Communication difficulties, both verbal and nonverbal, are inherent in the diagnosis of ASD. The typical sequence of communication development is disrupted. As a result, communication skills can range from nonverbal, gestural, the use of single words, to verbal conversation, and may include:
- Perseveration - repetitive verbal and physical behaviors
- Echolalia - immediate and/or delayed “echoing” of words, music, phrases or sentences
- Hyperlexia - precocious knowledge of letters/words or a highly developed ability to recognize words but without full comprehension
- Dactolalia - repetition of signs, pronoun reversals, inappropriate responses to yes/no questions, and difficulty responding to “wh” questions
When designing intervention strategies, it is important to understand both the individual’s receptive (comprehension) and expressive communication skills. Stressful situations that increase anxiety often interfere with the ability to communicate. Difficulty understanding humor, idioms (“keep your eye on the paper”), sarcasm, and other complex forms of verbal and written expression is common. Even the highly verbal individual may understand and use literal (concrete) language, but have difficulty with abstract concepts needed for higher order thinking skills.
A person’s communication ability usually changes over time. Therefore, it is important to maintain an ongoing communication assessment from diagnosis through adulthood as this provides current information, which is necessary to support appropriate communication strategies.
Supporting all forms of communication – verbal, signing, pictorial, augmentative devices (and often a combination of more than one) – promotes learning.
During therapy, the child’s functional communication skills, or the child’s intent, such as requesting and protesting, are assessed, and programs are developed to address communication deficits and improve communication skills. Therapy may occur in individual settings or in small groups. Families will always be involved in the therapy process in order to facilitate functional communication across various situations. Parent and caregiver training is a large component of speech-language therapy to maximize its benefits.
Be sure to choose a speech-language pathologist (SLP) who holds a Certificate of Clinical Competence from the American Speech-Language-Hearing Association (ASHA). The SLP is a skilled professional who can address the following areas of concern:
- Receptive language – the understanding of spoken or written messages as well as other forms of language. This includes identifying objects, actions, adjectives, prepositions, people, and so on.
- Expressive language – the production of language. This includes sentence structure, verb tenses, regular/irregular plurals, length of utterance, and so on.
- Articulation/phonology – includes developing speech sound production, the use of tongue, lips, teeth, and so on, to produce speech sounds.
- Oral-motor skills – includes improving the range, rate, complexity, strength, and coordination of oral motor movements. May also include massage of cheeks, lips, and gums, brushing teeth, and decreasing teeth grinding.
- Feeding and swallowing – includes ability to close lips, manipulate food with tongue, age-appropriate chewing pattern, and safe swallowing. Other areas that can be addressed include oral desensitization to different tastes, textures, smells, temperatures, and consistencies of foods.
- Social skills/play skills – includes appropriate social language, ability to read facial expressions, ability to understand social cues/body language, and age-appropriate play skills such as sharing, turn taking, and playing independently or with others.
- Pragmatics – the use of language in social context.
- Cognition – the mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment. (Source: dictionary.com)
- Alternative or augmentative communication (AAC) – the use of any device, technique, symbol system, or combination thereof to supplement, enhance, or increase a person’s communication abilities.
Common Communication Options
Sign language – use of signs alone or paired with speech.
Picture Exchange Communication System (PECS) – involves using picture symbols to communicate wants/needs, label, and so on. The child goes through a learning process that teaches initiation of communication and then expands to the use of sentences. Many children who use PECS develop some verbal skills and may graduate to speech as the primary form of communication.
Communication boards – can be made with pictures or objects that the child points to or removes from the board to communicate wants/needs.
Other communication devices – a wide range of devices designed to enable the user to create longer messages. These devices can also act as a universal remote, allowing the user to operate electronic devices in the environment such as the TV, lights, and so on. The speech-language therapist can assess the child’s abilities to use high-tech devices and make recommendations about the type of device that is best suited for the child’s individual needs.
Facilitation – involves holding the child’s hand or having the child hold the facilitator’s hand to help her write or keyboard messages.
Total communication – communication system that pairs simultaneous production of speech with manual signs or another augmentative devices or symbol systems. The child is encouraged to use the words/phrases that he is capable of producing and supplementing communication with signs, symbols, and so on, for what he cannot communicate verbally.
American Speech-Language-Hearing Association
Ohio Speech Language Hearing Association
Portions of the information above were duplicated from the following: