Selecting Augmentative Communication Systems on the Basis of Current Communicative Means and Functions

Abstract

Use of augmentative non-speech systems of communication have increasingly been reported as effective in promoting communicative development in individuals with autism and related handicaps. While various forms of sign language have constituted the primary non-speech communication mode, other approaches have also been used, including plastic symbol, written word and pictorial systems. While the reported results have overall been encouraging, questions remain as to whether one particular system, for instance, sign language is most suitable to the autistic population as a whole, and at which point and how it should be taught. This paper examines to what extent individuals with autism may share some common characteristics that would make them prime candidates for one particular system over another. Given that visuo-spatial abilities tend to be well developed, it is argued that a case could be made for the use of communication modes that incorporate non-transient stimuli. Nevertheless, given the heterogeneity of the population involved and the fact that the research conducted has not produced unequivocal results, decisions need to be made on an individual basis. The use of common decision rules in the selection of non-speech communication systems is critically examined, and some alternative practices are suggested. The need to directly assess communicative functioning, including communicative means and functions, is discussed as critical to the design of effective intervention programs. Discrepancies between motor skills, cognitive, communicative, and social knowledge are more readily assessed within such a context. The communicative interview is discussed as a viable assessment technique for the identification of communicative means and functions across specific communicative contexts. Two case descriptions are provided to illustrate how gathered assessment information is used to guide the selection of non-speech systems and the adoption of specific intervention goals.