How to Help Children with Asperger's and HFA to Develop Language Skills

“Do children with high functioning autism tend to have problems with speech and language? How can parents tell if their child has problems in this area, and what type of interventions are recommended?”

Language seems to develop on time in kids with Asperger’s (AS) and High-Functioning Autism (HFA), but words, while formulated according to the rules, seem to lack functional effectiveness, because they most often are used to express immediate needs or to expound on the youngster’s favorite subjects.

Young people with AS or HFA seem not to see the main idea or the pivotal point. They tend to have problems with abstraction, inference, or practical, functional language. Also, their semantic understanding is limited, which frequently shows up in tests and instructional measures of listening comprehension.

Instead of delaying language development, AS and HFA impairs the subtleties of social communication. These boys and girls have difficulty understanding nuances (e.g., irony, sarcasm, fanciful or metaphoric language, etc.), and many of them take language literally (e.g., expressions like “watching paint dry” or “smart as a tack” leave these kids very confused).

Young people with AS and HFA are often referred to as “little professors,” which is due to their stiff and often pedantic and monotonic use of language. The varied qualities of expressive language may be unusual, which is called prosody (i.e., the tempo, pitch, loudness, tonality, stress emphasis, and rhythm patterns of spoken language). AS and HFA speech patterns often seem odd to those who don’t know them. Tone, intonation and volume are often restricted, seemingly inappropriate, or appear at odds with what is being said.

These kids also have difficulty interpreting and displaying non-verbal communication. Body language, facial expressions, the use of personal space, gestures and postures are often mysteries to boys and girls on the autism spectrum. This inability to instinctively comprehend unspoken communication has led some experts to suggest Asperger’s is actually a non-verbal communication disorder.

==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

How can parents tell if their AS or HFA child has language difficulties? We’ve provided a checklist below…

Characteristics Checklist for Asperger’s and HFA: Language Skills Deficits—

1. Attempts to control the language exchange, and may leave a conversation before it is concluded.
2. Creates jokes that make no sense.
3. Creates own words, using them with great pleasure in social situations.
4. Difficulty discriminating between relevant and irrelevant information.
5. Displays a delay when answering questions.
6. Displays difficulty analyzing and synthesizing information presented.
7. Displays difficulty as language moves from a literal to a more abstract level.
8. Displays difficulty sustaining attention and is easily distracted (e.g., one might be discussing plants, and the AS or HFA child will ask a question about another country — something said may have triggered this connection, or the child may still be in an earlier conversation).
9. Displays difficulty understanding not only individual words, but conversations and material read.
10. Displays difficulty with problem solving.
11. Displays difficulty with volume control (i.e., either too loud or too soft).
12. Does not ask for the meaning of an unknown word.
13. Does not inquire about others when conversing. 
14. Does not make conversations reciprocal (i.e., has great difficulty with the back-and-forth aspect).
15. Engages in obsessive questioning or talking in one area.
16. Focuses conversations on one narrow topic – with too many details given.
17. Has a large vocabulary consisting mainly of nouns and verbs.
18. Has a voice pattern that is often described as robotic or as the “little professor.”
19. Has difficulty absorbing, analyzing, and then responding to information. 
20. Has difficulty discriminating between fact and fantasy. 
21. Has difficulty initiating, maintaining, and ending conversations with others. 
22. Has difficulty maintaining the conversation topic. 
23. Has difficulty understanding the meaning conveyed by others when they vary their pitch, rhythm, or tone.
24. Impairment in prosody (i.e., the pitch, stress, and rhythm of the voice). 
25. Impairment in the pragmatic use of language (i.e., the inability to use language in a social sense as a way to interact and communicate with others).
26. Impairment in the processing of language (i.e., one’s ability to comprehend what has been said).
27. Impairment in the semantic use of language (i.e., understanding the language being used). 
28. Interprets known words on a literal level (i.e., concrete thinking).
29. Interrupts others.
30. Is unable to make or understand jokes/teasing.
31. Is unsure how to ask for help/make requests/make comments.
32. Knows how to make a greeting, but has no idea how to continue the conversation (e.g., the next comment may be one that is totally irrelevant).
33. Lacks interest in the topics of others.
34. Makes comments that may embarrass others.
35. Moves from one seemingly unrelated topic to the next.
36. Once a discussion begins, it is as if there is no “stop” button (i.e., must complete a predetermined dialogue).
37. Processing of information is slow and easily interrupted by any environmental stimulation (i.e., difficulty with topic maintenance), which appears as distractibility or inattentiveness.
38. Rarely varies the pitch, stress, rhythm, or melody of his speech – and does not realize this can convey meaning.
39. Rhythm of speech is more adult-like than child-like.
40. Uses conversation to convey facts and information about special interests, rather than to convey thoughts, emotions, or feelings.
41. Uses language scripts or verbal rituals in conversation, often described as “nonsense talk” by others. Scripts may be made up or taken from movies, books or television programs (e.g., uses the voice of a movie or cartoon character conversationally and is unaware that this is inappropriate). At times, the scripts are subtle and may be difficult to detect.

Language Disorder—

Some children on the autism spectrum have a full-blown language disorder. Language disorder refers to problems with understanding the message coming from others (i.e., receptive language), and/or getting their meaning or message across to others (i.e., expressive language).

Language disorder is different than “delayed language.” With delayed language, the youngster develops speech and language in the same way as other kids, but later. In language disorder, speech and language do not develop normally. A youngster with language disorder may have any of the symptoms listed below:

• difficulty finding the right words when talking, and often use placeholder words such as "um"
• difficulty putting words together into sentences, or their sentences may be simple and short and the word order may be off
• difficulty understanding what other people have said
• have a vocabulary that is below the level of other kids the same age
• leave words out of sentences when talking
• problems following directions that are spoken to them
• problems organizing their thoughts
• use certain phrases over and over again, and repeat (echo) parts or all of questions
• use tenses (past, present, future) improperly

Because of their language problems, AS and HFA kids often have difficulty in social settings.

Speech and language therapy is the best approach to treating this type of disorder. Psychological therapy (e.g., psychotherapy, counseling, or cognitive behavioral therapy) is also recommended because of the possibility of related emotional or behavioral problems. Moms and dads who are concerned that their youngster's speech or language is lacking should see their doctor. Ask about getting a referral to a speech and language therapist.

Many people believe that speech and language treatment can’t begin until a youngster starts talking.  This is not true.  Treatment can - and should - begin as soon as possible.  Research shows that kids know a lot about language long before the first word is ever spoken.  Your youngster’s treatment team might include a doctor, an audiologist, a speech-language pathologist, an occupational therapist, and/or a social worker. 

==> Discipline for Defiant Asperger's and HFA Teens

In addition to speech and language therapy, there are a few things parents can do to assist early on in their child’s development. Here are some parenting tips for helping along your youngster’s language-skills acquisition:

• Answer your youngster every time he speaks. This rewards him for talking.
• Ask your youngster lots of questions. 
• Describe for your youngster what she is doing, feeling and hearing in the course of the day. 
• Don’t criticize grammar mistakes.  Instead, just model good grammar. 
• Don’t try to force your youngster to speak. 
• Encourage storytelling and sharing information. 
• Expand on what your youngster says (e.g., if your youngster says, “fruit” …you can say, “Oh, so you want some fruit”).
• Follow your youngster’s lead, so you are doing activities that hold his interest as you talk. 
• Have your youngster play with “typical” kids whose language may be more advanced. 
• Listen to your youngster. Look at her when she talks to you. Give her time to respond (it may feel like an eternity, but count to 10 before filling the silence). 
• Look at family photos and talk about them. 
• Make eye contact whenever you are conversing with your child (regardless of whether or not he/she is making eye contact with you).
• Plan family trips and outings.  Your new experiences give you something interesting to talk about before, during, and after the outing. 
• Play with your youngster one-on-one, and talk about the toys and games you are playing. 
• Read books aloud.  Ask a librarian for books appropriate to your youngster’s age. If your child loses interest in the text, just talk about the pictures. 
• Sing to your youngster and provide them with music.  Learning new songs helps your youngster learn new words, and uses memory skills, listening skills, and expression of ideas with words. 
• Talk a lot to your youngster.  Tell them what you are doing as you do it. 
• Use gestures along with words.
• When talking to your child, frequently vary the tempo, pitch, loudness, tonality, stress emphasis, and rhythm patterns of your voice.

Young people with AS and HFA can have problems with any - or all - of these aspects involved in producing or understanding speech and language. Especially, due to their deficits in appreciating social situations, they may not have any understanding of how others might respond to a communicated message.

These children frequently appear to have deficits in paying attention to auditory information. Thus, they frequently have to be ‘trained’ to pay attention to sounds. Even when they are paying attention, they often seem to have difficulty in decoding what sounds mean and in matching them to words or thoughts. In some children on the autism spectrum, this may be because they actually have difficulties with words and thoughts themselves.

Some children with AS and HFA have difficulties with articulation, often as part of a broader problem of difficulty with oral-motor functions (i.e., movements of the lips and tongue, and associated breath control). On the up-side, though, these children are frequently very good with paying attention and appreciating visual materials. Thus, the visual route is often the best way of getting access to their minds and giving them a way of expressing themselves, in turn.
 
Question: Mark, thanks for the very comprehensive article. I work a lot with HFA adults, and I have yet to find a way to get speech therapy for them. Most speech therapists are mystified by adult autism, it seems. Any suggestions?  

Answer: The best approach for these adults is to simply focus on the social aspects of communication (i.e., how to use language in a way that results in a desirable connection for both parties involved in the verbal exchange). 

More resources for parents of children and teens with Asperger's and High-Functioning Autism:

==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

==> Discipline for Defiant Asperger's and HFA Teens

==> Teaching Social Skills and Emotion Management

==> Parenting Children and Teens with High-Functioning Autism

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism