Communication and Autism


On Monday I focused on the area of Social Interactions in regards to the DSM IV (how autism is diagnosed.)  Today I’m would like to continue on to Communication.  As I said in my last post, just because someone has some of these characteristics, does not necessarily mean they have autism.  They must also meet the criteria in the areas of Social Interaction and Repetitive Behaviors.

According to the DSM IV, at least one of the following are present.

  • Delay in or total lack of, the development of spoken language (also without gestural communication)
  • Individuals with adequate speech have a marked impairment in the ability to initiate or sustain conversations
  • Stereotyped and repetitive use of language or idiosyncratic language
  • Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
Spoken Language and Gestural Language.  Many times the lack of spoken language is the most obvious sign for parents that their child may have delays.  Typically, kids should have several  consistent words they are using by 18 months.  You would start seeing more gestural communication, like pointing, around 14 months.  Here is a great blog about language development (Playing With Words 365), and particularly, here is a post about red flags in communication.  It gives some great timelines on language development.
Initiating and Sustaining Conversations.  There are some kiddos who have tons of words they know, but making their words functional can be more difficult.  Conversations are a give and take process, we build relationships when we have good conversations.  Some kids may know how to talk, but they do not participate in a back and forth interactions with others.  Some kids are good at responding, and will answer questions, but will not go further than that.  Others will initiate, but will rarely let others respond, thus they are very good at the giving part, but not so much at the taking part.
Stereotyped and Repetitive Language.  Some parents will report that their children speak in movie quotes.  Sometimes it’s in context with the situation, but a lot of times it is not.  Some kids may get fixated on certain phrases and will repeat them continuously.  Other kids will repeat what you say or other things they hear, this is called echolalia.  Echolalia includes when they immediately repeat what they hear, or they may also repeat what they heard hours ago.
Make-believe Play or Social Imitative Play.  Make-believe can be difficult for some kids with autism because it involves an understanding of what other people are feeling and doing.  It also requires imitation skills.  When playing with others in pretend play, this skill also requires that the child is able to see the points of view of other people and explain his/her point of view to them to create the experience that they want.  Many kids with autism prefer to play on their own, and may focus more on sensory type play.

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