Case Study: Ben
Ben uses a voice output computer as his AAC system. While he uses the system to effectively communicate his wants and needs, he also uses the computer to repetitively touch his favorite phrase that is build into the system, "How are you today?" It seems he likes the sound of this phrase and listens to it (in a noncommunicative way) hundreds of times a day. So while a voice output system may or may not be the best choice of an AAC system for Ben, consideration needs to be given to his ritualized use of the system. His ritualized use of the AAC system interferes with his social acceptability. He also needs to be taught an alternative skill to replace this ritual in order to limit his noncommunicative use.
Select an AAC system that increases the child's communicative competence!
AAC Usage Examples
There are four examples of AAC usage on this page. The third clip shows a person with autism utilizing a letter board for spelling. The other clips are individuals with a variety of disabilities, but are used here to show an assortment of device usage.
Comparison to Typically Developing Individuals
Important language development milestones to consider:
Age
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Receptive Language
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Expressive Language
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12 months
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Understands some words
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Uses babbling, jargon and word approximations
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24 months
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Understands simple sentences in routine contexts
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Uses over 100 words and some phrases
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2-3 years
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Understands simple conversations in natural contexts
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Uses simple sentences
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4-5 years
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Understands complex sentences in routine and natural contexts
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Masters syntax/grammar and uses complex sentences
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6+ years
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Understands abstract concepts and continues to build vocabulary
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Continues to build vocabulary
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When you remember these fundamental, yet critical language characteristics that are common in individuals with autism, it will enhance your ability to understand the person's perspective and become more successful in your efforts to interact and teach individuals with autism.
Important language features in autism to consider:
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Developmentally Different
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Receptive language
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Context-specific comprehension
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Poor comprehension of abstract social concepts
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Literal
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Expressive language
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AAC rituals
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Echolalia
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Verbal rituals
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Some final points about language to consider:
1. The individual with autism may understand you in routine contexts but not novel situations.
2. The individual with autism is more likely to understand concrete, not abstract information
3. The individual with autism often uses echolalia as a means to learn language and interact with others.
4. The individual with autism exhibits ritualistic language use for a variety of reasons, one of which is anxiety.
Do not assume language comprehension because an individual is verbal. Remember the important distinction between expressive language and communication.
Frequently Asked Questions
Question: What is language?
Answer: Language is a formal symbol system that has structural qualities, including morphology, semantics, and syntax.
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Morphology - rules for how words are structured in a sentence (for example, word endings to mark plural (book/books)
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Semantics - rules for how meaning is created by words and sentences (that is, word and sentence meaning)
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Syntax - rules for the ordering of words in a sentence (that is, sentence grammar)
Language can be (a) oral/speech, (b) sign language, or (c) written language. An individual learns the rules of a particular language to understand the meaning of another person's needs, feelings, and ideas. The development of this knowledge is referred to as receptive language. An individual learns to use the rules of his or her particular language to express wants, needs, feelings, and ideas. The development of these skills is referred to as expressive language.
Question: What is speech?
Answer: Speech is one form of expressing language. It is the ability to use all the speech sounds in a particular language. The development of speech is an oral-motor skill that follows a particular motor sequence. Most children learn to use all the speech sounds of their particular language by age 5.
Question: What is communication?
Answer: Communication is an interactive exchange between two or more people to express needs, feelings, and ideas. It is a fundamental social skill. An effective communicator has an inherent motivation to interact with others, something to express, and a means of communication. An effective communicator is constantly thinking about the multiple contextual, language, social and emotional aspects of the situation and making ongoing adjustments in response to the behavior of others. Communication can be expressed verbally (by means of spoken, signed, or written language) or nonverbally (by using pictures, gestures, emotion, and other behaviors). The social conventions of communication are learned and refined throughout development.
Question: What are the unique communication characteristics of individuals with autism?
Answer:
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Difficulty understanding nonverbal communication
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Difficulty with reciprocal interaction
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Difficulty understanding how to point out things of interest
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Limited range of communicative functions
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Impaired ability to initiate and maintain conversation
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Ritualized communication
Question: What are the unique language characteristics of individuals with autism?
Answer:
Receptive:
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Context-specific comprehension
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Poor comprehension of abstract social concepts
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Literal interpretation of what others say
Expressive:
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AAC rituals
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Echolalia
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Verbal rituals
Citation and References
Citation
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If included in presentations or publications, credit should be given to the authors of this module. Please use the citation below to reference this content.
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Quill, K. (2011). Language and Communication (Columbus, OH: OCALI). In Ohio Center for Autism and Low Incidence (OCALI), Autism Internet Modules, www.autisminternetmodules.org. Columbus, OH: OCALI.
References
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American Psychiatric Association. (1994). Diagnostic and statistical manual for mental disorders (4th ed.). Washington, DC: Author.
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American Psychiatric Association. (2000). Diagnostic and statistical manual for mental disorders (4th ed., text revision). Washington, DC: Author.
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Baron-Cohen, S. (1995). Mindblindness. Cambridge, MA: The MIT Press.
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Greenspan, S. (1995). The challenging child: Understanding, raising and enjoying the five difficult types of children. Reading, MA: Addison Wesley Longman.
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Hanschu, B. (1998). Evaluation and treatment of sensory processing disorders. Paper presented to the Sensory Integration Consortium, Boston.
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Prizant, B.M. (1996). Brief report: Communication, language, social and emotional development. Journal of Autism and Developmental Disorders, 26, 173-178.
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Prizant, B. M., Schuler, A., Wetherby, A.M. & Rydell, P. (1997). Enhancing language and communication development: Language approaches. In Cohen, D.J. & Volkmar , F.R.(eds.) Handbook of autism and pervasive developmental disorders,(2nd ed.).. New York, NY: John Wiley and Sons, Inc.
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Quill, K. (2000). DO-WATCH-LISTEN-SAY: Social and communication intervention for children with autism. Baltimore: Brookes.
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Tager-Flusberg, H., & Anderson, M. (1991). The development of discourse in autistic children. Journal of Child Psychology and Psychiatry, 32, 1123-1134.
Resources
Books on the Characteristics of Autism Spectrum Disorders:
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Attwood, T (1998). Asperger's Syndrome: A guide for parents and professionals. London: Jessica Kingsley.
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Brosen, S. K. (2006). Do you understand me? My life, my thoughts, my autism spectrum disorder. London, UK: Jessica Kingsley Publishers.
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Bruey, C. T. (2004). Demystifying autism spectrum disorders: A guide to diagnosis for parents and professionals - Topics in autism. Bethesda, MD: Woodbine House.
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Cohen, D. J. & Volkmar, F. R (Eds.). (1997). Handbook of Autism and pervasive developmental disorders (2nd ed.). New York: John Wiley & Sons.
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Grandin, T. (2006). Thinking in pictures, expanded edition: My life with autism. New York: Doubleday.
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Janzen, J. (1996). Understanding the nature of autism: A practical guide. San Antonio, TX: Therapy Skill Builders.
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Powers, M., & Poland, J. (2003). Asperger syndrome & your child: A parent's guide, Unlocking your child's potential. New York: Harper Resource.
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Powers, M. D. (2000). Children with autism: A parents' guide. Rockville, MD: Woodbine House.
Books on Language and Communication Issues in Individuals with ASD :
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Beukelman, D. R., & Mirenda, P (2005). Augentative and alternative communication: Supporting children and adults with complex communication needs (3rd ed.). Baltimore: Paul H. Brookes.
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Freeman S., & Dake, L. (1998). Teach me language: A language manual for children with autism, asperger syndrome, and related developmental disorders. Langley, BC: SKF Books.
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Frost, L., & Bondy, A. (1994). PECS: The Picture Exchange Communication system. Cherry Hill, NJ: Pyramid Educational Consultants.
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Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social and academic development. Baltimore: Paul H. Brookes.
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Prizant, B., Wetherby, A., Rubin, E., Laurent, A., & Rydell, P. (2006). The SCERTS Model: A comprehensive educational approach for children with autism spectrum disorders. Baltimore: Brookes.
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Quill, K. (Ed.) (1995). Teaching children with autism: Strategies to enhance communication and socialization. Albany, NY: Delmar.
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Sussman, F. (1999). More than words: Helping parents promote communication and social skills in children with autism spectrum disorder. Toronto, Canada: Hanen Centre Publication.
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Schopler, E., & Mesibov, G. (Eds.). (1985). Communication problems in autism. New York: Plenum.
Books on Typical Language and Communication Development:
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Bates, E. (1976). Language in context: The acquisition of pragmatics. San Diego: Academic Press.
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Hart, B., & Risley, T. R. (1999). The social world of children learning to talk. Baltimore: Paul H. Brookes.
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Owens, R. (2000). Language development. Columbus, OH: Charles Merrill.
Post-Assessment
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Top of Form
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Post-Assessment
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Individuals with autism always have significant language impairments.
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Select an answer for question 658
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Individuals with autism always have speech problems.
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Select an answer for question 659
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Individuals with autism always have communication problems.
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Select an answer for question 660
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Echolalia is a term used to describe when an individual repeats something that he hears, either immediately or at a later time.
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Select an answer for question 661
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Echolalia should be discouraged and stopped.
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Select an answer for question 662
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Nonspeaking individuals with autism benefit from learning sign language or another augmentative communication system.
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Select an answer for question 663
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Once an individual with autism learns to talk, he is a good communicator.
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Select an answer for question 664
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Individuals with autism have difficulty communicating in a flexible way.
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Select an answer for question 665
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Communication is a _________.
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Select an answer for question 666
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Speech, language and communication are all synonymous.
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Select an answer for question 667
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