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Tuesday 21 Nov 2017

Autism and Communication

On the National Institute on Deafness and other Communication Disorders’ (NIDCD) website, they have a great summary of how autism affects communication. Below you will be able to read that information (in italics) along with my recommendations for treatment strategies which use applied behavior analysis (ABA) techniques.

How does autism affect communication?

The word “autism” has its origin in the Greek word “autos,” which means “self.” Children with autism often are self-absorbed and seem to exist in a private world where they are unable to successfully communicate and interact with others. Children with autism may have difficulty developing language skills and understanding what others say to them. They also may have difficulty communicating nonverbally, such as through hand gestures, eye contact, and facial expressions.

Not every child with an autism spectrum disorder will have a language problem. A child’s ability to communicate will vary, depending upon his or her intellectual and social development. Some children with autism may be unable to speak. Others may have rich vocabularies and be able to talk about specific subjects in great detail. Most children with autism have little or no problem pronouncing words. The majority, however, have difficulty using language effectively, especially when they talk to other people. Many have problems with the meaning and rhythm of words and sentences. They also may be unable to understand body language and the nuances of vocal tones.

The following are some specific language difficulties seen in different individuals with autism and possible treatment options. Remember, it is advised to consult a behavior analyst or a speech-language pathologist prior to implementing any interventions.

Repetitive or rigid language

Often, children with autism who can speak will say things that have no meaning or that seem out of context in conversations with others. For example, a child may count from one to five repeatedly. Or a child may continuously repeat words he or she has heard, a condition called echolalia. Immediate echolalia occurs when the child repeats words someone has just said. For example, the child may respond to a question by asking the same question. In delayed echolalia, the child will repeat words heard at an earlier time. The child may say “Do you want something to drink?” whenever he or she asks for a drink.

Some children with autism speak in a high-pitched or singsong voice or use robot-like speech. Other children with autism may use stock phrases to start a conversation. For example, a child may say “My name is Tom,” even when he talks with friends or family. Still others may repeat what they hear on television programs or commercials.

Individuals with autism who engage in echolalia can be taught to use more their language in a more functional and less repetitive manner by modeling and requiring them to imitate the language appropriate to the situation. For example, if a child was initiating for a drink by saying “Do you want milk?” rather than accepting that initiation we would model the more appropriate language “I’d like some milk” have the child imitate the phrase and then reinforce them by giving them the milk. In any situation in which the individual is attempting to initiate using language which is echolalic, repetitive or in inappropriate voice we intervene by applying the A-B-C’s. The antecedent (A) in this case is the prompt we are providing (exact model of what should be said), the (B) is the target behavior which in this case is the appropriate non-echolalic phrase, and the (C) is the natural reinforcement (i.e. the activity or item the individual wants).

Narrow interests and exceptional abilities

Some children may be able to deliver an in-depth monologue about a topic that holds their interest, even though they may not be able to carry on a two-way conversation about the same topic. Others have musical talents or an advanced ability to count and do math calculations. Approximately 10 percent of children with autism show “savant” skills, or extremely high abilities in specific areas, such as calendar calculation, music, or math.

If your child or student has a specific interest which dominates their conversation, then you may need to implement a conversation intervention which would target the individuals ability to engage in conversations on a variety of topics and utilize conversation conventions to initiate, maintain and end social conversations appropriately. Engaging in reciprocal conversations is a complex skill which may need to be broken down into it’s component parts to teach. The ability to engage in flexible, reciprocal conversations and utilize conversation conventions is important for an individual’s ability to succeed in life. No matter how intelligent a person is, if they are unable to engage in appropriate social conversations they will continue to have difficulty in life.

Uneven language development

Many children with autism develop some speech and language skills, but not to a normal level of ability, and their progress is usually uneven. For example, they may develop a strong vocabulary in a particular area of interest very quickly. Many children have good memories for information just heard or seen. Some children may be able to read words before 5 years of age, but they may not comprehend what they have read. They often do not respond to the speech of others and may not respond to their own names. As a result, children with autism sometimes are mistakenly thought to have a hearing problem.

It is important to assess each individual’s language development to identify specific areas in which they have the most difficulty. Once you identify the areas in which the individual needs intervention, you can develop specific goals and intervention programs.

Poor nonverbal conversation skills

Children with autism often are unable to use gestures—such as pointing to an object—to give meaning to their speech. They often avoid eye contact, which can make them seem rude, uninterested, or inattentive. Without meaningful gestures or the language to communicate, many children with autism become frustrated in their attempts to make their feelings and needs known. They may act out their frustrations through vocal outbursts or other inappropriate behaviors.

Many times an individual’s ability to use and understand non-verbal conversational skills is limited. Specific intervention procedures will need to be implemented to specifically target their areas of difficulty.

If you have specific questions about your child or student and would like information on what types of interventions may be effective, please submit them below.

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