How Autism Affects Communication and Pragmatic Speech in Young Children

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Children with autism often have communication deficits due to their neurological or developmental impairments. Up to 25% of children with autism with communication deficits are non verbal during their early developmental years and some (a small number) never speak at all.

However, autism communication disorders can present themselves in a number of ways. Being non verbal is not the only deficit that needs attention and development. Many children with autism don’t have problems with communication in speech and language; most children with autism show signs of communication deficits in how they use their language and speech capabilities.

For example, a child with high functioning autism might be labeled “little professor” because of his advanced and eloquent speech. His pronunciation might be articulate, and he might be able to tell you the background details and history (dates included) of all of the Star Wars series. But, can this “little professor” carry on a conversation with another person in a typical social setting?

Carrying a reciprocal conversation with another person falls into the category of pragmatic skills.

Pragmatic skills include:

• Maintaining eye contact with the person you are speaking with.
• Responding to and initiating greetings: hello, how are you?, what’s your name?, goodbye.
• Initiating conversations
• Taking turns in a conversation and waiting for others to finish speaking.
• Maintaining a topic without switching topics or cutting the conversation short.
• Allowing others to share, then asking questions or adding personal, relevant information.
• Asking for clarification when confused
• Understanding social and facial nuances: sarcasm, boredom, irritation etc.
• Knowing when and how to end the conversation. Using conversation stoppers such as, see you later, thank you, see you soon, I have to go, and goodbye.

When children with autism struggle with this sort of communication, it is considered a social communication disorder. More specifically, it is called pragmatic language impairment or PLI, as an acronym.

Now, let’s put a little twist on these ideas for a minute, and look at each skill from both sides.

Take each one of those pragmatic skills and ask the following questions:

• Does a child with autism notice whether the person he or she is speaking with makes eye contact?” Does it concern children with autism if the other party is not looking at them while they speak?
• If children with autism initiate greetings, do they wait to hear a response? Are they concerned with whether they receive a response or not?
• Do children with autism expect others to start communication with them? Or, are they happy to carry on with their own endeavors without seeking communication?
• Do children with autism expect other people to keep a topic going if they initiate a conversational topic?
• Do children with autism want others to ask them questions?
• Do children with autism like being asked for clarification?
• Do children with autism expect others to understand their unique signs and signals that shows they are done with communication?
• Does a child with autism seek out signs that the conversation is winding down, and do they respect communication signals from others when they end the conversation?

These are important questions to answer because we are discussing how to make sure a child with autism feels heard when they communicate. To answer that, we first have to start with either the assumption that they want to be heard or that they understand what it means to be heard.

In order to understand whether others are listening to you, it stands to reason that you know how to listen to others. Most children with autism struggle with the skill of listening, so they may or may not pay attention to whether they are being listened to by others in return. Autism communication deficits make these concepts difficult to understand. Pragmatic skills are something that develop slowly over time with experience and with the assistance of others: teachers, parents, therapists and peers. You have to teach these skills to children with autism from a position that teaches them to care about reciprocation and from a position that teaches them to expect these things in return during a conversation.

What research is being conducted to improve communication in children with ASD?

Look back at all of the rhetorical questions above. Try to find research articles on these topics. You will find that there is not a lot of information out there that answers these questions. All of the research and practices that we currently use are primarily focused on how to get a child with autism to communicate with the rest of the population because social skills in communication are expected as a social norm.

So, the question as to how to help a child with autism to be heard would be more accurately stated if the question was– (are you ready for this?):

How do you teach a child with autism to practice active listening skills, so they know that they are listening and understanding others- and in return that they are being listened to and being understood by others?

Until you teach this concept specifically, a child with autism communicates primarily by way of emotions- what they are feeling at the time. It could be fear, anxiety, excitement, happiness, confusion, or overwhelm. When a child with autism, or any person for that matter, responds to the environment or others around him or her based on his/her feelings at the moment, there isn’t a huge concern for pragmatics. The biggest concern is getting away from the strong negative feelings or keeping the positive feelings alive for as long as possible, so that children with autism feel heard in their own way. Most of the research you will find that addresses autism communication struggles will suggest how to improve social skills, speech, and language. You will be hard pressed to find anything that pertains to teaching a child with autism how to understand whether or not they are being heard.

How can you help your child with autism to feel heard?

There are ways that children with autism “feel heard” by others, and have little to do with improving social skills or communication skills. The way that children with autism feel “heard” or attended to is by the responses that they receive when they are in the midst of their feelings that drive their behavior.

For example, if something is too loud and an adult lowers the volume for their sake, they will feel calmer. Someone has “heard” them and helped them to diffuse the tension that they were feeling.

If a child with autism is feeling anxious in his/her surroundings or by an aversive task that he/she has been given, and an adult removes him/her from the environment or task then they will feel better. Someone has “heard” him/her and helped him/her to escape the task or place that he/she was unhappy about.

If a child with autism wants something that is out of reach and someone makes access possible, the child will feel happy instead of needy. He/she has been heard.

If a child is stressed or lonely and is seeking the comfort of another person (parent, teacher, friend), and that person responds positively to the child- the child has been heard.

At the most foundational level, this is how children with autism feel heard- by others responding to their needs that drive their emotions.

All of the other concerns with communication can be taught over time as the child develops. With early intervention and continual instruction and communication, a child with autism can begin to learn pragmatic skills, and in addition to that they can learn to understand empathy and consideration in their communication with others. Circle Care Services provides a social skills group that provides the opportunity to learn and practice these skills from the earliest stages into the adolescent years. Call now for your child’s evaluation.