Significant Impairment in Verbal and Non-verbal
Communication
Individuals with autism commonly experience severe difficulties in using and understanding both verbal and non-verbal language. In this respect they are behaviorally different from their peers rather than developmentally delayed, although a delay in their development is also usual. Their basic deficit seems to be in their capacity to use language for social communication, which is evidenced in the following ways:
Receptive Communication
Young children with autism do not respond to conversational language in the same way as other children. They may echo the words of others, squeal, or show no interest in conversation. As well, it is likely that their inability to understand and use language, gestures, and facial expressions leads them to focus on the intensity of the communication (e.g., the loudness of the voice, the urgency of the gestures) rather than on its meaning. A child may incorrectly react to being scolded by laughing and jumping, for example, because the scolding is exciting and focuses attention on him or her.
Students with autism often fail to understand the meaning of words or phrases that are abstract or that have more than one meaning. They also tend to take words and expressions literally. Thus, they may misunderstand common expressions such as "Step on it".
Because they are unaware of the subtle non-verbal cues of communication, some of these children are unable to co-ordinate their own speech with non-verbal forms of expression and to interpret the non-verbal cues used by others. Similarly, they often have trouble understanding language that relies on such imaginary activities as those used in pretend and make-believe games. Because they do not appreciate the benefits of language use, they may not even pay sufficient attention to the speaker.
The ability of these individuals to understand and respond to language usually improves with appropriate education or treatment. Their ability to learn and interpret language is also often related to their degree of intellectual development.
Expressive Communication
About half of all students with autism do not acquire verbal language. These students may express their frustration at being misunderstood through excited behaviour, screaming, crying, tantrums, or acts of aggression or self-abuse. However, these children may be taught alternative or augmentative forms of communication such as the use of meaningful sounds, gestures, signs, or pictorial systems.
One prerequisite skill for learning gesture and sign-language systems is the ability to imitate motor patterns. The absence of this basic skill may make it necessary for many students with autism to learn simpler communicative approaches, such as pointing to pictures and objects to express their needs and interests. Some students who are not able to communicate verbally may master the use of these systems fairly readily, while others may require extensive training before they are able to use them.
The prognosis for skill development is best for those children who develop spoken language before the age of five. Even they, however, will experience difficulties in using verbal language in social situations. For example, they may use language in socially inappropriate ways, such as saying out loud the one- or two-word utterances they have learned, without intending to communicate with another person.
Often these students do not understand why people talk to one another or what they talk about. Their problems with the give and take of speaker-listener relationships may be aggravated by a general difficulty in maintaining a social rapport when speaking. When listening they seldom reinforce the speaker through smiles, head nodding, or other signs of approval, and when speaking they experience difficulty in shaping their own speech in response to the cues of approval, amazement, disbelief, or boredom that they are receiving from their listeners. While other children with communication problems frequently use body language to communicate, children with autism often do not.
Students who have been taught complex grammatical skills may have problems in conversation. They may exhibit stilted speech. They may confuse their listeners by the misuse of pronouns; for example, a student might say "He wants to go to the park" instead of "I want to go to the park." They might also have problems with the content of a conversation because they go on and on about topics that have no interest for the listener. When interrupted, they almost invariably reinitiate the topic, even when there is supposed to be turn taking. Such extremely repetitive talk leaves no room for questions or exchanges of opinion.
Individuals with autism often have difficulties with the production of speech, including volume, pitch, stress, rate, rhythm, and intonation (e.g., a monotonous tone, questioning intonation, or high pitch).
Such problems may reflect a lack of understanding about what is socially acceptable rather than defective speech production. As well, poor vocal quality may reflect the speaker's failure to monitor his or her speech characteristics on the basis of feedback supplied by the listener.
These individuals often exhibit echolalia, the repetition of the words, signs, phrases, or sentences spoken or used by other people. Echolalia seems to be a stage in the normal development of expressive language, in that it is a part of a progression from a non-verbal state through echoic verbalization to spontaneous, creative, non-echoed utterances. It also has communicative value and may serve as functional communication. For example, in response to the question "DO you want a cookie?" individuals with autism might echo "Want a cookie?" to mean yes. Or they might repeat over and over what they have been told or have heard in the past (e.g., "Sit down and work") as a means of regulating their own behaviour. When they begin to change some of what they have heard by adding a word or two or by changing the intonation (this is called "mitigated echolalia"), they are demonstrating progress, since they are beginning to use language creatively. For this reason their use of language in this way should be encouraged.
Unique Patterns of Behaviour
Children with autism display a variety of behaviors that are either unique to them or different from those of their peers. Often these differences are clearly identified when a child enters the school system. Since these behaviors may severely restrict the child's ability to adjust to school and to benefit from instruction, it is important that educators be able to identify and understand them.
This section examines five of these behaviors.
Individuals with autism commonly experience severe difficulties in using and understanding both verbal and non-verbal language. In this respect they are behaviorally different from their peers rather than developmentally delayed, although a delay in their development is also usual. Their basic deficit seems to be in their capacity to use language for social communication, which is evidenced in the following ways:
- a delay in, or a total lack of, the development of spoken language, which is not compensated for by the use of gesture or mime as alternative modes of communication
- a failure to respond to the communications of others, such as not responding when called by name
- a related failure to initiate or sustain conversational interchange, such as in turn taking
- a stereotypical and repetitive use of language
- pronoun confusion
- an idiosyncratic use of words and phrases
- abnormalities in the pitch, stress, rate, rhythm, and intonation of speech
Receptive Communication
Young children with autism do not respond to conversational language in the same way as other children. They may echo the words of others, squeal, or show no interest in conversation. As well, it is likely that their inability to understand and use language, gestures, and facial expressions leads them to focus on the intensity of the communication (e.g., the loudness of the voice, the urgency of the gestures) rather than on its meaning. A child may incorrectly react to being scolded by laughing and jumping, for example, because the scolding is exciting and focuses attention on him or her.
Students with autism often fail to understand the meaning of words or phrases that are abstract or that have more than one meaning. They also tend to take words and expressions literally. Thus, they may misunderstand common expressions such as "Step on it".
Because they are unaware of the subtle non-verbal cues of communication, some of these children are unable to co-ordinate their own speech with non-verbal forms of expression and to interpret the non-verbal cues used by others. Similarly, they often have trouble understanding language that relies on such imaginary activities as those used in pretend and make-believe games. Because they do not appreciate the benefits of language use, they may not even pay sufficient attention to the speaker.
The ability of these individuals to understand and respond to language usually improves with appropriate education or treatment. Their ability to learn and interpret language is also often related to their degree of intellectual development.
Expressive Communication
About half of all students with autism do not acquire verbal language. These students may express their frustration at being misunderstood through excited behaviour, screaming, crying, tantrums, or acts of aggression or self-abuse. However, these children may be taught alternative or augmentative forms of communication such as the use of meaningful sounds, gestures, signs, or pictorial systems.
One prerequisite skill for learning gesture and sign-language systems is the ability to imitate motor patterns. The absence of this basic skill may make it necessary for many students with autism to learn simpler communicative approaches, such as pointing to pictures and objects to express their needs and interests. Some students who are not able to communicate verbally may master the use of these systems fairly readily, while others may require extensive training before they are able to use them.
The prognosis for skill development is best for those children who develop spoken language before the age of five. Even they, however, will experience difficulties in using verbal language in social situations. For example, they may use language in socially inappropriate ways, such as saying out loud the one- or two-word utterances they have learned, without intending to communicate with another person.
Often these students do not understand why people talk to one another or what they talk about. Their problems with the give and take of speaker-listener relationships may be aggravated by a general difficulty in maintaining a social rapport when speaking. When listening they seldom reinforce the speaker through smiles, head nodding, or other signs of approval, and when speaking they experience difficulty in shaping their own speech in response to the cues of approval, amazement, disbelief, or boredom that they are receiving from their listeners. While other children with communication problems frequently use body language to communicate, children with autism often do not.
Students who have been taught complex grammatical skills may have problems in conversation. They may exhibit stilted speech. They may confuse their listeners by the misuse of pronouns; for example, a student might say "He wants to go to the park" instead of "I want to go to the park." They might also have problems with the content of a conversation because they go on and on about topics that have no interest for the listener. When interrupted, they almost invariably reinitiate the topic, even when there is supposed to be turn taking. Such extremely repetitive talk leaves no room for questions or exchanges of opinion.
Individuals with autism often have difficulties with the production of speech, including volume, pitch, stress, rate, rhythm, and intonation (e.g., a monotonous tone, questioning intonation, or high pitch).
Such problems may reflect a lack of understanding about what is socially acceptable rather than defective speech production. As well, poor vocal quality may reflect the speaker's failure to monitor his or her speech characteristics on the basis of feedback supplied by the listener.
These individuals often exhibit echolalia, the repetition of the words, signs, phrases, or sentences spoken or used by other people. Echolalia seems to be a stage in the normal development of expressive language, in that it is a part of a progression from a non-verbal state through echoic verbalization to spontaneous, creative, non-echoed utterances. It also has communicative value and may serve as functional communication. For example, in response to the question "DO you want a cookie?" individuals with autism might echo "Want a cookie?" to mean yes. Or they might repeat over and over what they have been told or have heard in the past (e.g., "Sit down and work") as a means of regulating their own behaviour. When they begin to change some of what they have heard by adding a word or two or by changing the intonation (this is called "mitigated echolalia"), they are demonstrating progress, since they are beginning to use language creatively. For this reason their use of language in this way should be encouraged.
Unique Patterns of Behaviour
Children with autism display a variety of behaviors that are either unique to them or different from those of their peers. Often these differences are clearly identified when a child enters the school system. Since these behaviors may severely restrict the child's ability to adjust to school and to benefit from instruction, it is important that educators be able to identify and understand them.
This section examines five of these behaviors.
- Stereotyped body movements. Many of these children display unusual, repetitive movements of the body that can interfere with their ability to attend to tasks or activities. Such movements include hand flapping, finger flicking, rocking, hand clapping, grimacing, and posturing. These movements appear to be powerfully and intrinsically reinforcing. Restricting them may be extremely difficult, and attempting to do so without providing alternatives can lead to the development of other inappropriate behaviors.
- Persistent preoccupation with parts of objects or
attachments to unusual objects. Children with autism develop
preoccupations with particular objects (e.g., wheels, light switches, string,
screws), sounds, colours, or textures that go well beyond the stage of a simple
interest. Often, their involvement with these objects is more reinforcing than
any activity or object that a teacher can offer.
For example, a child might be preoccupied with tipping a toy
car upside down and spinning its wheels and might totally ignore a teacher's
suggestion that the toy be rolled along the floor in the usual way.
- Marked distress over changes in seemingly trivial
aspects of the environment. These children often resist or have extreme
reactions to changes in their environment that other students would not even
notice. For example, a child might have a tantrum if one book were moved on the
bookshelf or if his or her books were moved from one side of the desk to the
other.
- Unreasonable insistence on following routines in precise detail. Although all children require a level of predictability in their environment, children with autism may be compulsive about the repetition of certain patterns or routines. For example, a child's sudden disruptive behaviour on the school bus could be the result simply of a change in the bus driver or the route. As a result of such behaviour these children often learn tasks exactly as they are taught.
- Markedly restricted range of interests and a preoccupation with one narrow interest. Most people with autism have a narrow range of interests and neither the inclination nor the ability to expand that range. For example, a child may have a preoccupation with baseball scores and trivia but no wish to play baseball. Often the few interests and preoccupations that these individuals do have dominate their social interaction with others.
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