Language and autism

Language is the mind’s most mysterious ability and one of its most powerful tools.  It is what allows us to contemplate the vastness of the night sky, ponder on Plato’s nonmaterial world of ideas, and helps us stablish a spiritual connection to a higher power. Since our origin, language has served humans as a basic survival mechanism.  Indeed language genes have been highly conserved throughout the evolutionary process, and are used, in different ways, by many species.

One of the core deficits of autism is language difficulties and language development.  Some autistic individuals may not speak at all; they are nonverbal.  For those who do speak, language development may be delayed, and speech may be unnatural.  The “back and forth” of a conversation is difficult for them and some may require functional aids like a voice output device, pictures or the use of other types of symbolic communication (e.g., sign language).  Studies of language difficulties in autism have shown that its causes are heterogeneous and that, even within the same individual, there may be many contributing factors.  This is to be expected as language itself is complex; a system composed of multiple components working together (i.e., morphology, phonetics, pragmatics, semantics, and syntax). None of these components when taken individually can be called language.  However, among the different components of language, the most difficult to learn is pragmatics.

Pragmatics is the art of using language in a social context.  Changing your tone of voice when talking to a baby and then to an adult is an example of pragmatics. The ability to use language for different purposes (as in demanding something, greeting or for information purposes) is also pragmatics. This aspect of language is also what provides rules for conversation and storytelling (e.g., taking turns in a conversation).  My own assertiveness and sarcasm in English may be construed as rude in other languages. Without pragmatics people around you may as well be talking in a foreign language.

I must believe that for many utterances, listeners will first interpret the literal explanation and immediately following would deal with other suggested meanings. With practice this is done automatically, without waste of time.  Can you pass me that book? This is not a question about a person’s physical ability to pass a book but rather a polite request. Any chance for a cup of coffee? The question is not about mathematical probability but rather a request for coffee. Language in this regard helps people build expectations of those around them.  By talking about our shared intentionality, we showcase our ability to see things from different perspectives. Without pragmatics, autistic individuals are stuck in the phase of literal interpretation; the analysis phase of suggested meanings no longer follows.  They are trapped in the present tense of a conversation and often fail to displace their thought process to other aspects of social communication.

Speech-language pathologists (sometimes called speech therapists, or speech teachers) help asses, diagnose, and treat, pathological conditions of communication. They, along with social skill therapists, work synergistically with autistic children in order to overcome pragmatic speech delays.  I have been to many sessions where speech pathologists try to teach communication skills to autistic individuals. They do a wonderful job with standardized test to focus on problems and help individuals improve their verbal fluency. Treatment for them is individualized; every patient is different. Some of the best ideas I have seen to improve communication are given below (from Communication and Autism | Cortical Chauvinism, Casanova 2015).

The best way to make a child learn is by stressing that communication is a type of game where words, and the ideas they convey, are flung back and forth in-between contestants. It feels good to play the game. Some of the rules for playing this game are as follows:

1) In this game, like others, you have to take turns. People are given the opportunity to talk and express their views in roughly similar amounts of time. Talking far too long may be seen as attempt to monopolize the conversation.

2) If somebody asks you a question in a few words, you also answer with a few words. Question: How are you? Answer: I am well. Thank you. How about yourself? If you were to answer with a long drawn-out reply or divert the conversation to your favorite subject, this would be considered improper.

3) You respond to questions in the same mood they are provided. Somebody making a joke requires a light answer. Somebody making a serious statement requires a serious answer.

4) Solving the puzzle in terms of communication means talking about what has been brought up in the conversation; talking about things we have in common.

5) Sport psychologists usually advice using your imagination to review or even increase your preparation for an event. Prepare yourself by imagining different scenarios: how to start a conversation, what to expect? Imagine cartoons made by line drawings. Fill in the balloons on top of the heads of the characters (i.e., ideas) with your thoughts. People prepare for emergencies before they actually happen. They develop routines for the same and practice until they learn to respond as a gut reaction. This type of forethought is useful for communication and other aspects of life. Rehearse with family and friends. Always remember that in order to make things clear to others you have to start by making things clear to yourself.

6) Too many patterns within a conversation may make you confused. Pay attention primarily to those that make sense to you from previous experience.

7) Accept the fact that everyone have biases and may not respond in the way you would like them to. Talk to family members or friends to see if you are reacting or interpreting things properly. Don’t jump to conclusion about people.

8) Sometimes it is worth talking to yourself and interpreting the behaviors of others this way.

9) Accept your limitations. It is not always possible to understand what the other person is thinking or feeling. Be humble and ask questions.

10) If you cannot read a person, don’t assume things as facts. Do not assume that all your beliefs are true or that the same should be obvious to other people.

Above all, a single bad moment does not mean a pattern of defeats. “This always happens to me!” is a phrase to be avoided. Learn to let things go. Treat yourself as a friend. In addition, be careful as pragmatic speech skills can be overtrained. Patients may learn the rudimentary mechanics of a conversation but lack the required fluidity within a social setting.

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