Communication Issues and Delays in Autism

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Qualitative impairment in communication is one of the defining characteristics of autistic disorder according to the DSM-IV-TR (APA, 2000). The communicative abilities of individuals with autism spectrum disorders are quite varied (Olgetree & Oren, 2006). For many, this impairment is manifested at a very young age when infants with autism do not follow the gaze of their caregiver or engage in a shared focus on objects and social partners referred to as coordinated joint attention (Adamson & Chance, 1998). By 18 months of age typical children are sharing attention with caregivers (Adamson & Chance), and the lack of these behaviors (sharing gaze and protodeclarative pointing) are two of the identifying factors used in the CHAT screening tool (Baron-Cohen, Allen, & Gillberg, 1992) for autism spectrum disorders. In addition, failure to attend to speech is an early and strong predictor of autism (Osterling & Dawson, 1994; Paul & Sutherland, 2005).

As previously described, impairment in communication may include delays in or lack of spoken language, or impairments in the ability to initiate or sustain a conversation with others even if the individual uses speech (APA, 2000). Learners with ASD have overall reduced rates of communication (Paul & Sutherland, 2005). Speech may be used in an idiosyncratic manner, such as echolalia, or the immediate or delayed repetition of language (Fay, 1980b). If asked, “Do you want a book or music?” the child may respond, “book or music” (immediate echolalia) or the child may repeat a television commercial heard days prior (delayed echolalia) without comprehension of the content (Fay, 1980b). Immediate and delayed echolalia may serve different functions for some individuals with autism (Prizant & Rydell, 1984, 1993).

It is not uncommon for learners with autism to have difficulty with use of pronouns. When referring to himself, the student may say, “He wants toy,” or “Jack wants toy,” instead of using I or me correctly (Scheuermann & Webber, 2002). Correct usage of pronouns requires an understanding of the changing referents of a speaker obtained through observational learning or practice (Fay, 1980b). Confusion with gender and the use of “he,” “she,” and “it” is likely to be an issue for individuals with autism.

If speech is used, the prosody, pitch, or volume (Fay, 1980b) of the sentence may be unusual. The intonation of individuals with ASD has been described as “mechanical,” “wooden,” or “arrhythmic” (Fay, 1980b; Scheuermann & Webber, 2002). There may be a lack of understanding of word boundaries and a tendency to comprehend phrases as single chunks of speech (Fay, 1980a). Individuals with ASD often have difficulty answering Wh-questions, most likely due to their focus on irrelevant aspects of the question instead of on the key Wh-word used (Koegel & Koegel, 1995; Krantz, Zalenski, Hall, Fenske, & McClannahan, 1981). When asked, “Who took you for a car ride?” the students may respond, “to the store” or “red car.”