First Published Friday, 27 March 2009

Friday, Sep 5 (Psych Central) —

Feeling a connection to others is a critical component of a person’s mental and physical health.

New studies show that a sense of rejection or isolation disrupts not only will power and perseverance, but also key cellular processes deep within the human body.

Chronic loneliness belongs among health risk factors such as smoking, obesity or lack of exercise.

Feeling connected to others is vital to a person’s mental well-being, as well as physical health, research at the University of Chicago shows.

The studies, reported in a new book, Loneliness: Human Nature and the Need for Social Connection, show that a sense of rejection or isolation disrupts not only abilities, will power and perseverance, but also key cellular processes deep within the human body.

The findings suggest that chronic loneliness belongs among health risk factors such as smoking, obesity or lack of exercise, according to lead author John Cacioppo, the Tiffany & Margaret Blake Distinguished Service Professor in Psychology at the University.

“Loneliness not only alters behavior, but loneliness is related to greater resistance to blood flow through your cardiovascular system,” Cacioppo said.

“Loneliness leads to higher rises in morning levels of the stress hormone cortisol, altered gene expression in immune cells, poorer immune function, higher blood pressure and an increased level of depression.

Loneliness also is related to difficulty getting a deep sleep and a faster progression of Alzheimer’s disease, said Cacioppo.

One of the founders of a new discipline called social neuroscience, Cacioppo used functional Magnetic Resonance Imaging (fMRI) brain scans and advanced scientific techniques to document the roles of loneliness and social connection as central regulatory mechanisms in human physiology and behavior.

The authors traced the need for connection to its evolutionary roots. In order to survive, humans needed to bond to rear their children. In order to flourish, they needed to extend their altruistic and cooperative impulses beyond narrow self-interest and immediate kin. But in the environment of evolutionary adaptation, the only real safety was in numbers.

Just as physical pain is a prompt to change behavior (such as moving a finger away from the fire), loneliness evolved as a prompt to action, signaling an ancestral need to repair the social bonds. Feelings of loneliness take a variety of forms, Cacioppo said.

“There are three core dimensions to feeling lonely—intimate isolation, which comes from not having anyone in your life you feel affirms who you are; relational isolation, which comes from not having face-to-face contacts that are rewarding; and collective isolation, which comes from not feeling that you’re part of a group or collective beyond individual existence,” he said.

It is not solitude or physical isolation itself, but rather the subjective sense of isolation that Cacioppo’s work shows to be so profoundly disruptive. Yet, outward circumstances such as moving to a new community or losing an intimate partner can trigger loneliness. And as the authors make clear, today’s culture is not always conducive to promoting strong social bonds.

The problem of social isolation will likely grow as conventional societal structures fade. The average household size is decreasing, and by 2010, 31 million Americans—roughly 10 percent of the population—will live alone. Sociologists also have found that people report significantly fewer close friends and confidants than those a generation ago.

Cacioppo and Patrick also demonstrate how loneliness creates a feedback loop that reinforces social anxiety, fear and other negative feelings. By learning more about what underlies this experience, then learning to reframe their response, lonely individuals can reverse the feedback loop, overcome fear and find ways to reconnect.

“We try to offer some help for those who’ve become stuck,” said Patrick. “The process begins in rediscovering those positive, physiological sensations that come during the simplest moments of human contact. But that means overcoming the fear and reaching out.”

“Lonely people feel a hunger,” Cacioppo added. “The key is to realize that the solution lies not in being fed, but in cooking for and enjoying a meal with others.”

Source: University of Chicago

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First Published Friday, 27 March 2009

First Published Sunday, 29 March 2009

By SALLY BROOK
Sun Woman Editor

First Published Monday, 30 March 2009

REBECCA McQUILLAN

SAFE HAVEN: Brian Rafferty feels secure in his Broughton Street bookshop.

Brian Rafferty’s secondhand bookshop feels like a sanctuary. Painted claret red and lined with the colourful spines of several thousand volumes, its quiet, compact interior is the sort of place you could happily while away your lunch break. Open just a few months, it is already a popular fixture on Edinburgh’s cafe-lined Broughton Street.

Brian, 21, runs the shop from behind a desk in a back corner and is happy to give his customers the space and time to make their choices, though with his precise knowledge of the stock, he’s also able to help them find a particular volume in seconds. Temperamentally, he appears to be ideally suited to the work of a second-hand bookseller – a job which has given him fresh hope.

“I like the interaction with the customers,” he says, laying down his own book, Sharon Osbourne’s autobiography. “I like it when there are several people in at once.”

But he also loves the calm. “I get things done when it’s quiet, like moving the books around and sweeping up. It’s relaxing.”

For any 21-year-old to be running his own shop would be an achievement, but for Brian it is doubly so, because he has Asperger’s syndrome, a condition on the milder end of the autism spectrum. He did well at school and college, but struggled to find a full-time job afterwards.

“When he was looking for employment in banks, and in IT, he found it really difficult because he was coming up against people who were, in inverted commas, normal’,” says Brian’s stepfather Kevin, a police officer, who has popped in from the family home around the corner. “He was getting up at midday, and had no purpose. Now he’s up first thing in the morning.”

How does he feel about life now? “I’m really happy that I’ve managed to get more employment.”

Brian has a leaflet that he hands out to customers explaining what Asperger’s is and that he intends to donate a percentage of profits each year to the National Autistic Society.

The bookshop was the suggestion of a family friend, who owns the premises, and has been trading since before Christmas. But it was opened officially earlier this month by the entrepreneur Sir Tom Farmer, who paid tribute to Brian’s “can-do attitude”. The stock is donated.

Kevin, and Brian’s mum Sandra, who works in the pharmaceuticals industry, have been deeply touched by how local traders have taken Brian to their hearts. “Broughton Street is a small community. He feels safe here. This is now his home environment, which is fantastic,” says Kevin. “I see such a difference in him. Prior to this, you’d ask him what his day had been like and he’d say fine’. Now, when he goes for a pint, he’ll talk about the shop. It’s something to talk about.”

Brian’s experience underlines how people with certain forms of autism can participate fully in society and the economy. But loneliness and social isolation are widespread among people on the autism spectrum, and are a cause of deep unhappiness.

Autism and Asperger’s are characterised by difficulties in communication, interaction and social imagination. At one end of the spectrum are high functioning people with Asperger’s whose social difficulties may not be very noticeable, while at the other are those with severe autism who may not be able to communicate through speech at all.

“From childhood right through to adulthood, their experience is often of being bullied for being different, or ignored,” says Carol Evans, Scottish director of the National Autistic Society. “Often they want to make friends, but find it very hard.”

One-third of adults with autism develop severe mental health problems like depression or anxiety disorders. Many people with autism spectrum disorders, particularly severe autism, therefore remain at home. “If there was ever a condition that breaks up families, it’s this one,” says Evans. “We find an awful lot of families split because they can’t cope with the sense of stigma. Because autism often results in inappropriate behaviour, people start avoiding the general public. They go to Tesco at midnight instead of midday.”

In a bid to tackle this, 19 autism charities have come together to open people’s eyes to autism on World Autism Awareness Day on Wednesday. The theme is Stand Up For Autism, and a procession of celebrities such as Jane Asher and Patrick Kielty have recorded short videos of themselves doing just that. The aim, says Evans, is to end the litany of tuts and mutterings that autistic people and their families often encounter.

“Our message is: be more tolerant,” says Evans. “Don’t assume the child on the shop floor screaming or waving their arms about is badly behaved. That is their way of trying to convey they’re in trouble. If people were more tolerant, a more normal family life might be possible rather than fearing to leave the house.”

Maureen Rocks from Paisley has two sons with mild Asperger’s syndrome. Her son, Oliver, was diagnosed aged 10. Maureen says: “He was shy and didn’t like to go anywhere. He liked collecting things and doing the same things repetitively, and found it difficult to mix with other children.”

Oliver didn’t like going to school. His teachers noticed him becoming isolated in the playground. One lunchtime, the bell rang and he refused to go in. “The headteacher was brilliant,” says Maureen. “She went out to speak to him and I think she saw in him similarities with another child. She suggested speaking to a psychologist. It was a bit of a relief because I was thinking I was doing something wrong.”

After being diagnosed, Oliver became much happier at school, like Brian,he was picked on by other children. But having a talent for both drumming and playing the guitar, he had a focus and is now studying music performance at college. Oliver’s younger brother Harry was diagnosed with Asperger’s aged five because his behaviour was more challenging, but his character is completely different. “I’d say his social skills are very good,” says Maureen. “He left primary school with lots of friends and won an award for creativity.”

Now the two boys and their brother Jack, 10, who does not have Asperger’s, support one another. Maureen says: “I’m very lucky, my boys have very mild autism. The boys all have an interest and we all get on really well.”

Evans points out that often after leaving the education system, people with autism spectrum disorders get little formal support, because their condition falls between learning disability and mental health problem. Greater public understanding can make a difference.

Maureen’s message is simple: “Learn more about it, be more aware and if you come across someone whose behaviour is negative or difficult, try to be sympathetic and understand why they are behaving that way.”

Broughton Street Book Shop, 44 Broughton Street, Edinburgh. Donations gratefully received. Call 07960 015499 or visit www.nas.org.uk

Autism: the facts
Autism spectrum disorders affect 50,000 Scots, one in 100 people, though some scientists believe the rate is rising.

*Autism is more prevalent among males than females.

*Many adults with autism have not been formally diagnosed, as the condition is usually picked up in school.

*Genetic factors are thought to be responsible for some forms of autism, though environmental factors have an influence.

People with autism have difficulties in three areas:
Social communication
Difficulty understanding facial expressions or tone of voice; body language; jokes, sarcasm and metaphor. Some people with autism may not speak; others will have good language skills.

Social interaction
Difficulty understanding unwritten social rules like how close to stand to another person; may become withdrawn or behave in what might seem an inappropriate way.

Social imagination
People with autism have imagination and many are very creative. But social imagination – understanding or guessing another person’s thoughts and feelings – is more difficult.

*People with autism like routines, and may have sensory sensitivity.

Source:   http://www.theherald.co.uk/features/features/display.var.2498557.0.Treatment_by_the_book.ph

First Published Monday, 30 March 2009

Playing action video games can boost an aspect of adult vision previously thought to be fixed, a US study shows.

Researchers found playing the games improved the ability to notice even very small changes in shades of grey against a uniform background.

“Contrast sensitivity” is important in situations such as driving at night, or in conditions of poor visibility.

The Nature Neuroscience study raises the possibility of using a video game training regime to improve vision.

Contrast sensitivity is often one of the first aspects of vision to be affected by ageing.

There is some evidence that the visual system can learn John Sloper Moorfields Eye Hospital

It can also be affected by conditions such as amblyopia, known as “lazy eye”.

Improving contrast sensitivity usually requires physical changes in eye optics, through eye surgery, glasses or contact lenses.

A team from the University of Rochester studied expert video game players playing games involving aiming and shooting at virtual targets.

They found that they had better contrast sensitivity when compared with players who played non-action video games.

These results were not because people with better contrast sensitivity were more likely to be action video game players – giving non-video game players intensive daily practice in video game playing improved this group’s performance on tests of contrast sensitivity.

Crucially, the improvements in this study were sustained for months or even years in some cases, suggesting that time spent in front of a computer screen is not necessarily harmful for vision, as has sometimes been suggested.

Unpredictable events

Lead researcher Dr Daphne Bavelier said it was likely that several aspects of playing video games combined to produce the beneficial effect.

The games immersed players in an environment where they had to be constantly ready to react to unpredictable events, and where visual information had to be responded to instantly in very precise physical ways.

In addition, the mere fact that the games were stimulating and rewarding should not be overlooked.

Dr Bavelier hopes to make use of the discovery to develop new ways to treat amblyopia.

The hope is that by using video games researchers can encourage the two eyes to work together, and restore the stereo vision which is lacking in people with a lazy eye.

Professor Gary Rubin, of the University College London Institute of Ophthalmology, said he was surprised by the findings.

He said other work had shown that it was possible to train people to improve some aspects of their vision – for instance, to widen the visual field.

But he said: “Contrast sensitivity is a very basic visual function, and usually they are more difficult to alter in adulthood.

“This is a small study, showing a small effect, but it was carefully done, and merits further investigation.”

John Sloper, a consultant at Moorfields Eye Hospital in London, said other researchers were also examining the potential for using video games to treat amblyopia.

He said: “There is some evidence that the visual system can learn.”

Source:   http://news.bbc.co.uk/2/hi/health/7967381.stm

First Published Monday, 30 March 2009

The new edition of Scientific American Mind is out an it has an excellent cover article on the psychological effects of humour and laughter.

It’s a remarkably wide-ranging article, covering everything from the effect on the immune system, to laughter’s pain killing properties to its beneficial effect on mental health.

There’s also an interesting aside on the role of humour in attraction:

In 2006 psychologists Eric R. Bressler of Westfield State College and Sigal Balshine of McMaster University in Ontario reported that women are more likely to consider a man in a photograph a desirable relationship partner if the picture is accompanied by a funny quote attributed to the man. In fact, the women preferred the funny men despite rating them, on average, less intelligent and less trustworthy.

Although the men in Bressler and Balshine’s study did not prefer witty women as partners, other research indicates that both men and women value a “sense of humor” when choosing a partner. Either way, males do seem to like ladies who laugh at their jokes. A 1990 study suggests that when women and men chat, the amount of laughing by the woman indicates both her interest in dating the man and her sexual appeal to the man. (The man’s laughter did not relate to attraction in either direction.)

The issue also has freely available online articles on ‘brain training’, the psychological effect of architecture and personality disorder with many more in the print edition.

Link to April’s SciAmMind.

Source:   http://www.mindhacks.com/blog/2009/03/the_attractions_of_h.html

First Published Tuesday, 3 February 2009

According to research, almost 50% of AS children are late in their development of speech, but they are usually fluent talkers by the age of five (Eisenmajer et al. 1996). Although pronunciation and grammar (phonology and syntax) tend to be on a par with your average neurotypical child, differences tend to occur in the areas of pragmatics(ie how language is used in a social context); semantics (ie not recognising there may be several meanings); and prosody (ie an unusual pitch, stress or rhythm).

A proportion of children who are now widely accepted to have Asperger’s Syndrome, but showed the classic signs of autism in their pre-school years have been known to show significant improvement in communication and abilities later. “This improvement can be remarkably rapid and occur just prior to the age of five.” (Shah, 1988). The experts aren’t sure whether this is a natural progression for some children or a tribute to early intervention programmes; probably both.

As A Matter of Interest …

Einstein himself was well past 2 years of age before making any attempt at language. His most memorable utterance was at two and a half years of age when his sister, Maja, was born. Apparently expecting some kind of a toy, he demanded to know why she didn’t have any wheels! Until the age of seven, he had a habit of repeating softly to himself every sentence he uttered.

In an interview later in her life, his mother, Pauline, ascribed the success of her household to discipline – patient, persevering, warm but practical. Music played quite an enormous role in their lives. His typical playmates were chickens and pigeons in his temperamental youth …

It is approximated that around 90% of children on the spectrum develop speech by the age of nine years, and some, well beyond this. (Reference for this statistic: C. Lord, S. Risi, A. Pickles, “Trajectory of language development in autism spectrum disorders” in Developmental Language Disorders: From Phenotypes to Etiologies, edited by Mabel L. Rice and Steven F. Warren (Laurence Erlbaum Associates, 2004).

There are speech pathologists who will admit that in their studies, they found that the object was far too often to force speech at all costs, even if one of the costs was communication.

A very wise lady I know of, who is minus speech, once wrote that ‘communication is way more important than speech. Be sure that whatever you are teaching your child focuses on communication, not just speech. Some people aren’t cut out for speech even if they’re capable of making all the sounds and seem “promising”. Go with whatever communication method (or methods) works best for your child expressing himself, not with what communication method is the most normal.”

The following article is courtesy of NAS Communication Magazine, Autumn 2008 Edition.

Practical Advice – Speech and Language Therapy

Speech and language therapy is vital for anyone with a diagnosis on the autism spectrum. Here, speech and language therapists (SALTs), working with autistic children at NAS schools across the UK, have gathered to tell us exactly why it’s so important.

From early diagnosis and intervention with young children to help for those with a late diagnosis and complex needs, a SALT can help access appropriate support for the individual’s communication needs. The type of work the SALT undertakes will depend on many complex factors. Whether the individual is non-verbal or has varying degrees of language, a SALT will be needed to advise on:

• *communication strengths and needs
• *the training of other staff
• *intervention strategies
• *the use of visual aids to enhance understanding and communication. These can be objects, photos, symbols or written words
• *the use of specific symbols or written words
• *the use of specific systems for communication – such as signing, picture exchange, pointing systems, voice output and communication aids
• *promoting social interaction
• *how to develop understanding of language
• *how to develop expressive language

Generally, most SALTs work within the person’s environment, whether that is in class, at home or in a residential setting. Generalising skills (transferring them from one setting to another) is often a problem for people on the autism spectrum.

Imagine being in a world where everyone speaks a language you can’t understand

Tips for Helping Communication

If you can imagine being in a world where everyone speaks a language you can’t understand, you will have a fleeting glimpse of the world inhabited by a person on the autism spectrum. Unlike the person with an ASD, however, you would still be able to interpret clues like facial expression, body language and tone of voice.

To make communication easier, here are some general points which can help many people on the autism spectrum, although each individual requires a SALT to assess their particular situation.

• *Ensure you’ve got the person’s attention before presenting information to them.
• *Allow lots of time for processing.
• *Present information visually where possible. Use objects, photos, symbols, drawings or write it down, depending on the person’s ability level.
• *Use a visual timetable to show what’s happening now, next and later.
• *When presenting information orally, try shortening sentences or just use one or two key words. Find out what the individual needs.
• *Use areas of special interest to motivate the person.
• *Watch for symptoms of stress and reduce demands, accordingly.
• *Don’t use idioms like ‘raining cats and dogs’ or ‘pull your socks up’ unless you’re confident that the person won’t take them literally!
• *Provide specific information on social rules at the level of understanding the person has: don’t expect the person will learn them automatically.
• *If choosing between options is a problem for the person, reduce the number of options.

By the SALT team, working across all six NAS schools: Faye Coles, Frances Edmonds, Karen Kerr, Joanne Neill, Katie Newton, Lilias Nicholls, Teresa Povey, Karen Reeves and Linda Robinson.

Further Information

Useful information sheets, available from the NAS Autism Helpline(0845 070 4004), on this and related subjects, include:

• *Speech and language therapy
• *Social skills in young children

http://www.autism.org.uk/a-z

Other Resources

Speech therapy activities http://www.speechtx.com/

The Makaton charity Call 01276 606760 or visit http://www.makaton.org/

Picture communications symbol clipart http://www.setbc.org/pictureset/

Picture sets and communication resources http://www.do2learn.com/

Picture exchange communication system (PECS) Call 01273 609555 or visit http://www.pecs.org.uk/

The Royal College of Speech and Language Therapists Call 020 7378 1200 or visit http://www.rcslt.org/

The Association of Speech and Language Therapists in Independent Practice Call 01494 488306 or visit http://www.helpwithtalking.com/

ICAN – children’s communication charity Call 0845 225 4071 or visit http://www.ican.org.uk/

Afasic – charity representing children and adults with communication impairments Call 0845 355 5577 or visit http://www.afasic.org.uk/

Talking Point – for information about speech and language development in children http://www.ican.org.uk/TalkingPoint/Home.aspx

Readers’ Advice

My autistic son is four. He is on the waiting list for speech and language therapy. What can I be doing in the meantime to encourage him to talk?

“We also have an autistic son who is four. Though he is very vocal, he has little discernible speech and we use Signalong/Makaton. This happened by accident when he was watching Something Special (pictured below) on CBeebies and made the sign for ‘eating’. We sat and watched all episodes of Something Special, and learnt the signs for basic things, such as toilet, eating, various foods, transport and colours. Our son now has a small repertoire of signs that he uses to convey what he wants and for us [to use] to communicate a little better with him, which lessens his frustration.

Other methods for helping your son are the Picture Exchange Communication System (PECS) which has pictures for your child to use when he finds difficulty in expressing himself and his needs. Our daughter, who is six, speaks fluently on a very superficial level. However, she needs pictures to sequence events and constant reassurance that her needs will not be ignored and are understood. Our daughter can’t read or write, yet when she sees signs and pictorial representations she can generally grasp the meaning of what information is being conveyed.

Finally, higher-level language is often the most cause for concern for children, as they fail to grasp the implied meanings in social settings and communication exchanges, as well as gestures, idioms and facial expressions.

Try and help your son by showing him pictures and gauging his understanding of events in the picture – for example, potentially dangerous situations, children being excluded and more everyday situations, like roads, cars and traffic, and what would happen if he ran into the road.

We wish you and your son all the best. Enjoy the journey – you will learn things you never thought you would!” Jeanette and Don Pearson

Something Special is a BBC CBeebies programme and website, aimed at children with learning difficulties. For more information, visit http://www.bbc.co.uk/cbeebies/somethingspecial/

Echolalia

Echolalia is meaningful communication and easily translated if you look at the total context in which echolalic statements are uttered, rather than taking them at face value and perceiving them to be meaningless. Many echolalic utterances will be about safety and security from the autistic person’s perspective.

A few more sites…can never have too many:) ~ either specifically for PECS or speech related:

Nonverbal Communication Pages:

http://trainland.tripod.com/pecs.htm

Widget Software:

http://www.widgit.com/

Special Education Technology – British Colombia – Assistive Techology for K-12 Students:

http://www.setbc.org/#top

Speaking of Speech:

http://www.speakingofspeech.com/

Speech Fun:

http://www.speechfun.com/

Use Visual Strategies:

http://www.usevisualstrategies.com

Special Reports

Support for Augmentative and Alternative Communication

Augmentative and Alternative Communication (AAC) is the umbrella term used to describe the full range of communication methods that can be used to supplement or substitute for ‘normal’ speech or writing when these are impaired or absent. The term encompasses everything from gestures and signing, to aids, which can be low-tech (such as picture boards) or high-tech (employing the latest technology). Impaired communication or speech loss can result from a range of conditions, including Down’s syndrome, autistic spectrum disorders (ASD), acquired brain injury, cerebral palsies, hearing impairment and learning disability.

While exact numbers of people who need AAC are not known, research carried out in 2007 by Scope as part of its No Voice, No Choice campaign estimated that 600,000 people in the UK would benefit from it, including 106,000 young people aged between five and 18. However, as the researchers note: ‘Whilst these figures give an indication of the overall level of need; there are no national statistics on what proportion of this population are getting their communication needs met.’

So what solutions are available and what do we know about current provision? Communication aids are usually split into two broad groups: unaided and aided, with the aids sub-divided into low-tech and high-tech. There is an obvious risk in labelling aided AAC systems in this way, in that it could suggest that some are better than others. This is not the case: as with much technology, there is no point in using high-tech solutions if low-tech resources will do the job. Most of us have learnt this lesson the hard way when a high-tech device has let us down in a situation where the low-tech solution would have been more than adequate.

Deciding which form of AAC a child needs requires a full and ongoing assessment, as the child’s needs are likely to be complex and may change over time. Assessment should involve family members as well as teaching and support staff, as the system chosen is likely to be used at home as well as in school. If the child’s needs are complex, it is best if a qualified and experienced professional carries out the assessment.

Where the child’s communication needs are not so severe it may be that an unaided or low-tech system to complement ‘normal’ speech will suffice. Many mainstream schools with units catering for children with speech, language and communication needs support spoken English with either one of the established signing systems (of which more later), or a system of objects, pictures or symbols. For example, a range of objects might be used to indicate what is going to happen next, such as a paintbrush to signify art or a triangle for music. These are sometimes referred to as ‘objects of reference’. Photographs are used instead of real objects in some instances, such as to show the items on a lunchtime menu. Sometimes line drawings or symbols might replace images, as they do in everyday life where it is critical that everyone understands what is being said, as in the warning signs we see on the roads.

Signs
British Sign Language (BSL) is probably the best known of the established signing systems. Although BSL is now familiar to most people through its use in signed performances and on television, its widespread adoption and development are relatively recent. The British Deaf Association’s Dictionary of British Sign Language was not published until 1992 and BSL was not recognised as an official British language until 2003. The exact number of people in the UK who use BSL as their first language is not known and common estimates range between 30,000 and 70,000.

BSL is different from other national sign languages because it is a visual-gestural language with its own grammar, syntax and dialects. Other signing systems draw on BSL, but they do not have the status or structure of a language. While BSL is used almost exclusively within some sections of the deaf community, it is these other signing systems that are used to complement spoken English in many schools where children’s speech, language and communication needs are due to causes other than deafness. There are four main signing systems that you are likely to come across.

• Signed English

Signed English, based on BSL, emerged in the 1980s in response to pressure for the use of sign in the education of deaf children. It follows the word order of spoken English and uses additional signs and finger spelling to convey what is being said. Originally developed for use within schools for deaf children, it is now also used with children and adults who have impaired speech and language. Signed English has a sign for every word and is regulated by the Working Party on Signed English.

• Makaton

Makaton was first developed in 1972 in Surrey as a project to teach sign language to deaf adults with learning disabilities and is now especially popular in early years settings, where it is used with children with delayed speech. Today it is an internationally recognised communication system, used in more than 40 countries. Makaton uses signs and symbols to support spoken and written English. Based on BSL, it uses a carefully selected core vocabulary (approximately 450 words/signs) structured into graded stages of increasing complexity. This core vocabulary can be combined to form short phrases and sentences and can be used in combination with other alternative communication tools.

• Paget Gorman Signed Speech

Paget Gorman Signed Speech was originated by Sir Richard Paget in the 1930s and developed by Grace Paget and Dr Pierre Gorman after Sir Richard’s death in 1955. It consists of a large vocabulary of approximately 4,000 words/signs, extended through the use of affixes to more than 50,000 words. Wherever possible, words are grouped together around a series of Basic Signs. Each word in a group uses the Basic Sign with a gesture that identifies the specific word. Signs are presented in the same sequence as the words in the spoken phrase or sentence. Paget Gorman is primarily used for people with specific speech disorders not related to learning disabilities. A simplified version is used with young children.

• Signalong

Signalong emerged in the 1980s when a group of practitioners wanted a signing system that was more flexible than Makaton. Signalong is a sign-supporting system: it requires you to speak as you sign. Signalong uses unaltered BSL signs wherever possible and is loosely modelled on the structure of the Derbyshire Language Scheme. Phase 1 of Signalong was first published in April 1992. Since then the authors have added to the core vocabulary, now available in four manuals, and published additional resources covering educational and vocational topics. Signalong is now widely used in the UK and Europe.

Symbols
Many AAC systems use symbols as well as signs. Some are specific to a particular signing system, such as Makaton, while others have been developed independently. At an elementary level, symbols can be used to reinforce speech or signs, or to supplement written text.

A small number of symbol systems besides Makaton are now well established and widely used. These include Widgit Literacy Symbols (previously known as Rebus) and Picture Communication Symbols (PCS: also referred to as Boardmaker Symbols and not to be confused with PECS, the Picture Exchange Communication System). Signalong doesn’t have its own symbol set but is working closely with Widgit to match its signs to WLS. As Signalong explained earlier this year: ‘We have always been clear that our core expertise is in sign-supported communication. While we strongly promote the Total Communication approach [an approach to deaf education that aims to make use of a number of modes of communication, depending on the particular needs and abilities of the child], we have always preferred to work with others who have special skills in other formats rather than introduce unnecessary competition.’

WLS and PCS have much larger vocabularies than other symbol systems and include a range of grammatical elements. This means they are inherently more flexible and symbols can be combined to form sentences and phrases. WLS, for instance, consists of 7,000 images in colour and black-and-white, covering a vocabulary of over 20,000 words.

Symbol systems have long been an important tool for aiding communication but it is computers that have really transformed their use. Bespoke and mainstream software programs have simplified the creation of symbols-based resources and made the translation of text into symbols and vice versa far easier.

Boardmaker from the American company Mayer-Johnson is among the best known software package for creating printed symbol-based resources. The program features more than 4,500 Picture Communication Symbols in colour and black-and-white, sample boards and templates. A new feature of the latest version of Boardmaker is the Symbolate button, which automatically inserts symbols alongside text as the user types. Boardmaker Plus builds on these features by allowing the user to create on-screen activities such as audio, animations and video.

Widgit produces another popular range of symbol-based software, which includes Writing with Symbols 2000, a talking word processor that also automatically inserts symbols as you type. Other features include the generation of grids to make teaching and communication resources, and the on-screen grids to be used as an aid to writing. Widgit’s other products include the Communicate suite, which consists of a desktop publishing program (Communicate: In Print, now available as Communicate: In Print 2), a program for generating early learning activities (Communicate: By Choice) and, most recently, a word and symbol processor for emergent writers (Communicate: SymWriter).

Although a number of symbol-based systems exist, the differences are subtle and there is extensive collaboration between the producers. In 2007 Widgit Software and Mayer-Johnson announced they were teaming up to bring both companies’ products to one another’s home markets.

Widgit says its own system (WLS) is designed to support literacy and written information, while Picture Communication Symbols are designed for face-to-face communication, as in communication aids for people with no speech. In the UK, both systems are also available through Inclusive Technology. Makaton is also now compatible with Communicate in Print, Symwriter (version 1.1.6444) and Writing with Symbols. As well as the established symbol sets, users of both WLS and PCS can import their own drawings and photographs. PCS can also be used in the Clicker software produced by Crick Software, which is popular in both mainstream and special schools.

High-tech aids
Children who have little or no speech might benefit from using a dedicated Voice Output Communication Aid (VOCA) as well as sign and symbol systems. These enable the child to communicate in a setting where signing or the use of symbols is not an option,  extending the child’s independence.

VOCAs range from single-message devices to those capable of storing thousands of messages. Understandably, the more complex the device the higher the price, which is why at this level, above all others, professional assessment is essential. Factors to be considered in choosing a VOCA include the setting in which it will be used, the cognitive ability of the user, how the device will be accessed, appropriate mounting, whether the device will use symbols or text (or both), the type of display (static or dynamic), training, support and, of course, cost.

Scope’s No Voice, No Choice campaign produces a useful Communication Aids Journey Map, which shows the varied — and at times tortuous — routes to acquiring a VOCA. It can be downloaded from www.timetogetequal.org.uk. Help in choosing an appropriate device can be provided by a number of centres, including the ACE Advisory Trust, the ACE Centre North, CENMAC, AbilityNet and the CALL Centre in Edinburgh. Most centres have a loan bank of equipment, which means children can try out devices before deciding which one to opt for. With the rapid changes in technology it is no surprise that the choice of communication devices has mushroomed in recent years. ACE North’s database of VOCAs includes more than 120 devices although, thankfully, there are relatively few key suppliers. Major names include DynaVox (Mayer Johnson’s sister company), Liberator (part of the Prentke Romich group), AMDi, AbleNet, Attainment Company, Toby Churchill and Techcess.

All VOCAs work by allowing the user to trigger pre-recorded messages, either directly — by touching the relevant text, image or symbol — or indirectly, through scanning and the use of switches. Devices that offer more stored messages than can be reasonably accommodated on the screen do so by storing them in ‘levels’. AMDi’s Smart/128, for example, has a maximum of 128 messages per level and six levels, which means it can store up to 768 messages of 2.25 seconds in length. Optional interchangeable keyguards on a system like this mean that a single user can choose between 4, 8, 16, 32 and 128 ‘buttons’ by grouping locations together. This means the device’s set-up can be changed depending on the user’s ability or the context in which it is being used. On some multi-level VOCAs, it is necessary to change the overlay to access a different level, while on those with ‘dynamic’ pages the level can be changed by pressing a button.

While dedicated aids simply provide speech output non-dedicated or ‘open’ devices combine speech output with other features. These might include wi-fi connectivity giving access to the typical features of a laptop computer, including email and the internet, or environmental control systems (ECS) that allow the user to turn on the lights or draw the curtains.

Funding
While technical advances in communication aids have created impressive new opportunities for their users, they have also highlighted a paradox all too familiar to those who work in the field of special educational needs. While everyone will happily subscribe to the view that society should do all it can help individuals realise their potential, there is a cost associated with making each opportunity a reality. Scope’s 2007 Communication Aids Survey found that the average cost of a high-tech aid was £5,800, with 47 per cent of respondents’ aids costing over £5,000. As the survey report noted:
‘The prohibitively high cost of AAC equipment, not including the ongoing costs of insuring, servicing and repairing equipment, means that disabled people on low incomes who cannot get equipment funded by statutory sources are often left without a voice. Significant numbers of people are still told by statutory agencies to ask charities to fund AAC equipment that should be provided
as of right.’

Rectifying this situation is at the heart of the campaigning efforts of Scope and other organisations concerned about provision for those with speech, language and communication needs (SLCN). Between 2002 and 2005-06, the Department for Education and Skills provided £5m a year through the Communication Aids Project (CAP) to help meet some of the demand for communication aids.

During this time, equipment was provided for more than 4,100 children and young people whose needs had not been met locally. Following CAP’s closure, campaigners lobbied for replacement funding.

Understandably, many organisations and individuals raised this issue in the course of the recent Bercow Review. In its final report, the review panel recommended ‘appropriate commissioning, guidance and inspection arrangements should be in place by April 2010 with funding streams identified and mandated across government, including the Department of Health and the Department for Children, Schools and Families’. It also proposed an immediate injection of capital for purchasing, monitoring and measuring the supply of equipment and services, and of revenue funding to avoid the imminent closure of both the ACE Centres. The government’s long-awaited Child Health Strategy, due to be published in the autumn, is expected to contain detailed proposals relating to this.

Meanwhile, Scope launched the second phase of its research project in August, ‘aiming to find out the true scale of the current crisis affecting communication equipment users’.

Its new survey is targeted at professionals and statutory agents, such as speech and language therapists, as well as people involved in the commissioning, assessment, provision and support of AAC services.

Ruth Scott, head of policy at Scope, said: ‘The UK is facing a real communication aid crisis — thousands of disabled people are being denied their right to communicate because they cannot get access to the equipment and support they need. It is essential that professionals and statutory agents are given the opportunity to discuss their experiences of providing AAC services and suggest ways of improving the current situation. This will help us achieve our goal of ensuring that those with communication impairments are able to speak for themselves.’

Scope is calling for any professionals who are concerned with disabled people’s use of AAC, including those working for statutory agencies, to get involved in the research project.

Links

General
1 Voice
Afasic
Bercow Review
Communication Matters
ICAN
Scope’s No Voice, No Choice campaign

Assessment

ACE Centre Advisory Trust
ACE Centre North
AbilityNet
CALL Centre
CENMAC

Signing
BSL
Makaton
Paget Gorman
Signalong
Signed English

Symbols
Makaton
PCS
WLS

Source:   http://www.teachingexpertise.com/articles/support-augmentative-and-alternative-communication-4968

Pragmatics – The Art Of Conversation

Carol Gray developed a technique entitled Comic Strip Conversations as a pictorial representation of the different levels of communication that occur on a conversation. Stick figures, speech and thought ‘bubbles’, symbols and colour are used to enable the child to see aspects they may not have been aware of.

Take the skill of learning how to interrupt a conversation without causing offence or disruption, for example. It’s quite complex and difficult to explain, but a picture is worth a thousand words. The technique of using drawings of stick figures and speech bubbles may be applied to a wide range of situations that are proving challenging conversation and social skills wise. Speech bubbles may be drawn in a variety of ways to convey emotion – for example, sharp edges may be used to indicate anger or wavy lines may be used to indicate anxiety. Colours may also be useful in conveying happy or positive statements. These may be written in green, for example, while unpleasant thoughts may be written in red. In developing a colour chart, embarrassed comments may be written in pink marker, while sad feelings are written in blue. These may then be translated into relevant aspects of the person’s tone of voice or body language.

Comic Strip Conversations are a wonderful tool in allowing children to analyse and understand the range of messages and meanings that are a natural part of conversation or play. While children may become naturally confused and upset by teasing or sarcasm, speech and thought bubbles in conjunction with colour choice, can illustrate the hidden messages.

Carol Gray learned that children on the spectrum often assume that the other person is thinking exactly what they are thinking or they assume the other person was thinking exactly what they said and nothing else. Comic Strip Conversations can be beneficial in showing that each person may have very different thoughts and feelings in the same situation. An added advantage is that they may be used to represent the sequence of events in a conversation , as well, illustrate the effects of a range of alternative comments or actions for different scenarios.

My Social Stories Book

Carol Gray

http://www.jkp.com/catalogue/book/9781853029509

Revealing the Hidden Social Code: Social Stories TM for People with Autistic Spectrum Disorders

Marie Howley and Eileen Arnold

Foreword by Carol Gray

http://www.jkp.com/catalogue/book/9781843102229

Acting Antics: A Theatrical Approach to Teaching Social Understanding to Kids and Teens with Asperger Syndrome

Cindy B. Schneider

http://www.jkp.com/catalogue/book/9781843108450

Getting IT: Using information technology to empower people with communication difficulties

Dinah Murray and Ann Aspinall

http://www.jkp.com/catalogue/book/9781843103752

Baj and the Word Launcher: Space Age Asperger Adventures in Communication

Pamela Victor

http://www.jkp.com/catalogue/book/9781843108306

Brief Summary of Strategies for Language

Pragmatics

Learn:

appropriate opening comments

to seek clarification or assistance when confused

Encourage confidence to admit ‘I don’t know’

Teach the cues of when to reply, interrupt or change the topic

Model sympathetic comments

Whisper in the child’s ear what to say to the other person

Use speech and drama activities on the art of conversation

Use Social Stories and Comic Strip Conversations as a verbal or pictorial representation of the different levels of communication

Literal Interpretation

Think how your comment or instruction could be misinterpreted

Explain metaphors and figures of speech

Prosody

Teach how to modify stress, rhythm and pitch to emphasise key words and associated emotions

Pedantic Speech

Avoid abstractions and lack of precision

Idiosyncratic Words

A genuinely creative aspect of Asperger’s Syndrome to be encouraged

Vocalising Thoughts

Encourage whispering and ‘think it, don’t say it’ when near other people

Auditory Discrimination and Distortion

Encourage asking for the instruction to be repeated, simplified, put into other words or written down

Pause between instructions

Verbal Fluency

Anxiety may inhibit speech and require treatment

Both children and adults on the autism spectrum are prone to stuttering when anxious. Language skills in this case tend not to be the issue, but rather, the effect of emotion on the ability to speak. There are a range of strategies that may assist in coping with anxiety should stuttering become an issue. For further information …

“Autism Spectrum Disorders and Stuttering”
http://www.stutteringhelp.org/Default.aspx?tabid=625

[Being lost for words, or even being mute may certainly be due to high levels of anxiety. Prolonged periods of severe anxiety can lead to a secondary psychiatric condition such as Obsessive Compulsive Disorder.]

Articles

“Communicating with Children Via Fragrance”:
http://aspie-editorial.blog-city.com/communicating_with_children_via_fragrance.htm

Selective Mutism “Big Rise in Children Left Mute Outside the Home”:
http://aspie-editorial.blog-city.com/selective_mutism_big_rise_in_children_left_mute_outside_the.htm

“Benefit of Early Detection of Developmental Language Disorders Cannot Be Proven Due to Lack of Data”:
http://aspie-editorial.blog-city.com/benefit_of_early_detection_of_developmental_language_disorde.htm

“Speech & Language Issues in Children”:
http://aspie-editorial.blog-city.com/speech__language_issues_in_children.htm

USA TODAY “iPhone Applications Help The Autistic”:
http://aspie-editorial.blog-city.com/usa_today_iphone_applications_help_the_autistic.htm

“Assistive Technologies eSchool News: Five Key Trends In Assistive Technology/Talking Head Baldi Now An iPhone App”:
http://aspie-editorial.blog-city.com/assistive_technologies_eschool_news_five_key_trends_in_assi.htm

“Communication: Voice4u iPod Touch iPhone App”:http://aspie-editorial.blog-city.com/communication_voice4u_ipod_touch_iphone_app.htm

“A Crucial Tool In English Language Development: Reading To Our Children”:http://aspie-editorial.blog-city.com/acrucial_tool_in_english_language_development_reading_to_ou.htm

First Published Wednesday, 4 February 2009

First Published Wednesday, 4 February 2009

First Published Wednesday, 4 February 2009

Autistic adults from across Scotland have highlighted their own experiences of living with the condition by producing artwork and poetry, which is being shown in an unique exhibition running at the Mitchell Library, Glasgow from 10-16 February.

The pieces in the exhibition, entitled ‘My life with autism or Asperger syndrome’ were entries in The National Autistic Society’s recent creativity competition, and provide fascinating individual perspectives of autism through poetry and prose, 2D art and photography.

The competition is part of our ongoing I Exist campaign, launched in 2008, which highlights the lack of support available for adults living with autism. Based on the largest ever survey in Scotland on the experiences of adults with autism and their families, the campaign revealed for the first time the daily reality for many thousands of adults who feel isolated, ignored and unable to access the required support.

Carol Evans, National Director of NAS Scotland and Northern Ireland, said: “There are 50,000 people in Scotland with autism - that’s 1 in 100 – and many adults with autism from across Scotland tell us how important art and creativity are to their well-being.

“We believe this exhibition is an exciting and rewarding way of showing how a person with autism expresses themselves and it allows us to share their unique experiences and creativity. We hope that the works in this exhibition will bring home to the general public just some of the realities faced by adults living with autism across Scotland today.”

The exhibition can be seen at the Mitchell Library, Glasgow, from Tuesday 10th February until Friday 16th February 2009, from 9am to 8pm.

For more information about the I Exist campaign and how you can get involved, visit www.think-differently.org.uk

Related resources

External links

• *More information about The Mitchell Library, Glasgow

Source:  http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=253&a=18695