An autism diagnosis can be extremely overwhelming on a lot of levels. There is A LOT of information out there, some helpful, some downright toxic. This topic will be part of a 2-part series to allow caregivers the opportunity to fully explore resources available instead of being overwhelmed by the amount of information.
So where does BAC guide parents? Here are a few places to start …
By: Ariel Schuman, MS, CF-SLP
Parents of children who attend the Boston Ability Center may find that our clinicians frequently appear to be “playing” with young clients. While our therapists are certainly playing and having fun with children, they are simultaneously targeting their language development. Using bubbles, Pop-the-Pig, and countless other toys allows our clients to increase their language development in natural contexts. Researchers have found that play-based intervention styles result in a systematic increases in language skills that are maintained after treatment. While our clinicians play with your child, they also utilize the following approaches to increase and support language.
Parallel Talk: Our clinicians use what is referred to as “parallel talk” to encourage children to describe their actions during play. Using parallel talk supports children in their ability to make connections between their language and what they are doing. If a client was playing our popular game, “Pop the Pig”, this might sound like, “The pig is so hungry! We need to feed the pig hamburgers. He needs to chew, chew, chew! What do we need to do?”
Expansions: Expanding what our clients are saying, while using appropriate syntax and sentence structure, assists with children’s grammatical development. If a child was playing with bubbles and said, “open”, this might sound like, “Yes, we need to open the bubbles.”
Extensions: When our clinicians comment on children’s utterances they are adding semantic information. This provides clients with ways to expand and elaborate their language, in addition to teaching grammatical development. If a child was playing with bubbles and said, “open”, this might sound like, “Yes, we need to open the bubbles. We will blow big bubbles up towards the sky!”
Mileu Teaching: Through Mileu Teaching, the clinician can arrange the child’s environment to increase interactions that the therapist can use to model appropriate language and play schemes. Our clinicians may give a child a bottle of bubbles with the lid screwed on tightly. This provides the child with an opportunity to ask for help or request assistance, and the clinician with the opportunity to model how to utilize this specific language (e.g. “I need help” or “help me”).
Script Therapy: Using “scripts”, or language embedded in a familiar routine, can reduce cognitive demands on children as they are working towards increased language development. Scripts can be utilized through repeated book reading, or during familiar games. A common example may be singing “clean up” as our clients clean up toys at the end of a session. Singing this song while pausing and allowing the child to fill in words such as, “up” is an effective way to use this method.
Researchers have found that these play-based, or naturalistic interventions styles, are successful in improving children’s functional, everyday language. Teaching these skills in natural contexts, or through play, has also been found to increase children’s spontaneous use of language. At the Boston Ability Center, our clinicians use these techniques in order to support both function and fun for our patients.
For more information regarding play-based intervention, specifically Mileu Teaching, follow the link to the research article below: http://jslhr.pubs.asha.org/epdf.aspx?doi=10.1044/jshr.3706.1320
Kaiser, A. P. & Hester, P. P. (1994). Generalized Effects of Enhanced Milieu Teaching. J Speech Hear Res, 37(6), 1320-1340. doi: 10.1044/jshr.3706.1320.
By: Ariel Schuman, MS, CF-SLP
Filiatrault-Veilleux, et al. (2016) studied 3-6 year old children and their ability to comprehend inferences. They found that this skill typically emerges early in development, between the ages of 3 and 4. Inferential abilities continue to develop gradually until children are about 6 years old. Researchers have determined that this period, between the ages 3 and 6 years, is important for the emergence and continued development of inferencing and prediction skills. Furthermore, this skill is also important in aiding children in their later reading comprehension abilities.
At the Boston Ability Center, we target inferencing and predicting through various activities. A popular project that many of our clients enjoy involves creating special crafts and/or conducting different experiments each week. Often times children complete these activities with a peer, simultaneously encouraging the development of their social pragmatic skills. As our clients create beaded dragon flies, flour-filled stress balls, pool noodle pumpkins, and countless others, they utilize pictured supports in the form of photographic images. These pictures can help children predict what the next step in the sequence may be. Our clinicians stop periodically throughout the activity to ask clients questions such as, “What do you think we will do next?” or “Why do you think we will need to use a funnel?” These conversations support comprehension of WH-questions, and encourage children to utilize their inferencing skills to make decisions and plan accordingly.
Books are another great way to learn about inferencing and making predictions. Below are also some wonderful books to support your child’s development:
By: Caroline Curran, MS, CCC-SLP
Social Thinking is a teaching framework developed by speech-language pathologist Michelle Garcia Winner to help those with social learning challenges better understand the dynamic nature of social communication. For those of you who have spent time in our waiting room, it is likely you have already been exposed to bits and pieces of the curriculum concepts and vocabulary. For example, the “group plan”, “expected” and “unexpected” behaviors, and being a “flexible friend” are common concepts we teach as part of the curriculum.
But what is it about this curriculum that is effective in helping children develop social problem solving skills and overall social competencies?
The Social Thinking methodology is developmental and incorporates aspects of behavioral and cognitive behavioral principles. It takes into account personality, cognitive abilities and evidence-based concepts to create conceptual frameworks, treatment frameworks, specific strategies, and motivational tools.
Here at the Boston Ability Center, we regularly incorporate these frameworks and strategies into treatment for our patients of all ages. We utilize the “We Thinkers” storybooks with our younger patients to introduce concepts such as flexible and stuck thinking, following the group plan, size of the problem, and understanding hidden rules. With our older patients, we incorporate the Superflex teaching curriculum to promote self-regulation, social thinking, and related social skills.
For more information about Social Thinking visit: www.socialthinking.com
By: Ariel Schuman, MS, CF-SLP
Evidence-based practice, or EBP, is an interdisciplinary approach to treatment and clinical decision making that first began in medicine and has since spread to other fields such as speech-language pathology, as well as occupational therapy and physical therapy. EBP incorporates the following three principles: the best available research regarding a treatment’s efficacy, the clinician’s skilled expertise, and the client’s personal preferences and values. Evidence-based practice allows the therapist to make decisions regarding client care by integrating these equally important factors (American Speech-Language-Hearing Association, 2017). We utilize EBP in our treatment at the Boston Ability Center because including current research, applying clinical knowledge, and recognizing client’s characteristics, needs, and interests allows for the best quality of care for our patients.