1. 10 A cross-Disciplinary Model of Communication Coaching for College Students with asd

AHEAD Conference 2013, Baltimore, MD

1.10 A Cross-Disciplinary Model of Communication Coaching for College Students with ASD


The University of Rhode Island

Pamela Rohland, M.A., Director, Disability Services for Students

Amy L. Weiss, Ph.D. Professor, Department of Communicative Disorders and ASHA Fellow

The University of Rhode Island

Program Abstract:

Eligible students with Autism-Spectrum-Disorder (ASD) at the University of Rhode Island, receive support toward college success through an interactive, cross-disciplinary partnership between Disability Services for Students (DSS) and Department of Communicative Disorders (CMD). Collaboratively planned activities include weekly sessions of disability counseling and support, communication therapy, peer-communication-coaching, and interaction with upper-class student mentors with ASD.

Today’s Learning Objectives:

1. 
   Participants will gain resources to help adapt the model of collaboration between Disability Services and the Communicative Disorders Program to support the success and retention of college students with ASD at other higher education institutions.
   
2. 
   Participants will view learning outcomes reported by all categories of student participants (i.e., student clients with ASD, graduate and undergraduate speech-language pathology students and upper-class student mentors with ASD).
   
3. 
   Participants will consider a reciprocal view of inclusion in support services (i.e., developing a more welcoming campus climate for students with disability, while simultaneously teaching students specific skills that help them adapt to the campus community).
   

Definition:

“… Autism Spectrum Disorder (ASD) [in college students] is where the individual is high functioning in a cognitive sense but without intervention is not likely to ‘solve the social puzzle.’ Thus, the person diagnosed with AS often has difficulty making friends easily, succeeding in typical classroom learning environments, etc. Attending college may present a significant set of challenges for the student with AS.” (Kaufman, N. & Lord Larson, V. (2005). Asperger Syndrome: Strategies for solving the social puzzle. Eau Claire, WI: Thinking Publications.)
Possible Aspects of ASD Supporting College Success

• 
  Average to superior intellectual ability
  
• 
  May have strong interest in subject of study
  
• 
  Relevant special talents
  
  • 
    writing, drawing, mathematics
    
• 
  Committed to following rules (perhaps?)
  
• 
  May enjoy reading, intellectual pursuit
  
  • 
    Not as distracted by social life…
    

Possible Aspects of ASD not supporting academic success

• 
  Social
  
  • 
    Social thinking, social communication
    
  • 
    Need for own space
    
• 
  Cognitive
  
  • 
    Executive functioning deficits
    
    • 
      Higher order planning
      
    • 
      Decision making
      
    • 
      Time management
      
    • 
      Organization
      
  • 
    Rigidity
    
    • 
      Difficulty adapting
      
    • 
      Overly literal in interpreting rules
      
  • 
    Information processing
    
    • 
      Difficulty dealing with complex input
      
    • 
      Making rapid decisions in new environments
      
• 
  Emotional
  
  • 
    Anxiety
    
  • 
    Depression
    

Recent neurological findings:

• 
  Emerging view of ASD as disorder of global processing
  
  • 
    Sensory issues
    
  • 
    Attention deficit concerns
    
  • 
    Executive functioning, rapid decision-making
    
  • 
    Difficulty in social contexts
    
    • 
      Now seen as possibly secondary deficit
      
    • 
      Social information complex, changeable, requires multi-modal processing
      
• 
  Problem is not one system but connection between/among systems (Minshew & Williams, 2007).
  

From young adults with ASD:

“I guess you might say I have many autistic moments where I say exactly what’s on my mind. Humor is hard for me to understand when you take things literally. It’s so difficult when you see the world as it is but you don’t really feel a part of it (Arthur, p. 80).”

“My communication skills also depend on how many people are present. If there is not too much sensory chaos, I am much better at decoding social behavior than when I find myself in a noisy group of people in a small space. When there are more than two people present my appreciation of all the possible cues to interpretation quickly deteriorates (Darius, p. 23).”

Decoding Ability-

• 
  Reading printed language (decoding representation of speech sounds for meaning)
  
• 
  Reading use of language (decoding nonverbal cues, gestures, tone of voice, irony, etc for meaning)
  

Divisions of Language:

FORM (the code)

• 
  Phonology
  
• 
  Morphology
  
• 
  Syntax
  

CONTENT (meaning)

• 
  Semantics
  

USE (in context)

• 
  Pragmatics
  

The following PPT image of five circles overlapping in complex intersections around a central core, reflects the interconnectedness of all linguistic divisions:

WHY COMMUNICATION COACHING?

• 
  Support the Transition to College.
  
• 
  Enhance college retention and recruitment.
  
• 
  Teach the communication PRAGMATIC skills needed for academic success.
  
• 
  Teach organization and executive function skills needed for academic success.
  
• 
  Students require multi-disciplinary supports to succeed.
  
• 
  Reciprocal view of inclusion principles – it is a “two-way street.”
  

RECIPROCAL VIEW OF INCLUSION

• 
  The environment adapts to the individual with universal design and accommodations.
  
  • 
    Disability as cultural diversity, civil rights, and equal opportunity.
    

• 
  College students with ASD become more adept at navigating the college environment.
  
  • 
    Students are capable of learning new skills even in areas of difficulty such as pragmatic language rules.
    
  • 
    Speech-Language Pathologists are uniquely qualified to teach these skills.
    
  • 
    Communication is essential for academic success.
    

History Of The Program’s Development:
URI’s “Changing the Culture” training grants (1999-2006; Rohland, Roush & Erickson) from the US Department of Education Postsecondary Education Demonstration Projects.

• 
  Created Partnerships with faculty, administrators and the URI Instructional Development Program (IDP).
  
• 
  Information and awareness dispel many stereotypes, thus creating a more welcoming and accepting climate for people with disabilities
  
• 
  Disability Resource Mentors still work together to change the culture of Rhode Island Higher Education toward a model of support, inclusion and civil rights for students with disabilities.
  

Training partnership with Weiss, Rohland, and IDP developed training seminars to support faculty and administrators in their ability to teach students with ASD.

• 
  Discussed communication difficulties that may be experienced by students with ASD,
  
• 
  Focused on the pragmatic competencies necessary for effective conversation and other social interactions (i.e., non-verbal communication that is nevertheless rule-governed such as gestures, intonation, irony, eye-contact, connotation, sarcasm, turn taking in conversations, etc.)
  
• 
  Faculty and administrators developed broader understanding for improved communication with students with ASD,
  

Influence of developing ASD support models at other universities and prominent practitioners in the fields of Higher Education & Disability and Communication Disorders.

• 
  UCONN - Jane Thierfeld-Brown
  
• 
  Bowling Green State University – Lynne Hewitt
  

Partnership of DSS and CMD continued to support college students

• 
  URI Speech and Hearing Clinic (CMD Graduate Training Program)
  
• 
  URI Disability Services for Students
  

Project Staff:

Supervising Faculty in CMD – recruits and supervises graduate clinicians and peer coaches; consult with Disability Services regarding client students.

Director Disability Services for Students – with DSS team, recruit new students to participate in the communication-coaching program.

Communication Coaches: M.S. Students of the CMD pre-professional training program provide explicit teaching of non-verbal communication cues, executive function skills, and conversation protocols.

Peer Coaches: B.S. student majors in the undergraduate CMD program provide guided practice with goals and objectives established by the communication coaches (e.g., non-verbal communication, and assistance navigating a complex university environment).

Peer Mentor (Advanced Student with AS): Previous client of the Communication Coaching Project who is comfortable and capable to lead or facilitate weekly group discussions of the clients with ASD.

DSS Advisors: Professional Disability Services staff provides academic and accommodation one-on-one support reflecting the communication goals of student clients.

Project Components:

1. 
   DSS identifies and recruits eligible students with ASD.
   
2. 
   CMD faculty recruit qualified M.S. level communication coaches and B.S. level peer coaches.
   
3. 
   DSS Director and the CMD Graduate Program Director collaborate in a credit-bearing course to train and mentor the peer coaches (weekly meeting).
   
4. 
   Therapy/Coaching Sessions are collaboratively supervised and observed by the program staff.
   
5. 
   CMD Graduate Director supervises communication-coaching therapy according to the guidelines of the American Speech-Language-Hearing Association (ASHA).
   
   1. 
      Participants learn verbal and non-verbal, social- pragmatic communication skills.
      
   2. 
      Participants learn executive functioning/ organizational skills needed for college success.
      
6. 
   Peer Coaches, required to observe their assigned client’s Communication Coaching sessions, develop coordinated one-on-one Peer Coaching activities providing social practice and carryover in the community.
   
   1. 
      Participants are provided with opportunities to practice social independence skills on campus.
      
   2. 
      Participants are provided with opportunities to practice successful organization strategies for planning and completing academic work.
      
7. 
   DSS advisors meet regularly with student clients .
   
   1. 
      Meeting frequency is determined case by case between student and advisor.
      
   2. 
      Participants receive disability-related academic support.
      
   3. 
      DSS Advisors support the communication coaching goals and participate in the clinical team of coaches.
      
8. 
   DSS and CMD personnel work interactively and collaboratively to identify specific unique social-communication and academic needs of each client. Therapy and coaching are designed and adapted accordingly.
   
   1. 
      Connect new skills to the academic environment.
      
9. 
   DSS Director recruits successful former client with ASD to mentor/interact with current Communication Coaching clients.
   
10. 
    Student clients:
    
    1. 
       Receive ADAAA accommodations, adjustments, and support from DSS as required each semester.
       
    2. 
       Participate weekly in specific communication skill-building instruction and support with a Communication Coach (graduate-student clinician).
       
    3. 
       Practice weekly one-on-one or group communication and organization skills with a peer coach – undergraduate student.
       
    4. 
       Participate weekly in a group discussion/social group facilitate by a peer mentor (advanced student client).
       

Sample Activities and Tools:

• 
  Acronyms guide practice:
  
  • 
    GATED: greet, ask, think extend/elaborate, don’t distract; Identify distracting communication behaviors and teach alternatives.
    
  • 
    SODAS: S = Situation, O = Options, D = Disadvantages, A = Advantages, S = Solutions (National Network on Youth Transition for Behavioral Health. Social Problem Solving)
    
  • 
    SMART protocol: Specific, Measurable, Attainable, Relevant and Timely Self assessment tool
    
• 
  Perspective taking protocols and self-assessments.
  
• 
  Games with controlled cues for group communication and reading non-verbal cues.
  
  • 
    Jenga^TM,
    
  • 
    Go Fish,
    
  • 
    Pictionary^TM,
    
  • 
    Charades– other communication, non-verbal cues in particular.
    
• 
  Teach Irony, Dual meaning, and Humor – Ads, Signs, captions:
  
  • 
    Sign for funeral home: AMIGONE FUNERAL HOME
    
  • 
    “Psychic Fair cancelled due to unforeseen circumstances”
    
  • 
    “Police begin campaign to run down jaywalkers”
    
  • 
    “Teacher Strikes Idle Kids”
    
  • 
    “Clinton wins budget, more lies ahead.”
    
  • 
    “Miners refuse to work after death”
    
  • 
    “Juvenile court to try shooting dependent.”
    
• 
  Students find articles to discuss under clinician supervision.
  

Self-reported Student learning outcomes demonstrated:

1. Student Clients (including Peer Mentor): (Categorized) self-report of communication skills or strategies learned:

1. 
   Executive Function/Planning
   
   1. 
      Keep a weekly schedule [to better] keep track of what is due for the week.
      
2. 
   Setting Attainable Goals
   
   1. 
      I learn S.M.A.R.T. goals which make goals more achievable.
      
   2. 
      Improved goal making skills – able to better create, meet and set goals.
      
   3. 
      I learn to ask help more.
      
3. 
   Social Communication Skills
   
   1. 
      Inviting others in a group into a conversation
      
   2. 
      Making sure to talk to everyone in a group
      
   3. 
      Relating the conversation to others in a group.
      
   4. 
      I learn non-verbal hints to tell how a person feels.
      
   5. 
      Remember to try to find common ground between the people in a conversation.
      
   6. 
      We worked on skills needed in interviews; to give a good first impresention, be attentive, pay attention to the speaker, present yourself in an appealing manner.
      
   7. 
      Differentiating between qualities of communication
      
   8. 
      Better eye contact skills.
      
   9. 
      …. How some things annoy people.
      
   10. 
       Tone. How tone of voice changes how things are perceived.
       
   11. 
       Attitude. How an attitude makes it hard to make friends.
       
       
       
1. 
   Communication Coaches’/Clinicians’ self-reported learning outcomes:
   
   1. 
      ASD greatly varies across clients – no two clients are the same
      
   2. 
      Working with RG & EW has taught me to be patient
      
   3. 
      [to be] far more explicit in instructions than I ever imagined necessary (for something so automatic to me.
      
   4. 
      To teach conversation skill, I was required to think about how to explain proper communication without it seeming confusing or opaque – a challenge.
      
   5. 
      ….develop greater understanding of the fundamental basis of conversation; to determine where the breakdown occurred for each [client}
      
   6. 
      …thinking about conversation skills made me more self-aware,
      
   7. 
      teaching ….strategies to help her get more organized also required self-reflection.
      
   8. 
      Working with these students made me a better clinician; ….I had to take responsibility for helping these students….in their academic and daily lives.
      
   9. 
      ….the experience taught me that it is ok to stop your plans in order to support your client when necessary.
      
   10. 
       I have gained a deeper understanding of Autism Spectrum Disorders; I thought those with ASD had impairments to social communication only.
       
   11. 
       I learned that the impairments run much deeper and affect executive functions, making organization and planning of day-to-day activities very difficult.
       
   12. 
       Being a Communication Coach …taught me to be more understanding of those on the Autism Spectrum…comments …..are the result of impaired perspective-taking and difficulty gauging what their conversational partner know/needs to know to guide ….content in the conversation.
       
   13. 
       The Communication Coaching program can help students in the field of Communicative Disorders become advocates for those [with ASD] by respecting their needs, understanding their social deficits and providing them with a skill set that can help them participate in socially appropriate ways within their activities of daily living.
       
   14. 
       I learned it is important to counsel the student …to always assure them that you are doing what you can to help them communicate successfully and be prepared for daily tasks.
       
       
       
2. 
   Peer Coaches’ self reported learning outcomes:
   
   1. 
      I have gained insight about myself and about my clients.
      
   2. 
      I have learned a lot about the Asperger’s Disorder in general.
      
   3. 
      This is the first time I have ever been involved in working with clients with this disorder and I enjoy helping them, I learned a lot from them
      
   4. 
      No person with Asperger’s is the same…. [As other persons with Asperger’s}
      
   5. 
      I have learned how to plan activities to benefit both of my clients.
      
   6. 
      Being a peer coach is not always an easy task.
      
   7. 
      …. Clients with Asperger’s struggle with a lot more than just communicating with others, but also organization, directions, and perspective taking.
      

Measured improvement of communication skills or strategies. (From progress reports)

1. 
   Goal: Improve Executive Function/Planning needed for academic and social activities.
   
   1. 
      Meet deadlines; understand communication technology, problem-solving skills, contacting professors, etc.) (bc, sc, ew)
      
   2. 
      keep a calendar (ew, sc)
      
      
      
2. 
   Goal: Improve ability to set relevant and attainable goals.
   
   1. 
      create goals relevant to academics (sc, ew)
      
   2. 
      conciseness and attainability. (ew)
      
   3. 
      create multiple strategies for each goal (ew)
      
      
      
3. 
   Goal: Improve Social Communication skills by improving conversation management (i.e. Initiating, maintaining, terminating and turn-taking, )
   
   1. 
      conversation management skills (increased conversation turns, improved initiation/maintenance/termination, identify distractors) (bc, sc, rg,)
      
   2. 
      perspective taking. (sc, rg, ew, bc)
      
   3. 
      reading body language or nonverbal cues. (rg, bc,)
      
   4. 
      eye contact (rg, sc)
      
      
      

Barriers: What needs to Improve?

• 
  Earlier, more consistent identification of and buy-in by students who will benefit from a combination of weekly communication coaching and academic counseling
  
• 
  Scheduling is currently a great challenge.
  
• 
  Appropriation of personnel is expensive.
  
• 
  Families are unused to paying for these students’ support services; URI has no mechanism to collect additional tuition charge.
  
• 
  Data collection is needed to demonstrate efficacy for purposes of grant proposals, recruitment and revenue generation.
  

Conclusion:

1. 
   Communication Coaching has enhanced individual success and communication skill development for its student clients
   
2. 
   Communication Coaching provides practitioners-in-training with a broad view of the individuality and strengths of college students with ASD;
   
3. 
   We continue to be a resource to the university community to help faculty and administrators develop greater understanding of university students with ASD.
   
4. 
   We CAN hold students to college standards of academic performance and student conduct.
   
5. 
   We CAN teach students to understand and meet those standards.
   

Thank you to our colleagues:

Jacqui Tisdale, Counselor and Graduate Assistant, Disability Services for Students

Rosemary Lavigne, Coordinator, Disability Services for Students

Paige Ramsdell, Coordinator, Disability Services for Students

Billy Connors, Clinic Coordinator, URI Speech and Hearing Center
URI M.S. students who have served as ”Communication Coaches”

• 
  Alyssa Mason
  
• 
  Kayla McCarthy
  
• 
  Lindsay Selby
  
• 
  Sharon Lakatos
  
• 
  Emily Galen
  
• 
  Brooke Lowery
  
• 
  Shannon Muldoon
  
• 
  Lauryn Rita
  
• 
  Kristy Wallace
  
• 
  Ashley Leite
  

URI B.S. students who have served as “Peer Coaches”

• 
  
  

• 
  Mollie Smith**
  
• 
  Morgan Talbott
  
• 
  Ashley Pezzillo
  
• 
  Kali Varney
  
• 
  Lexi Caruso
  
• 
  Mary Ellen Vigeant
  
• 
  Erin Mack
  
• 
  Jessica Vanner
  
• 
  Morgan Lynn
  
• 
  Amy Donilon
  
• 
  Kaitlin Turcotte
  
• 
  Lauren Benvenides
  

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