Promoting conversation in students with autism spectrum disorders; Scripts and semantic mapping.

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Promoting conversation in students on the autism spectrum: scripts and semantic mapping
40 GAP,17,1, 2016
Promoting conversation in students on the autism spectrum: scripts and semantic mapping
Address for
correspondence
E-mail: dbattaglia@
adelphi.edu
Acknowledgements
The authors would
like to acknowledge
the individuals on the
autism spectrum and
their families, whom they
have had the privilege
to serve.
From a developmental and communication perspective,
conversational skills are quite complex and extend
signicantly beyond the exchange of information.
During typical language development, vocabulary
and subsequent conversation skills are based upon
experience. Children can talk about themselves, events,
objects, and other people. While a typically developing
4 year old may be able to discuss a wide range of
topics, conversations are initially very topic oriented.
Again, with experience, children will embed comments
within these topics, as well as ask questions. The termi-
nation of a conversation may include a true termination
(eg “bye,”) or a topic shift (eg “I also like libraries”), or
an overt change of topic (eg “Let’s talk about dinosaurs
now”). Due to the complexity of language development
and use, it is important to consider typical develop-
ment when teaching conversation skills to students
with autism (Gena and Kymissis, 2001).
Introduction
“Charles is a 14 year old with autism who is socially
motivated. He approaches adults and peers
but frequently doesn’t initiate communication.
He hovers within the general proximity of adults
and peers without communicating with them
effectively. His speech-language pathologist
and behaviour analyst have come together to
formulate goals to teach him conversation skills.”
Children with autism are frequently taught commu-
nicative reciprocity. This is often accomplished using
scripted responses (eg audio, text and video). Teaching
communication skills using scripts, however, can be
problematic, as the speaker often needs to demonstrate
exibility in their responses and questioning (Cooper
et al, 2007). As one feature of autism is rigidity, using
scripts may not teach children to respond exibly.
Although scripts may provide the student with a possible
“response” or an “initiation” these may not t the context,
and so be deemed inappropriate or insensitive.
Promoting conversation
in students on the autism
spectrum: scripts and
semantic mapping
Dana Battaglia and Mary E McDonald, New York
Editorial comment
Dana Battaglia works in the Department of Communication Sciences and Disorders at
Adelphi University and Mary McDonald is based in the Special Education Department
at Hofstra University. In this paper they discuss the potential benets of using scripts
and semantic mapping to facilitate communication and conversation between
individuals with autism and their peers or adults. They explore the research base for
each method and illustrate the type of work they have done with individual children
and young people. They conclude that further research is required as there is far
more written about the use of semantic mapping in helping written skills, than exists
for conversational skills.
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Promoting conversation in students on the autism spectrum: scripts and semantic mapping
GAP,17,1, 2016 41
may be used for instruction with individuals with autism
(MacDuff et al, 2007). Flores and Ganz (2007) describe
scripts as simple reminders of the words needed to
communicate (eg “help”) or provide suggestions for
phrases to initiate conversations (eg “What shall we
play? or “What did you do last night?”). For scripts to
be effective students should have some expressive
ability using words or symbols or pictures (Terpstra
et al, 2002). For those who can read, written scripts
can be used. For example, a teacher may write out the
words “Good morning Mrs Brown” to prompt a child to
speak to his teacher.
General steps in teaching the use of scripts can be
implemented by way of a task analysis. Each sub step
in a conversation is given and an assessment made as
to what the child was able to accomplish. Prompting
and reinforcement for each step along the way should
be individualised to optimise positive outcomes.
These steps include teaching the child to identify an
environmental stimulus (eg teacher opens the class-
room door to welcome the student to the classroom),
making an initiation, formulating a response, and
potentially engaging in follow-up interactions.
A scenario of how to implement the use of written scripts
is now given. Mia is an 8 year old girl with autism. She
is able to read phonetically and is socially motivated to
engage with her teachers and peers. She encounters
difculty, and subsequent frustration, with knowing
when to initiate and which specic words or phrases to
say. Her team identies the use of written scripts as an
intervention strategy.
The rst step would be for Mia to say “Good morning Mrs
Abby” once the classroom door opens in the morning.
She would need to be taught that the classroom door
opening with the teacher standing at the doorway is the
rst step in the sequence. Assuming this is a new skill
being taught, the prompt would be for the teacher to
point to a sentence strip with this statement written on
it, on the wall adjacent to the door in the hallway. The
teacher could then socially reinforce Mia’s behaviour by
giving her a high ve, and providing behaviour specic
verbal praise, such as, “I like the way you said good
morning to me! How was your weekend?” At this point,
For a child to successfully engage in a conversation,
s/he must possess several synergistic skills. In addi-
tion to the basic vocabulary required (eg “hi,” “bye”),
knowing when to initiate, how to transition topics, and
the use of interpersonal space are all required to have a
successful conversation (Maurice, 1996). When these
skills are appropriately demonstrated, conversation
may be reinforcing for both the communicator and the
recipient of the message. There is often an emphasis
on the number of exchanges during a conversation
rather than the quality of the exchange (Paul et al, 2009;
Todman, 2000).
The transactional model proposes that a child initiated
communication gesture invites interaction, and a
response from a communicative partner (eg adult or
a child). Research has shown that when children with
autism do initiate contact with adults, those adults are
then more likely to initiate conversation with the child
and, in some cases, adults will then describe the child
as more likeable (McDonald and Hemmes, 2003).
Children with autism who do not initiate contact or
respond to a communicative partner, are then at risk of
further deprivation of social reciprocity.
According to the diagnostic criteria in the Diagnostic
Statistical Manual, fth edition (American Psychiatric
Association, 2013), children with autism have decits in
social communication skills. Some children only initiate
contact with adults, and not with peers, and these
initiations may be largely in the form of requests to have
needs met (Stone and Caro-Martinez, 1990). Many
children with autism communicate for a more limited
range of purposes than typical children of the same
age (Stone and Caro-Martinez, 1990).
Using scripts
In addition to setting targets or goals, professionals
have several decisions to make about which specic
strategies to use. When should a clinician use a script?
What modality should be used to teach the script? This
next section explores the literature base for scripts and
the efcacy and limitations of script use with individuals
with autism. A script is essentially a prompt that cues
a communicative response for the learner (Krantz and
McClannahan, 1993). Either written or audio scripts
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Promoting conversation in students on the autism spectrum: scripts and semantic mapping
42 GAP,17,1, 2016
Step one
Step one is to teach Joseph to obtain his iPad mini,
place his ear buds in his ears, open the respective
sound le, and sit at the snack table. This sequence
should occur when his preschool teacher announces
that it is snack time. This step can be taught with
physical modelling from his teaching assistant, and
social praise can be provided for reinforcement,
assuming that is motivating for Joseph.
Step two
Joseph will tap on the play icon on his iPad mini and
hear the prerecorded message, “Hi Abigail.” Once it
stops, he will turn to his peer and repeat, “Hi Abigail.”
His teacher will provide reinforcement for the accom-
plishment of this step (eg “That was wonderful how
you said “Hi” to Abigail!”). He would also receive a
reinforcer for waiting for her to respond. Once his peer
reciprocates this greeting, step three should begin.
Step three
Joseph will independently comment on his own snack.
To do so, he will repeat the sequence in step two. That is,
he will hit the play button on his device, and repeat the
prerecorded message (eg “I have apples for snack!”).
Praise is then provided. If Joseph does not begin to eat
his snack, he is encouraged to do so at the end of step
three. Once complete, step four should begin.
Step four
Joseph will ask Abigail if she likes apples. The same
sequence will occur as in steps two and three, with the
following additions. He should be encouraged to initiate
using body language (eg closer physical proximity, eye
contact). Once he repeats the prerecorded message (eg
“Do you like apples?”) his reinforcer should be delayed
until Abigail responds. If Joseph provides a follow up
comment, or interjects with any additional appropriate
communication (gestures, uses spontaneous language),
he will receive further reinforcement. This way, the
behaviour of spontaneous communication is more likely
to reoccur. It is important to note that ideally the peer’s
verbal responses during the conversation will serve as
a reinforcer to the student with autism. However this is
often not the case, and team members therefore need
to use tangible rewards or specic praise.
the second interaction is now beginning. As a prompt,
Mrs Abby could be holding two sentence strips,
providing Mia with a choice of preselected sentences.
The rst could be, “It was ne”. The second could be,
“I did ___”. The teacher could implement differential
reinforcement for Mia at this point, meaning that if she
chooses to say, “I did ___” and lls in the blank line with
a spontaneous utterance, she can be given a special
prize, in addition to the social reinforcement provided
in the previous verbal interaction (ie step one). She will
receive a more powerful reinforcer for using a sponta-
neous response, in addition to using the written script.
For other students, audio scripts may be effective.
These can be created using smartphone applications.
These apps have replaced the button activated voice
recorders of the past. So the phrase, “That was fun”
could be played to the child when a play activity with
others is coming to an end – or the phrase “See you
later”. The child’s own voice could be used to record
these phrases. In the following scenario, a 4 year old
boy with autism is being taught how to use an audio
script to initiate and reciprocate with a peer during
snack time.
Joseph is a 4 year old boy who appears to be an auditory
learner. He loves to listen to music, and independently
uses his iPad mini to turn on favourite songs during
playtime. He responds more readily to prompts which
are spoken rather than written. In fact, he appears to
be struggling to learn to read by rote. He can initiate
greetings with adults, as well as reciprocate for two turns.
He can talk about past events, future plans, and engage
in small talk. His challenge is transferring these skills
to his peers. He appears to be interested in his peers
but does not initiate, nor respond to them consistently.
The team decided to implement auditory scripts as
prompts, which will be delivered to him via his iPad
mini and ear buds. The goal for Joseph is to approach
a peer in his class, greet him or her, comment on his
snack, and ask his peer about his/her snack. The
desired responses would therefore be “Hi Abigail,”
“I have apples for snack!” and “Do you like apples?”,
respectively. There are four steps in this task, as follows:
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Promoting conversation in students on the autism spectrum: scripts and semantic mapping
GAP,17,1, 2016 43
their shopping experience. In 2001, Sarakoff et al
increased conversational speech in two children with
autism across three situations by using embedded text.
Textual scripts were attached to various settings and
the scripts were directly related to the items to promote
conversation about those items in the natural environ-
ment. Participants increased their conversation ability
and generalised to novel peers and novel stimuli.
Potential strengths of using scripts
The potential strengths of using scripts are that they
are static, exactly replicated, and provide continuity
of prompting for the learner across contexts. They can
be further helpful for children who are sight readers or
auditory learners, depending on their modality prefer-
ence. One strength of scripts is that they bring children
into contact with language models in a context that
encourages a variety of verbal productions and does
not feature instructions such as “Say…” (Krantz and
McClannahan, 1998). Finally, they seem to be highly
benecial for individuals who appear to learn easily
through rote learning.
Limitations of the research in this field
While the literature supports the use of scripts for
individuals with autism, the research is not without
limitations. Some limitations include the lack of or
limited generalisation in the absence of the script
(Krantz and McClannahan, 1993), limited assessment
of responding in the absence of textual cues (Sarakoff,
2001), the cost in time to train peers to respond to the
student’s script (Ganz, 2012) lack of generalisation to
new settings, script recipients and scripts (Stevenson,
2000), and the need for individuals with autism to be
skilled readers to benet from the use of written scripts
(Charlop and Kelso, 2003).
As research continues to explore the use of scripts,
other ways to implement scripts can be considered.
To that end, rather than providing a student with a
pre-developed script, it may be possible to work with
the student as an active participant to develop and
plan for conversational topics. In effect, engaging
the student in the process of script development may
enhance the scripting process for conversational inter-
actions. One such method could be through the use
In general, scripts have been shown to be effective for
students with autism in a variety of ways. They have been
shown to increase initiations with peers (Krantz and
McClannahan, 1993; Charlop-Christy and Kelso, 2003),
to promote socialisation during play (Ganz and Flores,
2010; Goldstein and Cisar, 1992; Flores and Ganz,
2007), and to produce novel utterances (Wichnick et al,
2009; Wichnick et al, 2010), and to increase initiations
in the community (Brown et al, 2008). They have also
been shown to promote initiations in non-readers using
audio scripts (Stevenson et al, 2000; Wichnick, et al,
2010) and to promote bids for joint attention (MacDuff
et al, 2007).
Scripts have also been effective in teaching con-
versation skills to children with autism. Krantz and
McClannahan (1993) used scripts with four pre-
adolescent boys with autism to increase conversation
with peers during a group activity. They faded the
scripts systematically in a ve step process. However,
the nal script cue in the form of a quotation mark was
not able to be faded.
Charlop and Kelso (2003) used scripts in a question
and answer format to increase conversation skills
between students with autism and adults. Abstract,
age-appropriate, non-present topics (eg favourite
pastimes, watching television) were taught and the
participants acquired the scripts quickly. In addition,
the participants maintained and generalised scripts
to novel topics, adults and settings. Stevenson et
al (2000) taught four adolescent boys to engage in
conversation regarding present items using audiotaped
scripts. The participants displayed rapid mastery of the
audio scripts and maintained the skills in the absence
of the scripts after script-fading. Brown et al (2008)
showed the effects of script-fading on the conversation
skills of three young people with autism. Scripts were
used in simulated shopping experiences and both
scripted and unscripted responses were measured
throughout the study. Participants demonstrated an
increase in both scripted and unscripted responses.
Conversational skills generalised to novel stimuli and
to the community setting. This study assessed the
efcacy of scripts in a situation in which the students
were required to be mobile as they moved through
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Promoting conversation in students on the autism spectrum: scripts and semantic mapping
44 GAP,17,1, 2016
the exception of one peer-reviewed paper on the use
of semantic webbing as a communication tool (McCoy
et al, 1989), there is a dearth in the literature regarding
the application of semantic mapping to conversation
skills instruction, with no evidence in the area of
autism. In their case report of a 17 year old woman
with a dual diagnosis of major depressive disorder and
oppositional disorder (DSM-III), McCoy and colleagues
(1989) were able to provide effective intervention using
semantic mapping. Intervention was geared towards
guiding the individual to organise expressive commu-
nication, neutralise irrational thoughts, and help her to
formulate appropriate future plans.
Case study to illustrate the use of
semantic mapping
Olivia is a 6 year old girl with autism who is very active
and loves the summertime. It is late in the springtime
in her school, and she is excited that the summer will
be arriving soon. She loves outdoor activities and
having play dates. She benets from single written
word prompts as sentence starters during group
activities. She excels in commenting on statements her
peers have initiated, but struggles with selecting an
appropriate topic to initiate or respond with. The team
decided to implement a semantic map to help her to
independently engage in motivating conversations with
her peers in the class (see Figure 2).
The initial step in this instructional process was to ask
Olivia about all the activities she was looking forward to
in the upcoming summer. Those items were identied
as going to the park, playing with sand on the beach,
attending barbeques, and going hiking with friends.
As can be seen in Figure 2, those items, as well as
opportunities to initiate questions to her peers, were
included as single word prompts.
Step two in the process was to provide Olivia with the
semantic map, and show her that all of her favourite
summer topics were available as prompts, in case
she struggled with talking to her peers. She was also
taught that rectangles with question marks meant those
were opportunities for her to ask her friend a question.
As a result of this strategy, the conversation depicted in
Figure 3 occurred.
of semantic mapping. Just as clinicians and teachers
use graphic organisers with students with autism in the
pre-writing stages to develop ideas for writing (Kluth
and Darmody-Latham, 2003), semantic mapping could
be used as a pre-conversation strategy.
Semantic mapping
For individuals with autism who have had success with
traditional scripts, and who may be able to make basic
level inferences, a semantic mapping approach may be
used. Semantic mapping is a strategy for graphically
structuring and representing concepts in an organised
manner (Johnson et al, 1986). In the area of literacy, a
semantic map is a graphical model designed to help
students identify important ideas and how these ideas
t together in a text (see Figure 1 for an example of a
semantic map).
Traditionally, semantic mapping has been used to facil-
itate vocabulary instruction, either for the acquisition of
novel words or the organisation of words into semantic
categories (Rupley et al, 1998). To our knowledge, with
Figure 1: Example of semantic map to
describe a dog
Dog
Paw
Cat
Brown
Tail
Lick
Pet
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Promoting conversation in students on the autism spectrum: scripts and semantic mapping
GAP,17,1, 2016 45
Practically speaking, the semantic map functions in a
similar way to a script, in that it is a visual prompt. The
difference, however, is that it allows for more student
engagement while actually teaching the conversation
skills. Developing the map itself is more exible in
terms of the order of the use of the text and the amount
of text provided to promote conversation. For example,
scripts often ow from top to bottom in a list format,
whereas semantic maps (see Figures 1 and 2) are
circular and allow for the map to be rotated. This shift
allows for a more exible ‘starting point.’ In addition,
the orthographic text in the map is typically generated
from the student’s own ideas and vocabulary, within
the framework of a therapeutic session. Phrases and
sentences are subsequently generated from the initial
one word descriptors. In effect, there is a scaffolding of
semantic information, beginning from the single word.
When thinking about which strategy one should use
to teach a communication skill (eg scripts, semantic
maps), there are several questions which need to be
considered, as follows:
Is the child an auditory learner, a visual learner
and/or a multisensory learner?
Which strategies are currently used to teach
typically developing peers in this individual’s
natural environment?
Does the individual engage in learning actively
or passively? Is s/he a rote learner? Can s/
he generate novel responses once taught a
particular strategy?
Does s/he read by sight or phonetically? Does s/
he understand the underlying semantic concepts
represented in print?
Does s/he demonstrate an interest in drawing,
connecting-the-dots, or writing activities?
Does s/he have receptive/expressive vocabulary
similar to that of his/her peers?
In order for a team member to choose an intervention,
responses to the questions above will lead to the
considerations set out in Figure 4.
Figure 3: Conversation between Olivia and
her friend, with the support of an
individualised semantic map
Speaker Statement
Olivia “The summer is coming! I’m so happy!”
Juliana “Me too! I am going to camp.”
Olivia “I am going to the beach with my mommy.
Do you like the beach?”
Juliana “Yes, and I like pools too.”
Olivia “Do you want to come with us to the beach?”
Juliana “Sure.”
Olivia “Yay!”
Figure 2: Semantic map for Olivia to facilitate
a conversation about her upcoming
summer vacation with her friend in class
Summer
is coming!
?
?
Hiking
Park
Beach
BBQ
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Promoting conversation in students on the autism spectrum: scripts and semantic mapping
46 GAP,17,1, 2016
the opportunity for social interaction with their typical
peers. This stands to be mutually reinforcing to both the
sender and receiver of the message.
Although there is a robust body of literature regarding
teaching communication skills in individuals with autism
in general (Lavonne et al, 2003; Simpson, 2005; White
et al, 2007), teaching exibility in conversational skills
continues to be a challenging domain for this popula-
tion (Lee et al, 2002). Inherent to obtaining a diagnosis
of autism, individuals on the autism spectrum may
demonstrate rigidity and perseverative interests. This
rigidity appears in conversation topics and style as well.
Using scripts and/or semantic maps when teaching
conversation skills may be an effective procedure to
remediate decits in conversation skills, by introducing
exibility and aiding decision making.
Both scripts and semantic mapping can be used as
complementary strategies, with the ultimate outcome
being the expansion of effective conversation skills.
Once a child learns how to benet from scripts, and
these scripts are effectively generalised, the use of
semantic maps may be introduced to formulate a differ-
ent style of conversation. In the domain of literacy, there
is a wealth of research on the topic of semantic mapping
(Blachowicz, and Lee, 1991; Johnson, Pittelman, and
Heimlich, 1986; Kang, 2004; Rupley, Nichols, 2005;
Paratore, 2005; Vaughn, and Edmonds, 2006). However,
there is far less research into its use in developing
communication for social interaction. Designing well
controlled studies to evaluate the effectiveness of scripts
and semantic maps is an important goal for the future.
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