Imagine being dropped in a foreign country where you are completely unfamiliar with the language. All around you, people are talking – sometimes to you, sometimes to each other – and you can’t make out any of the meaning. People are getting frustrated that you are not responding or doing what they ask, and you have no way to tell them that you’re trying, you just don’t understand. You want to ask someone for clarification, or even to ask for a break because all of the noise is exhausting you, but you don’t know how.
Welcome to a day in the life of many children with autism.
Autism is a rapidly-growing diagnosis, with a current estimated prevalence of 14.7 children per 1000 in the U.S., or an equivalent of 1 in 68 children, according to the CDC. One of the defining characteristics of autism is a deficit in communication skills. For many lower-functioning children on the autism spectrum, this means they are either nonverbal or have very limited verbal skills. Great focus is often placed on improving the expressive language abilities of these children, but too often we forget to appreciate and address the challenge of their language comprehension: understanding the language of the world around them.
Recent research supports the idea that children with autism, even as young as infancy, demonstrate differences in the ways they process spoken language. Although it is not clear why, children with autism seem to receive, interpret, and respond to speech differently from typically-developing children, which often results in a lack of comprehension. Fortunately, the literature also suggests that many people with autism have strong visual processing systems and may use traditionally-visual parts of the brain to help interpret spoken language.
So what does this mean for parents or professionals working with children on the spectrum? First: we need to be aware of how much verbal language we are using with our kids. Even for students who can use some spoken language, the bombardment of verbal instructions that they hear all day long can be overwhelming and confusing. Second: we can play to these children’s strengths if we use visual supports to aid with comprehension.
Here are a few concrete suggestions to think about:
- Slow down. The pace of our speech can be too quick for our children with autism to process. If they have a chance of understanding, we need to give them the necessary processing time before we expect them to respond or before we say more.
- Reduce unnecessary verbal repetitions. Too often, we say something too many different ways, with too many words. Consider: “Brad, it’s time to get your shoes on. Quick, put them on now or we’re going to be late. Come on, did you find them? Good. Put them on. Put your shoes on. Now the other one. Did you get it on? Do the Velcro.” Compare this to giving the simple direction: “Put on shoes,” – and stopping there. If we resist the temptation to continue speaking once we’ve said the main message, we give our children with autism less to process and a better chance of successfully understanding. Focus on key words, and try to eliminate verbal “clutter.”
- Use visual supports! There is strong research supporting the idea that children with autism are often better able to understand a message that is presented visually than one that is presented only verbally. When you give the direction, “Put on shoes,” hold up a picture of the shoe to cue your child to the meaning of your words. Or, use a simple gestural cue by pointing to the shoes themselves. When we present information in multiple modalities, we draw on the visual strengths of children with autism and don’t require them to rely on spoken language alone.
These steps can go a long way in alleviating that foreign-language feeling for our kids with autism.
Written by: Anna Fredman, M.S., CCC-SLP
Certified Speech Language Pathologist