Tait: Communicating Emotions
Tait is a 12-year-old boy who was diagnosed with ASD at age 2. Tait is generally healthy although he has recently been diagnosed with rheumatoid arthritis and is sensitive to pain. He has difficulty with small spaces and "bottlenecks" where many people are congregated. Tait participates in special education at a local elementary school. His strengths include being curious, social, and visually astute. His challenges include communication, impulsivity, and behavior that may include tantrums, aggression, and property destruction. These challenges have made it difficult for Tait to participate in activities with peers.
Communication Profile
Tait has a positive-behavior support team and receives speech-language intervention at the Schiefelbusch Speech-Language-Hearing Clinic. He is a multimodal communicator whose verbal communication is not understood by most people. He uses a Palm 3 (Dynavox Technologies), pictures, idiosyncratic signs, gestures, and some words to communicate.
Assessment
Tait's communication was assessed with the SCERTS® Assessment Process (SAP; Prizant, Wetherby, Rubin, Laurent, & Rydell, 2006) in spring 2007. As a criterion-referenced, curriculum-based tool, the SAP determines a child's profile of strengths and needs based on his or her developmental stage in the domains of social communication and emotional regulation. Tait was in the Language Partner stage of communication. We collected data in three contexts: school, home, and an intervention session in the Schiefelbusch clinic.
Social Communication
Tait's strengths in the area of social communication included engaging in reciprocal interactions, sharing attention to regulate the behavior of others, and using several modes of communication. His needs in social communication included sharing a range of emotions with symbols and sharing intentions for joint attention by commenting on objects, actions, events, or requesting information across partners and contexts.
Emotional Regulation
Tait's emotional regulation strengths included responding to assistance from a familiar partner that he trusted, recovering from extreme dysregulation with support from a familiar partner, and using a behavior strategy (holding a block of wood) to remain focused and calm in some familiar environments. His needs in the area of emotional regulation were seeking assistance with emotional regulation from others, responding to assistance across contexts, and responding to the use of language strategies across environments.
Transactional Support
Transactional support was strong in some areas. For example, all of Tait's partners wanted him to learn and communicate more conventionally and he had consistent, responsive communication partners at home. Tait needed the same responsive style across all partners and the consistent use of visual and organizational supports as well as his AAC system to enhance learning and comprehension of language and behavior.
Intervention
Goals included:
Increased use of emotion words on the AAC device.Commenting on objects, actions, or events.Choosing what he needs to calm himself from choices offered (from an adaptation of the 5-point scale by Buron and Curtis, 2003).
Transactional goals included:
Using augmented input (Romski & Sevcik, 2003) with redirection, expansion, and modeling by Tait's partners.
Providing a binder with a schedule and social stories (Gray, 1995) for preparation for activities.
Making an AAC device always available and using an interactive diary developed by his mother.
These supports were implemented in activities of interest to Tait such as holidays, his life in photo albums, tools, and events at home.
Outcomes
In the past two years, Tait has made many communication gains. His AAC device has more than 200 pages of icons, which he accesses independently to express feelings. He has told us when he is angry, happy, sad, frustrated, and sick, and he engages in reciprocal exchanges, commenting on the shared object or event of interest. He has started to mark tense when he comments by using the "later" and "past" icons on his device to clarify his message. He is able to indicate to his partner what he needs to calm himself when choices are offered. In addition, he has more communication partners who are responsive and able to provide him with the learning supports he needs.
Jane Wegner, PhD, CCC-SLP, is a clinical professor and director of the Schiefelbusch Speech-Language-Hearing Clinic at the University of Kansas. She teaches courses in AAC and autism spectrum disorders and directs the "Communication, Autism, and Technology" and "Augmentative and Alternative Communication in the Schools: Access and Leadership" projects. Contact her at jwegner@ku.edu.
