Functional Communication - getting our priorities right when focussing on the communication needs of children with autism.

When we are working with children with autism, we need to focus on functional communication skills when we want to find strategies to enhance communication. Although our end goal is to try and create a system of communication that is functional, effective and easy to understand for everyone, we often need to put a lot of building blocks in place before this will work. Initially, we need to look at a couple of questions.

1. What are the current priorities issues around communication and behaviour?

2. What are our long term goals, and what short and medium term objectives do we need to accomplish to achieve these goals.

This may seem very obvious, but often the goals we set are too big in the short term and/or, are not functional. To explain what I mean here are some examples:

Example 1.

The father of 4 year old John, who has Autistic Spectrum Disorder (ASD) and no speech or functional system of communication, states: “I want John to learn to speak”.

John needs a system of communication to express his basic needs prior to teaching him to speak (and it is conceivable that speech may not be his long term system of communication). Even if John learns some new words, will he be able to tell you he is hungry, sick or needs the toilet, these are functional every day requests that John needs to have some way of communicating. Using some kind of picture exchange system might be a good start.

So while I am not criticizing John's father's wish that he should be able to talk, my feeling would be, lets look at the first step which is teaching John how to communicate and how to initiate. We then want John to have a system to express his basic needs and make choices, and then, maybe, we can focus more on whether John will learn to speak, but only if it is practical and functional i.e. if John has the capabilities for speech and we have a good rationale for working on this goal.

Example 2.

The teacher of 6 year old Julie with ASD, says: “She keeps wondering from her hair, doesn't sit down, doesn't listen and throws a tantrum if we try and get her back to her desk. I want her at her desk for every lesson, all of the time”.

For Julie, there are lots of small steps to take before we can expect her to be sitting at her desk all day. We need to get her to understand routine and structure (probably by using some visual schedules - see here for more information on visual schedules). We need to teach her about looking, listening and attending. We need to get her to be at her desk for short periods and build on this. We need to give her timeouts so she can re-charge her batteries.
We need find ways of dealing with her inappropriate or challenging behaviour when it occurs. There are many smaller goals to accomplish before we can expect Julie to be sitting at her desk for longer periods and attending.

Example 3.

The key-worker for 52 year old Kenneth who is on the autistic spectrum, is non-verbal and has been in institutionalized care for most of his life states: “I want him to request and make choices”.

Kenneth has been in institutionalized care for most of his life, he has probably had everything done for him, now we want him to request and make choices. This is a good goal, but before we can get John to do this we have to teach him about communication. We have to teach him that communication is a tool and he can use it to get what he wants. We have to teach him to approach someone and initiate communication when he wants something, and we have to give him the tools to communicate. These things can take a long time to teach, and staff have to be prepared, when they set these goals, to be consistent and persevere with the teaching. After 50 years of not having to request or communicate it may take a long time for him to learn these skills.

These examples highlight that there are often many steps to take before we can reach our longer term goals. Often individuals with ASD do not have many basic skills such as listening and attention or initiating communication to request. These skills all have to be taught before we can achieve our bigger goals.

A downloadable version of this article, with a suggested reading list, is available for viewing and / or downloading from the Autism Section of the Downloads Centre.