Edward is 5 years old and speaks in full sentences. He talks about what he wants and what he doesn't want. He asks peers to play but struggles to have a conversation with them. He is very motivated to talk about his movie interest with peers, but is unable to "read" their lack of interest in his topics. He repeatedly asks them questions about specific scenes of different movies and does not understand their frustration with his constant questions. Edward knows the answer to his questions, but asks because one of the only aspects of conversation that he understands is "take turns asking or answering a question." He understands that conversation requires partners to take turns, but lacks all the other features of conversation, especially perspective taking, needed to engage in a reciprocal, mutually enjoyable conversation.
Ritualized Communicative Behaviors
Using a ritualized style of interacting with others is how individuals with autism compensate for their social and communication impairments. These ritualized communicative behaviors include, but are not limited to:
The nonspeaking child:
Making communicative vocalizations
Using the same behavior to get someone's attention
The child with emerging spoken language:
Repeating the last word that someone has just said (one form of immediate echolalia **)
Saying the same word repeatedly (one form of delayed echolalia **)
The child with spoken language
Repeating the phrase of sentence that someone has just said (one form of immediate echolalia **)
Saying the same phrase or sentence repeatedly (one form of delayed echolalia **)
Asking the same questions repeatedly (spoken or on a communication device)
Talking about the same topic repeatedly
Listen as this three year old boy uses jargon with rhythm and changes in tone to attempt communication.
All of these examples can be the child's attempt to communicate and interact. In addition, these examples can be used for nonsocial reasons; that is, the individual may repeat things to himself without any intent to interact with others.
** Echolalia is the most common form of communication rituals observed in autism. The two basic forms of echolalia, immediate and delayed echolalia, are discussed in more detail in the section on language characteristics in autism.
Repetitive, ritualized behaviors are a dominant characteristic of all individuals with autism. Communication rituals can occur for a variety of reasons, including:
1. Communication rituals are social and the individual's best effort to interact with others.
2. Communication rituals are nonsocial and are used by the individual to express anxiety.
3. Communication rituals are nonsocial and are used by the individual to calm himself.
4. Communication rituals are nonsocial and are an expression of poor inhibition in the individual.
Case Study: Kim
Kim was a fifth-grade student whose communication intentions were often difficult for others to understand. She spoke in full sentences, but the purpose of many of her messages appeared unrelated to what was happening around her. Kim's favorite activity was watching movies. She often made unusual associations between people that she met and characters from a movie. For example, the first time she met her teacher, she repeatedly said "there's no place like home," a phrase from the movie Wizard of Oz. Kim's mother noticed that the teacher often wore a red pair of shoes, and this seemed to remind Kim of Dorothy's ruby slippers in the movie. During the entire school year, Kim would approach her teacher saying "there's no place like home" each time her teacher wore the red shoes to work. This message, an example of delayed echolalia, was Kim's unusual way of initiating communication with her teacher. Her words actually meant "Hi, you are wearing the red shoes today just like Dorothy in the Wizard of Oz who says 'there's no place like home' when she wants to go home. Do you want to go home now?" Kim's short message, once understood by the teacher, had a different meaning and the teacher could acknowledge and respond to her differently.
You travel to a remote island in the middle of the pacific. You encounter people who speak a foreign language and have social conventions that you do not understand. What would you do during your visit?
1. Would you isolate yourself from the people because you are overwhelmed, anxious and confused?
3. Would you try to use your language and social communication skills to interact with them even though they might not understand you?
4. Would you use the one or two communication patterns that you see most often in the people to interact with them?
5. Would you focus your attention on how to have your personal needs met (food, drinks, shelter, preferred activities)?
Individuals with autism have sometimes been referred to as "anthropologists on Earth"; individuals whose neurological make-up is such that they struggle to learn the social and communication conventions that most of us take for granted. They perceive our communication and social skills as foreign and difficult to understand. Each individual with autism uses a somewhat different compensatory strategy - some isolate themselves, some are passive observers, some pick up patterns that they hear frequently in the environment to communicate with others (especially words heard most often spoken by adults, and TV, radio, movies), some learn a few fundamental social rules and use them continuously, and most learn the best means to have their personal needs met.
The atypical communication patterns observed in individuals with autism are their best effort to get their needs met and to interact with others.
Comparison to Typically Developing Individuals
Important communication development milestones to consider:
When you remember these fundamental, yet critical communication characteristics that define 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 communication features in autism to consider:
Individuals with autism want to interact, but don't understand how
Communication is generally used for a specific outcome and is used less for social pleasure
Communication interactions look very different from typical interactions
Communication rituals are the individual's means of compensating for social confusion
Individuals with autism struggle to understand: reciprocity, nonverbal signals, how to share experiences, and other's perspectives
Some final points about communication to consider:
1. The individual with autism may understand what you say but not what you mean.
2. The individual with autism uses ritualistic interactions when he does not know what else to do or say.
3. The individual with autism often uses challenging behaviors to express his social and communication frustrations.
You are the competent communicator. Adjust your interaction style to the level of the person with autism.
Language Development in Individuals with Autism
Language develops as a result of learning (a) vocabulary concepts, (b) sentence grammar, and (c) how to link words and sentences what is happening in a meaningful way. Cognitive, social and emotional knowledge are linked to the development of meaningful language.
A wide range of language impairments are observed in individuals with autism due to the diverse developmental disabilities associated with the disorder, including cognitive and motor impairments. As a result, some "high-functioning" individuals have minimal differences in how their language develops; individuals with cognitive or motor deficits have specific language impairments; and individuals with severe cognitive deficits have significant delays in their development of language. However, impairments in social and emotional understanding profoundly affect the quality of language understanding and use for all individuals with autism.
On the following pages in this section, we will examine language characteristics that are most commonly associated with autism. These specific language differences are linked to the social and communication impairments and repetitive behavior patterns that define autism.
Language characteristics commonly associated with autism for:
In order to comprehend language, we need to consider (a) who is talking, (b) what the person said, (c) how the speaker says the words, (d) how the words relate to what is happening, and (e) how the words relate to what we know about the topic. The social context contributes greatly to understanding the meaning of language.
In autism, individuals have difficulty understanding the relationship between the words and the social context. As a result, they often make a concrete association between what they hear and what they see in the environment, which results in a constrained understanding of what is said. The following example shows how this problem is observed in a child with significant delays.