Can Computer-Assisted Training of Prerequisite Motor Skills Help Enable Communication in People with Autism?

Our and others' research indicates that in fully a third of people with autism who lack communicative speech, the communication deficit may actually be a deficit in motor skills necessary to move the mouth and the vocal tract. These individuals have difficulties in fine, gross and especially oral motor skills, and a disparity between impaired expressive language and relatively intact receptive language: that is to say, they can listen but not speak. Because involvement in research and receipt of the fullest educational, occupational and other services demands ability to interact verbally and to control one's movements and actions, these people get the short end of the stick when it comes to scientific enquiry and pedagogic and therapeutic practice. Point OutWords, tablet-based software designed in collaboration with autistic clients and their communication therapists, exploits the autistic fascination with parts and details to motivate attention to learning manual motor and oral motor skills essential for communication. Along the way, autistic clients practise pointing and dragging at objects, then pointing at sequences of letters on a keyboard, and even speaking the syllables represented by these letters. Whereas many teaching and learning strategies adapted from methods for non-autistic people end up working against autistic cognition by asking people with autism to do what they cannot easily do, Point OutWords works with autistic cognition, by beginning from the autistic skill at manipulating parts and details. Users and their parents or guardians can opt into collection of data on motor interactions with Point OutWords, these internal measures of motor skills development are complemented by external, standardised tests of motor, oral motor and communicative development. These quantitative measures are collected alongside reports on Point OutWords's acceptability to users, and users' fidelity to a recommended treatment regime, so as to evaluate feasibility of a larger randomised controlled trial.