11 Best Methods for Teaching Nonverbal Students with Autism

functional life skills how to teach special education teachers teacher experience transition Apr 01, 2024
Visual Supports for Teaching Life Skills to Nonverbal Students with Autism

I think every special education teacher has had the feeling of wanting to teach new skills or address IEP goals with a student and knowing all the ways that haven't worked.  Educators often turn to other coworkers looking for the right tools, including ideas, insight, and suggestions for different methods and approaches.  Allow me to be the educator next door.  In my experience teaching transition-age young adults, I worked with non-verbal autistic students and am highlighting approaches I took and methods with evidence-based practices of effectiveness.  

 

Below is a list of 11 methods for teaching students who have autism and are nonverbal/non-speaking, specifically: Alternative Communication, Direct Instruction, Engagement Strategies, Modeling and prompting, Peer-to-Peer Teaching, Pivotal Response Training, Positive Reinforcement, Routine/Schedule, Sensory Input, the TEEACH Method, and Visual Supports.    

 

 

 

What Defines Minimally Verbal or Non-Verbal Autism?

According to Minimally Verbal School-Aged Child With Autism Spectrum Disorder, there is no clear definition of a minimally verbal or nonverbal individual.  However, most studies refer to individuals with no verbal words or 20-30 or fewer words or phrases as minimally verbal.  These phrases may be ones they repeat frequently or be scripted.  The Autism Self Advocacy Network defines autism spectrum disorder as a developmental disability that affects how one experiences the world around them.  

 

Nonverbal autism is when an individual has a small field of vocabulary or no spoken words or vocalizations and has a diagnosis of autism.  Nonverbal, nonspeaking, preverbal, and nontalking are all terms used to identify someone who has minimal or no verbal speech.  The terms are interchangeable and some are preferred over others.  

 

To be clear, non-verbal students are NOT non-thinking, non-learning, or non-communicative, a non-verbal child can learn and has communication skills, including receptive language, even with no or limited expressive language.  Nonverbal communication involves eye contact, body language, hand gestures, pointing, and behavior, among others.  

 

 

Teaching Strategies and Tips for a Special Education Teacher:

  • Teaching is not a one-size-fits-all profession (and the article Evidence-Based Practice for Teachers of Children With Autism: A Dynamic Approach confirms this).  The method used to teach important skills to a special needs student should be individualized based on the student's unique needs, strengths, preferences, special interests, and abilities.  Trial and error and being willing to take risks to find the most effective way to provide instruction for a student.  
  • Read student's nonverbal behavior.  Are they easily distracted by everything in the learning environment when using in-person modeling, but video modeling drowns out the visual noise and helps them to focus?  Look at facial expressions, physical proximity, and vocalizations when reflecting on the effectiveness of a chosen method.
  • Consult the student's IEP team.  Ask the speech therapist and other service providers, like the occupational therapist, for insight into previously successful methods and approaches to save time, energy, and frustration. 
  • Proximity matters. When using any method mentioned below, consider that the proximity between you as the teacher and the student may impact its success. Some strategies may be more successful if you are physically closer to the student. Sit at a comfortable distance right in front or next to them, at their eye level. 
  • Small sample sizes are okay.  Journal articles linked below often have small sample sizes, many with five or fewer participants.  While this matters, especially to the world of researchers and experts, educators know that when you are looking for a strategy that makes a positive difference for one student, all it takes is the right idea to make it click.  

 

While I'm sharing methods I used during my time in the classroom working with students with autism and who were non-speaking or minimally verbal, I felt it was important to share methods that have been found to be effective outside of my scope of teaching experience.  Therefore, I'm including journal articles with evidence-based research to substantiate this list.  All articles included can be accessed for free, either through open public access or by creating a free account, as it was important to make the research easily available for reference and learning.  My goal isn't to make this a boring list of structured teaching strategies with a bunch of research jargon (although I did have a lot of fun researching and reading through all these articles, even with the jargon), but rather to highlight an array of methods with social proof of effectiveness.    Through my research, I found The National Professional Development Center on Autism Spectrum Disorder's list of 28 Evidence Based Research methods for additional teaching methods and approaches if you want even more ideas than the ones I share below.     

 

 

 

11 Best Methods for Teaching Nonverbal Students with Autism:

1. Alternative Communication

Definition: Augmentative and Alternative Communication (AAC) is a communication system that uses pictures and/or typed words to communicate a thought, idea, request, want, need, feeling, or other.  AAC devices can be electronic, meaning the pictures, words, or programs are accessed through a tablet or other device, can be printed on paper, or can be a physical object, like a miniature figurine.  

 

Example: Using AAC can give students who are nonverbal access to words and speech in order to teach communication of social skills with peers.  A communication device, such as a tablet, can have pictures and vocal output sounds to ask and answer questions with peers.   AAC is frequently used to support the initiation of requests (aka mand) to help students get their basic needs met.  

 

Research & Ideas: Speech-language pathologists can serve as support when using AAC assistive devices for communication and teaching specific needs and can assist in using the information from the article Designing effective AAC displays for individuals with developmental or acquired disabilities: State of the science and future research directions to determine the best placement and style when designing the screen to maximize communication and learning.    The study Enhancing Instruction via Instructive Feedback for a Child With Autism Using a Speech-Generating Device used the method of Instructive Feedback to teach a young boy who was minimally verbal problem identification communication using AAC, specifically TouchChat.  

 

 

2. Direct Instruction

Definition: A classroom teacher explicitly teaches skills or knowledge to students and typically includes verbal instructions for a method or steps to a process.  Direct instruction can be used to teach a wide variety of content, from vocational to academic skills.  This learning experience method is led by a teacher and can be used for a whole class, small group, or 1:1 instruction.  

 

Example:   Direct instruction can be used to teach nonverbal students with autism how to use a debit card to pay for a purchase at the grocery store.  The teacher might use verbal instruction and/or modeling to teach the steps of sliding the debit card across the debit card machine, pressing 'No' for a cashback question, typing in the 4 digit PIN, press 'Yes' to approve the total cost, and then pull the card out of the debit card machine upon the 'Remove card' visual prompt.  

 

Research & Ideas: Review of Research-Based Interventions for Students with Autism Spectrum Disorders in Content Area Instruction: Implications and Considerations for Classroom Practice study (which can be read for free simply by creating a JSTOR account) highlights proof that direct instruction was an effective means of instruction for reading, writing, and math.  The study also makes note of the need for additional research on middle school and high school-aged students with autism and the lack of research in areas of science and social studies.  In the study Effects of a Social Skills Intervention Among High School Students With Intellectual Disabilities and Autism and Their General Education Peers, direct instruction teaching method was used to teach high school and transition-aged students with autism who were nonverbal or minimally verbal to use a communication book to interact with typically developing peers.  The books used simple language that was age-appropriate for the group.  The study indicated that the students felt they had more friends at school and that their conversational communication greatly increased.  Both paraprofessionals and classroom teachers reported that conversations were happening outside of classroom instruction settings (i.e. hallways and cafeterias).  

 

 

3. Engagement Strategies

Definition: To engage means to attract and sustain attention.  An engagement strategy is used to gain and maintain a student's attention for a period of time in order to learn, communicate, or complete a task.  Engagement strategies can be used in the community or classroom setting.  

 

Example:  An individual remaining engaged in completing hygiene steps in the shower will result in better outcomes for both personal hygiene and completion of the task (i.e., not taking a 20-minute shower) if the individual is engaged in the task and able to sustain that attention.   

 

Research & Ideas: The most common example of an engagement strategy is to use the student's unique and preferred topic or interest (i.e. comic book character) to initially hook and then sustain attention to a learning task.  The article Teaching Children With Autism Spectrum Disorder With Restricted Interests: A Review of Evidence for Best Practice (which can be read for free simply by creating a JSTOR account) shows evidence that when students with autism feel enticed by their restricted interests (i.e. washing machines or 1990's TV commercials) they showed gains in learning, communication, social engagement, behavior or social well-being, motivation, and task performance.    This article, Engaged Moments: Mediated Action and Children With Autism in the Classroom Setting highlights true 'engagement' with others, like peers and adults, and with objects, like signs and materials, for a young boy who has autism and is nonverbal through the use of a therapy ball seat.  The article does make note of increased engagement when a lesson includes music and singing as well, both of which are sensory in nature.   The Individual and Envrionmental Determinants of Engagement in Autism study highlights that engagement was highest for individuals with autism when they were working and learning in small groups.  

 

 

4. Modeling & Prompt Style

Definition: To model means to physically show the steps for completing a task. It can be executed in person or via video or pictures. Video recordings are taken of the student or another person showing the steps to complete a given task.  

 

A prompt is a verbal alert or nonverbal motion to bring attention to or serve as a reminder of a task or the next step in a process.  These two teaching methods are often intertwined (as are a few others on the list) as one is hard to do without the other, and there are a variety of different approaches to each method.   These methods can be used to introduce, reinforce, or remind students of a learning concept or task and can be used across academic and life skills settings.    

 

Example:  A video model of the student completing a work system task that is later used as a visual prompt to support their mental recall of the steps and fine motor skills needed to complete the overall task.  Educators can use modeling and/or prompting to develop skills or reinforce previously learned skills.  

 

Research & Ideas: Modeling includes video modeling.  The study Comparison of Two Video Prompting Interventions to Teach Daily Living Skills to Adolescents with Autism used video modeling with teenagers who were nonverbal or minimally verbal and provides evidence that video modeling and fluency building (where the video clips were shown when an error was made vs the student being interrupted when they made an error and skipping to the next step) when used with for home maintenance tasks of washing windows, mopping floors, and washing dishes.  

 

The study, The Effectiveness of Simultaneous Prompting in the Teaching of Towel Folding Skills for Students with Intellectual Disabilities, studies functional routines like towel folding for three teenagers with moderate and mild intellectual disabilities.  While this study doesn't specify if any of the participants had autism or were nonverbal, the teaching method used was a combination of model, verbal prompt, and physical prompt to learn how to fold towels.  All three participants learned the towel folding tasks and were able to maintain the skill for the 2, 3, and 4-week check-ins.  

 

The purpose of this study, Comparing Error Correction to Errorless Learning: A Randomized Clinical Trial, was to compare errorless correction learning and errorless learning, both of which direct or redirect learning through prompts, and error correction tends to be more effective, more efficient, or both more effective and efficient than errorless learning.  Another prompt style, backward chaining, where a student masters the last step before a task is considered 'complete' and then learns to add previous steps one at a time, is different as compared to the more widely used forward chaining, where the student starts with learning the first step of a task.   In the study Teaching Nonvocal Children with Autism to Request for Missing Items, interrupted chaining, where a step in the middle is missing, was successfully used with a small group of nonverbal children to mand (i.e. request) materials using AAC for academic skills, self help skills, and play.  

 

 

 

5. Peer-to-Peer Teaching

Definition:  Peer to Peer teaching utilizes the peers of a student with a disability to assist in learning or reinforcing a concept or skill.  Including peers in the learning process may (reduce pressure, increase motivation, and provide immediate feedback and natural models for social behavior.  

 

Example:  Peer-to-peer teaching can be used by pre-teaching typically developing peers how to interact and support their peers with autism, such as ways to prompt and provide feedback when completing group work for an academic skill, like dissecting an animal or functional skill, like moving through the busy lunch line.  

 

Research & Ideas: Peer-to-peer teaching is usually associated with social interaction and group activities.  This method is a great way to extend learning models across an array of different learning environments.  In the study, A Meta-analysis of Peer-Mediated Instructional Arrangements and Autism, a review of past articles shows success when peers are trained and supported in helping their peers with autism learn an academic skill, like comprehension, a social behavior.  The peers to peer interaction also reduced the student with autism's problem behavior.   The study The Efficiency of Peer Teaching of Developing Non Verbal Communication to Children with Autism Spectrum Disorder shows evidence that training typically developing students (ages 8-12 years old) to interact and give instructions and feedback to peer students with autism was effective and non-verbal communication skills, like pointing, imitation, and listening and understanding, were retained by the student with autism.  High school and transition-age autistic students who were nonverbal or minimally verbal were highlighted in the study Effects of Social Skills Intervention Among High School Students with Intellectual Disabilities and Autism and their General Education Peers.  Researchers used communication books to support social interaction with same-age peers and typically developing peers who are informally trained in how to accept an initiation, verbalize the question being shown by the student with autism and expand on their response, and how to prompt their autistic peer to ask a new question from their communication book.  

 

 

6. Positive Reinforcement

Definition: Reinforcement is the consequence, be it positive or negative, that occurs after an action or inaction. Positive reinforcement is a reward for engaging in the ideal choice or action for a given task or demand. Teachers, educators, classroom staff, family, and others can give a reinforcement, including positive reinforcement, on-demand or on a schedule.  

 

Example:   If a student is motivated by watching basketball game highlights on YouTube, then the student can earn 3 minutes of video watching after completing daily routines, such as carrying their backpack off the bus, putting it in their locker, taking off their coat, and placing their lunch bag in the classroom kitchen.  

 

Research & Ideas: While positive reinforcement is typically associated with developing positive behavior in academic and natural environments (like the community), it can also be used to reduce negative behavior.  The study Positive Behavior Support: Supporting Adults with Autism Spectrum Disorders in the Workplace highlights a 25-year-old man with autism who is minimal/non-verbal and the effect of positive reinforcement in his workplace setting, a small coffee shop.  The reinforcement schedule reduced escaping correction, pushing, and loud vocalizations and increased asking for a break when feeling stressed.  The study Effects of a Systematic AAC Intervention using a Speech Generating Device on Multi-Step Requesting and Generic Small Talk for Children with Severe Autism Spectrum Disorder included minimally verbal and non-verbal students with autism aged 7-13 years old use reinforcement as one of the teaching methods to successfully teach students to use AAC for multi-step requests of preferred things and engaging in small talk with another conversation partner.  Participants were able to sustain the skills learned using the reinforcement method, among others (such as modeling and prompting), after a 2-week period post-intervention.   

 

 

 

7. Pivotal Response Training/Pivotal Response Treatment 

Definition: The Pivotal Response Training or Pivotal Response Treatment (PRT) method connects a student's natural interests to build key skills.  'PRT® targets pivotal areas of a child's development, such as motivation, responsivity to multiple cues, self-management, and social initiations.' (Source)   PRT is often associated with ABA, however is more child-initiated than other ABA methods.  

 

Example:  PRT is a method that can be used to teach putting on a work uniform top by leading with the student's interest in completing a preferred work task, like using a scanning wand to add inventory back into a building, and using that task as a motivation to put on a work uniform top.  The PRT Module: Steps for Implementation guide offers ideas for this method.  

 

Research & Ideas: PRT is a method that has been used to address inappropriate behaviors and increase communication.  The article Using Individualized Orienting Cues to Facilitate First-Word Acquisition in Non-Responders with Autism provides evidence of three young autistic children who were noverbal increasing their verbal communication after PRT interventions.  The article Effects of Pivotal Response Treatment for Children with Autism provided insight into young children, aged 3-8 yrs old, who were minimally verbal (at least 1-word utterance) improving their social-communication skills and self-initiation motivation through PRT with less intervention time than other intervention options.  The study did include parent training too, as this is an important component of the PRT method.  

 

 

 

 

8. Routine/Schedule

Definition: A routine is a teaching method where the same steps are completed upon a trigger or set time.  A schedule is the specific steps that are followed in order and may or may not be time-specific.  The use of structure, or predictability, is a key component of both routine and scheduled teaching methods.  

 

Example:   A schedule of a vocational training task analysis may include visual support of the steps to set up a fitness studio for a pilates or yoga class.  Simple routines for an academic or life skills class may include plugging a classroom tablet into a charging station as students leave class as triggered by the bell schedule.  

 

Research & Ideas:  The study The Effect of Activity Schedules to Teach Appropriate Activities During Free Time to Students with Autism Spectrum Disorders provides evidence of visual picture schedules increasing follow-through for minimally verbal young students with autism.  The study Teaching Teamwork to Adolescents with Autism: The Cooperative Use of Activity Schedules highlights the effectiveness of using task analysis schedules to learn multi-step vocational skills for teens with autism who have significant deficits in language communication.   The Interventions Supporting Health‐related Routines for Children with Intellectual and Developmental Disabilities: A Systematic Literature Review study included participants with autism, with some participants having communication needs, and looked at the success of routines for self-help skills, such as handwashing and teeth brushing, among other medical routines.  The routines were taught using video modeling and reinforcement, and other teaching strategies were included in this list. Table 1 in the study lists the other studies and the effectiveness of different teaching methods used to improve medical and personal hygiene routines.  

 

 

 

9. Sensory Input

Definition:  The sensory input teaching method uses visual, tactile, auditory, taste, and scent to meet the sensory needs of the student to refocus mind and body to a task at hand.  Sensory input may be used before or during a lesson to increase attention and engagement or to re-engage a distracted student to support learning or to provide a sensory break to reduce behaviors or anxiety.   Sensory input may be most successful when individualized to meet the unique needs of each student.  

 

Example:  Sensory input may include lowering lights, playing soft, slow spa-like music, and diffusing a relaxing essential oil, like lavender, to help calm the overall feel of a group of students before they engage in a challenging or new lesson or conversation, such as sexual health and relationships.  

 

Research & Ideas:  A participant (Malcolm) in the study The Impact of an In-Class Sensory Activity Schedule on Task Performance of Children with Autism and Intellectual Disability: A Pilot Study was identified as having autism and a severe speech delay and saw success after engaging in a sensory activity for 10 minutes before attending to a classroom learning task (i.e. matching, gluing, and puzzles).  The study A Systematic Review of Sensory Processing Interventions for Children with Autism Spectrum Disorders is a fascinating review of Sensory Intervention (SIT), which is different from Sensory Based Intervention (SBI) because SIT is student-led and individualized and SBI is adult-led.  The study highlights the need to meet sensory needs when a need arises (perhaps less on a specific time schedule) and to let the individual needs identify the best sensory input experience to increase engagement and satisfaction. The positive effects of using a stability ball seating option were reviewed in the study The Effects of Stability Ball Seating on the Behavior of Children with Autism During Instructional Activities.  Brandon, a participant in the study, was identified as being nonverbal and saw a significant increase in attending and in-seat behavior.  

 

 

 

10. TEACHH Method

Definition: Treatment and Education of Autistic and related Communication Handicapped Children (TEACHH) includes the overall learning environment and student demands, including the classroom layout, visuals, schedules, and tasks.  

 

Example: Executing the TEACHH method includes setting up the classroom so students can work independently and use individualized visual schedules based on work systems (for example- task boxes) with detailed step-by-step expectations that teach or reinforce specific skills.  

 

Research & Ideas: The study Effects of TEACCH Structured Teaching on Independent Work Skills among Individuals with Severe Disabilities (which can be read for free simply by creating a JSTOR account) shows evidence that 2/3 of participants in their 20s who were minimally verbal increased their task engagement using this method for independent work skills.  While the entire An Evaluation of the TEACCH Approach for Teaching Functional Skills to Adults with Autism Spectrum Disorders and Intellectual Disabilities study isn't publically available, the snippets are positive!    

 

 

 

11. Visual Supports

Definition: Teaching using visual supports includes hand-drawn, graphic, and real pictures to communicate in place of or in support of text, verbal, or other non-verbal communication.  Visual communication may serve to prompt, remind, encourage, or offer an option.   Graphics include cartoon images and a picture exchange communication system (PECS).

 

Example:   Visual cues may be used in daily routines, such as handwashing or packing a community bag for the fitness center, or to inform a student of a schedule (I,e. picture schedule) or reinforcer, as in a first-then board.  Visual aids can also be used within other strategies, including social stories.  

 

Research & Ideas:  The benefits of using visuals are well documented across autism research.  The article Classroom Structuring Methods and Strategies for Children and Youth with Autism Spectrum Disorders generally highlights a variety of visual supports in the classroom and schedule.  The study Effects of Visual Activity Schedules on Independent Classroom Transitions for Students with Autism provides evidence that 2/3 of participants (aged 9-11 years old) who were minimally verbal increased independence with transitioning using a visual schedule.  A nonverbal participant (Brian) in the article The Social Validity of Social Stories™ for Supporting the Behavioural and Communicative Functioning of Children with Autism Spectrum Disorder used Social Stories, which include visuals, to begin communicating eating and drinking needs.  

 

 

 

 

 

Two Strategies Might be Better than One

The above list of methods for teaching nonverbal students with autism had strategies embedded within other strategies.  Prompting was embedded in modeling, sensory input was embedded in engagement, and visual supports go hand-in-hand with AAC.  Therefore, educators of nonverbal autistic children may use two or more methods at the same time to increase learning outcomes, as reviewed by the study The Strategy Chain Combining Strategies to Maximize Reading Comprehension Effectiveness for Students with Autism Spectrum Disorder.  

 

The article Evidence-Based Practice in Autism Educational Research highlights that although research may indicate that a particular method or approach 'works,' it does not take into account your student, your teaching schedule, and other factors that would make it successful.  Educators may need to trial a set of teaching techniques with a student to find the most effective one and their own classroom may be a safe place to try, learn, and grow as a professional.  

 

 

Where is Hand-Over-Hand (Most-to-Least Prompting) and Discrete Trial Training Methods?

There have been variations of Hand Over Hand, including Hand Under Hand methods, as an approach when teaching/modeling a physical gross or fine motor pattern.   The intent, duration, and intensity of the hand-over-hand method, as well as subsequent variations, for teaching a skill, are where it becomes an ethical issue.   The full physical prompts of hand over hand are believed to diminish or outright disregard one's autonomy over one's body, wants, needs, preferences, and desires.   Read more about this particular method, which is heavily associated with ABA-based interventions and therapy, and the ethics around it in the article How Much Compliance Is Too Much Compliance.  Check out these Ethical Standards and Guidance from the Autism Self Advocacy Network for ethical guidance.   

 

The instructional methods of discrete trial training or teaching (DTT) are common in ABA.  While the article Discrete Trial Training in the Treatment of Autism doesn't specifically include nonverbal students, it discusses the pros and cons of the method, including DDT being implemented with fidelity with proper teacher education, as well as the time commitment (which is significant when first starting, about 40 hours a week) and the effectiveness of the method across different age groups.

 

 

New Method: Virtual/Augmented Reality

Through my Googling to find research-based evidence to substantiate my experience, I came across a few journal articles highlighting VR (Virtual Reality) options for nonverbal autistic students.  While these articles were small in sample size and newer to this particular field of research, the results were promising.  You can read about the Experience Based Communication Training for Nonspeaking Autistic People and Interactive AR Applications for Nonspeaking Autistic People

 

 

Other Studies and A Note 

Autistic College Students

For nonverbal students who are in or pursuing college, The Significance of Involving Nonspeaking Autistic Peer Mentors in Educational Programs article shares about nonverbal autistic peer to nonverbal autistic peer mentoring at the college level.  Although the participants in this study were not nonverbal autistic students, the article Promising Instructional Practices for College Students with Autism provides insight into an older student population.  

 

Teaching Employment Skills

Given that I taught vocational skills in my time teaching special education transition, I found the article Systematic Review of Instructional Methods to Teach Employment Skills to Secondary Students With Intellectual and Developmental Disabilities insightful for instructional techniques and employment outcomes.  

 

Lack of Studies of Non-Elementary Age Individuals with Autism & Non-School-Based Settings

The journal pickings for free research on high school and transition-age students, which is where my experience is based, were slim or simply non-existent. The Relations Between Language, Non-Verbal Cognition, and Conceptualization in Non- or Minimally Verbal Individuals with ASD Across the Lifespan study confirms the lack of research for this age group.   This Positive Behavior Support: Supporting Adults with Autism Spectrum Disorders in the Workplace study mentions a lack of research on effective teaching methods in workplace settings, which includes both paid and volunteer positions.  

 

 

Now For Some Fun

After you wrap up that lesson using the best, most effective methods for teaching students with autism, check out my list of 100 fun and engaging activities for individuals with autism and other developmental disabilities to have fun in the classroom and community.   

 

 

Special Note: This blog post was written by an individual who does not identify as having autism spectrum disorder, nor did any of the researchers in the above-linked articles make special note of an autistic or neurodivergent identification.    

 

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