# Enhancing Communication for Individuals with Autism

## A Guide to the Visual Immersion System™

by  
**Howard C. Shane, Ph.D.**  
**Emily Laubscher, M.S., CCC-SLP**  
**Ralf W. Schlosser, Ph.D.**  
**Holly L. Fadie, M.S., CCC-SLP**  
**James F. Sorce, Ph.D.**  
**Jennifer S. Abramson, M.S., CCC-SLP**  
**Suzanne Flynn, Ph.D., CCC-SLP**  
and **Kara Corley, M.S., CCC-SLP**

### Baltimore • London • Sydney

Excerpted from Enhancing Communication for Individuals with Autism: A Guide to the Visual Immersion System by Howard C. Shane Ph.D. Brookes Publishing | www.brookespublishing.com | 1-800-638-3775 © 2015 | All rights reserved

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## Contents

1. An Overview of the Visual Immersion System™
2. Language Acquisition and Symbolic Competence
3. Tools Used to Support Visual Language and Communication
4. Principles of Assessment
5. Principles of Intervention
6. Protesting
7. Organization and Transitions
8. Requesting
9. Directives
10. Commenting
11. Questions
12. Social Pragmatics
13. References
14. Index

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## About the Authors

### Howard C. Shane, Ph.D.
Associate Professor of Otolaryngology at Harvard Medical School and Director of the Center for Communication Enhancement at Boston Children’s Hospital.

### Emily Laubscher, M.S., CCC-SLP
Speech-language pathologist in the Autism Language Program at Boston Children’s Hospital.

### Ralf W. Schlosser, Ph.D.
Professor in the Department of Speech-Language Pathology and Audiology at Northeastern University.

### Holly L. Fadie, M.S., CCC-SLP
Speech-language pathologist at Boston Children’s Hospital.

### James F. Sorce, Ph.D.
Director of Media Applications in the Autism Language Program at Boston Children’s Hospital.

### Jennifer S. Abramson, M.S., CCC-SLP
Speech-language pathologist at Boston Children’s Hospital.

### Suzanne Flynn, Ph.D., CCC-SLP
Professor in the Department of Linguistics and Philosophy at MIT and researcher at Boston Children’s Hospital.

### Kara Corley, M.S., CCC-SLP
Specializing in pediatric communication disorders with a particular interest in social-pragmatic impairments.

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## An Overview of the Visual Immersion System™

Communication disturbance is a hallmark of autism spectrum disorder (ASD). The primary focus of this book is individuals with moderate-to-severe ASD who experience difficulty comprehending and expressing spoken language. This chapter describes the communication impairments of these individuals and presents the rationale for a visually based approach to communication intervention.

### COMMUNICATION IMPAIRMENTS OF INDIVIDUALS WITH MODERATE-TO-SEVERE AUTISM SPECTRUM DISORDER

Individuals with moderate-to-severe ASD struggle to understand and express spoken words. Common patterns include:

- Strong comprehension of nouns but difficulties with verbs, prepositions, adjectives, and adverbs.
- Trouble understanding semantic relations and complex syntactic structures.

### Spoken Language Difficulty: Comprehension

Many individuals with ASD have trouble understanding spoken language. Comprehension can be masked by the individual’s ability to use context clues from their environment.

### Spoken Language Difficulty: Expression

Individuals with moderate-to-severe ASD often have difficulty using spoken language expressively. Approximately 50% of individuals do not use speech functionally. Common impairments include limited vocabulary and difficulties with syntax and generative speech.

### THE VISUAL IMMERSION SYSTEM’S RATIONALE FOR EMPHASIZING VISUALS IN COMMUNICATION AND LANGUAGE

The VIS model proposes using visual strategies as an alternative to traditional spoken language approaches, capitalizing on the visual processing strengths often seen in children with ASD. Visual supports can serve multiple communicative functions and enhance comprehension and expression through structured use of visual cues.

### FRAMEWORK FOR VISUAL LANGUAGE INTERVENTION

The VIS framework consists of visual expressive, instructional, and organizational modes. This cohesive approach provides a means of strengthening communication and learning through graphics.

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### Table 1.1. Example of emerging speech showing corresponding semantic relationship

| Two-word utterance | Semantic relation expressed |
| --- | --- |
| 1. Mommy come; daddy sit | agent+action |
| 2. Drive car; eat grape | action+object |
| 3. Mommy sock; baby book | agent+object |
| 4. Go park; sit chair | action+location |
| 5. Cup table; toy floor | entity+location |
| 6. My teddy; mommy dress | possessor+possession |
| 7. Box shiny; crayon big | entity+attribute |
| 8. Dat money; dis telephone | demonstrative+entity |

### General Principles of the VIS

1. Communication is used for multiple pragmatic functions.
2. There are two tiers of communication: scenes and element strings.
3. Communicative competence flourishes in a visually immersive environment.
4. Spontaneous communication is vital for learning.

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## Conclusion

The VIS aims at teaching individuals with moderate-to-severe ASD to become effective communicators through a structured visual communication system that supports their unique strengths and learning needs.