Autism and Communication Problems

April is Autism Awareness Month, which was established to promote a better understanding of those with autism. Also known as autism spectrum disorder (ASD), autism is a range of conditions categorized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. According to the Centers for Disease Control and Prevention (CDC), approximately one in 59 children in the United States are on the autism spectrum.

How does autism affect communication?

Children with autism may have difficulty developing language skills and understanding what others say to them. They also often have difficulty communicating nonverbally, such as through hand gestures, eye contact, and facial expressions.

Some children with ASD may not be able to communicate using speech or language, and some may have very limited speaking skills. 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 meanings of different vocal tones. These difficulties affect the ability of children with ASD to interact with others

Below are some patterns of language use and behaviors 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 do not relate to the conversations they are having with others. For example, a child may count from one to five repeatedly in a conversation that is not related to numbers. Or may continuously repeat words he or she has heard—a condition called echolalia. Some children with ASD speak in a high-pitched or sing-song voice or use robot-like speech. 
• 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 may have musical talents or an advanced ability to count and do math calculations. Approximately 10% of children with ASD show “savant” skills, or extremely high abilities in specific areas, such as memorization, 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 with autism have good memories for information just heard or seen. Some may be able to read words before age five, but 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 are sometimes mistakenly thought to have a hearing problem.
• Poor nonverbal conversation skills. Children with ASD are often 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 other nonverbal skills to enhance their oral language skills, many children with ASD become frustrated in their attempts to make their feelings, thoughts, and needs known. 

If a doctor suspects a child has ASD, he or she will usually refer the child to a variety of specialists, including a speech-language pathologist (SLP). The speech-language pathologist will perform a comprehensive evaluation of the child’s ability to communicate, and will design an appropriate treatment program. 

Teaching children with ASD to improve their communication skills is essential for helping them reach their full potential. 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 that it becomes part of the child’s daily life.

For some younger children with ASD, improving speech and language skills 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, imitation, 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.

At the Speech-Language Institute (SLI) of Salus University, SLPs work with children of all ages who are on the autism spectrum. For more information on SLI’s services or to schedule an appointment, call 215.780.3150.