People with ASDs who are verbal, may use words without their usual meanings or repeat verbatim words or phrases they have heard (echolalia). Others will speak in odd ways, using a high pitched voice or using staccato, robotic speech patterns Even those with exceptional vocabularies, may miss the subtleties of practical communication and still have a hard time conversing.
Language difficulties can also greatly affect behaviour. The inability to communicate needs effectively can cause anxiety and frustration leading to challenging behaviours such as screaming, tantrums, etc.
Communication assistance is usually provided by trained speech and language therapists (pathologists). Experts agree that treatment should begin as early as possible. The Speech and Language Therapist should have experience with individuals with ASD and their unique communication deficits.
The Speech Therapist will evaluate whether the speech and language difficulties of the child is caused by autism or another disorder. The therapist will analyze the child’s hearing, expressive language, receptive language, oral-motor functions, voice quality, articulation and fluency, auditory processing and functional skills.
After a full assessment of individual needs, the focus may be on increasing verbal language skills and/or organizing a functional alternative communication system through techniques such as PECS. Speech therapy can also be beneficial for adults with ASDs especially when integrated into other treatment and educational programs.
Picture Exchange Communication System (PECS)
While some people with ASDs do not develop functional and fluent spoken communication, they may be able to use an alternative and augmentative communication system. The most successful of these techniques is the Picture Exchange Communication System (PECS).
PECS was developed at the Delaware Autistic Program to help children and adults with autism to gain functional communication skills. It uses ABA-based methods to teach people to exchange a picture card for something they want - an item or an activity or to express a feeling. As the person progresses, the pictures are replaced with symbols and eventually the symbols are combined to make simple sentences. PECS allows a person to initiate communication and have a need immediately understood. PECS helps the person acquire a functional communication system so that they can communicate and so that learning can expand.
PECs cards can be purchased in manual form or some families make their own using drawn pictures or pictures cut out of magazines, etc. Pictures are used which might motivate the individual child to get the thing they want and they are encouraged with constant feedback in a step by step process to engage with others to get their needs met.
PECS.com: This is the site for information on upcoming PECS training, purchasing materials, etc. It is run by Pyramid Educational Consultants.
Picture Card Communication: Personalized/individualized visual resources and educational materials for people affected by Autism and their families, teachers, therapists, etc.
Research suggests that the use of sign language increases the chance of non-verbal children learning to speak. However, it may be less effective for children with autism than PECS because many children with autism have difficulty imitating others.
There is debate about the best use of sign language for people with autism. Signed English may be more useful than American Sign Language (ASL) because ASL has a completely different grammar and structure. Consequently, verbal people cannot sign and talk at the same time. On the other hand, Signed English lets you speak normally and sign while speaking, reinforcing regular verbal communication.
Parents can learn and use signs when talking to their child. This is called ‘simultaneous communication’ or ‘signed speech.’
Improving Communication for Children with Autism: Does Sign Language Work? [PDF] Jamie B. Schwartz, PhD and Chad Nye, PhD. EBP Briefs, 2006.
Fluency training is used within other programs to maximize generalization and retention of learned language skills. Fluency techniques can result in increased accuracy and speed of performing speech tasks.
Facilitated Communication (FC)
Experts report that FC as a stand-alone program approach is ineffective and potentially harmful for individuals with ASD. Evidence-Based Practices for Children and Adolescents with Autism Spectrum Disorders: Review of the Literature and Practice Guide. Perry, Adrienne and Condillac, Rosemary. (2004). Children's Mental Health Ontario.