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Language and communication (autism)


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How these difficulties might present

Language and Communication differences are a key element of the autism profile.

Differences in expressing themselves

  • Child may find it difficult to initiate interaction/communication. Can find it difficult to gain someone’s attention to ask for what he needs.
  • Child may be pre verbal and use other means of communication: pulling a person to what they want, gesturing, standing beside an object and/or make a physical attempt get an item themselves. Child may use alternative system of communication to convey message such as pictures/symbols/signing.
  • Child may repeat what other people say verbatim. This is called echolalia. For instance if the child is asked if he wants a drink he may say “Do you want a drink?” in response. This may be because he has not understood what has been said to him or is processing out loud what he has heard. Child may be able to recite dialogues from films and retell stories word for word, imitating accents and slang but is not able to ask for what he wants.
  • Child may talk for a long time about something that he is interested in, but does not show interest in what other people are saying. There is a lack of “to and fro” flow, turn taking in conversation.
  • Child may have a level of vocabulary greater than would be expected for his age. This may relate to their specific areas of interest, and may mask gaps in quite basic vocabulary within other topics

Differences in understanding what is said to them

  • The child’s use of language may mask their level of understanding. They may be able to use a wider vocabulary than the vocabulary that they understand. It is beneficial to assess and monitor levels of understanding from an early stage. Level of understanding can be explored through a screening tool such as the Language Link assessment, and a full assessment can be requested through a referral to the NHS speech and language therapy team”.
  • The child may take an unusually long time to process, “take in”, what is being said to him. Increased levels of anxiety and additional sensory stimuli will affect his ability to process information.
  • The child may have a difficulty in interpreting body language, tone of voice and facial expression and therefore in understanding the “meaning” behind the words when someone is talking to them.
  • He may be easily confused with idioms such as “pull your socks up”. Children with autism often take things literally.

Differences in attention

  • A child with autism may find it difficult to attend to conversations, teaching and instruction that do not interest him. He may find it difficult to shift his attention from one thing to another as happens frequently during the school day.
  • He may be easily distracted by sensory experience, by things that others may not even notice, (and if they do notice are able to “ignore” in order to focus on the conversation), and by his own focus of attention.

Strategies to support expressive language:

  • Make available the tools that the child needs to communicate: (objects of reference, photos, symbols)
  • Give the child opportunities to communicate his wants by offering regular choices. These may need to be presented visually as well as verbally.
  • Do not anticipate and meet the child’s every need. Prompt him to communicate with you by having something that he wants, pausing and waiting for him to approach you. Follow his lead by responding to any attempts at communication and then pausing again.
  • Model and practise ‘turn taking skills.’ Structure games and activities to make “turn taking” clear. This will support the child to understand the social expectations.
  • Develop social interaction with others through activities such as ‘Lego based therapy’ where roles and responsibilities are clearly defined.
  • Provide structure to unstructured times, such as break and lunch time.

Strategies to support understanding

  • Set up and consistently use a visual timetable to indicate the key routines of the day. (Objects of reference, photos, symbols, hand drawings, words). Hand-drawn images on a mini white board can work just as well as professionally produced laminated symbols and are more flexible to support with unexpected or last-minute changes.
  • Use the timetable to prepare the child for any change in their usual routine
  • Use consistent clear language for everyday events. All adults to decide on the language to be used.
  • Adjust your communication: speak clearly, slowly and calmly. Give the child time to process what you are saying by pausing and waiting before giving the next bit of information. Give child the time to respond to your instruction. Avoid instructions such as “hop in the bath” which the child may take literally.
  • Organise, structure and plan activities supported by visual cues (Objects of reference, photos, symbols, hand drawings, words)
  • Teach and support child to understand his own and others’ emotions. Develop the child’s understanding of body language, tone of voice and facial expression. Use comic strips and social stories to “unpick” and facilitate social interactions.

Strategies to support attention

  • Find out what the child is interested in and use this to engage the child, following their lead and avoiding ‘taking over.’
  • Give the child time and preparation to shift their focus of attention from one activity to another. This change in attention can be difficult. Simple visuals can be helpful at these times to back up verbal warnings about an approaching change (timers/counting)
  • Break work tasks into small, achievable chunks. For example cut/fold a “worksheet in half”. This makes the activity less overwhelming.
  • Use visual cues to support the child’s understanding and focus to the task/activity (first/then approach)
  • To support the child to follow an instruction or complete an adult directed activity, show and tell him what he can do once he has completed the activity. Use his interests to motivate him
  • Include regular breaks in focussed activity so that the child can “recharge” his batteries.
  • To support attention give each activity a purpose for the child: For example “Write down the instructions so that you know how to do this experiment next time”.