LANGUAGE AND COMMUNICATION IN

ASD

Reference:

Kim, Paul, Tagher-flusberg, & Lord (2014). Language And Communication In ASD. In Volkmar, Fred R., Paul, Rhea,
& Rogers, Sally J., Eds. Handbook Of Autism and Pervasive Developmental Disorders, Diagnosis, Development, and
Brain Mechanisms, Volume Volume 1 : Diagnosis, Development, And Brain Mechanisms (4). Somerset, US: Wiley.
LANGUAGE PROFILE IN ASD
 ATYPICAL ASPECTS OF
LANGUAGE AND COMMUNICATION
IN ASD
THEY INCLUDE:

1. Difficulties with joint attention

2. Difficulties using communication for a variety of
purposes/social communication
3. Difficulties using and understanding Non-
linguistic Communication
4. Confusion of personal pronouns
5. Echolalia
6. Language Comprehension
7. Language use
1. Difficulties with Joint Attention
Parents of ASD often report the difficulty to interact
with their child;
Child with ASD can appear to:
• be indifferent to attempts to communicate
• not hear communication
• fail to respond to communication
• find it difficult to attend to an activity or an event,
object, or a person

Joint attention is a key skill

 Joint attention is a key skill

• It requires being able to divide the attention

between at least two things at the same time
(e.g., being able to attend to an object and a
person with whom the object is being shared)
• The ability to establish and maintain joint
attention is the most common attentional
problem in ASD.
• This difficulty creates difficulties in both
language and social development
2.
Difficulties Using and Understanding Non-linguistic Communication

People with ASD may have difficulties in understanding and

using:
v facial expression
Their facial expression does not reflect their feelings; smiling
while screaming and clearly upset
They are not able to ‘read’ other people’s facial expressions and
body language
v tone of voice
They may use a very flat intonation pattern; monotonous
They have difficulty understanding prosodic information
expressed by others.
v Gestures
Cont. Difficulties Using and Understanding Non-
linguistic Communication
v Gestures
• Children who have communicative difficulties compensate for
their difficulties by using additional means of communication
like gestures (e.g., pointing, nodding the head)

• Children with ASD use contact gestures (leading, pulling or

direct manipulation) rather than conventional gestures.
• Why ?

• Because there is a direct link between contact gestures and

the communicative intent, whereas the meaning of
conventional gestures is less obvious and has to be learnt.
What is atypical in Simon’s language ?
4. Confusion of personal pronouns
This is a frequently mentioned atypical language behavior
associated with autism.

• This difficulty is viewed as part of a general difficulty with the

aspect of language that codes shifting reference between the
speaker and the listener.

EXAMPLE: in labeling a person by name (e.g., James ), the label

remains the same without regard to who is speaking; whereas,
for pronouns, whether James is referred to as “I” or “you”
depends on whether he is the speaker or the listener during a
particular conversation.
5. Echolalia

Ø One of the most salient aspects of deviant speech in autism is the

occurrence of echolalia.
Ø Echolalia is the repetition, with similar intonation, of words or
phrases that someone else has said.
q It can be immediate; for example, a child repeats back her
teacher’s greeting, “Hi, Susie,” exactly as it was said to her.
q It can be delayed, as in the case of a child who approaches his
father and says, “It’s time to tickle you!” as a signal that he wants
to be tickled, repeating a phrase he has heard his parents say in
the past.
 Echolalia

• Echolalia was once viewed as an undesirable, nonfunctional

behavior.

• More recently, it has been emphasized that often echolalia

serves the child specific functions.

• 6 communicative functions served by immediate echolalia:

turn-taking, assertions, affirmative answers, requests, rehearsal to

aid processing, and self-regulation.

• Immediate echolalia is most frequent in children with autism

who had minimal expressive language
 Echolalia

• Delayed echoes can be used communicatively to

I. request re-creations of the scenes with which the remarks were

originally associated, such as a child saying “You’re okay” in a
sympathetic tone of voice if he falls down.

II. as a base for analyzing linguistic forms.

Echolalia

Ø echolalia is one of the most classic symptoms of autism,

Ø not all children with autism echo, nor is echoing seen only in
autism (e.g., blind children, children with language impairments,
in some TD children)

Ø The children with autism at the early stages of language

development produced the most echolalic and formulaic
speech. For all children, echolalia declined quite rapidly over
the course of development.

Ø Echolalia has been offered as evidence of gestalt processing in

autism (learning language in chunks).

Ø It is proposed that children with autism are especially

dependent on the gestalt approach to acquiring language
Echolalia

In summary,

Ø although immediate and delayed echolalia are salient

features of autistic speech, they are not unique to ASD.

Ø Although some echolalia in autism may appear to be

nonfunctional or self-stimulatory, both immediate and

delayed echolalia can serve communicative purposes for the

speaker.
Echolalia, what to do as an SLP?

http://autismdigest.com/echolalia-on-the-spectrum/
Echolalia

http://autismdigest.com/echolalia-on-the-spectrum/
6. Language Comprehension

Ø Unlike TD, comprehension of words is delayed relative to production

in ASD.

Ø Comprehension skills are depressed relative to production in the 2nd

year of life, while the gap tends to narrow, with receptive skills
moving closer to expressive levels, in the 3rd to 4th year.

Ø It has been suggested that when a child displays substantially more

difficulty with language comprehension than production at early
periods of development, it may be a strong indicator of ASD

§ The significant impairment in receptive language compared to

expressive language is unique for toddlers with ASD even though
both toddlers with ASD and late talkers without ASD show similar
levels of expressive language.
Possible sources of difficulty in language comprehension in ASD:

1. ASD may lack knowledge about social events used by TD children to

support emerging and developing linguistic structures.

• ASD are much less consistent in identifying probable events that

involved relationships between people (e.g., knowing that a mother is
more likely to pick up a baby than a baby pick up a mother).

2. Difficulties in comprehending the word order that depicts the

situation.

3. difficulty in ability to integrate nonverbal cues to help interpret

linguistic input.

4. Difficulty in relying on pragmatic cues especially in unstructured

context and in interrupting the speaker’s intention without explicit
cueing.
7. Language Use
7. Language Use
7. Language Use
 8. Reading
• 5– 10% of children with autism show hyperlexia; remarkable decoding
ability. They usually begin reading words before they get to school, and
are obsessive in their interest in letters, writing, and reading
• In these children, there is a significant discrepancy between strong
word recognition and weak comprehension of what has been read; they
can understand simple reading passages at grade level, but may have
relative deficits in comprehending longer, more complex texts, such as
narratives.
• Hyperlexic ASD are often mysterious to families: independent, early
acquisition of word recognition contrasts so sharply with their severe
handicaps in social communication and learning in other areas.
• Hyperlexia is a savant skill in children with autism (e.g. other savant
skills: drawing, calculation, music), which fails to connect to general
intellectual and functional abilities.
• Hyperlexia can be used as a starting point for teaching other, more
functional behaviors with direct instruction and intensive practice to
move from the unprocessed reading to more purposeful and
communicative uses of reading.
• Written material provides a helpful medium of intervention for these
children. Written scripts, social stories, graphic organizers, reminder
cards, and lists are useful in increasing social and communicative
behavior for ASD who read
END OF LECTURE