 |
||||||
|
||||||
|
 |
 |
|
Communication Impairments and Intervention
 An interview with Barry M. Prizant, co-author of Autism Spectrum Disorders. From the April 2002 Disabilities newsletter.Q: How do communication impairments differ among children with different types of autism? A: There is great heterogeneity among children with autism spectrum disorders. This is reflected in differing cognitive, motor, social, and communication abilities. In general, a specific subcategory of autism spectrum disorder (e.g., autistic disorder, pervasive developmental disorder-not otherwise specified [PDD-NOS]) does not necessarily correlate with different types of communication impairments. The only exception is Asperger's disorder, where children, by definition, have measured intelligence within or exceeding "normal limits." These children tend to be quite verbal and competent in their linguistic skills, but have considerable difficulty in the social use of language, such as conversational abilities. However, children with autistic disorder and PDD-NOS, the two other most common types of autism spectrum disorders, may vary from children who are not using any speech for communication (relying primarily on very primitive, idiosyncratic nonverbal communication abilities) to children who are quite verbal but still demonstrate social-communicative problems. Motor speech disorders also are quite prevalent in children with autism spectrum disorders, resulting in mild to severe speech production problems. The common problem across all children with autism spectrum disorders is significant social-communicative difficulties and problems in developing social relationships. Q: How does the process of learning language differ in children with autism compared to typically developing children? A: In general, children with autism spectrum disorders tend to have relative strengths in rote memory co-occurring with difficulties in language processing and more abstract semantic (language-based) memory. This learning profile results in a relatively unique approach to learning language for many children. We have referred to their style of language learning as a "gestalt" style of language learning, in which they rely on immediate and delayed repetition or immediate and delayed echolalia (repeating words and sentences said to them) to communicate and to acquire language. In the past, behavior therapists viewed echolalia primarily as a "deviant" or socially undesirable characteristic of autism and attempted to extinguish echolalia through punishment procedures. Through a number of studies, we were able to demonstrate that echolalia served important communicative functions for children with autism spectrum disorders, and that it reflected their unique strategy for acquiring language that resulted from their learning style; therefore, echolalia is now viewed as a positive prognostic factor for speech and language development. Q: How can professionals determine the best communication intervention plan for children with autism? A: In our opinion, the best way to determine a communication intervention plan for children with autism spectrum disorders is to assess a child's developmental strengths and needs in social communication, language-related cognitive abilities, and related socioemotional abilities. Assessment should take into account a child's abilities across different settings. Parents should always be involved as collaborators in assessments and in intervention planning, as they are the most knowledgeable about their child, and they must value intervention goals to be actively involved. Over the past few years, my colleagues and I have developed a model called the SCERTS Model, which prioritizes Social Communication, Emotional Regulation, and Transactional Supports to enhance a child's abilities in everyday settings and activities. We discuss this model in our chapter on communication intervention in Autism Spectrum Disorders: A Transactional Developmental Perspective.
|
|
