The long-awaited DSM-V has been released, and with it “refreshed” diagnostic criteria for Autism. Individuals with autism, families, professionals, and other stakeholders are weighing in with accolades, concerns and criticism. Respected organizations like Autism Speaks Science are soliciting feedback from those affected by the changes and will be analyzing the data moving forward. If you are interested in participating in the Autism Speaks survey, please click here. I am interested in learning the results of their analysis once the dust has settled.
What I see when I compare the DSM-IV and DSM-V criteria is a streamlining and meshing of what used to be the separate social interaction and communication strands. As a speech-language pathologist this makes sense to me, as communication, in one form or another, is the linchpin of our social interaction as human beings. Communication/social interaction impairments have long been integral to a diagnosis of autism, just as interventions addressing communication/social interaction are keys to the treatment of individuals with autism spectrum disorders.
So how does AAC fit in with all of this? The same way it always has. AAC is a best-practice intervention for any individual who is unable to meet communication/social interaction needs with speech alone. AAC intervention may be long or short term. It may be needed all day long in every activity and situation or it may be needed in specific settings or situations only. It may be no-tech, low-tech, or high-tech in nature. The American Speech Language Hearing Association reminds us that AAC should be thought of as a system comprised of four components: symbols, aids, strategies, and techniques. (ASHA, 2004).
There is nothing inherently communicative or socially interactive about symbols and aids alone. The key to functional, meaningful, social communication is the combination of symbols and aids with the strategies and techniques that are employed to teach and sustain their use in real life interactions with real life important others. We should be using AAC (all four parts) to support communication for building social-emotional reciprocity and fulfilling relationships for individuals with autism. That has not changed with the DSM-V!
American Speech-Language-Hearing Association. (2004). Roles and responsibilities of speech-language pathologists with respect to augmentative and alternative communication: technical report [Technical Report]. Available from www.asha.org/policy.