Defining Characteristics of AS (Deletion Positive)

1. Communication in PeopleWith Angelman SyndromeStephen N. Calculator, Ph.D., Professor Dept. of Communication Sciences and DisordersUniversity of New HampshireDurham, NH 03824-3563<stephenc@cisunix.unh.edu>

2. Defining Characteristics of AS(Deletion Positive) • Tremulous movement of limbs • Easily excitable • Hypermotoric • Short attention span • Apparent happy • demeanor and frequent • laughing/smiling • Severe to profound mental retardation • None or minimal use of words • Receptive language exceeds expressive language • Ataxic gait

3. Other Characteristics Significant to Communication • Protruding tongue • Frequent drooling and excessive chewing/mouthing • Sleep disturbance

4. Communication Profile of AS • Problems first noted in early infancy. • Fail to develop any functional speech. • One group identified on REEL with receptive language skills in 9-22 month range and expressive skills in 9-14 month range (Joleff & Ryan, 1993). • May use one or more words indiscriminately early on. Often drop out of lexicon.

5. Communication Profile of AS (cont.) • Typically rely on multimodal communication (Calculator, 1997). • Marginal success with VOCAs in terms of spontaneous use. • All required prompting to use AAC systems. • Minimal initiations. • Self-selected simple means of communication: (natural gestures – actions on people and objects, eye gaze, and reaching). *Majority of gestures required physical contact with referent or interactant – contact gestures.

6. Use of Gestures by Children with AS • Frequent reliance on gestures (Alvares & Downing, 1998; Clayton-Smith, 1993). • Those using manual sign (about 20% of population) use signs difficult to understand – motor problems (Clayton-Smith, 1993). • Manual communication is preferred modality for most individuals (Alvares & Downing, 1998). • Difficulty imitating gestures, including those already in communication repertoire (Joleff & Ryan, 1992; Penner et al., 1993).

7. What Other Communicative Behaviors Should I Be Looking For? • Vocalizations • AAC • Challenging Behavior: (socially unacceptable and perhaps harmful behavior).

8. Vocalizations • Often limited – vowels, consonants and syllable shapes • Goal – expand phonetic and phonemic inventories

9. AAC • Principle of Zero Exclusion • Moving away from cognitive prerequisites • Cognitive skills that ARE important (Rowland & Schweigert, 2003) • Awareness (theory of mind, social awareness.

10. AAC • Communicative intent (importance of parents’ responsiveness and contingency). • World knowledge (general experience) • Memory (sensory, working, long-term) • Symbolic representation (levels of abstraction)

11. AAC • Cognitive and Related Requisites to Use Different AAC Systems? • Consider child’s language skills when introducing (immediate needs) and planning future uses of AAC systems. • AAC to foster communication growth.

12. Challenging Behavior • Functional alternatives to socially unacceptable behavior • Self-injury • Aggression • Must identify function (impact on environment) of behavior. • Functional communication training (Carr & Durand, 1985).

13. Challenging Behavior • Functional communication training (FCT) • Identify function of the unacceptable behavior. (what are the reinforcers?) • ABC paradigm (escape, attention, gain item or activity, sensory. • Make certain the communicative response is as efficient or more efficient than the unacceptable behavior (effort, frequency of reinforcement, and delay). • Evaluate reinforcers provided for unacceptable and communicative responses.

14. Communication Stages • Perlocutionary Stage • Lack communicative intent. • Not goal directed per se. • Adults ascribe meaning. • Include responses to internal states. • Might teach adults to read and interpret children’s behaviors, gaze patterns.

15. Communication Development • Perlocutionary Stage – Intervention • Alter partners’ perceptions of children as communication partners. • Replace children’s unintentional behaviors with voluntary communicative behaviors (BIGmack) • Increase children’s responsiveness to others, as well as to objects and events. Means-end behavior. • Move toward functional uses of objects. ENGs

16. Communication Development • Illocutionary Stage • Intentional communicative acts. • Usually gestures and vocalizations • Often to request attention or request objects and actions (protodeclaratives and protoimperatives)

17. Communication Development • Illocutionary Intervention • In late stage may be taught to use symbols to request, reject, share information, and engage in conversations. • Scripting & embedding communication within routines • Partial participation • Backward chaining • Communication dictionary?

18. Communication Development • Locutionary Stage • Emergence of symbolic communication • Expansion of communicative functions, vocabulary, and conversational skills. • Reciprocal social exchanges

19. Communication Development • Locutionary Stage Intervention • Stress conventional methods of communication. • Topic initiation and turn taking. • Home-school coordination – VOCA journal • Expansion of vocabulary. • General case instruction. • Fast mapping (Rice, 1989; Wilson & McIlvane, 2002).

20. What do we mean by ‘Success’ of Communication’? • Success – adult acknowledges (“okay”, “I see”, “mmhmm”), interprets (oh, you’re telling me…; you’re still thirsty, huh?), or complies with child’s message. Rejections are also successes since they are contingent replies. • Non-success – adult ignores, fails to respond, requests clarification, or responds non-contingently. • Circle of Conversational Partners