• A Review of Promoting Functional Communication Within the Home

    This month’s ASAT feature is a review of Promoting Functional Communication Within The Home ( Bondy, A., Horton, C. & Frost, L.) by Kaitlyn Evoy, BA, and  David Celiberti, PhD, BCBA-D. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

    The ongoing COVID-19 pandemic has created an abrupt and enduring disruption to the educational programs of countless children with autism spectrum disorders (ASD) and with little preparation, placed parents in a primary instructional role. For any number of circumstances, such as outbreaks in their communities, parents are often required to assume or resume this role. We applaud Andy Bondy, Catherine Horton, and Lori Frost for writing this comprehensive and useful article at a time when so many were struggling with creating meaningful experiences for our learners and their families. To put the authors’ swift effort in perspective, their article was published online on May 12, 2020 and was accessible in PDF form at no cost to the reader. The authors purposefully used language to promote understanding by all readers by removing unnecessary jargon, using abundant practical examples, and explaining complex concepts in accessible ways.

    These authors highlight nine critical communication skills as a response to the COVID-19 crisis and the subsequent increased time children were/are spending at home. These critical communication skills encompass both speaker and listener roles and were highlighted because of their relevance and necessity for everyday functioning.  Furthermore, helping children to use these skills reliably and competently may lessen frustration and reduce or eliminate the need to engage in other ways to get those needs met (e.g., challenging behaviors).

    The authors describe and elaborate upon each of the nine skill areas. The summaries include the rationale for prioritizing that skill, useful teaching strategies, commonly faced problems, and possible solutions. The article reviews the process for assessing current performance levels for the nine skills and offers tips to caregivers through this effort. For assessment of present levels, a checklist is provided with specific examples of phrases and/or subcategories. For example, the authors separated “request reinforcers” into edibles, toys, and activities. The skill of responding to directions is broken down into the two distinct areas of visual and oral directions. Authors elaborate on these two areas and provide examples for each (i.e., “come here,” “stop,” and “sit down” for oral directions). The tips given to parents and other caregivers include prioritizing activities and routines that are of the highest need for an increase in functional communication and using these core areas as a basis for overall instruction. In short, the authors emphasize targeting most immediate needs as a means to improve overall communication skills.

    Nine Critical Communication Skills

    1. Requesting Reinforcers: We wholeheartedly agree with the authors that the skill of requesting reinforcers is of paramount importance. The authors suggest that parents should start with discerning what is reinforcing for a child before working on this skill. Rather than conducting preference assessments finding one item or activity on its own, the authors recommend trying combinations of items to create more motivating rewards. They also recommend re-creating situations as needed, setting realistic goals, raising expectations carefully, and using different levels of motivating reinforcers in an intentional and strategic manner. For instance, if the task is routine and not challenging, the reinforcer should not be the most highly motivating one.
    2. Requesting Help/Assistance: The authors aptly note that this skill is one that all children and adults will need in their lives. They recommend increasing levels of difficulty over time to promote mastery. Start with tasks which are easier to solve. When the child can ask for help in less challenging situations, increase the level of difficulty. It is important to gauge their frustration levels and be willing to decrease the demand when warranted. As stated above, the authors remind readers to re-create situations to create clean learning opportunities rather than address them amidst a challenging behavior.
    3. Requesting a Break: Asking for a break when overwhelmed or tired is another critically important skill for all of us, and we appreciate the authors inclusion of this skill. When working on newer, challenging skills with your child, it is essential that they can ask for a break when needed. This can decrease physically aggressive behavior, self-injurious behavior, and other problematic behaviors. The authors recommend that parents should work on this skill before frustrations reach crisis levels. Once you have an understanding (baseline) of tasks/work time your children can consistently do without needing a break, you can slowly increase the number of tasks and/or work time. Perhaps one of the most important points that the authors raise with respect to break requests is that parents should not rely on their hunches as to when a break is needed and provide one in the absence of a direct request, but rather give children the tools to request a break themselves on their own terms.  In addition to the suggestions offered by the authors, we would recommend working towards a more elaborate response (“I need a break. I am tired.” or “Can we stop? My stomach hurts.”).
    4. RejectingWe agree that learning to reject appropriately is an essential skill and can be critical in decreasing maladaptive behaviors. Being able to reject, refuse, or withdraw consent is another important skill that will be needed throughout one’s life. If children are not able to reject situations, activities, or items, this can lead to frustration and challenging behavior. The most important thing to remember when teaching this skill, is to always honor their rejection.  Furthermore, new skills such as this require abundant and consistent reinforcement. As with the teaching of other communication skills, caregivers can increase the difficulty by including situations, activities, or items that have a higher chance or severity of dislike.
    5. Affirming/Accepting: As with rejection, affirmation is a communication skill needed for everyday life. The authors were right to include this in this resource. Answering “yes” is also an important communication skill. This is especially true when options are difficult to show or when situations arise that a caregiver can’t prepare for ahead of time. When teaching children to differentiate between “no” and “yes,” try teaching them separately before giving them both as options.
    6. Responding to “Wait” or “No”: This is particularly relevant during the pandemic given that many preferred activities may be less available during times of social distancing. We commend the authors for including this challenging, yet inevitable skill in their article and for making the important distinction between learning to accept delayed versus denied gratification. Learning to wait is a challenging skill, particularly when the duration of time needed to wait is not clear. Although difficult, waiting and accepting an unwanted answer are important skills in situations that children will often encounter. This skill can be difficult for caregivers to increase complexity.  The authors recommend predicting negative responses, coping with them, and being willing to reset the challenge. The authors also highlight three essential elements to consider, and we refer the reader to the article to learn more.
    7. Following Directions: In addition to the obvious benefits of being able to follow directions, there are also possible risks when children cannot follow directions, especially in safety situations. To promote skill acquisition, the authors recommend starting with tasks that are more desirable for the child (e.g., accessing a favored item).
    8. Following a Schedule: Although the above skills involve the expression of communication, following a schedule is necessary and can be an essential tool for creating a predictable environment, as well as for learning to tolerate changes in those schedules. Visuals help children anticipate expectations and learn independence. The authors also discuss how schedules can vary in terms of the number of tasks/activities as well as descriptive factors. For example, scheduled items can be represented by physical objects, pictures, or words. Once children are able to follow a schedule, parents can introduce planned changes (the authors refer to this as a “surprise”) in order to increase tolerance of unexpected changes that naturally occur.
    9. Transitions: We appreciate the decision to discuss transitioning as an essential functional communication skill. Transitioning between activities and coping with unexpected transitions can be particularly challenging for children with autism. Parents can prepare children for transitions, but not all changes can be predicted. Like many of the skills noted above, frequent practice is needed. The authors suggest that parents showcase upcoming reinforcers as a way to promote successful transitions across activities. This recommendation may be a helpful strategy for many families particularly when the next activity is not inherently rewarding.

    Final Thoughts

    Parents and other caregivers need support, guidance, and accessible information in providing instruction to their children in the home environment. The COVID-19 crisis disrupted children’s lives, including therapies targeting functional communication. This comprehensive, useful, and easily accessible article aids in breaking down the main areas of functional communication and actionable steps for caregivers to take to work on each of these areas. Although beyond the scope of this brief article, we would also like to draw attention to a few other skills such as initiating and responding to greetings; and expressing feelings, discomfort, fatigue, and sickness.

    As a resource, this very accessible article is valuable to other stakeholders besides the target audience of caregivers. Teachers, therapists, and other educational staff can use these critical functional communication skills to assess current overall functioning and target areas for improvement.  Now that onsite service delivery has resumed, the advice given to caregivers throughout Bondy, Horton, and Frost’s article bears much relevance for education and other therapies in the school environment.

    Citation for this article:

    Evoy, K., & Celiberti, D. (2022). Review of Promoting functional communication within the homeScience in Autism Treatment, 19(1).

    About The Authors

    Kaitlyn Evoy, BA is a special education teacher with a Bachelor’s degree in Special Education, and she holds a Learning Behavior Specialist-1 Certification in Illinois. She obtained her Bachelor’s degree from Lewis University in 2014, and she is currently studying Autism and Other Pervasive Developmental Disorders at Johns Hopkins University. Kaitlyn is drawn towards the study of evidence-based practices and their execution in classroom environments. She is an Extern at the Association of Science in Autism Treatment focusing on dissemination to teachers and other educational support staff. 

    David Celiberti, PhD, BCBA-D, is the Executive Director of ASAT and Past-President, a role he served from 2006 to 2012. He is the Editor of ASAT’s monthly publication, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993 and his certification in behavior analysis in 2000. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis (ABA), and early childhood education. He works in private practice and provides consultation to public and private schools and agencies in underserved areas. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. In prior positions, Dr. Celiberti taught courses related to ABA at both undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism.

     

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