This section is under review following revised diagnostic SIGN guideline 145
Many young people with autism require only understanding, tolerance and encouragement to support their communication. For others difficulties in social communication are associated with use and understanding of both verbal and non-verbal language such as gestures, facial expressions and tone of voice.
People with high-functioning autism or Asperger Syndrome are often articulate and appear to have good language skills. For many however their ability to understand language and use it in a social context can be impaired. They might talk extensively about their own interests, but have difficulty starting and maintaining a conversation on other topics.
Sarah is 15. She is very talkative but has very little interest in conversations not focused on her current passion which is the Romans . She will respond when people try to have a conversation with her however she will very quickly introduce her subject regardless of what has gone before.
Sometimes speech can lack expression, or have an unusual pitch or accent. Many people on the spectrum find non-verbal communication very difficult to interpret, including eye contact, facial expression, use of gesture and body language. This can result, for example in failing to recognizing signs that a conversation partner is no longer interested in the subject they are talking about. Their own use of eye contact, facial expression and gesture can be poorly co-ordinated with communication
The way in which young people with autism interpret language might be very literal eg ‘it’s getting noisy in here’, ‘it would be good to get an answer before lunch time’ or ‘don’t cut corners’ contain implied meanings which might be difficult to interpret and could lead to unexpected behaviours.
David is 9 and often seems listless or tired in school. In conversation with his mum it turns out David often finds it difficult to go to sleep since he read on an overhead sign on the motorway - ‘Tiredness kills’
Difficulties in social communication might affect ability to:
Respond to group instructions
Take turns appropriately in group discussion
Understand ‘implied’ meanings, affecting aspects of literacy
Process information and respond within expected time
Organise several instructions given together
Remember or follow information or instructions given verbally
Some pupils with autism may have disordered or delayed language but the degree of impairment varies greatly. Some may remain non-verbal throughout their life. Others may have limited skills, only using speech to communicate their needs.
Grant is 4. He has no verbal language but seems to understand some words and very simple instructions. The Speech and Language Therapist has been working with Grant to introduce him to a visual communication system to make basic choices and follow a visual schedule to know what is happening NOW and NEXT .
Echolalia, the repetition of words or phrases, is frequently seen in early childhood. While It can indicate that the child has not fully understood what is being said, it may also be a calming strategy.