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Prosody Intervention for High-Functioning Adolescents and Adults with Autism Spectrum Disorder

Prosody Intervention for High-Functioning Adolescents and Adults with Autism Spectrum Disorder

Michelle Dunn | Larry Harris | Julia Dunn

(2016)

Abstract

When making the transition to adulthood, young people with Autism Spectrum Disorder can find their opportunities limited by their impaired prosody. Through a program of evidence-based lessons and resources, this book helps to develop verbal and nonverbal skills essential to adult life, particularly in the context of looking for a job or social situations. It is a complete curriculum, covering everything from self-calming to fluency and conversational skills, and includes lesson plans, handouts, and homework.

The program has been successfully used by the authors in their work with people on the autism spectrum and will be a life-changing resource for professionals as well as for parents and people on the autism spectrum wanting to improve their ability to communicate well.


Dr Michelle Dunn is the Director of the Montefiore Einstein Center for Autism and Communication Disorders, and Professor of Clinical Neurology at the Albert Einstein College of Medicine. Michelle is the author of S.O.S.: Social Skills in our Schools: A Social Skills program for children with Pervasive Developmental Disorders and their typical peers.

Larry Harris is a former NFL American Football player turned opera singer. He became a research assistant and vocal therapist at the Montefiore Einstein Center for Autism and Communication Disorders in 2012. Larry uses his experience in both sport and music to help young people understand the mechanics of their voices.


This is an absolutely wonderful and quite unique book for teaching skills in an area that is almost universal in autism: that of prosodic and related deficits. As pointed out early in the book, abnormal prosody gives 'a first impression of oddness' and interferes with ongoing social relationships. This readable, fascinating, and explicit book gives very specific lessons in all areas of what we usually include in 'prosody' (pacing, volume, pitch changes, word stressing), as well as in related pragmatic areas that are almost universally deficient in autism (conversing, narrating, gesture, eye contact, small talk, giving instructions). Lessons are spelled out in hierarchical fashion, and are detailed and explicit enough to be implemented by a variety of professionals (speech/language therapists, psychologists, teachers, behavior therapists). The authors also provide a clear and easy to use assessment tool for rating aspects of prosody, that does not require technical linguistic expertise, and which I intend to adopt for all the individuals I assess. Finally, the clinical and vocal expertise of these two authors (Dr. Dunn is a neuropsychologist specializing in autism and Mr. Harris is an opera singer) is very obvious in how they approach the whole endeavor, that is, by working first on helping the learner to be calm and reduce tension (which makes adjusting muscles easier and helps the learner to be ready to attend and learn). The intervention program in this book could change the social lives of many individuals with autism, which in turn could improve their academic attainments, vocational prospects and lifelong emotional fulfillment.
Deborah Fein, Ph.D., Board of Trustees Distinguished Professor, University of Connecticut and author of ‘The Neuropsychology of Autism’ and ‘The Activity Kit for Babies and Toddlers at Risk’

Table of Contents

Section Title Page Action Price
Prosody Intervention for High-Functioning Adolescents and Adults with Autism Spectrum Disorder - Enhancing communication and social engagement through voice, rhythm, and pitch by Michelle Dunn and Larry Harris 3
Introduction 13
Prosody deficits in ASD 14
The association of prosody deficits with communication and socialization 16
Discussion: Implications for clinical practice 17
Chapter content 19
Structure of the lessons 24
Note 25
Chapter 1 - Assessment 26
The future of prosody assessment 29
The screening instrument 29
Appendix: Qualitative Screening Assessment 31
Chapter 2 - Emotional and Behavioral Modulation 34
Introduction: Finding calm 34
Self-calming 36
Having a calm baseline: Mindfulness of breathing and internal triggers 42
Maintaining calm through mindfulness of emotions, thoughts, and behaviors 47
The importance of being calm: Understanding the consequences for your thinking 54
Communicating emotions and the need for help 57
Chapter 3 - Voice: Creating a More Oral Timbre 63
Introduction: The concept of the balanced mix 63
Learning about timbre 68
Oral timbre: Tongue position – vowels 1 77
Oral timbre: Tongue position – vowels 2 83
Oral timbre: Tongue position, vowels, consonants, and words 89
Oral timbre: Words and pre-formulated sentences 92
Oral timbre: Consonants in spontaneous speech 95
Oral timbre: Consonants P, T, and K in consonant–vowel syllables and words 97
Oral timbre: Consonants P, T, and K in pre-formulated sentences 100
Oral timbre: Consonants P, T, and K in spontaneously formulated sentences 105
Oral timbre: Consonants B, D, and G in consonant–vowel syllables and words 106
Oral timbre: Consonants B, D, and G in pre-formulated sentences 109
Oral timbre: Consonants B, D, and G in spontaneously formulated sentences 114
Oral timbre: Consonants M and N in consonant–vowel syllables and words 115
Oral timbre: Consonants M and N in pre-formulated sentences 118
Oral timbre: Consonants M and N in spontaneously formulated sentences 122
Oral timbre: Consonants J and ch in consonant–vowel syllables and words 123
Oral timbre: Consonants J and ch in pre-formulated sentences 126
Oral timbre: Consonants J and ch in spontaneously formulated sentences 131
Oral timbre: Consonants W, L, and R in consonant–vowel syllables and words 132
Oral timbre: Consonants W, L, and R in pre-formulated sentences 135
Oral timbre: Consonants W, L, and R in spontaneously formulated sentences 140
Oral timbre: Persistent problems 141
Oral timbre: Connected speech 1 144
Oral timbre: Connected speech 2 146
Chapter 4 - Voice: Volume 147
Introduction: Increasing volume 147
Nasal timbre: Introduction to discrimination, production, and anatomy 163
Nasal timbre: Tongue position for vowels 172
Nasal timbre: Tongue position – nasal and oral vowels 177
Nasal timbre: Tongue position for vowels, consonants, and words 183
Nasal timbre: Learning the sensations associated with directing airflow and sound through the nasal pharynx: “ah,” “uh,” and “awh” 185
Nasal timbre: Learning the sensations associated with directing airflow and sound through the nasal pharynx: “oh,” “ow,” and “ooh” 189
Breath support: Posture and expansion 194
Breath support: Optimal expansion and maintaining expansion 198
Modulating breath release: Learning the relationship between the speed of airflow and volume 204
Modulating breath release: Maintaining an expanded chest 207
Modulating breath release: Using the vocal cords as a valve 210
Modulating breath release: Regulating the volume of sustained sounds 213
Modulating release and increasing volume: Combining the Breath–Pause technique with nasal timbre 219
Regulating breath release: Mindfulness of sensations associated with Breath–Pause 224
Modulating breath release: Learn the Breath–Pause notation to practice management of breath release 227
Modulating breath release: Using the Breath–Pause technique and arc phrasing to increase volume in spontaneous connected speech 233
Open passage: Releasing tension in the jaw 236
Open passage: Releasing tension in the jaw and tongue 239
Putting it all together: Sound production with an open passage, in combination with nasal timbre and appropriate breath support 1 245
Putting it all together: Sound production with an open passage, in combination with nasal timbre and appropriate breath support 2 249
Modulation of volume: Adjusting to situation 253
Chapter 5 - Rhythm of Speech 258
Introduction: Fluency and rate 258
Introducing the Breath–Pause technique for improving fluency and rate 264
Breath control associated with the Breath–Pause technique 274
Using the Breath–Pause technique with spontaneous single words and pre-formulated connected speech 276
How calming positively influences fluency and rate of speech 280
Staying calm and mindful to promote effective fluency through the Breath–Pause technique 282
Using the Breath–Pause technique with spontaneous questions and sentences 284
Using the Breath–Pause technique to speak spontaneous sentences fluently and at an appropriate rate 286
Shadow Vowel technique: Addressing misarticulation produced by muscle tension resulting from overly rapid speech or anxiety/overexcitement 289
Rules for answering others’ questions about you 293
Graphic Organizer: Formulating a description of a person 297
Graphic Organizer: Using a book, periodical, or article 302
Sequential Graphic Organizer: Giving step-by-step instructions 1 307
Sequential Graphic Organizer: Giving step-by-step instructions 2 310
Web Graphic Organizer: My best day ever 313
Web Graphic Organizer: Description of a vacation 316
Plot Contour Graphic Organizer: Telling a good story 319
Web Graphic Organizer: Recounting what I learned from an article 322
Web Graphic Organizer: Recounting a fable and its significance 326
Learning to play the Conversation Game to develop fluency in conversation 330
Achieving fluency in spontaneously generated small talk 333
Using small talk to get to know someone 337
Learning the red card technique to monitor use of the Rules for Fluency 341
Fluently relating information and making a point about something you learned 343
Applying the Rules for Fluency to spontaneous conversation 351
Chapter 6 - Pitch 353
Introduction: Pitch modulation to convey meaning 353
Assessment/learning pitch modulation 355
Pitch modulation: Tones 359
Pitch stress and word meaning 363
Pitch stress in sentences 365
Pitch stress in poetry 1 369
Pitch stress in poetry 2 372
Pitch stress in narrative 374
Pitch stress in written text 377
Applying pitch notation to spontaneous speech 379
Talking about a topic using pitch inflection 380
Chapter 7 - Stress 383
Introduction: Using stress to convey meaning 383
Introduction to stress in spoken language 386
Grammatical stress in single words 389
Stressing words in sentences 392
Stressing words in sentences with a louder volume, using volume stress notation 401
Stressing words in sentences with a change in pitch 407
Stressing words in sentences with a change in rhythm, specifically an increase in duration 414
Stressing words in poetry to inform and share feelings 420
Stress notation on a famous speech to inform and share feelings 422
Telling a story from memory, applying all types of stress: Volume, pitch, rhythm (duration) 425
Telling a personal experience story, placing stress on important words 428
Talking about a topic, using appropriate stress 432
Planned discussion of a topic from memory, using all stress forms to inform and share feelings 435
PowerPoint presentation to inform: Part 1 – Deciding what to include 436
PowerPoint presentation to inform: \nPart 2 – Deciding which words to stress 439
Spontaneous speech in conversation, employing word stress to inform and share feelings 441
Conclusion 442
References 445
Subject Index 449
Author Index 455