Monday, August 1, 2011

Autism - New Effective Therapy Techniques

According to recent statistics, autism is the fastest growing developmental disability in the U.S. today. Autism affects 1 in 110 children and 1 in 70 boys. About 40% of children with autism do not talk at all. Another 25%-30% of children with autism have some words at 12-18 months of age and then lose them. Others may speak, but not until later in childhood. (1) In 20 years there has been a 600% increase in the cases of autism. About a third to a half of those individuals will not develop enough natural speech to meet their daily communication needs. (2)

Thanks to recent technology (iPad/iPod Touch) a groundbreaking and exciting therapeutic technique to teach non-verbal students to use spoken language has emerged. VAST Autism 1 - Core (app available from iTunes) combines best practices, video modeling, and literacy with auditory cues to provide unprecedented support for the development of vocabulary and word combinations. What this means is that students simply watch a video of a syllable, word, phrase or sentence being spoken, see the visual representation and hear it auditorily. It's like watching a close-up movie of someone talking with subtitles. The VAST technique is also extremely effective in providing specialized therapy to help individuals with motor planning disorders, non-fluent aphasia, apraxia, deaf and hard of hearing speak for themselves.

Speech has always been a challenge for individuals on the spectrum. Therapies for non-verbal students may include: teaching sign language, gestures, picture exchange and/or voice output devices. To teach verbalizations therapists attempt to have students repeat sounds or words from their model. The idea is that a student watches the therapist articulate the target word or sound and then attempts to reproduce it. This technique does not usually work well due to the challenge students on the spectrum have with making eye contact or looking at a person's face. It is difficult to see how the articulators move when the ability to look at the face is fleeting. Technology, iPad and iPod, along with the VAST technique, has made it possible to effectively demonstrate how sounds, words and word combinations are produced without the challenges of face to face interactions. Students with autism will intently watch VAST videos on their devices free from the distraction of personal interaction.

The VAST Autism 1 - Core Videos are organized into a hierarchy of 5 categories beginning with syllables and ending with sentences. Each video gives a spoken target utterance that is preceded by the written word(s). Each word, phrase and sentence is concrete and has meaning that can be generalized and practiced throughout the day.

Providing the written word(s) will prevent a student from labeling a picture of a frog jumping as "go," a person lying on a mat as "break time" or labeling a swing as "wee." Furthermore, there is significant research that suggests pairing picture symbols with words may actually increase confusion, especially when they represent abstract concepts, have multiple meanings or serve more than one grammatical function. (3) The ability to recognize the written target word(s) will increase functional communication and enhance acquisition of reading, writing and spoken language.

The progression of VAST-Autism Videos is as follows:

  1. Syllable Repetition
  2. Single Syllable Words
  3. Phrases
  4. Sentences

VAST Videos can be played in full-length or separated playlists; this allows the therapist to choose the individual target(s) that best fit their student's needs. The developers are in the process of expanding upon this offering through future applications and via the SpeakinMotion web-based platform.

Ongoing research and initial pilot studies indicate that students are highly interested in VAST videos, and will almost immediately attempt lip movements or touch their lips in response to the models. After a few short weeks, many students who were essentially non-verbal have begun word approximations and word attempts more readily. Perhaps, the best and most unexpected therapeutic improvements have been the student's ability to generalize skills. Students actually begin attending to the speaker's oral motor movements during daily communication and continue learning speech in a more traditional, naturalistic manner.

VAST Autism has been extraordinarily effective with older (18-22) non-verbal students with autism. In two individual cases students were attempting word approximations and speaking several one syllable words after one session of watching the VAST videos. One of those students was diagnosed with severe sensory neural hearing loss and autism. He was able to produce four words by the end of his first session.

A word about video modeling-

A significant amount of research has shown video modeling to be rapid and highly effective not only in teaching new behaviors, but also in generalizing and maintaining these behaviors as well. Video Modeling involves the individual or child observing a videotape of a model engaging in a target behavior and subsequently imitating that behavior (see resources).


1. Johnson, C.P. (2004). Early Clinical Characteristics of Children with Autism. Gupta, V.B.ed: Autistic Spectrum Disorders in Children. New York: Marcel Dekker, Inc., 85-123.

2. Noens I, van Berchelaer-Onnes I, Verpoorten R, van Duijin G (2006). An instrument for the indication of augmentative communication in people with autism and intellectual disability. J Intellect Disabil Res. 50(9):621-32

3. Hatch, P. (2009). The effects of daily reading opportunities and teacher experience on adolescents with moderate to severe intellectual disability. Unpublished doctoral dissertation, University of North Carolina at Chapel Hill.

Lois Jean Brady is a practicing Speech-Language Pathologist and Assistive Technology Specialist with over 20 years of hands-on experience. She holds additional certificates in Computer Based Intervention and Animal Assisted Therapy. She has written Apps for Autism, (due out summer 2011), Speech in Action book series, conducts research, develops apps and other products to enhance communication for individuals with special needs. As the founder of Rancho La Paz, a non-profit Ranch for individuals on the spectrum, Lois hopes to provide a refuge for families and/or individuals to grow, learn, make friends, receive support, obtain information and acquire hands on vocational skills.

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