By Stephanie Dille-Huggins, MA, BCBA
Stephanie Dille-Huggins began as an ABA therapist with Cornerstone Autism Center in April 2011. After becoming a BCBA in 2014, Stephanie has pursued the continued integration of access to ASL for Cornerstone staff, as well as guiding treatment for non-vocal, Deaf, and hard of hearing clients. Stephanie is currently working with school administrators, teachers, behavioral consultants, psychologists, and other BCBAs from across the country in order to work towards providing access to services without barriers for all individuals living on the spectrum.
All individuals living on the spectrum deserve access to the method of communication that best fits them. This has been one of Cornerstone’s guiding standards as the integration of American Sign Language (ASL) came into fruition officially within our center in 2013. Cornerstone has allowed its mission of, “maximize those who struggle, embrace those who love, and fulfill those who serve”, to drive its Applied Behavior Analysis (ABA)-based treatment into uncharted territory with the integration of ASL for non-vocal hearing, Deaf, and hard of hearing clients.
Maximizing Those Who Struggle: Cornerstone Guiding the Way for Deaf & Hard-of-Hearing Clients
Access to communication, especially in one’s native language, remains a critical component in providing quality and ethically sound ABA-based intensive therapy. Here at Cornerstone Autism Center, we quickly identified that there was a considerable disconnect between the Deaf and hard of hearing community and their ability to access resources and alternative therapies, specifically ABA. As outreach began in 2014 to the community, the need to be a provider that focused on bridging that gap began. In 2015, Cornerstone fulfilled its mission to maximize those who struggle by serving its first Deaf client. Since 2015, Cornerstone has served a total of six Deaf and hard of hearing clients. Although specific assessment tools do not exist for Deaf and hard of hearing children with
autism, Cornerstone has customized programming derived from the Verbal Behavior and Milestones Placement Program (VB-MAPP) and the Assessment of Functional Living Skills (AFLS) to guide teaching skills and abilities across the verbal operants, as well as listener responding, social, and daily living skills in ASL. In addition, other programs have been created to support our clients’ social customs and norms specifically related to Deaf culture and their community, which include learning to use their cultural name sign, appropriately tap others to gain their attention, respond to flashing lights, and attend to an interpreter to name a few. Additionally, Cornerstone has created desensization programs to assist our Deaf clients in wearing hearing aids or cochlear implants when deemed medically necessary and appropriate.
Watch this video from local news station WRTV6 titled, “Autism Center in Indianapolis Utilizes Sign Language to Help Non-Vocal Clients Communicate.”
Read an article about our first Deaf Client to formally graduate from Cornerstone here at this link.
Fulfilling Those Who Serve: Cornerstone Dedicates Sign Training & Support to RBTs
The goal for all clients upon starting intensive treatment with us is to transition that child back to a less restrictive environment where they will thrive with the skills and abilities developed during hundreds of hours of individualized treatment; however, for Deaf and hard of hearing clients this is impossible without registered behavior technicians fluent in ASL to bridge the gap, allowing access to functional communication training and an intensive understanding of Deaf culture and their community. In 2013, sign language classes, with guided insight into Deaf culture and their community, began to be offered to therapists, as well as clinical team and administrative members. A curriculum created from the VB-MAPP assessment was created in order to teach participants the communication tools necessary to implement programming using ASL across the varying developmental operants, as well as implement functional communication training procedures. These classes cover teaching the signs for varying family members, how to place programming demands per the respective operant, words of praise, restaurants and food, etc. Since 2013, over 150 individuals at Cornerstone’s Polk Center location have taken a leveled one through five sign course, fulfilling the dream to serve without communication boundaries. Leslie Kidd, MA, who is also an RBT for Cornerstone is one of the thirteen individuals to complete all five sign courses and pursue additional immersive training within the Deaf community. Leslie shared, “after having served in the field for over five years, I have seen many of the everyday struggles our clients encounter. When the opportunity was provided to me to assist a new group of clients that had minimal access to ABA therapy, I wanted to be a part of it. I did not expect the Deaf culture and community to become a professional asset to me as I observed an entirely different way to help support our clients from new perspectives, utilizing their culture.”
Watch this video from the very first Cornerstone Talent Show when Cornerstone’s sign classes performed the song Shake It Off by Taylor Swift.
Embracing Those Who Love: Cornerstone Guided Sign Trainings for Families
Cornerstone’s families have been able to access ABA training on varying applications and principles in ASL, as well as attend hosted workshops with access to the information in ASL. Additionally, families requiring access to sign resources for Deaf, hard of hearing, and non-vocal children, have been able to access customized sign books based on their child’s current ASL abilities, with additional individualized sign modifications as necessary. Family centered sign trainings have been offered during past years to bring together families in order to learn signs that could be used in home with their child. When the COVID-19 pandemic forced the shutdown of our center, Cornerstone offered telehealth services, allowing access for Deaf families, as well as hearing families of Deaf or non-vocal children to access continued services, which aided in the prevention of regression of these children during this unprecedented and challenging time. Also, during this time, families were presented with the option of attending sign classes weekly through Zoom to continue to maintain their signing abilities, as well as learn to use new signs at home with their child. In addition, Cornerstone has provided sign training videos through YouTube to allow for additional sign training to be provided to Cornerstone families and the community.
How Can ASL Help My Non-Vocal Child Communicate?
According to the Center for Disease Control (CDC), 40% of children living with autism are non-vocal, meaning that they are unable to use their voices to communicate. When we use sign language and speech simultaneously with our non-vocal clients, we are able to use the VAK method of teaching, which stands for visual, auditory, and kinesthetic (Berg, 2012). The visual aspect allows the child to see the sign being made, the auditory aspect allows the child to hear the letter or word being said, and the kinesthetic aspect allows the child to see themselves making the letter or word. Due to ASL being a topography-based language system, it allows immediate access to communication across objects, actions, letters, etc., (Nam & Hwang, 2016). A reoccurring fear that families express when the goal is vocal speech is that sign language will hinder their child’s progress in this area. Research has shown that spoken language is processed
in the left hemisphere brain, whereas images are processed on the right side of the brain; this means that sign language is processed on both sides of the brain. Research studies have shown that sign language may accelerate the development of vocal speech (Berg, 2012). A number of substantial benefits exist when we teach our non-vocal children how to sign including earlier development of communication, reduced frustration and less engagement in maladaptive behaviors because they can accurately express their wants and needs, and a mutual happiness/stronger bond between the client and therapist and/or the child and parent.
Learn if Sign Language is Right for Your Child:
If you are interested in learning more about using ASL with your child or to see if using signs would be an appropriate fit, please contact your team lead and/or BCBA to set up a virtual meeting. Below are several links to access resources that you may find beneficial:
https://www.youtube.com/watch?v=NXBDVvSAia8&feature=youtu.be (ASL Feelings)
https://youtu.be/-3lnfM5BpUo (ASL Home Routines)
Book: The Baby Signing Bible by Laura Berg
Watch These ASL Videos on our Youtube Channel
By Clicking the Image:
Centers for Disease Control and Prevention. (2019) ASD Signs and Symptoms. Retrieved January 18, 2021, from https://www.cdc.gov/ncbddd/autism/signs.html
Nam, S. and Hwang, Y. S., (2016) Acquisition of Picture Exchange-Based vs. Signed Mands and Implications to Teach Functional Communication Skills to Children with Autism. The Journal of Special Education Apprenticeship,5(2), 1-15.
When Side Matters: Hemispheric processing and the visual specificity of emotional memories. (2009) National Institute of Health. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643360/pdf/nihms-85539.pdf
Berg, L. (2012). The baby signing bible: Baby Sign Language Made Easy. New York, NY: Penguin Group.
January 22, 2021, Stephanie Dille-Huggins, MA, BCBA