Communicaton, Language, and Speech
Development of Communication
Major advances have been made over the past two decades in delineating and understanding the communication and language difficulties of children with autism. The characterization of communication deficits in the diagnostic criteria for autism has changed dramatically. Until about 1980, peculiar speech patterns were emphasized, such as echolalia, pronoun reversal, and unusual intonation (Baltaxe and Simmons, 1975; American Psychiatric Association, 1980). Now, verbal and nonverbal communication are considered a core deficit in the diagnostic criteria for autistic spectrum disorders (American Psychiatric Association, 1987; 1994). This change highlights the recognition that children with autistic spectrum disorders not only have difficulty in the acquisition of speech and language, but also have difficulty understanding and using nonverbal behavior in communicative interactions. The level of communicative competence attained by individuals with autism has been found to be an important predictor of outcome (Garfin and Lord, 1986; McEachin et al., 1993). The presence of fluent speech (using multiword combinations spontaneously, communicatively, and regularly) before the age of 5 continues to be a good prognostic indicator of IQ scores, language measures, adaptive skills, and academic achievement in adolescence (Venter et al., 1992). Moreover, the severity of the communicative impairment may be one of the greatest sources of stress for families (Bristol, 1984). There is much heterogeneity in the speech, language and communication characteristics of children with autistic spectrum disorders. Language impairments in autistic spectrum disorders range from failure to communicate to inappropriate social skills.
Children with ASD can develop a variety speech patterns, to the development of functional but idiosyncratic use of spontaneous speech and language (Lord and Paul, 1997). One-third (Bryson, 1996) to one-half (Lord and Paul, 1997) of children and adults with autism do not use speech functionally. For both verbal and nonverbal individuals, impairments in social or pragmatic aspects of language and related cognitive skills are the most salient (Wetherby et al., 1997). CORE COMMUNICATION DEFICITS Research over the past decade has identified core communication deficits in children with autism that fall into two major areas: joint attention and symbol use (Dawson et al., 1990; Kasari et al., 1990; McArthur and Adamson, 1996; Mundy et al., 1990; Sigman and Ruskin, 1999; Stone et al., 1997; Wetherby et al., 1998). Joint attention reflects difficulty coordinating attention between people and objects and is evident by deficits in orienting and attending to a social partner; shifting gaze between people and objects; sharing affect or emotional states with another person; following the gaze and point of another person; and being able to draw another persons’ attention to objects or events for the purpose of sharing experiences. Symbol use reflects difficulty learning conventional or shared meanings for symbols and is evident in deficits in using conventional gestures; learning conventional meanings for words; and using objects functionally and in symbolic play. Joint attention has been found to be a significant predictor of language outcome. Mundy et al. (1990) found that measures of gestural joint attention (e.g., showing or pointing to direct attention) at initial testing were a significant predictor of language development 1 year later for preschool children with autism. The failure to acquire gestural joint attention appears to be a critical milestone that impairs language development and an important target for early communication intervention. Similarly, children with autism do not compensate for their lack of verbal skills with gestures; they show limited gestural use, both in quantity and quality. They predominantly use primitive motoric gestures to communicate (i.e., leading, pulling or manipulating another’s hand). They lack the use of many conventional gestures, such as showing, waving, pointing, nodding the head and symbolic gestures depicting actions (Loveland and Landry, 1986; McHale et al., 1980; Stone and Caro-Martinez, 1990; Stone et al., 1997; Wetherby et al., 1998; Wetherby et al., 1989). Moreover, in this population, there is much variability in the capacity to use vocal communication which likely contributes to the wide range of limited verbal skills. (Educating Children with Autism, page 47 & 48)
The links below provide information about communicaton, language, and speech development as well as tools when deciding, developing, and implementing a communication system.
Normal Communication, Language, and Speech Development from birth to 48 months
Picture Exchange Communication System (PECS)
"Boardmaker"
Examples of Picture Based Communication Systems