Today, a six year old girl with autism looked me right in the eye and said "More push"!
What's miraculous about that?
A year ago, this little girl was non-verbal. She had a few consonant sounds (b, m) and a couple vowels. Mostly, she threw tantrums because she could not get what she wanted. She was a great Picture Exchange user - which provided critical experience in social interaction - but she didn't always have icons that expressed her wants, or what she wanted wasn't available all the time. A professional had recommended that things she "perseverated" about not be available to her.
Moreover - she did not acknowledge (or process?) sound. She only responded to very low frequency, large wave sounds. She may have perceived speech, but did not respond to it. She apparently enjoyed the reverberation produced by really deep pitches.
This child craved visual input - as though she was replacing the auditory input she was missing with visual input. She had specific preferences for pictures and books, and showed the adults that we needed to make icons representing the specific input she sought. Some of the biggest tantrums were when she couldn't access the books she wanted.
This child's life used to be a constant stream of frustration and protest.
Today - she not only looked at me and said "More push" - she...
...spontaneously initiated social praise (Yaaaayyyy!!) and shared the enjoyment of her success with three adults.
...consistently produced the desired verbal response during a fine-motor task paired with language and a signed cue
...said (using her iPad with ProLoQuo2Go) "It's time for Starfall" when her para said "It's time for reading books" (using the iPad, by the way!)
...joined in a song and dance of "Shake the Sillies Out" with two adults and her sister - who she used to pretty much ignore.
...ate lunch in the cafeteria with a buddy
A year. One. It takes typically developing children with no auditory difficulties and no autism longer than that to produce two-word utterances.
What brought about this major success?
A really dedicated, caring school-based team who are consistently following recommendations and modeling around these evidence-based interventions:
Picture Exchange Communication System
Discrete Trial Learning (early in her school experience)
Antecedent Behavioral Interventions
Computer Aided Instruction
Pivotal Response Training
Speech Generating Devices
Addressing Sensory Differences
The two most critical pieces of intervention - regular sensory "breaks" designed to aid in regulating sensory differences and a reliable system of communication.
Her early experience with Picture Exchange taught her that symbolic communication with another person got her what she wanted (once she was allowed access and had specific icons). She transferred that knowledge smoothly to the iPad with ProLoQuo2Go, which provided a consistent unchanging speech model. Less than 8 months after receiving her iPad -with careful planning, implementation and reinforcement - she is not only creating and delivering multi-word "device" messages: she's TALKING!!!
This girl's interactions with her environment and with people is now under HER internal control. The environment is set up for success - the adults have learned to share control, be sensitive to intense desires, honor her attempts at communication in any mode. and to compassionately model the kinds of behaviors desired - but she is using her internal motivation to communicate, play and learn.
Her favorite things to do are Starfall (a computer-based pre-reading program), explore the calendar, numbers and people words on her iPad, ANYTHING to do with music, read books and "Shake your Sillies" out. Restricted patterns of interest? Her interests are expanding all the time!
The professionals involved are a Psychologist, Speech-Language Pathologist (2), Occupational Therapist and Special Educator - all with extensive training in the neurological bases of autism and how to design and deliver evidence-based interventions. And a REALLY great para-educator!
Notice anything not mentioned?
It is a pleasure to congratulate her school-based team on their success. It's exciting to see this girl making huge progress every time we visit. I expect she'll be "wowing" us with a full verbal sentence, soon! Can't wait.