Functional Communication Training: The Role of Speech Pathologists and Behavior Analysts in Serving Students with Autism
LaRue, Robert, Weiss, Mary Jane, Cable, Mary Kelly, The Journal of Speech-Language Pathology and Applied Behavior Analysis
Autism is a neurological disorder characterized by significant impairments in language/communication, deficits in social interaction and restricted interests/ stereotypical behavior (American Psychiatric Association, 1994). Perhaps the most central of these impairments, especially in young learners, is the communication deficit. Learners with autism have difficulty in all aspects of communication, including receptive understanding, expressive language, and comprehension. Even in learners with a well-established capacity to communicate, there are often very significant deficits in spontaneous communications, in complex communication, and in reciprocal communication.
These deficits in communication and social skills place these learners at risk for developing significant behavior problems. Learners with autism often engage in stereotypical behavior (e.g., repetitive, non-goal directed behavior), aggression, self-injurious behavior (SIB), pica, elopement, disruption, property destruction, and inappropriate vocalization (Kelli Dominick, Ornstein Davis, Lainhart, Tager-Flusberg, & Folstein, 2007; Smith, Vollmer & St. Peter Pipkin, 2007). Research has indicated that the ability to communicate is often directly related to the prevalence of maladaptive behavior (Carr & Durand, 1985). In many cases, challenging behavior serves a communicative function. In the absence of more effective means of communicating wants and needs, learners with autism often communicate through aberrant behavior. Learners with autism will often engage in disruptive behavior to access positive reinforcement (e.g., access to tangibles, access to attention) or to access to negative reinforcement (e.g., escape from demands, escape from a sensation).
Given the detrimental nature of maladaptive behaviors and their negative impact on social and academic functioning, it is essential for learners with autism to receive intensive intervention to address their communication deficits at the earliest available opportunity. Intervention to address communication deficits should be an integral part of both Speech/Language and Behavior Analytic programs. Challenging behavior and its relationship to the ability to communicate highlight the importance of collaborative interaction between SLPs and behavior analysts.
Historically, speech pathologists and behavior analysts have both served the needs of learners on the autism spectrum. The alliance has not always been an easy one, as the disciplines sometimes approach language acquisition differently. However, increasingly, there have been attempts to bridge these two communities of professionals, as a joint and integrated approach can maximize success. Collaboration between these two fields promotes comprehensive programming, which maximizes the scope and quality of services provided to learners with autism.
Addressing communication deficits
When addressing communication deficits, practitioners need to consider two important factors during the intervention process, the modality for communication and the procedures for teaching the response(s). A considerable amount of evidence has shown that learners with autism may respond to a variety of different modalities of communication. For instance, learners with autism have been taught to effectively communicate using verbal speech, (e.g., Carr & Durand, 1985), sign language (Mirenda, 2003), picture exchange (e.g., Yoder & Stone, 2006) and electronic augmentative devices (e.g., Millar, Light & Schlosser, 2006). It is important for practitioners to account for the strengths and weaknesses for different learners as well as the environment that the learners exist to choose an appropriate communication modality. For instance, teaching communication through verbal speech may not be appropriate for a learner with severe apraxia. Low functioning learners may respond better to picture exchange systems as they provide visual prompts for communication. …