Pragmatics
Pragmatics is
Use of Language in Social Contexts
1) paralinguistic features
2) extralinguistic features
3) linguistic features
4) conversational features
Can be nonverbal aspects too-
1) Eye gaze – tells speakers that their conversational partners are attending & listening. Children with ASD utilize less eye gaze during interactions.
2) Proximity – the use of space & body orientation. Children may have difficulty recognizing a comfortable “talking space” during conversation.
What is the objective?
Three Specific Areas to Watch for Early Communication Challenges
1) Development of intentional communication. Joint attention is often an important target for assessment & Tx. (It has been linked to limitations in play and in the development of peer relationships.); 1st goal; they need to have it
2) Gesture use. Gestures are typically used by young children to convey info & provide a means for sharing affective experiences. Children with ASD tend to have less frequent eye contact, decreased pointing to/showing objects, & fewer gestures combined with vocalizations.
3) Use of unconventional verbal behavior such as echolalia, perseverative speech (repeating words/phrases), & excessive questioning. During assessment, recognize these things but also try to understand the purpose it may serve for that child.
What do you teach children with ASD
1)To understand & value interactions between people. Show them the value of social interactions through a social story or video (should what people get out of being able to communicate)
-Social story= write a fictional story relating to a goal and personalize it to a client (family, pets, likes, etc), they take the book home and read it every day; make it repetitive and build on it
2)That words & signals have power
3)A method for sending messages (can be gestures, speaking, pointing, or symbols)
SCERTS
developed by Prizant, Wetherby, Rubin, Laurent, and Rydell in 2006
Follows a team approach
Utilized to focus on social communication, emotional regulation, and transactional supports
Paralinguistic Features
- Paralinguistic features of communication are those skills speakers possess that manage their speech intelligibility and prosody.
- Children with ASD may have difficulty fine-tuning speech production.
Prosody or rhythm of speech involves intonation or an emphasis on particular words that can distinguish subtle word meanings, signal whether an interpretation should be literal or nonliteral, & add emotion.
-Child with ASD may have monotone voice quality; inappropriate pitch; inappropriate intensity, & flat or unusual intonation. In addition, they may not be able to interpret and use prosodic information. Screen!
-Speech intelligibility impaired
-Schiberg- high prevalence of distortions in kids and teens with ASD; differences in phrasing, stress, and nasal resonance
10 Tips for Planning the Assessment to increase the likelihood that you have obtained good results
1) Talk with parents/teachers beforehand; see what kinds of communication cues they need, cues for when they are about to shut down, rewards that work
2) Arrange for parents/teachers to observe the assessment session to verify results
3) Schedule several short testing sessions
4) Develop a relationship with the individual first
5) Select both language based and nonverbal skills
6) Present a broad range of tasks & start below CA
7) Have index cards available for visual supports
8) Organize a “finished” box
9) Break from standardized procedures to probe – determine the type or level of support needed for a correct response
10) End session while student still working at optimal level
-If you modify the standardized test in any way, the scores become invalid and you cannot compare the scores to other scores
Pragmatic assessment includes
1)Communicative intentions –
What’s the intent of the speaker?
What’s the effect of that intent on the listener?
Intent can be expressed by words (linguistic) or gestures (nonverbal) or intonation/stress (paralinguistic) or a combination.
Is there flexibility?
Inflexible/rigid forms
2)Presupposition –
Can the child understand their communication partner’s perspective and attitude? Look at the following:
what topics the child talks about
his/her ability to comment & add new info
use of vague messages
talking about things present vs. not present
ability to interpret inferences
3) Social organization of discourse –
Does the child have the skills necessary for assuming & interchanging roles of speaker and listener?
6 critical goals to address deficits
1. To value people, interact, and communicate intentionally; teach them that people provide information, assistance, comfort and pleasure; teach them to tolerate closeness of people; intentionally seek out and initiate conversations and interactions and how to stay in it (take turns); teach them theory of mind
2. To learn language and to communicate effectively; semantics (multiple meanings; everything has a label); symbols; words are spoken and written; functions of different objects; words can label and define concepts; how they are going to communicate; language comprehension
3. To tolerate change and accept new experiences; to be more flexible; rehearse new events; tell them change is okay; change can be good and fun; help them step by step to be more flexible; okay to do things different ways
4. To focus on and participate in instruction; how instruction is given; use cues in classroom to help with instruction; focus on most relevant info.; how they can help themselves pay attention ; self motivation; teach them how to work in different ways (1 on 1; individual; small or large group)
5. To do things independently without constant verbal direction; visual info. System; utilize gestalt and routines to learn
6. To monitor and manage stress; figure out what works; learn to take criticism and challenges; problem solving; how to ask for help
Social stories
created by Carol Gray
They are short descriptions of a particular situation, event or activity, which include specific information about what to expect in that situation and why.
Social stories can be used to:
Extralinguistic Features
- Nonverbal components of pragmatic communication.
- Includes gestures & body movements to aid communicative intent & the expression of emotions or feelings in an utterance.
- Children with ASD often lack expected arm/hand movements, facial expressions, & head nods in conversation.
-Also difficulty interpreting meaning of various facial expressions.
- Can compromise the ability to relate to others.
What are we looking for?
Through interviews, observations, & functional assessment forms & checklists, we determine:
1) Person’s Home & School Priorities. Analyze how the individual participates in daily routines. Ask parents which routines should be targeted. Consider:
A) Which routines would make life more interesting?
B) Which would make it easier for the family?
C) Which would lead to greater independence?
2) Determine components/steps of chosen routines and the student’s current skills.
3) Assess sensory & Instructional demands. To determine modifications, consider:
A) Environment (light, noise, temp, odor, crowds)
B) Instructional demands (teacher’s language, visual supports, cooperative work, etc.)
C) Response demands (verbal, written, homework)
4) Functional Communication – in natural environments. Note skills & deficits.
5) Social skills – lots of checklists & tools available. Assess social skills with family, peers, & teachers.
6) Identify Preferences & Interests – find out what is highly reinforcing for the child vs. highly punishing.
7) Assess Daily Life Activities linked to behavior problems.
8) Monitor (keep records) progress & address issues.
Assessment of semantics includes
Children with ASD often have difficulty meaningfully expressing semantic relationships in socially appropriate ways.
a)Semantic knowledge – check both receptive & expressive vocabulary
b)Semantic relationships between words (phrases, sentences)
c)Word categories
Convergent - small category into big (ex. milk, cookies, bread->food)
Divergent - big category into small (ex. cars-> mustang, mercedes, ford)
Both difficult, convergent comes later
d)Antonyms & synonyms
Hyperlexia - higher level/advanced reading but may not comprehend
e)Figurative language/ inferencing/prediction
Using a story, theory of mind, semantics
Assessment of semantic language - looking at general semantic language in children with ASD, atypical semantic behavior is the last category examined
f)Narrative production & discourse comprehension
Tools and skills for kids
Go from least to most abstract
Card/symbol systems: use index cards inside envelopes or file folders; display boards on wall with card symbols in sequence; put on clipboards
Visual schedules- make sure to answer what, when, where, and what’s next
Checklists
Cue cards
Semantic maps
Experience stories
Social stories
Computer/video modeling
Discrete trial training
-clinicians make decisions on how to arrange the trial
-Discriminate the stimulus, Response, Consequence, Intertrial interval
-Uses operant conditioning- interaction between action and consequences
-Clinician must have control over environment, understand kid’s skill level on task, have some level of success, maintain kids motivation
-Best with one-to-one ratio
-High intensity (at least 25 hours a week)
-Address goals on a cycle- make sure to maintain skill and keep motivation with easy skills; use a familiar skill then make it into a new skill
-Clinician does not allow the client to make an error
Linguistic Features
- Children must be able to use utterances that demonstrate what they know and understand about the listener.
-Children with ASD have difficulty:
1) Attending to their communicative partner. Difficulty with disengaging, orienting, & shifting attention.
2) Utilizing language skills to express themselves. This is due to those unconventional types of language use (discussed previously), but also a real limitation in both the quantity & quality of linguistic info they can understand & express.
Most popular standardized tests for ASD
A) ADOS-G: Autism Diagnostic Observation Schedule – Generic – standardized interview & observational assessment. Toddlers through adults.
B) ADI-R: Autism Diagnostic Interview-Revised– semi-structured interview given to parents/caregivers
C) SCQ: Social Communication Questionnaire – yes/no format for parents for communication & social functioning
What if the Child is Nonverbal?
Look at functions - nonverbal behaviors and determine what the nonverbal behaviors mean
1) Determine the presence of communication functions in nonverbal behaviors.
2) Determine the means used for communication across the three categories of communicative function: behavior regulation, social interaction, & joint attention. Do you see contact (with object or partner)? Distal gestures (pointing/reaching/waving)? Vocalizations?
3) Examine nonlinguistic comprehension. Does the child respond to situational cues (placing object in container)? Does he know what pointing or looking at an object means?
Intervention in autism should address:
the core symptoms of problems in communication and decreased social reciprocity. Pragmatic language is the primary area for intervention in this population. Semantically a child with autism would struggle
Functional Communication Training
replace challenging behaviors (self harm) with communication skills and decrease them with increasing alternative behaviors
Assess function of problem behavior (why they are doing it)
Select appropriate behavior (verbal or nonverbal)
Teach new behavior and fade prompts over time
Conversational Features
Conversation
- Children with ASD often restrict language use to instrumental functions (such as asking an adult for a desired object).
- They may be unable to judge conversational cues to tell when they have said too much (quantity), how important a specific comment is to the topic (relevance), or whether they have been clear about the info (clarity).
-Conversation may be more redundant & linguistically peculiar.
-They may fail to recognize the speaker’s intent, misinterpret nonliteral language, or misunderstand roles of speaker & listener.
Assessment of Unconventional Verbal Behavior of a nonverbal child by asking yourself
1) When does it occur most frequently? In transitions or difficult tasks?
2) Antecedent events (what happens right before this)?
3) Range of functions served (requesting, commenting, labeling)
4) Level of interference with successful communication
5) Any progressive changes in behaviors (inconsistency and variability)
Example: Look at the timing, conversational role, & intention of echolalic behavior.
Pivotal response Training (PRT)
Developmental- Individual Relationship Model (DIR model)