Currently this disorder includes Autism, Asperger syndrome, Rett syndrome, and Pervasive Developmental Disorder (NOS-Not Otherwise Specified). Some of the characteristics do overlap. Autism is often noticed around the age of two with a more firm diagnosis at age three or four. According to Ratner, Autism revolves around four major sets of communication features: delayed spoken language or absence of it, impaired conversational skills, stereotypical and repetitive use of language skills, and lack of imaginative or socially imitative play that is appropriate for the child's developmental age. Asperger syndrome is characterized by a person who has restricted and repetitive interests, mild social and pragmatic deficits, less obvious delay of language and cognitive development. Rett syndrome is characterized by autistic behaviors, intellectual disability and sudden regression in communicative abilities in early childhood. This disorder affects girls, progresses to motor, sleep and skeletal problems, and often times shortens their lifespan. Pervasive Developmental Disorder-NOS is actually the category of disorders that all of these disorders fall under. Oftentimes children are diagnosed with PDD-NOS until a professional is certain that they have autism or aspergers.
When does Autism Spectrum Disorder start to present itself?
Autism is often noticed around the age of two with a more firm diagnosis at age three or four. Studies are now identifying some prelinguistic markers of a later diagnosis. Some of the markers include the child's lack or responsively to his or her name and aberrant eye-gaze behaviors. By 18 to 24 months, patterns of gazing, gesturing, and communicating really start to present themselves as being atypical. Some children may also appear to develop language normally and then regress in communicative ability. It is important to go to regularly scheduled pediatrician appointments so that they can do a screening if you are concerned about the development of your child. It is also important for you as a parent to look at a chart of typical language development in order to recognize what your child should be doing at certain ages.
How does ASD affect language?
75% of children on ASD (at some point) are echolalic which means they have immediate or delayed repetition of the speech of others. And for the 23% of children with autism who have less problems with vocabulary and structures, functions in language are their main barrier. The following breaks down how children with autism struggle in the different acts and aspects of language:
Vocabulary- 20% experience difficulty with expressive and receptive vocabulary (certain types of words like mental state verbs (think, know) and abstract process (divide, love)
Syntax/Morphology - delayed but follows typical sequence of acquisition
Semantic- struggle to interpret semantics even if all words are known, for example:
- The boy bumped the girl and fell down. (easy)
- The boy that bumped the girl fell down. (harder)
- The girl that the boy bumped fell down. (hardest)
Phonology-difficulty repeating nonsense words (for example can repeat pig and leg but not lig)
Pragmatics is a widespread problem which includes:- trouble using language for different purposes (such as greeting, informing, demanding, promising, requesting)
- difficulty changing language according to the needs of a listener or situation (talking differently to a baby verses adult, speaking differently in classroom verses the playground)
- a hard time following the rules of conversations (turn taking, introducing topics, staying on topic, proximity, using and reading facial expressions and eye contact)
Rhetoric-may have limited inventory of different genres (i.e. conversation verses lessons verses tests), problems with formal verses informal style, and struggle with decisions or cues to initiate, maintain, and close genres
What happens if the child with ASD is nonverbal?
If a child is not able to learn expressive language there are many forms of augmentative/alternative communications (AAC) that are used that enable them to communicate. Some children are taught to use sign language as a form of unaided communication. Other forms of communication are aided systems which include: paper/pencil, or communication books/boards/computer software. A pre-requisite for these aided communications is that the child use convey needs via pre-symbolic behavior (such as body movements, vocalizations, facial expressions, and simple gestures like tugging on people). One example of an aided system is the picture exchange communication system (PECS) which starts off enabling the child to initiate requests using a set of representative pictures and then it grows to more functions and abstract symbols. Contrary to popular belief, there is no evidence that AAC impedes or replaces language development, in fact, it has promoted language development in some cases.
What are some ways I can help my child who has been diagnosed with ASD?What happens if the child with ASD is nonverbal?
If a child is not able to learn expressive language there are many forms of augmentative/alternative communications (AAC) that are used that enable them to communicate. Some children are taught to use sign language as a form of unaided communication. Other forms of communication are aided systems which include: paper/pencil, or communication books/boards/computer software. A pre-requisite for these aided communications is that the child use convey needs via pre-symbolic behavior (such as body movements, vocalizations, facial expressions, and simple gestures like tugging on people). One example of an aided system is the picture exchange communication system (PECS) which starts off enabling the child to initiate requests using a set of representative pictures and then it grows to more functions and abstract symbols. Contrary to popular belief, there is no evidence that AAC impedes or replaces language development, in fact, it has promoted language development in some cases.
Currently the treatment to reduce the impact of the development of children with ASD includes early intervention that is intense and frequent. Children may need 25 house a week or guided instruction as well as a focus on communication, emphasis on generalizing skills being learning, and systematic individualized instruction. There is no single approach to treat autism that meets the strict criteria for treatment efficacy however Applied Behavior Analysis is a research based proven technique to shape behaviors. This is also combined with Verbal Behavior in order to teach the deficits in language that children with ASD experience.
How can I help my typically developing child understand a peer who has ASD?
It is important to talk to your child who is typically developing about different disabilities. It is really helpful for you as a parent to explain how different disabilities make it hard for others to learn or socialize like they do. You can describe how autism might affect a student in their everyday life. Ask your child what they have noticed about their peer who has autism. It is important to stress the strengths that the child with autism has as well as the things in their day that are hard for them. According to a study done by the Prince Edward Island Department of Education, here are some helpful skills to teach a typically developing child: welcome/greet students with autism, share toys with them, offer them assistance if they are struggling with something, ask them to help you with certain activities, compliment them, model appropriate responses and actions, and ask them questions about activities. The American Speech Language Hearing Association has an extensive list of books that might also be helpful in reading with a typically developing peer or sibling to help them better understand the child who has autism.
Next we will learn more about children with specific language impairment.
Resources:
Griffin, P. (2012). Class 8 Notes. Retrieved from online lecture notes.
Ratner, N.B. (2009). Aytpical language development. Pp. 315-390 in Berko Gleason, J. & Ratner, N.B. (eds.) The Development of Language (7th Edition). Boston: Allyn & Bacon.
American Speech Language Hearing Association. http://www.asha.org/public/speech/development/pragmatics.htm. Retrieved online March 19, 2012.
American Speech Language Hearing Association. http://www.blogger.com/..www.asha.org/public/books_aas.htm. Retrieved from Search for (good) Research Task 5 Activity April 25, 2012.
National Dissemination Center for Children with Disabilities. http://nichcy.org/babies/overview. Retrieved online May 5, 2012.
Department of Education and Early Childhood Development. http://www.gov.pe.ca/photos/orginal/ed_autisminc.pdf. Retrieved online May 5, 2012.
