Language and Communication in Autistic Children

Today we will discuss about language development in Autistic children. First and foremost we need to understand the difference between speaking words or phrases and language development.

A baby enjoys looking at mother’s face, smiling and imitating her expressions and this is the stage where visual communication begins. An Autistic child mostly does not achieve this mile stone and most of the times it goes unnoticed. Family members will say that the “Baby is not looking at the face or not responding” but nobody says “Why? Is there a Problem?” or even if this questions pops up, the answer will be “May be the baby does not feel like responding” However communication is a God given gift to mankind. Language development is not just about repeating the words when someone says. Language development is communicating with parents, family and society using words, facial expressions and body language.

Most children with ASD(Autism Spectrum Disorder) have little or no problem pronouncing words. The majority, however, have difficulty using language effectively, especially when they talk to other people. Children with ASD often are self-absorbed and seem to exist in a private world where they are unable to successfully communicate and interact with others. Children with ASD may have difficulty developing language skills and understanding what others say to them. They also may have difficulty communicating nonverbally, such as through hand gestures, eye contact, and facial expressions.
Teaching autistic children to not just understand the society but to enjoy the simple pleasures that communicating can bring has been big challenge for me as a therapist. When I meet mothers who struggle to help their children mingle with the society, my heart breaks as the child is missing out on this important aspect.
However a percentage of lucky children do learn to use language and communication effectively. Not every child with ASD will have a language problem. A child’s ability to communicate will vary, depending upon his or her intellectual and social development. Some children with ASD may be unable to speak. Others may have rich vocabularies and be able to talk about specific subjects in great detail. Many have problems with the meaning and rhythm of words and sentences. They also may be unable to understand body language and the nuances of vocal tones.
Below are some patterns of language use and behaviours that are often found in children with ASD.
• Repetitive or rigid language. Often, children with ASD who can speak will say things that
have no meaning or that seem out of context in conversations with others. For example, a child may count from one to five repeatedly. Or a child may repeat words he or she has heard over and over, a condition called echolalia. Immediate echolalia occurs when the child repeats words someone has just said. For example, the child may respond to a question by asking the same question. In delayed echolalia, the child will repeat words heard at an earlier time. The child may say “Do you want something to drink?” whenever he or she asks for a drink. Some children with ASD speak in a high-pitched or singsong voice or use robot-like speech. Other children may use stock phrases to start a conversation. For example, a child may say “My name is Tom,” even when he talks with friends or family. Still others may repeat what they hear on television programs or commercials.
• Narrow interests and exceptional abilities. Some children may be able to deliver an in-depth monologue about a topic that holds their interest, even though they may not be able to carry on a two-way conversation about the same topic. Others have musical talents or an advanced ability to count and do math calculations. Approximately 10 percent of children with ASD show “savant” skills, or extremely high abilities in specific areas, such as calendar calculation, music, or math.
• Uneven language development. Many children with ASD develop some speech and language skills, but not to a normal level of ability, and their progress is usually uneven. For example, they may develop a strong vocabulary in a particular area of interest very quickly. Many children have good memories for information just heard or seen. Some children may be able to read words before 5 years of age, but they may not comprehend what they have read. They often do not respond to the speech of others and may not respond to their own names. As a result, these children sometimes are mistakenly thought to have a hearing problem.
• Poor nonverbal conversation skills. Children with ASD often are unable to use gestures—such as pointing to an object—to give meaning to their speech. They often avoid eye contact, which can make them seem rude, uninterested, or inattentive. Without meaningful gestures or the language to communicate, many children with ASD become frustrated in their attempts to make their feelings and needs known. They may act out their frustrations through vocal outbursts or other inappropriate behaviours.
How are the speech and language problems of ASD treated?
If a doctor suspects a child has ASD or another developmental disability, he or she usually will refer the child to a variety of specialists, including a speech-language pathologist. This is a health professional trained to treat individuals with voice, speech, and language disorders. The speech-language pathologist will perform a comprehensive evaluation of the child’s ability to communicate and design an appropriate treatment program. In addition, the pathologist might make a referral for audiological testing to make sure the child’s hearing is normal.
Teaching children with ASD how to communicate is essential in helping them reach their full potential. There are many different approaches to improve communication skills. The best treatment program begins early, during the preschool years, and is tailored to the child’s age and interests. This is called as Early Intervention. It also will address both the child’s behaviour and communication skills and offer regular reinforcement of positive actions. Most children with ASD respond well to highly structured, specialized programs. Parents or primary caregivers as well as other family members should be involved in the treatment program so it will become part of the child’s daily life.
For some younger children, improving verbal communication is a realistic goal of treatment.
Parents and caregivers can increase a child’s chance of reaching this goal by paying attention to his or her language development early on. Just as toddlers learn to crawl before they walk, children first develop pre-language skills before they begin to use words. These skills include using eye contact, gestures, body movements, and babbling and other vocalizations to help them communicate. Children who lack these skills may be evaluated and treated by a speech-language pathologist to prevent further developmental delays.
For slightly older children with ASD, basic communication training often emphasizes the functional use of language, such as learning to hold a conversation with another person, which includes staying on topic and taking turns speaking.
Some children with ASD may never develop verbal language skills. For them, the goal may be to acquire gestured communication, such as the use of sign language. For others, the goal may be to communicate by means of a symbol system in which pictures are used to convey thoughts. Symbol systems can range from picture boards or cards to sophisticated electronic devices that generate speech through the use of buttons that represent common items or actions.

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