EFFECTS OF AUTISM ON
Speech development in people with
autism takes different paths than the majority of neurotypical
children. The effects of autism on communication are extremely varied.
autism is increasingly referred to as being part of the autism spectrum due to the variability and degree of its effects. Most
children will not have any trouble with pronunciation. The problems
lie in using language effectively.
Common problems are lack of eye contact, poor
attention, being able to point objects to others, and difficulty
with the 'give and take' in normal conversation. In severe cases,
some children remain mute throughout their lives but with varying
degrees of literacy. They may communicate in other ways – images,
visual clues, sign language, and typing may be far more natural
to them. Contrary to the prevailing traditional stereotype of mute
people with Kanner-type autism, around one third of people diagnosed
with this type of autism will develop what is often viewed as dysfunctional
verbal language - communication may have no content or information,
but relies on rote learning of phrases, songs, jingles and advertisements.
Those with the autism spectrum condition of Semantic Pragmatic Disorder
fall into this group.
Those who do speak sometimes use language in unusual ways, retaining
features of earlier stages of language development for long periods
or throughout their lives. Some speak only single words, while others
repeat a mimicked phrase over and over. Some may have a condition
called echolalia which is a repetition of something previously heard.
Sing-song repetitions in particular are a calming, joyous activity
that many autistic adults engage in. Many people with autism have
a strong tonal sense, and can often understand at least some spoken
language, whilst others can understand language fluently.
Lack of interest in social interaction
People on the moderate to severe end of the autism spectrum often display an indifference or dislike for interaction.
Infants might arch their backs when picked up to avoid contact,
while older children may escape or have an emotional outburst when
someone interacts with them. There is research that suggests the
pleasure-inducing chemicals normally released in the brain by social
interaction don't seem to emerge for many individuals on the autism spectrum. Many adults with autism report that they avoided social
interaction for a range of sensory reasons - voices that hurt their
hearing, unpleasant skin contact and so on.
Conversational issues with autism
Some children may exhibit only slight delays in
language, or even seem to have precocious language and unusually
large vocabularies, but have great difficulty in sustaining typical
conversations. The “give and take” of non-autistic conversation
is hard for them, although they often carry on a monologue on a
favorite subject, giving no one else an opportunity to comment.
When given the chance to converse with other autistics, they comfortably
do so in “parallel monologue”—taking turns expressing views and
information. The theory
of mind is one suggestion for these conversational issues.
There is no 'one size fits all' in Autism Spectrum Disorders, and this is especially so with communication. In some
cases, individuals on the autism spectrum avoid virtually all
forms of social interaction, and may ignore someone talking to them,
have an emotional outburst or escape. There is growing evidence
from interviews with autistic adults that a common cause of this
could be hypersensitivity due to sensory
problems. Individuals on the autism spectrum may simply be
indifferent to other people, or actively seek friendships but be
unable to maintain these due to difficulties with social skills.
Issues with reading the subtext of speech
Just as people without autism have trouble understanding
autistic body languages, vocal tones, or phraseology, people with
autism similarly have trouble with such things in people without
autism. In particular, autistic language abilities tend to be highly
literal; people without autism often inappropriately attribute hidden
meaning to what people with autism say or expect the person with
autism to sense such unstated meaning in their own words.
Some people with high-functioning
autism demonstrate advanced cognitive ability, but lack the
skills or are not inclined to interact with others socially. An
example of the this is the noted autistic Temple
Grandin, who holds a PhD and is a successful developer of livestock
handling technologies. She describes her inability to understand
the social communication of people without autism as leaving her
feeling “like an anthropologist on Mars.” Temple’s case was described
by neurologist Oliver Sacks in his 1995 book titled An Anthropologist
on Mars: Seven Paradoxical Tales.
Some infants who later show signs of autism coo and babble during
the first few months of life, but stop soon afterwards. Others may
be delayed, developing language as late as the teenage years. Still,
inability to speak does not mean that people with autism are unintelligent
or unaware. Once given appropriate accommodations, some will happily
converse for hours, and can often be found in online chat rooms,
discussion boards or websites and even using communication devices
at autism-community social events.
Difficulties with non-verbal communication in autism
Sometimes, the body language of people with autism
can be difficult for other people to understand. Facial expressions,
movements, and gestures may be easily understood by some other people
with autism, but do not match those used by other people. Also,
their tone of voice has a much more subtle inflection in reflecting
their feelings, and the auditory system of a person without autism
often cannot sense the fluctuations.
What seems to non-autistic people like odd prosody;
things like a high-pitched, sing-song, or flat, robot-like voice
may be common in autistic children and some will have combinations
of these prosody issues. Some autistic children with relatively
good language skills speak like little adults, rather than communicating
at their current age level, which is one of the things that can
lead to problems.
Expressing needs appropriately
Since non-autistic people are often unfamiliar
with the autistic body language, and since autistic natural language
may not tend towards speech, autistic people often struggle to let
other people know what they need. As anybody might do in such a
situation, they may scream in frustration or resort to grabbing
what they want. While waiting for non-autistic people to learn to
communicate with them, people with autism do whatever they can to
get through to them.
Communication difficulties may contribute to autistic
people becoming socially anxious or depressed or prone to self-injurious
behaviors. Recently, with the awareness that those with autism can
have more than one condition, a significant percentage of people
with autism are being diagnosed with co-morbid mood, anxiety and
compulsive disorders which may also contribute to behavioral and
Intervention for communication Problems
No one treatment method has been found to successfully
improve communication in all individuals who have autism. The best
treatment usually entails the following:
• Intervention begins early, ideally during the
• Intervention is individually tailored to meet
the child's needs
• It targets both behavior and communication
• Both parents or primary caregivers are involved.
The goal of therapy should be to improve useful
communication. For some, verbal communication is a realistic goal.
For others, the goal may be gestured communication. Still others
may have the goal of communicating by means of a symbol system such
as picture boards. Treatment should include periodic in-depth evaluations
provided by an individual with special training in the evaluation
and treatment of speech and language disorders, such as a speech-language
pathologist. Occupational and physical therapists may also work
with the individual to reduce unwanted behaviors that may interfere
with the development of communication skills.
Some children respond well to highly structured
behavior modification programs such as Applied
Behavior Analysis; others respond better to in-home therapy
that uses real situations as the basis for training. Other approaches
such as music
therapy and sensory
integration therapy, which strives to improve the child's ability
to respond to information from the senses, appear to have helped
some autistic children, although research on the success of these
approaches is largely lacking. The use of social
stories is increasing as a tool for helping autistic children
learn social skills.
may improve an individual's attention span or reduce unwanted behaviors
such as hand-flapping, but long-term use of these kinds of medications
is often difficult or undesirable because of their side effects.
One theory holds that individuals on the autism spectrum have
higher levels of naturally occurring opiates in the brain, so they
don't seek social interaction to trigger these pleasure-inducing
opiates. Naltrexone blocks the effects of these opiates and some
claim this leads to better communication skills, but to date no
medications have been found to specifically help communication as
treatment. Mineral and vitamin
diets, and psychotherapy have also been used, but research has
not documented their effectiveness.
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