Nicolas, age 8, enjoys tickling games and swinging on the swing. He will use eye gaze, move another person's hands to his belly, point to the swing, tell an adult "tickle me again" or "push me higher" to continue an activity that he finds enjoyable. He uses communication to request what he wants. However, Nicolas never uses eye gaze, pointing, or words to talk about what he and others are doing or feeling. He does not point to things of interest to him while playing or swinging, or says something like "look at this," "thanks, Dad," or "this is fun."
The following video clip shows a boy at a birthday party who definitely wants some food or cake, but is not directing his cues to anyone. He is having difficulty bringing items to a person to communicate his wants or showing his gestures to someone so they could help him meet his needs.
Limited Range of Communicative Functions
Communicative function is a key term used in any discussion about communication in autism. Communicative function refers to the many purposes or reasons to communicate a single message. Common communicative functions can be divided into several categories:
Requesting to satisfy personal needs - such as asking for a preferred object
Responding to others - such as answering a simple question
Requesting information - such as asking who, what, where, why questions to obtain NEW information
Expressing feelings - such as saying "I feel sick"
Use prosocial statements - such as saying "thank you" or giving a compliment
At all stages of language development, individuals with autism have a limited repertoire of reasons to communicate. At both the nonverbal stage (use of gestures, facial expression) and verbal stage (use of language), they are more likely to communicate for the purposes of having their needs met and less likely to communicate for social pleasure. Therefore, communicative functions are more commonly used to:
It is more common to hear "I want _______," "I don't want _______" (an object, an activity, or a topic of conversation) rather than "we have ________," "you can ________," "do you want ________?" (an object, an activity, a feeling, a shared experience). Communication that results in a concrete personal outcome is more likely than communication that results in a shared social experience.
Case Study: Carlos
Carlos, age 15, is verbal and able to speak in full sentences. In school, he is able to tell others what he wants, including asking for food, objects, toys, school materials, and help with his school work. He tries to interact with his peers but asks the same question every time. For example, he approaches a peer with the question "where do you live?" even when he knows the answer. He gets excited when the peer answers and frustrated when the peer ignores him. He uses communication to satisfy his need and get a clear and immediate result.
Impaired Ability to Initiate and Maintain a Conversation
Conversation skills involve all the features of communication discussed thus far, and much more. Conversation requires:
Listening to another person's spoken message
Paying attention to another person's nonverbal message (such as facial expression and emotion conveyed in the words)
Given that individuals with autism have difficulty with each of the separate features required for an effective conversation, the skill of pulling all the pieces together at the same time to have a reciprocal conversation with another person is extremely difficult for even the most able person with autism. Conversational turn-taking can be learned via "scripts" written for a communication device, but the partner's topics must stay within the confines of the script. While not a true, open-ended conversation, these can be a means to introduce the individual with ASD to the back and forth flow of real conversations. Consider how this man with Asperger Syndrome describes what it is like to try to carry on a conversation.
Researchers have compared the development of conversational skills in children with autism to control groups of typically developing children and individuals with other disabilities. As language abilities increased in control groups, there was a parallel increase in conversational skills. That is, children added new information, introduced new topics and used effective nonverbal communication skills. In contrast, as language skills increased in children with autism, improvements in conversational skills did not occur. (Tager-Flusberg & Anderson, 1991). Regardless of the level of language ability, conversation skills were significantly impaired because of their limited ability to understand and use nonverbal communication such as eye gaze, facial expression and gestures, understand social perspectives, talk out things of interest, and communicate for a variety of social reasons.