ATI 2014 Motor Implications in ASD & AAC, Meier

Motor Implications
in ASD & AAC
Gwendolyn Meier, SLP, MT
Villa Esperanza Services
gmeier@villaesperanzaservices.org

Monday, February 3, 14

Motor Skills Play a Role
• AAC Assessment
• Teaching
• Prompting
• Communication displays - high & low tech
• Core vocabulary learning & use

Moving to Budapest!


AAC Assessment
•

The snapshot

•

The full assessment

•

•

Trial/teaching
period

•


Icon recognition
(e.g., TASP)
Present a few
systems

•

Final
recommendation

Teaching AAC

• HOW are we teaching this new language?
Hungarian:

• More likely to learn in meaningful
chunks at ﬁrst

• Before segmentation occurs
Is there someone here who speaks English?
Beszél itt valaki angolul?
(BE-seyl it VÅ-lå-ki ÅN-go-loul)


Where is the toilet?
Hol van a mosdó?
(hol vån å MOSH-doa?)

Teaching AAC

In AAC:

• More likely to learn sequences made

meaningful by the reaction they elicit


Teaching AAC

Hungarian:

• Flashcards?
• Scripted interaction?
• Conversation?


Teaching AAC

In AAC:

• Labeling?
• Requesting?
• Answering questions?
• Scripted interaction?
• Conversation?

• Icon recognition?
• Verbal cues?
• Motor patterns?
• Gesture cues?
• Visual cues?

Teaching Language
• Use strengths to shore up weaknesses
In autism:
(-) Auditory weakness
(-) Symbolic weakness
(+) Visual strength
(?) Motor skills


Teaching Language
• Modeling and Augmented input highlight the
auditory boundaries between words

• Human speech alone does not


Teaching Language
• Neurons that ﬁre together, wire together
(Hebb’s rule)
• Seeing and hearing language
• Add motor pattern

• With the motor pattern for producing

words comes increased ability to perceive
that word in spoken language*


In infancy...
• With the motor pattern for producing

words comes increased ability to perceive
that word in spoken language*

*Halloran & Halloran, 2006. Language Acquisition Through Motor Planning.
Center for AAC and Autism.

AAC is a Multi-Sensory Language
Modeling & Augmented Input

• See the visual, See the movement, Hear the
auditory feedback, Experience the natural
consequence


Language Acquisition...
...requires organization and interpretation of
the world through a system of symbols
and referents.

ball

cat
bed


Language Acquisition...
...requires organization and interpretation of
the world through a system of symbols
and referents.

• AAC visuals (objects, photos, icon, text) add
an element of “referent” to spoken words
that have no physical referent
want


go

outside

Symbol Comprehension
The key to making the iconic or arbitrary
symbol-to-referent connection may be in the
comprehension skill that the learner
brings to the task.

Namy, L., Campbell, A. & Tomasello, M. (2004). The changing role of iconicity in non-verbal
symbol learning. Journal of Cognition & Development, 5, 37-57.

Symbol Comprehension
• Without understanding of the

referent, the iconicity of the visual
symbol may not affect his learning of
its meaning
✴

The iconic symbol may appear
just as meaningless as the
arbitrary symbol until it is given
meaning through its use

Barton, A., Sevik, R. & Romski, M.. (2006). Exploring Visual-Graphic Symbol Acquisition by Preschool
Age Children with Developmental and Language Delays. Augmentative and Alternative
Communication,Vol 22(1), 10-20.

TM

PECS & Symbol Comprehension

•

TM

PECS Phase 3:
Discrimination Training
- Aims to teach icon
discrimination skills given
a limited ﬁeld of choices


Picture Communication Books
Rely on icon association/
understanding


A Dual Role for Symbols
• Visual-graphic AAC icons themselves play a
role in their acquisition

• The message to represent an idea
AND

• The medium to achieve communication
Sevcik, R. A., Romski, M. A., & Wilkinson, K. (1991). Roles of graphic symbols in the language acquisition process
for persons with severe cognitive disabilities. Augmentative and Alternative Communication, 7, 161–170.

VIDEO
• Core vocab teaching in ASD w/AAC


• How is her icon recognition?
• How is she going to learn to use
“Put” + “on” to request?


So, how do we teach new
movement patterns?


Model +
Consequence
$$$ What’s the pay off $$$$


Visual Cues?


Physical Support for the Correct
Movement Pattern

PROMPT


TM

Practice! Practice!
Practice!
Daily
Over time
With support
With meaningful consequences


Motor Skills in ASD
•

Various altered motor behaviors in autism:

•
•

Slower repetitive hand movements

•

Reduced ability for rapidly alternating
movements (diadochokinesis)

Slower and less accurate manual
dexterity

Staples & Reid. (2010). Fundamental movement skills and autism spectrum disorders. Journal of
Autism and Developmental Disorders,Vol 40(2), pp. 209-217.

Motor Skills in ASD
1. Implicit motor learning processes are
relatively intact in autism

* Gowen, E. & Hamilton, A. (2013). Motor Abilities in Autism: A Review Using a Computational Context.
Journal of Autism and Developmental Disorders, Vol 43(2), pp 323-344.

Motor Skills in ASD
2. Reaction times improve to the level of
NT subjects given repetition

•

Serial reaction time task (SRT)

* Gowen, E. & Hamilton, A. (2013). Motor Abilities in Autism: A Review Using a Computational Context.

Serial Reaction Time Task


Motor Skills in ASD
2. Reaction times improve to the level of
NT subjects given repetition

•

Serial reaction time task (SRT)

3. Proprioceptive input may be more
reliable than visual input when learning new
motor patterns
Gowen, E. & Hamilton, A. (2013). Motor Abilities in Autism: A Review Using a Computational Context.

Imagine...PECS Phase 1
• Learning the “give” efﬁciency with practice


Pick from the Right


• Use motor learning strength to teach the
motor pattern

• Paired with a motivating consequence


• Then reduce the amount of visual cue


Motor Plan VS. Icon Comprehension

• Consistent placement of icons and

meaningful use of them in
communication may be more important
than iconicity of the picture

• Learners don't need to be able to

recognize/"point to"/"give" an icon
that is named before they can use that
icon to get something done in the world


Motor Plan VS. Icon Recognition

• Consistent placement of icons and

meaningful use of them in communication
may be more important than symbol
iconicity

• Learners don't need to be able to

recognize/"point to"/"give" a icon that is
named before they can use that icon to
get something done in the world


Why Teach Core Vocab?

YouTube

Why the fuss about
Motor Learning?

EVERY learned physical activity
depends on motor learning

• Walking, driving, climbing/descending

stairs, eating, dressing, typing, reading,
Smartphone or computer access


Automatic Motor Patterns


When motor patterns change...
Volitional

Automatic


Imagine...


When Motor Patterns Change

• It brings our awareness to our movements
• Requires re-learning
• Ideation - Plan - Execution - Feedback
✴ Not conducive to communicating!


Speaking
• Automatic motor patterns for words and
phrases are established as meaning is
attached (in infancy)

• We don’t think about how to physically speak
• Focus on: the words to use, how it will be
interpreted, our listener’s background...etc.


AAC Automaticity is aided when:
1. Consistent motor patterns to access
vocabulary we need
2. There is a unique pattern to reach your
word, regardless of the activity
3. Reliable, motivating consequences for
use of symbols

Halloran & Halloran, 2006. Language Acquisition Through Motor Planning.
Center for AAC and Autism.

Consistent motor patterns are
extremely important when...

•

When using multiple pages of vocabulary

•
•
•

When icon recognition is weak
Teaching the use of core vocabulary and use
of more abstract vocab/symbols

•

Visual tracking and scanning are not
efﬁcient

A visual search is meaningless

When Motor Patterns Change
•

By shifting locations of pictures:

•

Awareness moves from the message to the
execution

•

We are actually testing

•
•
•

Visual scanning skills
Icon association/understanding

Adding cognitive load

✴ Not conducive to communicating!


We can take advantage of motor
learning when:

• Patterns build upon themselves as
language grow

• Plan the end at the beginning
• Preserve relative location


Between activity-based pages...preserve location

Classroom

Snack

Consistent
Placement


Another beneﬁt...


Today

Tomorrow

“Here is your schedule”

As language system grows...preserve location


Motor patterns don’t change


NEW! in 2013


When we use motor learning to our
advantage...

• Our lower-functioning students can generate
multi-word phrases...

...across multiple pages
...using core vocabulary
...for greater communicative competence!


AAC News & Info


ATI 2014 Motor Implications in ASD & AAC, Meier

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