INTRODUCTION TO COMMUNICATION
ISSUES
By the age of three, typical children have passed
predictable language learning milestones; one of the earliest is
babbling. By the first birthday, a typical toddler says words, turns
when he or she hears his or her name, points when he or she wants
a toy, and when offered something distasteful, makes it clear that
the answer is “no.” It should be noted, however, that late language
development does occur in a minority of neurotypical children (children
with typical development of the brain).
What causes communication problems in autism or asperger's?
The causes of speech and language problems in
Autism Spectrum Disorders are still unknown, though experts believe
that the difficulties are caused by a variety of conditions that
occur either before, during, or after birth affecting brain development.
The individual's ability to interpret and interact with the world
is affected, and some scientists tie the communication problems
to a theory
of mind or impaired ability to think about thoughts or imagine
another individual's state of mind. Associated with this inability
to see another's point of view is an impaired ability to symbolize,
both when trying to communicate and in play.
In some cases, sensory
problems can mean children are so sensitive to touch that they
may find the feeling of their own tongue, teeth, lips touching each
other to be unpleasant so they may not move their mouths much, or
avoid talking completely. In more severe cases of autism, intellectual
disability can be a comorbid
disorder that affects the development of communication as well.
Variety of effects on communication across the spectrum
Speech development in people on the autism spectrum takes different paths than the majority of neurotypical
children. Common problems are lack of eye contact, poor attention,
being able to point objects to others, and difficulty with the 'give
and take' in normal conversation. Some children with autism will
remain mute throughout their lives with varying degrees of literacy;
communication in other ways – images, visual clues, sign language,
and typing may be far more natural to them. The effects of autism
or Asperger's on communication are extremely varied. They are both
increasingly referred to as being part of the autism spectrum due to the variability and degree of its effects.
Contrary to the prevailing traditional stereotype
of mute people with Kanner-type autism, around one third of people
diagnosed with this type of autism will develop what is often viewed
as dysfunctional verbal language, relying on rote learned stored
phrases, songs, jingles and advertisements. Those with the autism
spectrum condition of Semantic Pragmatic Disorder fall into this
group.
Those who do speak sometimes use language in unusual ways, retaining
features of earlier stages of language development for long periods
or throughout their lives. Some speak only single words, while others
repeat a mimicked phrase over and over. Some repeat what they hear,
a condition called echolalia.
Sing-song repetitions in particular are a calming, joyous activity
that many autistic adults engage in. Many people with autism have
a strong tonal sense, and can often understand at least some spoken
language whilst others can understand language fluently.
Some children, particularly those with Asperger's syndrome, may
exhibit only slight delays in language, or even seem to have precocious
language and unusually large vocabularies, but have great difficulty
in sustaining typical conversations. The “give and take” of non-autistic
conversation is hard for them, although they often carry on a monologue
on a favorite subject, giving no one else an opportunity to comment.
When given the chance to converse with other autistics, they comfortably
do so in “parallel monologue”—taking turns expressing views and
information. Just as people without autism have trouble understanding
autistic body languages, vocal tones, or phraseology, people with
autism similarly have trouble with such things in people without
autism. In particular, autistic language abilities tend to be highly
literal; people without autism often inappropriately attribute hidden
meaning to what people with autism say or expect the person with
autism to sense such unstated meaning in their own words.
Some people with high-functioning
autism demonstrate advanced cognitive ability, but lack the
skills or are not inclined to interact with others socially. An
example of the this is the noted autistic Temple
Grandin, who holds a PhD and is a successful developer of livestock
handling technologies. She describes her inability to understand
the social communication of people without autism as leaving her
feeling “like an anthropologist on Mars.” Temple’s case was described
by neurologist Oliver Sacks in his 1995 book titled “An Anthropologist
on Mars: Seven Paradoxical Tales.”
Some infants who later show signs of autism coo and babble during
the first few months of life, but stop soon afterwards. Others may
be delayed, developing language as late as the teenage years. Still,
inability to speak does not mean that people with autism are unintelligent
or unaware. Once given appropriate accommodations, some will happily
converse for hours, and can often be found in online chat rooms,
discussion boards or websites and even using communication devices
at autism-community social events such as Autreat.
Body language and autism
Sometimes, the body language of people with autism
can be difficult for other people to understand. Facial expressions,
movements, and gestures may be easily understood by some other people
with autism, but do not match those used by other people. Also,
their tone of voice has a much more subtle inflection in reflecting
their feelings, and the auditory system of a person without autism
often cannot sense the fluctuations. What seems to non-autistic
people like odd prosody; things like a high-pitched, sing-song,
or flat, robot-like voice may be common in autistic children and
some will have combinations of these prosody issues. Some autistic
children with relatively good language skills speak like little
adults, rather than communicating at their current age level, which
is one of the things that can lead to problems.
Since non-autistic people are often unfamiliar with the autistic
body language, and since autistic natural language may not tend
towards speech, autistic people often struggle to let other people
know what they need. As anybody might do in such a situation, they
may scream in frustration or resort to grabbing what they want.
While waiting for non-autistic people to learn to communicate with
them, people with autism do whatever they can to get through to
them. Communication difficulties may contribute to autistic people
becoming socially anxious or depressed or prone to self-injurious
behaviors. Recently, with the awareness that those with autism can
have more than one condition, a significant percentage of people
with autism are being diagnosed with co-morbid mood, anxiety and
compulsive disorders which may also contribute to behavioral and
functioning challenges.
Issues with reading the subtext of speech
Just as people without autism have trouble understanding
autistic body languages, vocal tones, or phraseology, people with
autism similarly have trouble with such things in people without
autism. In particular, autistic language abilities tend to be highly
literal; people without autism often inappropriately attribute hidden
meaning to what people with autism say or expect the person with
autism to sense such unstated meaning in their own words.
Some people with high-functioning autism demonstrate advanced cognitive
ability, but lack the skills or are not inclined to interact with
others socially. An example of the this is the noted autistic Temple
Grandin, who holds a PhD and is a successful developer of livestock
handling technologies. She describes her inability to understand
the social communication of people without autism as leaving her
feeling “like an anthropologist on Mars.” Temple’s case was described
by neurologist Oliver Sacks in his 1995 book titled “An Anthropologist
on Mars: Seven Paradoxical Tales.”
Some infants who later show signs of autism coo and babble during
the first few months of life, but stop soon afterwards. Others may
be delayed, developing language as late as the teenage years. Still,
inability to speak does not mean that people with autism are unintelligent
or unaware. Once given appropriate accommodations, some will happily
converse for hours, and can often be found in online chat rooms,
discussion boards or websites and even using communication devices
at autism-community social events.
Difficulties with non-verbal communication in autism
Sometimes, the body language of people with autism
can be difficult for other people to understand. Facial expressions,
movements, and gestures may be easily understood by some other people
with autism, but do not match those used by other people. Also,
their tone of voice has a much more subtle inflection in reflecting
their feelings, and the auditory system of a person without autism
often cannot sense the fluctuations.
What seems to non-autistic people like odd prosody;
things like a high-pitched, sing-song, or flat, robot-like voice
may be common in autistic children and some will have combinations
of these prosody issues. Some autistic children with relatively
good language skills speak like little adults, rather than communicating
at their current age level, which is one of the things that can
lead to problems.
Expressing needs appropriately
Since non-autistic people are often unfamiliar
with the autistic body language, and since autistic natural language
may not tend towards speech, autistic people often struggle to let
other people know what they need. As anybody might do in such a
situation, they may scream in frustration or resort to grabbing
what they want. While waiting for non-autistic people to learn to
communicate with them, people with autism do whatever they can to
get through to them.
Communication difficulties may contribute to autistic
people becoming socially anxious or depressed or prone to self-injurious
behaviors. Recently, with the awareness that those with autism can
have more than one condition, a significant percentage of people
with autism are being diagnosed with co-morbid mood, anxiety and
compulsive disorders which may also contribute to behavioral and
functioning challenges.
Intervention for communication Problems
No one treatment method has been found to successfully
improve communication in all individuals who have autism. The best
treatment usually entails the following:
• Intervention begins early, ideally during the
preschool years
• Intervention is individually tailored to meet
the child's needs
• It targets both behavior and communication
• Both parents or primary caregivers are involved.
The goal of therapy should be to improve useful
communication. For some, verbal communication is a realistic goal.
For others, the goal may be gestured communication. Still others
may have the goal of communicating by means of a symbol system such
as picture boards. Treatment should include periodic in-depth evaluations
provided by an individual with special training in the evaluation
and treatment of speech and language disorders, such as a speech-language
pathologist. Occupational and physical therapists may also work
with the individual to reduce unwanted behaviors that may interfere
with the development of communication skills.
Some children respond well to highly structured
behavior modification programs such as Applied
Behavior Analysis; others respond better to in-home therapy
that uses real situations as the basis for training. Other approaches
such as music therapy and sensory
integration therapy, which strives to improve the child's ability
to respond to information from the senses, appear to have helped
some autistic children, although research on the success of these
approaches is largely lacking.
Medications
may improve an individual's attention span or reduce unwanted behaviors
such as hand-flapping, but long-term use of these kinds of medications
is often difficult or undesirable because of their side effects.
No medications have been found to specifically help communication
in autistic individuals. Mineral and vitamin supplements, special
diets, and psychotherapy have also been used, but research has not
documented their effectiveness.
Click here for the full
range of autism and Asperger's fact sheets at www.autism-help.org
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