Autism Series Part IX: Reaching through the barriers of Autism with communication
Motor skill deficiencies are common among people with ASD and it’s frustrating and hard for them as they try to speak but can’t. During my first few days working at an ASD treatment center, a wise supervisor told me “Unintelligible words does not equal unintelligible minds.”
Yesterday, one of my new neighbors gave me a description of the non-verbal teenage boy down the street by saying “He’s the autistic child. He’s a great kid, but he can’t communicate.”
My well-meaning neighbor doesn’t realize that he shares the same all too common and gross misunderstanding that children with ASD cannot communicate. Although this boy’s communication may be difficult to understand and hardly intelligible, without having met this boy I can say with certainty that he communicates. Everyone does.
We need to eliminate the false pretense that children must vocalize and form words in order to communicate.
This could not be further from the truth. It may not look or sound like what we’re used to, but if we observe closely and pay attention to the non-verbal communication our eyes can be opened to our children’s curiosity, feelings, thoughts and triggers.
Accept, embrace and learn their communication
I have a cousin who is deaf. Outside of a few siblings and his parents that have learned American Sign Language, no one in the family has learned sign language.
Once or twice a year when we see him, we spend a few minutes writing pleasantries on a note card back and forth. I can only imagine how obligatory this must be for him as we take turns asking him repetitive questions. We recognize him, but we don’t know him.
Actually, it saddens me now as I write this, realizing how little I know this family member. I don’t know if he feels alone but I think I would in his situation. He clearly has a much different perspective of the world, and he’s probably a very interesting person that welcomes deeper conversations than the ones we’ve had thus far.
The same can be said for some individuals with ASD. Their physical limitations alter the way they communicate and therefore their relationships suffer and their connections are limited.
It may be difficult and require a lot of time, but the responsibility lies with us to change the way we communicate and more importantly to accept, embrace and learn their language.
You may have seen this video during the past few months. It is an amazing story about a young girl with ASD who finds her voice through the miracle of modern technology.
When I watched this for the first time, I was hit with the overwhelming understanding that society has not fully understood these individuals and their capacity to communicate. Carly and her father have written a book titled “Carly’s Voice”. In her book she describes her frustrations with communication, but also shares her optimism that advancements in technology and research will only further society’s acceptance and understanding of Autism.
She also describes the frustrating realization of knowing what she wanted to communicate, but being unable to do so for several years
We also learned from Carly that children are communicating through their behavior. The “hand flapping” and “stimming” tells us that children are being overwhelmed by sensory input and they are coping with the overload by regulating their own sensory output.
What happens then if we try and stop them from regulating these overwhelming sensations? Well, just like if you and I had our coping skills taken away when we were feeling overwhelmed (i.e. exercising, reading, listening to music etc.), it leads to more frustration.
Rather than simply trying to eradicate the problem behavior, the focus should be on understanding the communication within the behavior and then teaching a new positive form of communication.
If you really think about it, they are no different than the rest of us. Behavior is often communication.
I worked with a young man a few years ago, I’ll call him James. James was 15 and showed common signs of Echolalia. Echolalia takes place in the form of repeating the last thing a person with ASD has heard or more commonly a phrase that they hear several times a day.
James never vocalized more than five words and he repeated the same five words hundreds of times each day. “James, don’t hit your head”. “James, don’t hit your head”.
James had developed his own form of body language and sign before coming to live with us at the treatment center. At first, it was challenging and difficult for James. He tried to express emotions, wants and needs through behaviors that worked for him at home.
These behaviors were explosive, but at home he learned that the more explosive the behaviors, the faster he got what he wanted. We worked with James for several weeks and showed him simple signs for snacks, tv, bedtime and toys.
Now in full disclosure, there were times that the staff (myself included) were impatient, frustrated and felt sympathy for James and so we gave in.
Although it was temporary relief for James and the staff, in the long run these small instances set us back several weeks.
We were trying to set the precedent that he could only access certain things by communicating calmly and performing the appropriate sign language. When we gave in he ended up getting what he wanted without having to sign and it was confusing for him.
I think we did our best though and after all we’re human.
His parents came to visit after 60 days. They watched as James signed “hello” and “goodbye”, he signed to go on a walk, play with toys and pet the family dog. His parents were encouraged and quickly learned the same 20-25 signs and asked when they could take him home.
When children try to express an emotion, a want or a need, an inappropriate behavior may occur simply out of the fact that a socially acceptable method of communication has not been shown to them. As you all know, one time is never enough. The principles of ABA therapy require hundreds if not thousands of repetitions.
Individuals often create their own means for communicating. After a while, close friends and family learn that “pacing” might mean the individual needs to use a restroom or that standing in front of the refrigerator and tapping it, means the child is hungry. Other times the messages are more cryptic and only understood by close friends and family.
What happens then when this child goes to school, church, or a new friends home and no one is there to interpret for them?
Using an effective communication system can eliminate many problem behaviors because it empowers your child to communicate and participate in getting what they want, finding hobbies, and understanding how and where they fit in.
What do the professionals say?
ASD symptoms interfere with communication
1. Disorganization and distractibility may draw your child away from conversation, resulting in a lack of attention to important communication. Difficulty in sequencing and processing several auditory phrases results in problems with processing information accurately.
2. Tendencies to focus on irrelevant details or the inability to differentiate relevant from irrelevant information may cause the individual to miss important parts of conversations and thus the exhibition of poor understanding.
3. Often the environment interferes with a child’s ability to communicate. A child may become overwhelmed by sounds, sights and other environmental stimuli so much that they resort to running away, screaming, covering their ears or begin self-stimulating.
4. The words we speak convey roughly 10% of the message that is communicated. The other 90% is conveyed through eye movement, facial expressions, and body language. Imagine being dropped in a foreign country but understanding and recognizing 1 out of every 10 words. Pretty difficult right?
5. Idioms and metaphors are abstract concepts that typical children learn and begin using at a young age. A child with ASD’s inability to suspend reality makes idioms and metaphors difficult to understand and to use.
6. Concrete thinking leads to behavioral responses based on an ASD child’s interperation of language. What appears to be inappropriate behavior may actually be a very appropriate response, based on a literal interpretation of an instruction or a command.
1. Giving children one instruction at a time helps them not become overwhelmed. Giving a child a chance to reflect back one instruction also insures concrete understanding.
2. Be clear and specific. Something as simple as “go fix your bed” could be interpreted as “go grab a hammer and drive nails into your bed”.
3. Start young. If a child with autism acquires a form of effective communication before the age of 6, there is an improved chance that the individual will develop speech and become a higher functioning adult. (Frost & Bondy, 1994).
4. Here is a link to the Effective Communication Skill. Modify it to fit your child’s ability and need. What’s important is that you take time to listen to and observe your child’s communication. If you do, they will feel heard and understood.
5. If your child is non-verbal, create mobile charts on thick card stock that have several pictures of items that your child needs and wants each day. Below that picture, provide a visual of the associated sign. Start by getting everyone in the family involved and begin signing together!
Their physical limitations have made communication difficult but not impossible. Give it a shot and let us know how it goes in the comment section below!