Case study: Supporting Billy with non-verbal communication
Billy, aged 10 has Autism and is non-verbal. Laura started working with Billy in November 2016 as part of a school contract. In this case study, we will share details of the progress that Billy has made to date.
Laura started working with Billy in November 2016 as part of a school contract. Parents are always included as part of the assessment and intervention process through our school contracts and Billy’s mum and Laura have been in regular contact to ensure his targets can also be supported at home.
In November 2016, Billy was working on his understanding of language (increasing his vocabulary) and following 2 key words in an instruction. He had two forms of ‘expressive language’ (ways in which he communicated): Picture Exchange Communication System (PECS) and a communication app on an iPad (high tech Augmentative and Alternative Communication, AAC).
At the time, Billy was using neither effectively. He needed adult prompts to use his PECS and was using his iPad to gain auditory stimulation rather than to communicate. For example, he would press a button repeatedly to hear the word rather than approach an adult and press buttons to make a specific request.
Laura therefore advised for Billy to focus on PECS until he was more consistently approaching adults to make requests and was doing this without prompting. Billy worked on this alongside receptive targets (understanding of language) based around vocabulary, concepts (like size, colour, position words) and following longer instructions.
How we helped Billy:
By working through structured phases of PECS at home and school and working on his receptive language targets, Billy made good progress with both his vocabulary knowledge and use of language. He started to build phrases with his PECS book to ask for specific episodes of his favourite Mickey Mouse programme e.g. ‘I – want – picnic – Mickey’ and for his favourite coloured sweets e.g. ‘I – want – purple – sweet’.
Sentence strips were then introduced for Billy to make specific and functional requests for actions he needed in the moment (such as ‘mummy open the door’) when he wanted to play in the garden.
By February 2018, it was felt Billy’s language and communicative intent (his ability to gain the attention of another person and communicate his message to them) was at a level to re-introduce high-tech AAC. Laura made a referral to the Communication Aid Service and after assessment, a trial intervention period and training for adult’s working with Billy, he was set up with Snap Core First.
Billy has worked on a range of targets including answering questions, using greetings and making requests.
Billy has attended a communication group run by The Talking House in school to focus on spontaneous and functional use of his AAC, social skills with peers to engage in turn-taking interactions, learning new vocabulary and building flexible phrases.
Billy’s progress to date:
Due to Billy mostly using ‘nouns’ (objects and people), his most recent targets focus on ‘verbs’ (action words). He continues to work hard on this both in specific activities and within routines throughout the day. For example, his mum may ask ‘what is mummy doing?’ and Billy will respond with ‘mummy is driving’.
Collaborative working has been the key to success for Billy – regular discussions between home, school and the speech and language therapist have enabled Billy to work on his targets across environments and gain regular and consistent support for him to develop his language and communication skills. Billy’s mum does amazing work with him at home to focus on his targets throughout their daily routine and also to teach new skills during specific ‘learning’ activities.
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