Enhancing Communication for Individuals with Autism

A Guide to the Visual Immersion System™

by

Howard C. Shane, Ph.D. Emily Laubscher, M.S., CCC-SLP Ralf W. Schlosser, Ph.D. Holly L. Fadie, M.S., CCC-SLP James F. Sorce, Ph.D. Jennifer S. Abramson, M.S., CCC-SLP Suzanne Flynn, Ph.D., CCC-SLP
and Kara Corley, M.S., CCC-SLP

CONTENTS

1. An Overview of the Visual Immersion System™
2. Language Acquisition and Symbolic Competence
3. Tools Used to Support Visual Language and Communication
4. Principles of Assessment
5. Principles of Intervention
6. Protesting
7. Organization and Transitions
8. Requesting
9. Directives
10. Commenting
11. Questions
12. Social Pragmatics

About the Authors

Howard C. Shane, Ph.D.

Associate Professor of Otolaryngology at Harvard Medical School and Director of the Center for Communication Enhancement and the Autism Language Program at Boston Children’s Hospital.

Emily Laubscher, M.S., CCC-SLP

A speech-language pathologist in the Autism Language Program at Boston Children’s Hospital.

Ralf W. Schlosser, Ph.D.

Professor in the Department of Speech-Language Pathology and Audiology at Northeastern University and director of Clinical Research in the Center for Communication Enhancement.

Holly L. Fadie, M.S., CCC-SLP

A speech-language pathologist at Boston Children’s Hospital in the Augmentative Communication and Autism Language Programs.

James F. Sorce, Ph.D.

Director of Media Applications in the Autism Language Program at Boston Children’s Hospital.

Jennifer S. Abramson, M.S., CCC-SLP

A speech-language pathologist at Boston Children’s Hospital, active in the Autism Language Program.

Suzanne Flynn, Ph.D., CCC-SLP

A professor in the Department of Linguistics and Philosophy at MIT and a researcher at Boston Children’s Hospital.

Kara Corley, M.S., CCC-SLP

An experienced specialist assessing and treating pediatric communication disorders.

An Overview of the Visual Immersion System™

Communication disturbance is a hallmark of autism spectrum disorder (ASD). The nature and severity of an individual’s communication disorder vary along the autism spectrum. This chapter describes the communication impairments of these individuals, presents the rationale for a visually based approach to communication intervention, and provides an overview of the general principles underpinning the Visual Immersion System™ (VIS™).

COMMUNICATION IMPAIRMENTS OF INDIVIDUALS WITH MODERATE-TO-SEVERE AUTISM SPECTRUM DISORDER

Individuals with moderate-to-severe ASD struggle to understand and express spoken words.

Spoken Language Difficulty: Comprehension

Common patterns include:

• Strong comprehension of nouns but difficulty with more abstract language concepts such as verbs.
• Difficulty understanding semantic relations and complex syntactic structures.

Spoken Language Difficulty: Expression

Around 50% of individuals with ASD do not use speech functionally.

The Visual Immersion System’s Rationale for Emphasizing Visuals in Communication and Language

Three main reasons to focus on the visual modality include:

1. Children with ASD tend to have strong visual processing skills.
2. Visuals offer sustained referents, allowing additional time for processing.
3. Individuals with ASD generally understand visual graphics more readily than spoken language.

FRAMEWORK FOR VISUAL LANGUAGE INTERVENTION

The VIS includes three modes of visual support:

1. Visual expressive mode: Used for expressive communication.
2. Visual instructional mode: Used for comprehension alongside speech.
3. Visual organizational mode: Used to represent the organization of an activity.

GENERAL PRINCIPLES OF THE VISUAL IMMERSION SYSTEM

The overall goal is to teach children with moderate-to-severe ASD to become more effective communicators through a visual communication system that complements spoken language. The VIS is defined by the following four principles:

1. Communication is used for multiple pragmatic functions.
2. There are two tiers of communication: scenes and element strings.
3. Communicative competence flourishes in a visually immersive environment.
4. Spontaneous communication and language arts are important.

Principle 1: Communication Is Used for Multiple Pragmatic Functions

Seven basic communicative functions:

1. Protesting
2. Organization and transitions
3. Requesting
4. Directives
5. Commenting
6. Questions
7. Social pragmatics

Principle 2: Two Tiers of Communication: Scenes and Element Strings

• Tier 1: Visual scenes.
• Tier 2: Visual element strings composed of basic linguistic categories.

Conclusion

The VIS aims to illustrate that individuals do not require dexterity to manipulate concepts, posit that recognizing concepts or following directives may not need language, and emphasize that effective communication can be achieved through visual means.