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Aiding Comprehension of Individuals with Autism Spectrum Disorders During One-on-One Interactions

Contributed by Beverly Vicker, Speech Language Clinician

Writing guidelines to assist communication partners of individuals with autism spectrum disorders is not an easy task. Despite common areas of challenge, children and adults who have an autism spectrum disorder will differ from one another in the comprehension of the speech messages of others and in their response to strategies that might facilitate a communicative exchange. The following, however, represent some general guidelines for communication partners.

  • Understand the difference between comprehension and expressive abilities. Avoid making assumptions solely based on what the person with an autism spectrum disorder may be able to say. When he or she is talking, he or she is focused on formulating his or her own message. When you are speaking, the person may not want to focus on your message or have difficulty in doing so. Although it seems to violate what we think should be the norm, expressive abilities are frequently not predictive and consistent with the language comprehension abilities of the person with an autism spectrum disorder. Expressive abilities may appear better than true comprehension within a variety of situations. It will be important to remember that all individuals with an autism spectrum disorder experience some difficulties with the comprehension of the verbal and nonverbal messages of others in at least some circumstances. Your initial impression may not be an accurate guide to insure meaningful and successful interactions; other factors, such as those discussed in the remainder of this article, also need to be considered.
  • Know something about the individual with an autism spectrum disorder, if possible, before engaging in your first communicative exchange. Ask more than one individual for advance information so you can benefit from a variety of opinions and conclusions. You will want to check things out for yourself and adapt accordingly. It can be helpful, however, to know:
    • How much interest does the person with an autism spectrum disorder have in social interactions with others? Some individuals may desire or enjoy extensive social attention, while others may only want an interaction if it is on their terms and if it will get them their desired goal.
    • How much language (i.e., vocabulary and syntax) the person understand? It is important to avoid insulting the person with an autism spectrum disorder by over simplifying your language but, on the other hand, one does not wish to use vocabulary and syntax that the person will not understand. Some individuals, under non-stressful situations, may understand general communication at a level more consistent with their age level. Other individuals may understand very little, if anything, of your verbal message and their comprehension may depend upon environmental cues. For example, instead of responding to the message, “come on, time to eat,” the person will respond to clues from the situation and routine. Seeing Mom begin to put food on the table may serve as a cue to proceed to the dining area and to sit down.
    • How well does he or she understand the nonverbal aspects of communication? For example, will you need to provide feedback about the personal space between the two of you during interactions and rules about touching others?
    • Does the person with an autism spectrum disorder have processing difficulties? Will you need to slow your rate of speech, shorten sentences, and/or allow processing time between sentences? How much you need to slow down will be dependent on the individual and circumstances.
    • If the person has limited comprehension, will he or she only be responsive if a message is worded in a particular fashion or delivered in a specific style?
    • Does he or she adequately process a message while doing something else or looking elsewhere? If not, what is the best way of getting and keeping his or her attention other than insisting on eye contact or some type of spatial orientation? (For some individuals, eye contact is difficult and “painful;” they may perceive too much confusing information emanating from the communication partner’s face.)
    • Is he or she able to process a message if there is obvious background noise? If the noise is not obvious to you (e.g., the hum of the flourescent lights), will the person with an autism spectrum disorder have difficulty focusing on your message and interaction efforts?
    • Is he or she able to process a message while in the presence of competing stimuli that is of interest to him or her such as the sight of food, movement patterns of the trees outside the window, and so forth? You may want to move the interaction to another area or eliminate the competing stimuli, if this is the case.
    • Is he or she able to process a message when upset? What are the clues to help you know that the person is upset? What modifications do you need to make when this is the case?
    • Does the person need gestures, manual signing, picture supports, or text to aid in the comprehension of your daily or ordinary messages?
    • Is the person with an autism spectrum disorder more likely to “tune-out” people who use a particular communication style (e.g., assertive and moderately loud, happy and melodic, soft-spoken)?
    • Does the person have personal space boundaries that should not be violated? This may mean no touching or not standing too close.
    • Is the person prompt dependent or very passive? Has he or she learned only to respond to the initiation of others, or will he or she take the initiative in an interaction if allowed an appropriate opportunity/circumstance and enough time?
    • What are favorite topics that are more likely to promote interest in interaction?
  • Be concrete and direct. State your specific message to the person with an autism spectrum disorder in a clear manner. Do not use figurative or abstract language such as “shake a leg” when you want him or her to hurry. Figurative language can be very confusing to someone who interprets everything very literally.
  • Do not expect the person with an autism spectrum disorder to interpret your intended meaning if it is not obviously and explicitly stated. He or she will probably find it very difficult to make inferences and to understand subtleties or hidden meaning. For example, say, “Please turn on the air conditioning,” or “Open a window,” instead of saying “It sure is hot in here,” and expecting him or her to reach the conclusion that you would like something done about the room temperature.
  • Do not present a request or a directive as a choice by using indirect or “polite” language. Asking a child “Would you like to go to music?” implies a choice when in reality there may be no option in terms of the expected response. The child must go to music with the rest of his class so say, “Time to go to music.”
  • Avoid making threats since this may be confusing and can escalate the tension in a situation. Place emphasis on describing what seems to be happening, what must be done, and what reward is coming upon completion of a task. Encourage the person to use strategies previously taught. Instead of saying, “If you don’t finish your math, you will not be able to watch TV,” say “Looks like your math is almost done. Remember to check your answers when you finish. When you have done everything on the list, you can relax and watch TV.” (The amount of information provided will need to be contingent upon the processing abilities of the individual. The above example may be too much information for selective individuals.)
  • Try to avoid only asking questions when you are trying to be conversational. Instead, add some comment or personal information and give the person with an autism spectrum disorder a chance to initiate some type of response, even if it may be nonverbal. Too often people with autism spectrum disorders learn that communication is dominated by the adult and conversation consists of a series of questions to which they must respond. Real conversation is built on exchanges back and forth on a given topic. It will be more difficult for an individual with an autism spectrum disorder to understand that concept if he or she only experiences the question-response format.
  • Provide visual and gestural supports, as needed, to clarify your message. For example, tell the student, “Put your math paper here when it is finished,” as you point to a desk organizer box labeled Completed Work. “Your schedule says music class is next (point to picture); time to put your papers in your folder.”
  • Provide background information in a comprehensible manner if this will help the person understand the topic, message, or situation. For example, while showing a picture of a car, point to the tires and say, “Mom will be late. She had a flat tire. The car won’t go. Someone is fixing the tire. Mom will get a new tire. She will be here at 3:30. We will play a game until she gets here. Let’s put a picture of the game on your schedule.”
  • Repeat the message in a positive but direct fashion if there is no response and an adequate amount of time for processing has occurred. What constitutes an adequate delay is individual specific. For one person this might be five seconds, for another it might be 60 seconds or more.
  • Restate the message in another way, if this is needed, and emphasize the most important aspects of the message (e.g., “Time to go to music. Time to see Mrs. Smith.)
  • Consider the option of a physical prompt, if this is appropriate. For example, a nudge at the elbow might encourage the initiation of a directed action.
  • Remember that when a person is quite stressed, he or she may not listen or process your words until he or she is calm.
  • Be aware that many people with an autism spectrum disorder will not tell their communication partners that they have not understood specific messages. You may need to build in some informal comprehension checks and supports if it is crucial that the person understand the message or topic. Remember that recitation of your exact words can represent a display of excellent rote memory, and echoing or echolalic behavior; it does not mean that the person with an autism spectrum disorder necessarily understands the meaning of what he or she is repeating back to you. Some individuals may understand, but others won’t.
  • Do not be personally offended if the person with an autism spectrum disorder turns away from you, walks away, or begins to do something else rather than letting you know he or she has lost interest, is confused, or is overwhelmed. Watch for, and be responsive to, cues that the person wishes to terminate an interaction.
  • Use frequent, brief, positive interactions rather than less frequent prolonged ones if this seems more satisfying to you and the person with an autism spectrum disorder.
  • Consult with the individual’s speech language pathologist for additional specific information and strategies.

Also see the following IRCA training articles for supplementary information:

Vicker, B. (2001). Aiding comprehension of individuals with autism spectrum disorders during one-on-one interactions. The Reporter, 6(3), 9-14.

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