Autism – what is it?
ASD or Autistic Spectrum Disorder is just that, it’s a spectrum. So no 2 people with ASD present the same way and so giving it a definition in one sentence is impossible. The NAS describes it as ‘a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them’. As a SLT we often call the difficulties Social Communication Difficulties and is a sense these mean the same thing. Most people with ASD have trouble interacting with those around them and in making sense of the world at large.
Sometimes Autism is accompanied by a learning disability, mental health difficulties or other conditions. Where there are additional needs these children/adults need extra support but all children with ASD can learn and make progress.
I’m not going to go into too much detail about all the different types of Autism and the different labels that are used as I will be focussing on the communication methods that can be used to support their understanding and interactions and also some of the social communication difficulties that may be evident and how we can best support our children.
What communication difficulties may we see with a diagnosis of ASD?
Social communication
People with Autism have difficulties with interpreting both verbal and non-verbal language (e.g gestures or tone of voice). Many have a very literal understanding of language and think people always mean exactly what they say. They may find it difficult to use or understand:
- facial expressions
- tone of voice
- jokes and sarcasm.
Some may not speak, or have fairly limited speech. They will often understand more of what other people say to them than they are able to express, yet may struggle with vagueness or abstract concepts. Others have good language skills, but they may still find it hard to understand the expectations of others within conversations. Some may repeat what the other person has just said (this is called echolalia) or talking at length about their own interests as a cover for not understanding what is being said or the social situation.
Social interaction
Autistic people often have difficulty ‘reading’ other people – recognising or understanding others’ feelings and intentions – and expressing their own emotions. This can make it very hard for them to navigate the social world. They may:
- appear to be insensitive
- seek out time alone when overloaded by other people
- not seek comfort from other people
- appear to behave ‘strangely’ or in a way thought to be socially inappropriate.
People with ASD may find it hard to form friendships they may want to interact with other people and make friends, but may be unsure how to go about it.
How can we support the communication needs of people with Autism?
Think about your own language…..it helps to speak in a clear consistent way and to allow time for your words to be processed. Consider the language you are using and try to avoid non literal language or idioms as this can cause confusion and in some cases frustration.
The use of visual aids may help with both the understanding of language and also support them in expressing themselves. Some people with ASD benefit from or prefer to use alternative forms of communication such as sign language of visual symbols (PECS). With the use of alternate communication methods they can communicate very effectively without speech.
PECS – what is it? PECS is Picture Exchange Communication System and is a structured communication method of introducing symbols and supporting the user to initiate communicative interactions with those around them to get their needs met initially and as they move up the stages it introduces social language such as commenting and questioning that support social interactions.
Change is very scary to children with ASD as they find it very hard to understand. Preparation is the key and the use of visual supports to show their timetable and to explain change can help to reassure them. Often we can’t predict when things are going to change in order to prepare our children who need it and so they may need some extra supports and time to process the changes and how it is making them feel. As mentioned in an earlier section, those with ASD struggle to communicate and understand their feelings and so they may express their emotions in non conventional methods.
Social stories – these can be used to help our children and adults with ASD make sense of different social situations in a concrete visual method which will then support them when it is applied to a real life situation.
Games that we can play to support communication
The language targets that we work on with children with Autism are very similar to the ones we set for children without a diagnosis who have similar expressive and receptive language difficulties, although there will be a greater focus on social skills and supporting the development of social interaction.
One thing to be aware of with games is to explain the rules of the game, visual supports can help through the use of a turn taking wheel and visuals to show what happens at each stage of the game.
Games that have a clear start and end are often preferred by our children with ASD as again they can predict what is expected of them and how long the activity will go on for. With more open ended games, the use of a sand timer can provide this visual support for them.
Such games that have a clear end are – puzzles, mr potato head, lego sets, lotto games.
There are some structured approaches that can teach turn taking and social interaction and one of these is Lego Therapy….. I’ll talk about this in another blog……