New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 3: Education for learners with ASD
Implications for professional practice
The research strongly indicates that improving
communication is a very high priority for
children with ASD 11 . The assessment and
development of communication and social goals
should complement each other. Teaching of the
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two areas should be carried out in parallel
(Recommendations 3.2.1.1, 3.2.1.2).
One study reports success in teaching young
children joint attention skills and symbolic play
which generalised to playing with caregivers 216 .
Assessment and goal setting
The most functional and relevant
communication abilities that children acquire
emerge from self-generated and self-motivated
goals. Assessment of the function or purpose
of their communicative acts is as essential as
an assessment of the means (words, informal
gestures, pictures etc) they use to communicate
their message. Consequently, effective
assessments include observations in natural
settings and in activities that involve peers and
significant adults 215 .
Part 3
There is increasing evidence for the importance
of encouraging initiation and spontaneous
communication 189 (Recommendation 3.2.1.3). A
child’s attempts to initiate will tend to result
in others finding strategies to understand and
communicate with them, which is likely to result
in further positive initiations 96 189 .
The research increasingly emphasises the
importance of interventions which take
place in natural settings, within natural
routines and which use natural consequences
(Recommendation 3.2.1.4). These activities are
often built on the child’s interests 55 96 189 . Children
will benefit from communication goals that are
carefully planned and implemented by teachers
and carers throughout the curriculum and
throughout the day, rather than in one-to-one
therapy sessions in a clinical setting on a more
intermittent basis. Speech-language therapists
will need skills in scaffolding teachers’ and
carers’ learning to support such interventions 189
(Recommendation 6.6, Professional learning and
development).
Interventions which emphasise the capacity
to understand the purpose of communication
rather than simply focusing on the form of the
message (eg, learning to say words) are most
important 55 96 . Children who learn speech and
language out of the social context may become
prompt-dependent in their use of language and
fail to generalise their learning to other settings
and partners 189 192 .
Formal measures should always be
supplemented by informal assessments which
include observations across a variety of settings
and activities, and interviews with significant
adults 11 (Recommendation 3.2.1.5). Aspects which
need to be assessed include eye gaze, facial
expression, the child’s range of communicative
functions and use of gestures 96 . When assessing
immigrants and others where English is not their
first language it is important that interpreters
and translators are available.
The most effective communication assessments
are those performed by members of a
multidisciplinary team in conjunction with
assessments of other aspects of development 11 .
Consideration should be given to how these
assessments relate to and influence each other,
and goals based on these assessments need to be
planned with the child’s teacher and embedded
in the child’s day. An assessment of the
communicative demands of the environments
the child is in, as well as an assessment of
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the child, is required to do this effectively
(Recommendation 3.2.1.6).
For older children and higher functioning
young people, assessments should include
pragmatic aspects of communication such as
their understanding of figurative language,
ability to read the emotions and reactions
of others and ability to communicate and
understand abstract ideas 217 (Recommendation
3.2.1.7). It is also important to consider their
ability to engage in conversation and repair
breakdowns in communication 96 .
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New Zealand Autism Spectrum Disorder Guideline