Communication Barriers in Autistic Children
Autism is a developmental disorder which normally impairs a child’s ability to communicate, display appropriate social skills and causes repetitive tendencies in the child. Autism is severely incapacitating and is usually evident during the first three years of a child’s life. Autism is referred to as a spectrum disorder due to the magnitude of symptoms it causes ranging from learning problems to a variety of social disabilities. These unusual tendencies may occur independently or may be associated with other problems such as mental retardation or seizures. It is a developmental disability that affects children regardless of race or economic status. It normally impairs a child’s ability to learn.
Globally, autism is the third most prevalent developmental disorder. It is found in one child per every 500 children. It is predominantly found in boys and only 20% of the autistic children are girls.
Previously, emphasis was not laid on diagnosing autism and a lot of children were left frustrated at their inability to communicate and interact with others. Bowen indicates that “most of the autistic children possess normal or even higher I.Q. levels and as a result can attend regular schools and succeed in acquiring normal jobs” (Bowen, 66). The distinguishing factor is that these children with autism are incapacitated in expressing themselves and are unable to socially mingle with other people.
Autism has no specific diagnostic tests. A doctor normally relies on observing and evaluating the behavior of the child. Parents or the caregivers provide patient history which is required to confirm the diagnosis, including the developmental history of the child. There is an internationally set criterion which is used for diagnosis. Normally, genetic tests and other medical procedures are only used for confirmatory purposes so that the doctor can eliminate other causes which could be responsible for the child’s behavior.
Autism can be detected at birth or may occur along the development of a child. A child may display the normal trend of development and then exhibit deterioration in verbal and social skills between one and two years. In cases where a child has autism at birth, the signs are usually conspicuous as early as one year. Autism usually occurs alongside other developmental disorders such as mental retardation and signs of hyperactivity. These can also be addressed but normally, the autistic traits are what prevent the child from leaving a normal life (Dale & Ingram, 138). There has been a lot of debate on the difference between mental retardation and autism. The main distinguishing factor is that children with mental retardation exhibit impairment in all the areas of development including social, cognitive and motor skills whereas autistic children are normally incapacitated in areas that relate to social skills alone.
Autism has no major cause. It is however associated with any of the factors that may lead to structural and functional alterations of the central nervous system. These can be from bacterial or viral infections. In addition, autism has been associated with certain genetic structure after researchers discovered familial aggregation. Currently, almost 10% of all autistic cases can be attributed to similar genetic composition. So far, autism has no cure. This is mainly because researchers have not identified a major isolated cause. Due to this fact, there is no sure way of preventing it. However, scientists have documented significant success rates which are dependent on early intervention. Early intervention is necessary to ensure that necessary measures are taken to aid the child in the best possible and most effective ways (DeMyer, 82).
The only measure that parents can engage in order to ensure that their children live functional lives is to ensure that they receive the best structured training programs geared towards training a child on how to communicate effectively. These also focus on training parents on how to communicate with their autistic child. The success of such interventions relies on the age of initiation. It is therefore crucial that diagnosis be made as early as possible. If the skill profile for the child who has autism is okay and the child can mingle with the other children appropriately, autistic children can be integrated into ordinary schools. However, the teaching methodologies are altered to address their specific needs since the learning styles of autistic children vary from those of the ordinary children. 30 to 50% of autistic children do not use speech. It is scientifically impossible for doctors to predict when an autistic child will ever speak.
The development of speech in autistic children is not clearly understood. Some autistic children may have other physical disabilities that hinder them from speaking while others do not. These need to be ruled out to ensure the cause in addressed. Some of these children may have been speaking earlier on and then abruptly lost their speech. Researchers have however observed that if these autistic children are brought up in accepting environments where the people are aware of effective communication with autistic children, the autistic child is more likely to develop speech and other means of communication (Dale & Ingram, 142).
Children who have autism will prefer activities such as rocking or spinning as opposed to other playing activities. DeMyer concludes that, “their tendencies vary and at one time they may prefer to repeat the activity of their interest for several hours or at another time, they may appear hyperactive preferring to engage in as many activities as possible” (DeMyer, 96).
Autistic children are capable of building up on skills and living productive lives as adults. This is only possible through appropriate and early interventions which are well focused, to address their specific needs and to assist them to live relatively independent lives. Communication problems are prevalent in most autistic children. Speech therapy can be appropriately directed to enable the child interact with other people. Speech therapy has been successfully used with some autistic children. The speech therapist who is employed should have experience working with autistic children to ensure that they understand the autistic child and the way they relate with other people.
Although conventional methods used in speech therapy are mostly ineffective for autistic children, this is because they normally focus on speech impairment due to physical problems. An autistic child will greatly benefit from interventions in speech therapy that focus on effective communication skills. Speech therapy should be geared towards not only teaching the child on how to speak but also on how to use the acquired speech to communicate socially.
Typical speech development
A child’s normal speech development can be monitored from around three months although the process usually starts at infancy. A child develops speech from interacting with the environment. Learning is usually through mimicking other people making sounds in the immediate environment. Bogdashina believes that “this speech becomes the tenet on which the child bonds with people and forms interpersonal relationships” (Bogdashina, 235. In case there are problems in the development of speech in a child, these should be addressed early to ensure success in the child’s upbringing.
Speech development in any child should begin at infancy and can extend to the age of six or even seven years. There is a normal spectrum of what to expect from children at specific ages. Doctors use this spectrum to rule out any developmental disorders (Dale & Ingram, 138). It is also possible for children to lag behind this common trend without any problems whatsoever. These are refereed to as the late developers.
New born babies cannot make speech sounds due to the fact that their vocal cords aren’t completely developed. Between the ages of two and three months, the baby has developed vocal cords and oral muscles and can now be able to control them. As a result babies laugh more and they make sounds like “goo” at the back of their mouths. At this age, the baby can recognize the different voices in their surrounding and the tone of the caregiver’s voice.
At four to six months, the baby can now make better sounds that sound like speech. They have better control of their oral muscles and they experiment at this by forming words and strange syllables. They also yell and squeal in addition to making other sounds. The baby can also respond to his name and to other human sounds. This is indicated by visual cues in addition to turning his head when he hears someone speaking.
After six months to one year the baby starts babbling. This is when the child repeats syllables in continuous sequences. These syllabic utterances have no particular meaning and the baby may view it as play (Dale & Ingram, 146). At this stage, doctors say that the child is putting his oral motor skills into practice for later use during the actual speech.
From one year, the child attempts pronouncing the actual full words. They are aware of the function of speech and they exhibit inflection. Children attach strings of sounds similar to what they hear in adult conversations but it is mainly baby gibberish. These statements have meaning attached to them and the parent can recognize specific words that the baby uses to imply certain meanings (Bogdashina, 244). From the age of one and a half years to three years the baby goes through rapid speech development whereby there is increase in vocabulary. At one and a half year the baby has a vocabulary of five to twenty words. The baby demonstrates a lot of echolalia and can be able to follow simple directions and commands.
At two years the baby is able to name different objects in the surrounding and exhibit an ability to use at least two different prepositions such as, on or under. At this age the baby simplifies most of the hard words or long sentences by omitting the word endings or dropping syllables making in an attempt to make pronunciation easier. Babies can also simplify consonant blends and substitute harder to pronounce words for simpler words. The volume and the pitch of the voice of the child are uncontrolled and in most cases it is too high. More than two thirds of the child’s total speech should be comprehendible. The rhythm of the speech is usually very poor and the child starts to use pronouns referring to himself accurately. Most babies also produce those sounds that should be uttered from the front of the mouth at the back of the mouth. This is temporally and the child usually outgrows it by five years of age.
From three years the child attempts harder vocabulary and continues practicing until the age of seven to eight years. From three years the child starts using plurals and incorporating past tenses in his speech. The child also adventures into longer sentences and exhibits a vocabulary of more than nine hundred words. The child utters 90% coherent and audible sentences and is able to portray reasoning by relating different experiences. The child can answer harder questions like his name and the names of his parents.
After four years the child has extensive verbalizations and has an intensive pool of vocabulary. The child can understand the difference between normal colors and often uses imagination. The child will also portray a lot of repetition of words and common phrases. This goes on until five years when the child starts using descriptive words which were previously unused. All vowels and consonants are utilized in speech and there are a lot of adjectives and adverbs (Lynch &Fox, 89). The child can describe time broadly and has very intensive vocabulary.
From six to eight years the child enters the polishing up stage whereby, after gaining the basic fundamentals of speech, the child can now relate different aspects and associations with the environment. In addition the child can now use in-depth descriptions of objects and situations and express feelings quite adequately (Lynch &Fox, 104). They are able to interact with their peers as well as the adults in their environment. There is little or no repetition when talking and the child is able to control the pitch and the volume of their sound so that they can now whisper and scream at choice.
Speech/Communication problems in autistic children
An autistic child can exhibit problems either with speech development, language development or even communication. These problems vary from one child to the next depending on the social and intellectual abilities of the child. For these issues to be identified and tackled appropriately, it is essential for the right diagnosis to be made as early as possible. This is only possible if parents and caregivers are aware of the normal speech development in normal children and evaluate their specific child on the general guidelines (Ball & Kent, 226).
Severely autistic children are unable to speak and most of them never develop speech. Other less severe children may develop speech but may still exhibit various problems in using language in communication. They may exhibit unusual tendencies to repeat whatever is said to them or they may repeat specific words over and over again. Other symptoms will include the child referring to himself as you when they are asking for something and speaking only to ask for something and not to say how they feel.
Many children who have autism have also exhibited certain levels of sensitivity to different sounds or touch. Ball & Kent emphasize that these children “may also selectively block out certain sounds or touches” (Ball & Kent, 242).There are children who are diagnosed with Kanner-type autism. They usually exhibit dysfunctional verbal language which entails relying on phrases which they memorize. These may be part of songs, jingles and advertisements and they utter them without understanding the real meaning (Kilminster, 35).
If a child is not taught speech skills, they often use defined language in repetitive modes. Some autistic children will speak using single words or may use echolalia. Most autistic children usually carry this to adulthood and there are specific songs which calm them down when they are agitated.
Most autistic children exhibit only minor deviations from the normal development pattern. Some of the autistic children may exhibit a wide intensive vocabulary and a normal speech development pattern but they do not develop any conversation skills.
Most of these children will carry on monologues concerning their favorite topics without giving a chance for the audience to join in (Kilminster, 89). Their conversations exclude any one else’s input and they can therefore not relate or hold conversation with their peers.
The body language of children with autism is rarely understood by people without autism. The facial expressions, gesticulation and other body movements may be appropriately decoded by the other autistics, but they are not easily understood by non autistic people since they vary from the ordinary gestures. Their tone and pitch of voice corresponds with the feelings that they have at that particular time.
All these communication problems may lead to feelings of anger. Since the autistic child cannot convey his feelings accurately, he may end up becoming frustrated. This usually leads to panicking, screaming and grabbing what they wanted in the first place. All these inappropriate actions are done in an attempt to make their feelings and requests known.
Autistic children exhibit problems with the meaning of sentences and words. They can also have varying problems with the rhythm of words and sentences. Some autistic children exhibit poor attention spans on things that do not interest them and yet they will stare at a thing that is of interest to them over long periods of time.
Speech Therapy with Autistic kids
For an autistic child to receive speech therapy, the child must exhibit impairment in their social interaction skills. They must show inability to use ordinary non verbal cues such as eye to eye gaze, facial expressions and normal responses of body postures. Trevarthen &Aitken indicate that in addition to this, “the child must show inability to form social interactions with his peers and lack of initiative to share his emotions. The child must also have communication impairment characterized by a long delay or total absence of spoken language” (Trevarthen &Aitken, 217). The child in question must also display a lack of other compensatory attempts to communicate such as the gestures normally exhibited by deaf children. For those children who are able to use speech they cannot be able to initiate normal conversation with other children or even adults.
There are various functions of speech therapy. Speech therapy for autistic children should always be initiated as early as it the problem is detected. The therapist should always relate the therapy into the practical aspects of the child’s life. This makes it relevant to the child and ensures that the therapy is of benefit to the child. The frequency of the speech therapy should be increased as communication develops between the child and the therapist. In addition, the therapy should always emphasize on applicability of the taught skills in the actual child’s life.
There is an option of having the therapy in the therapist’s office or in the child’s home. The benefit of having the sessions within the child’s home is that it ensures that the child is in a familiar environment and it takes less time to ease them into the therapy session.
Speech therapy for an autistic child can be non-verbal. This focuses mainly on sign language. This is where the therapy entails the use of gestures, other facial expressions and the use of physical or body language. The therapist can also use generalized imitations that entail the therapist using mouth to form specific words and encourage the child to attempt forming similar words. These two methods are simplistic and are widely encouraged especially for children below three years. In addition there are more complex methods that can be applied including the picture exchange communication system which incorporates visual aids to facilitate communication. The therapist may also encourage conversation skills by encouraging the child to develop their vocabulary. This is done by using augmentative as well as alternative communication skills. The therapist uses several cues which range from simple pictures and may include simple words to portray meaning (Trevarthen &Aitken, 217). In the children who only have difficulty in conversations, the therapist focuses on providing them with easy to understand communication examples. The speech therapist may incorporate pictorial story scripts which are interactive and will involve the participation of the child.
The therapist will also use social pragmatics which aids the child to know when social communication is appropriate. The child is trained on when to greet people and when to exhibit other social etiquette skills. This training also focuses on trying to establish relationships between these children and the other people in order to form emotional connections.
Speech therapy is ideal for teaching the child on how to use the learnt abstract words and concepts, to communicate with other people. Losquadro argues that “playful interaction is very crucial to development of speech”. This is an area that is always problematic with autistic children (Losquadro, 79). Autistic children have exhibited improved communication abilities after continuous and objective speech therapy. When it is initiated early, speech therapy ensures that autistic children can successfully interact with other people in their environment. This facilitates their learning process and their social skills, ensuring that they can live functional, relatively independent lives in the society.
Bogdashina, O. Communication Issues in Autism and Asperger Syndrome. London: Jessica Kingsley Publishers. 2005, 212-280.
Bowen C. Developmental phonological disorders. Melbourne: ACER Publishers.2006, 50-100.
DeMyer K. Parents and Children in Autism. Michigan: University of Michigan. 2007, 80-125.
Kilminster, M. Articulation development in children aged three to nine years. Melbourne: Croswell publishers.2006, 30-106.
Lynch, J.I. & Fox, D.R. Developing Speech and Language. Oregon: CC Publications.2002, 85-120.
M. Ball & R. Kent. The new phonologies and Developments in clinical linguistics. California: Singular Publishers. 1998, 200-266.
Philip S. Dale & David Ingram. Child Language, an International Perspective. New York: University Park Press. 2008, 135-230.
Tara Losquadro. Why Motor Skills Matter: Improve Your Child’s Physical Development to Enhance Learning and Self-esteem. New York: McGraw-Hill Professional. 2004, 70-89.
Trevarthen C. & Kenneth J. Aitken. Children with Autism: Diagnosis and Interventions to Meet Their Needs. London: Jessica Kingsley Publishers. 1998, 215-350.