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Purchase Access <>1) Communication is impaired in all persons with Autism Spectrum Disorders (ASDs) to some degree (Paul, 2001), even those diagnosed with Aspergers Disorder (AS). The performance on language tests of persons with AS challenges the assumption that their early language development is normal (Howlin, 2003). Assessing these people for change, or for programming needs, however, can be very challenging. Furthermore, if assessments fail to define deficits intervention is not forthcoming. 2) Many of the formal tests for assessing pragmatic communication lack the sensitivity to unmask the subtle language comprehension and use difficulties. In persons with ASDs the impairments are in social-communicative or pragmatic aspects of language therefore, formal instruments assist with few aspects of ASD communication (Prizant et al., 1997; Schuler et al., 1997; Wetherby & Prizant, 1999). In persons with ASDs we need to assess communicative functions, use of gestures, use of repair strategies, understanding of conventional meanings, as well as conversational skills (Schuler et al, 1997; Wetherby et al., 2000). <>Assessments should document natural communicative exchanges, (informal procedures will be needed, Wetherby et al., 1997). They will need to be dynamic and ongoing (Twachtman-Cullen & Twachtman-Reilly, 2002). Furthermore, the clinician will need to combine assessment strategies: direct assessment, interview significant others, observe in everyday settings, and review written work, to name a few strategies. a) Informally the clinician must observe how language is being used; is it to convey information (talking at people) or to establish relationships (talking with people)? Typically persons with ASD will be able to ‘talk at’ with much greater ease than establishing relationships. A language sample (narrative as well as conversational) will be helpful to look at Gricean Maxims, initiation, maintenance and termination of conversations as well as topics and perspective taking. Narrative discourse skills should also be examined due to their difficulties with critical thinking (Minshew, Goldstein, Taylor and Siegel, 1994). The more sophisticated skills like use of repair strategies, negotiation, understanding sarcasm/irony, and presuppositional knowledge will most often be challenged. Shriberg and his colleagues (2001) alerted us to the notable deficits in prosody (associated more with pragmatics and affective processes than with deficits in the grammatical functions of prosody); they determined the need also to screen for possible prosody-voice involvement that effect social and vocational adjustment. b) <>Difficulty with comprehension has been documented in even the most able students with ASDs. Often their expressive abilities exceed their receptive abilities because of the way they learn language (echolalia). In addition, factual information is easier to understand than is emotionally based information. They also often have difficulty with answering questions and following directions which can them make them appear noncompliant. They tend to interpret language literally and they have difficulty understanding figurative language as well as speaker intent (Peeters & Gillberg, 1999). In addition they have difficulty comprehending nonverbal cues and signals ((Landa, 2000; Mundy & Sigman, 1989; Tantum, 2000). WH question comprehension performance in persons with ASDs is also unique (Vicker, 2002). While the order of acquisition is similar to non spectrum individuals (who, what, where - why and how were most difficult), ASDs error pattern was different from non spectrum individuals; ASDs gave a different WH class answer, whereas non spectrum individuals responded with vague or ambiguous answers (Vicker, 2002). c) 3) a) Conversational skills at all levels (initiation, maintenance, and termination) can be taught through the use of role play, written scripts, topic charts and cue cards. For instance McAfee (2002) stresses teaching the child an acronym PATHS for conversation initiation (P-plan ahead, A-Ask yourself what you are going to talk about, T-time it right, H-Hello, and S-Signals (nonverbal). Topic charts can provide visual guidelines for what topics are okay and what topics are taboo; this can prevent the issue of ‘talking at’ the conversational partner. Teaching a response such as requesting assistance or help can be beneficial for stress reduction but also to assist with comprehension. In the absence of more formal repair strategies the child can be taught to request help which is applicable across multiple contexts. Ensuring that the child has a broad array of communicative functions is critical. Teaching a conventional protest or reject function is fundamental for many students with ASD. b) Visual supports are critical to assist the person with ASDs to comprehend language (Hodgdon, 1995; Twachtman-Cullen & Twachtman-Reilly, 2002). Best practice with this population dictates good teaching (avoid questioning-testing) specifically through the aide of visuals. Intervention strategies must utilize meaningful material and be functional, organized, multi-sensory. Techniques that utilize recognition memory (multiple choice format) will be more helpful than those that utilize recall memory. Much of the material will need to be taught directly (Myles & Adreon, 2000), such as figurative language, idiomatic expressions, nonverbal cues and signals, comprehension monitoring. Referential communication tasks (barrier games) can be of assistance, as can role plays, and graphic organizers. a) Learning Objectives:
Content Area: Communication Glenis L. Benson, Ph.D.
ASD Consultant
Private Practice