Stepping Outside Your SLP Comfort Zone: Working with Nonverbal Students

Today, I'd like to give a warm welcome to my good friend Felice, who is presenting the latest installment of, "Stepping Outside Your SLP Comfort Zone!"   - Natalie

Nonverbal Students with Autism

Hey there everyone! This is Felice Clark, the author of the blog The Dabbling Speechie and I am here to share how I stepped outside my comfort zone while working with nonverbal autistic students. To be honest, I step out of my comfort zone every year because something always comes up! My career as an SLP has been primarily in the school setting in areas with rich diversity in culture, languages and economic status. Within the first 3 years of my career, I had worked with PreK-12th grade!  It wasn't until my 4th year in my district that I got the opportunity to have TWO elementary sites (not the newbie anymore).  During that year, I did a lot of bilingual assessments, targeted articulation and language disorders as well as worked with students with social pragmatic disorders.  My expertise was with the higher leveled students on the autism spectrum and I hadn't had many students with AAC needs since grad school (I love pragmatic therapy).  The start of my 5th year, I learned that one of my sites was going to have two moderate-severe autism classrooms, k/1st and 2nd/3rd grade. That year, most of the students placed in those classrooms were verbal. Most of my therapy focused on improving language comprehension and social skills. That year I attended a PECS training and used that with one of the students for about 4 months until he moved.

The following year, things got a bit overwhelming for me. Both classrooms had more non-verbal or limited verbal students.  They ALL had different strengths and weaknesses and wait for it......unique and diverse high interests.  Also, there were 2-3 students who could potentially benefit from a higher tech AAC device.  Did I mention, I had on average 75-80 students on my caseload that year (that is a whole different sort stepping outside my comfort zone discussion)!?

To say I was rusty with this population was an understatement. Here was what I did from August to October...cried and complained weekly, asked Starbuck's if they would hiring me again and put on my "fake it till ya make smile" every day at work.

Most of my therapy during that time worked on "requesting"...I want _____.  It is not a BAD place to start, but it was the only place I was going with therapy and progress was not what I had hoped. I was also having a really hard time connecting with my students.  I networked with their teachers to find out high interest activities, but some of my kids had an attention span of 30-60 seconds.  Add in limited joint attention abilities with limited modes of communication and that makes for a very LONG day of therapy. I was used to kids telling me what was wrong, sharing their opinion and enjoying my therapy activities.......this was not always the case with my mod-severe autism students. Most days, I felt incompetent and not a reliable resource for my teachers. Plus, I was starting to resent these little guys and gals because I was running out of ways to connect with them!!

In October, one my SLP colleagues mentioned that they wanted to go to a yearlong training on AAC assessment at one of our department meetings.  I instantly raised my hand and said "I wanna go!"
Between November-May, I attended 2 day courses every month through the County of Special Ed. It was amazing!  I finally had a starting point on how to assess my nonverbal students current modes of communication, implement visual supports for every session and target functional communication beyond "requesting".

Immediately, I went back to my school and made my first CORE board.  I brought that to every lesson whether I pushed in or pulled out students.  There were 2 students that really needed to start with PECS, so I used what the teacher had made AND the CORE board.  Then, I made visual necklaces with CORE communication words that I used often with my students such as "help", "stop", "all done", etc. that I could use to communicate even if I didn't have my communication boards handy (i.e. walking in the hallway).

As the year went on, I continued to make fringe vocabulary and visuals that I needed for these students.  Above is a picture of the AAC starter kit that I made to have more low-tech tools to aid in improving functional communication. What happened during the rest of the year was pretty exciting............
Here is what I learned:
  • CORE boards changed my life! I had visuals for every session that I prepped one time.  Even if I wasn't able to make fringe vocabulary, I always had my CORE board visual ready to use.
  • Try new activities.  You NEVER know what a student may like/not like.  It was humbling when an activity was a giant disaster and a small reminder that I don't know everything.  I did a post 10 days that helped facilitated communication if you need some ideas.  If I didn't try new things, I wouldn't have discovered that my kids liked doing a nature walk, they do love craftivities and making snacks were a big hit!
  • Modeling how to communicate with the CORE boards and communication tools will help your students learn what to do. For my kids with a higher desire to communicate, caught on really easy when I communicated while touching the icons.
  • Even my kids who were verbal, but needed visual supports benefited from aided communication boards. My verbal kids who sounded really robotic began to have MORE novel utterances with less visual and verbal prompts.  They increased in comments, requests, and greetings.
  • Some of my kids started calling me by name when I walked through the door! I was able to build better relationships with them when I had more visual communication tools.  When my students were better able to communicate with me, I was able to listen to them, which helped with reducing behaviors. I even got some hugs and day ever!!
  • Getting staff and teachers to use CORE boards is difficult.  Teachers and staff are not always used to incorporating new ways to communicate with students.  My biggest success was modeling my skills in the classroom setting when I pushed in.  Getting into debates about which approach is better will only create friction.  If they won't try your ideas, then you need to find the teacher who will!! Speech Room News has a great new series for getting staff more involved in using visuals!
  • Figure out skills your students need for communication throughout the day and then target those areas.  For example, greetings are great to work on because the student has to greet teachers/staff on and off the bus, the lunch ladies to get their food, the SLP, OT, coming in from recess and circle time. I made some visual supports in my starter kit that help with visuals.
  • Some of my students didn't progress the way I had hoped.  Many of my students increased there functions of communication (greetings, requests, opinions, comments, affection), but a few were still working on initiating and engaging.  Keep trying, but remember if they don't have a desire to communicate, you have to work with high interest items to increase initiation and joint attention first.
  • Don't stop believing in your students.  I had my days when I stopped believing in my students abilities to communicate better.  It's horrifying to write, but it was a struggle I had to overcome.  You may wake up one day a couple months later and see a completing different student.  It's amazing when this happens!!
  • Ask for help! I went to my AAC guru's in our district, asked the staff/teachers for insights and went to trainings to learn more.
Above all, I learned how to LOVE my students better through that experience.  Currently, I changed school districts, so I don't have those students anymore.  Hope this helps you have a starting point if you are going to be working with nonverbal and limited verbal students on the autism spectrum.

1 comment

  1. Ahhhh, I appreciate how honest you were in this post!!! I'm a recent grad and working with this population. I've had so many days when I feel very frustrated and like I'm not cut out for this job. It makes me feel better to know I'm not alone. Finding motivators is so difficult-but I do need to try more! I always think "he/she won't enjoy this" but I will start giving it a go anyway! You made so many good points! Thank you for sharing!


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