads so much better, but we continue to have the lyrics on screen and the singer in the background, so that he hears when he reads a word incorrectly and learns to correct. He reads quickly, his inflection is great, his speaking voice is slightly less robotic, and although you will hear coughing, it is much reduced. Although he’s never going to be a rock star, the anticipation in his face as he awaits karaoke time speaks volumes, and it also happens to be my favourite time of the day too.

So I urge you, follow their lead, how can it ever be wrong when it brings them so much happiness? Once in a while you may even get some validation for following your intuition!"

Well said Carole! You always get the best learning at the point where passion and fun meet - when you find that sweet spot, everyone has a great time and the skills you teach stick.

~ Sheila B ~

note: for those who are interested in the research, here's a recent reference provided by Carole:

Fronto-Temporal Connectivity is Preserved During Sung but Not Spoken Word Listening, Across the Autism Spectrum.
Sharda M, Midha R, Malik S, Mukerji S, Singh NC.
Autism Res. 2014 Nov 5.

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Emma learns to sew

Emma is a young adult artist on the autism spectrum. She has a strong sense of fashion, and her visual art style is bold using shapes and blocks of colour. Because of her love of fashion, we thought that sewing was a skill she would enjoy that could open up opportunities in the world of work. Because of her own personal art style, we decided to start our sewing lessons with applique projects.

Our first project (introducing the use of a sewing machine) was a pocket for an apron (Emma also loves cooking, and is quite independent and happy working in the kitchen).

Step 1: Design the applique. Emma drew these design ideas using the iPad app "Drawing with Carl".


Step 2: Under Emma's direction (and following the bird pattern she had drawn), we cut out pieces of coloured material to sew onto the pocket (she selected the material & told me what shape to cut, I handled the very sharp sewing scissors for this initial session).

Step 3: Then we ran the sewing machine together: I threaded the machine, Emma chose the stitch pattern, then Emma ran the peddle (controlling on/off and speed) and I fed/steered the material past the needle. It was a little exciting in spots because we didn't sew slow! But we ended up with a bright bird on the apron pocket (and neither one of us sewn into the design!).





Emma really enjoyed the sewing and was very pleased with having her design turn into something she could wear. (for this first project, I sewed up a simple apron design ahead of time, and Emma sewed the pocket onto the apron so we could have a completed project in a shorter time-frame).

Our second project was a throw pillow.

Step 1: designing the pattern, once again using "Drawing with Carl" iPad app. Emma drew out several design ideas (including a very funky zebra), then decided to go with this bright bird:




Step 2: I cut out the fabric pieces for the design under Emma's very definite verbal directions (great context for language use, she was highly motivated to tell me exactly what she wanted me to do, and also not shy to tell me when I had done it wrong and it needed to be redone - she has always been a woman who knows her own mind, something I really like about her).

Step 3: Emma approached the sewing with more confidence the second time around, and experimented with various types of applique stitches and with the speed control on the machine. Once again I steered the material while she ran everything else (important to go step-wise when working close to sharp objects, like the mechanized needle on a sewing machine).

This time, Emma sewed the whole project. We used a pre-made pillow form (from IKEA) and sewed a pillowcase (one side was Emma's art design, the other was patterned material she chose to match). We used the machine for all the seams, including the one sewing the side closed after the pillow form was in the pillowcase (Emma chose a lovely decorative stitch style, it looked great). Again, the pillow was done in one session:

I love Emma's bold bright design sense. We plan to continue our sewing lessons, and our next project will likely be shoulder/carry bags that can be used for books or iPads or shopping. Stay tuned for updates!

Sheila Bell


Posted using BlogPress from my iPad

ASD Adults and Life-long Language Learning

One of my strong interests when I went through graduate school for speech pathology was the connection between the brain (neurology) and language learning.

At that time (early 1980's), conventional wisdom in the field of neurolinguistics was that there was a defined window for language acquisition. Scientific studies of people who lost language skills because of acquired brain damage (resulting from something like a head injury or stroke) showed patients had a different capacity for language learning, depending on their age - pre-puberty the brain was plastic and had a good ability to relearn language skills, but post-puberty that learning window seemed to close.

I never really questioned this until several years later when I started working with adolescents and young adults on the autism spectrum. Everyone was post-puberty and many had severely limited verbal language skills, with some completely non-verbal. I found myself mixing my clinical experience with stroke victims (including the use of non-conventional communication means like drawing) into my language development therapy techniques. And I learned an interesting thing: the neuroplasticity necessary for new language learning that was not supposed to exist in this population, did exist. Many of the students desperately wanted to crack the code of conventional communication, and their brains were capable. The limiting factor was more me than them - I could see the potential, but was only beginning to discover the tools that might be effective to bridge that communication gap.

Fast forward a couple of decades and I have more tools in my therapy toolbox - my ASD students have been my teachers, and working with the same individuals over time has taught me some very important things about language learning and ASD:

1. The early years may not be optimal for language learning because neural pathways are developing in a different way at a different pace - if the world is a screaming wall of sound, you can't pick out the words.

2. Written words can help to sort out the string of sounds at the ear, so the person can begin to make sense out of auditory language.

3. Drawing can be a clarifying communication tool that helps therapists/teachers/parents to explain and highlight important information about everyday life, and that can help ASD individuals to explain their perspective and experience of the world.

4. Most importantly, language learning is a life-long process and significant language learning can happen in the adult years, so don't give up trying to reach and teach.

And so for today, an illustration of point #4: 

Adam (age 23) has started writing complex sentences in the past couple of months. We begin with a picture (one of his favourite topics is animals):

Adam then uses Word Mover (iPad app) to write a sentence about what he sees (I love this app because it lets you create sentences like a puzzle). After that, he writes the sentence out and illustrates it with a cartoon drawing:

In this instance, he has spontaneously and purposefully made a lengthy compound sentence (using a clause introduced by a preposition "under ....") to express a complex thought. His picture is a projection of his thoughts about the animals and their feelings - he gives the animals personality and connection (it's not copied, it's "inspired by").

I love to see errors in the sentence construction - they show me that I'm looking at meaningful language learning rather repetition of memorized language "chunks".The spelling error in "hideing" indicates that he's using his own grammatical rules to change verb tenses (add "ing" to the verb for present tense), and the missing word "of" in "family (of) elephants" shows me that he's using a rule he's made about modifying nouns with adjectives (he's used the same structure as "baby elephant").

And that's what gets this speech pathologist excited! Especially when this level of language development was not predictable from his language level in his childhood or early teens. It means that I don't know the ceiling on his learning potential.

.... here's a few more recent sentences and pictures from Adam for your enjoyment:

I'm a big believer in life-long learning. My best advice to parents, educators and therapists would be to let go of any preconceptions about how and when things are usually learned, continually modify your teaching methods to match  the individual's learning profile, and never underestimate the power and plasticity of an intelligent brain ... SB




Note: Recently, someone asked me if there were any neurolinguistic studies connected to the type of therapy I do (using drawing/art to teach communication and language skills). I am not aware of any, but I think it would be an interesting thing to study. If anyone reading this blog knows of related research (or is connected to an academic institution and has an interest in this area), please feel free to contact me via e-mail.