The fields of Applied Behaviour Analysis (ABA) and Speech and Language Therapy (SLT) .... The target was implemented acr
SPEECH AND LANGUAGE THERAPY IN THE CABAS CURRICULUM: AN INTEGRATED APPROACH ® Hannah Lynch, Speech and Language Therapist - Jigsaw CABAS School ®
Language difficulties are apparent in a vast majority of children and young adults with autism, therefore an important goal within any curriculum is to develop effective speech, language and communication, (Sundberg & Michael, 2001). Two approaches that complement each other to promote these skills in children diagnosed with autism are Applied Behaviour Analysis (ABA) and Speech and Language Therapy (SLT). This paper will discuss how these two approaches can be integrated effectively into a CABAS® School to increase speech, language and communication targets. Literature review • The fields of Applied Behaviour Analysis (ABA) and Speech and Language Therapy (SLT) often have similarities in terms of forming goals for those with communication impairment, regularly working towards decreasing problem behaviours that can be because of a lack of functional communication skills, (Koenig & Gerenser, 2006). • There are many advantages for collaboration between the two fields, such as contribution to evidence-based practice, (Dyer & Kohland, 1991; Frost & Bondy, 2001; Gerenser, 2005; Koegel & Koegel, 1996; Mirenda, 1997; Reichle & Wacker, 1993). • For example, the Augmentative and Alternative Communication intervention of Picture Exchange Communication (PECS) is a collaboration of SLT and ABA teaching procedures, principles and tactics to allow for functional communication for those with Autism Spectrum Disorder (ASD) and related developmental disabilities. This intervention has been shown to be effective, allowing for functional communication and development of speech in some individuals (Charlop-Christie et al, 2002). • Another advantage of collaboration is improvement in the integration of support provided by SLT and ABA professionals as professionals on school based intervention teams. For example, integration leads to fewer problems with programme implementation and confliction if ABA professionals and SLTs collaborate effectively, (Koenig & Gerenser, 2006). This paper gives specific examples of how SLT is integrated into a Comprehensive Application of Applied Behaviour Analysis to Schooling (CABAS®) setting.
Case 3 • The pupil was a 7-year-old female who had limited play and social skills.
Definition of behaviour and tactics Results • The graph indicates that the pupil achieved their SLT target of turn taking with a peer, when using the tactics of verbal and gestural prompts and when run daily in the CABAS® classroom.
• The target behaviour was defined as: the pupil will take a turn after a verbal and gestural prompt is given during a simple turn taking game alongside another peer. The target was implemented across 3 different turn taking games.
Setting • Integration of SLT took place in a CABAS® school in the UK, a school for those age 4 to 19 with an ASD diagnosis. Classes ranged in number from totals of three to six pupils all having a 1:1 CABAS® curriculum. SLT was implemented through assessment, liaison with staff, direct therapy sessions and SLT programmes run on a daily basis monitored and supervised by the SLT. Programmes within class used the learn unit as a teaching method for pupils. The learn unit is a unit of instruction consisting of a three term contingency including, antecedent, behaviour and consequence. The learn unit is used to demonstrate when learning has occurred and when further support is required, (Greer & McDonough, 1999).
Case 1 • The pupil was a 6-year-old female who had some vocal communication, but could not always get her communication needs met due to using approximations of words that were not always understood by those less familiar to her. Therefore, PECS was implemented by the SLT into her curriculum to support her vocal communication. The data were collected by a teacher using a data sheet and a pen to mark correct and incorrect responses.
Definition of behaviour and tactics • The target behaviour was defined as: when it is identified that the pupil wants a motivating item, the pupil will independently pick up the PEC symbol, reach to and touch their teacher with the PEC symbol, (PECS phase 1). Two adults were required to teach the pupil the behaviour; with one to teach the communicative exchange through physical prompting and the other to be the communicative partner. Prompts were gradually reduced using backward chaining.
Results • The graph shows that the SLT target of implementing PECS phase 1 with use of backward chaining was successful when taught everyday within the CABAS® curriculum. The pupil then moved on to PECS phase 2.
Discussion • The three cases detailed in this paper, provide specific examples of integration of SLT into a CABAS® curriculum. • The examples support previous research arguing for the collaboration of SLT and ABA professionals, (Koenig & Gerenser, 2006). • In particular case 1 provides support for the intervention of PECS as an effective communication system, (Frost and Bondy). • However, only one phase of the intervention was shown in case 2, due to the pupil still working on the longer term objective. • Future research should continue to extensively monitor how integration of SLT and ABA can progress speech, language and communication skills in those with ASD and further contribute to evidence-based practice.
References Case 2 • The pupil was an 8-year-old male who required progression of listener skills, specifically comprehension of verbs.
Definition of behaviour and tactics • The target behaviour was defined as: the pupil will follow directions containing single actions of pour, mix, push, turn, wipe within a play activity. Listening and comprehension of verbs was supported through a picture prompt displaying symbols of key vocabulary.
Results • The graph shows that the pupil was successful in completing the SLT target which was run daily as part of the CABAS® curriculum. The results indicate that incorporation of a picture prompt was successful in supporting the pupil’s understanding of verbs.
• Charlop-Christie, M. H, Carpenter, M., Le. L., LeBlanc, L.A., & Kellet, K. (2002). Using the Picture Exchange Communication System (PECS) with children with Autism: assessment of PECS acquisition, speech, social communicative behavior, and problem behavior. Journal of Applied Behaviour Analysis, 35, 213-233. • Dyer, K. & Kohland, K. (1991) Communication training at the May Center’s Integrated Preschool: Assessment, Structured Teaching, and Naturalistic Generalization Strategies. In Cipani (Ed) A guide for developing language competence in preschool children with severe and moderate handicaps. Springfield, Ill.: Charles C. Thomas Publishing Co. • Frost, L. & Bondy, A. (2001) The picture exchange communication system (PEeS): 2nd Edition. Newark, DE: Pyramid Educational Products. • Gerenser, I.E. (2005). Promoting speech and language in children with autism: From Theory to Practice. Workshop, Association for Behavior Analysis Conference, Chicago, Ill. • Greer, R. D. & McDonough, S. (1999). Is the learn unit a fundamental measure of pedagogy? The Behavior Analyst, 22, 5-16. • Koenig, M., & Gerenser, J. (2006). SLP-ABA: Collaborating to support individuals with communication impairments. SLP-ABA, 1, 2-10. • Koegel, R. L. & Koegel, L. K. (1996) Teaching children with autism: Strategies for initiating positive interactions and improving learning opportunities. Baltimore: Paul Brookes Publishing Co. • Mirenda, P. (1997) Functional communication training and augmentative communication: A research review. Augmentative and Alternative Communication. 3, 207-225. • Reichle, J. & & Wacker, D. P. (1993) Communicative alternatives to challenging behavior: Integrating functional assessment and intervention strategies. Baltimore: Paul Brookes Publishing Company. • Sundberg, M.L. & Michael, J. (2001). The benefits of Skinner’s analysis of verbal behaviour for children with autism. Behavior Modification, 25, 698-724.
