What is Autism Spectrum Disorder (ASD)?
Autism spectrum disorder (ASD), which is characterized by severe deficiencies in social communication and interaction skills and limited, repetitive behaviors, is a neurodevelopmental disorder that occurs in the early stages of development (American Psychiatric Association / APA, 2013). The term "spectrum" refers to the wide variety of symptoms, abilities, and levels of impairment that individuals with autism may have. ASD affects individuals in different ways, and these can range from mild to severe. Individuals with autism share some symptoms, such as difficulties with social interaction, but differ in when symptoms begin, how severe they are, the number of them, and whether there are other problems. Symptoms and their severity can also change over time. Behavioral symptoms of ASD usually occur early in development. Most children show symptoms between 12 months and 18 months or earlier. Deficiencies in non-verbal social communication skills such as eye-gaze, vocalizations, gestures, joint attention, and non-verbal social interaction skills such as imitation and playing with objects are among the early symptoms of ASD (Zwaigenbaum, Bryson, & Garon, 2013) and these characteristics of children with ASD, are considered as criteria in diagnosing them.
How Does ASD Affect Communication Skills?
The origin of the word "autism" comes from the word "autos", which means "self" in Greek. Children with ASD often prefer to be on their own and appear to be in a private world where their ability to successfully communicate and interact with others is limited. They show serious limitations in communicative intention. Children with ASD may have difficulty developing language skills and understanding what others are saying to them. They also have difficulty understanding and using non-verbal communicative behaviors such as gestures, eye contact and facial expressions. The ability of children with ASD to communicate and use language depends on their cognitive and social development. Some children with ASD have very limited speaking skills; some may not be able to communicate using speech or language. On the other hand, some children with autism, may have a rich vocabularies and be able to talk in detail about specific topics. These children often have problems with the rhythm of speech. In addition, they may not be able to understand body language and the meanings of different vocal tones. Taken together, these difficulties negatively affect the ability of children with ASD to interact with others, especially peers of their own age.
Some of the language usage and behavior patterns frequently found in children with ASD are as follows:
-Repetitive or strict language
Often, children with autism who can speak say things that have no meaning or that have nothing to do with conversations with others. For example, a child can count from one to five repeatedly during a conversation not related to numbers. Or a child may repeat the words he hears continuously (echolalia).
Immediate echolalia occurs when the child repeats the words someone has just said. For example, a child can answer a question by asking the same question. In
delayed echolalia, the child repeats the words he hears at a later time. For example, the child can say "Do you want something to drink?" whenever he or she asks for a drink. Some children with ASD may speak in a high-pitched or melodious voice or use a monotone (robot-like), unemotional speech.
-Limited and fixed areas of interest
Some children with autism may present an in-depth monologue about a topic that holds their interests, even if they cannot have a two-way conversation on the same topic.
-Abnormal, irregular language development
Many children with ASD develop some speech and language skills, but this development is not at a typical level of ability and their progression is often irregular. For example, some children with ASD can very quickly develop a strong vocabulary on a particular topic of interest. Some may start reading before the age of five, but may not understand what they are reading. They often do not respond to the speech of others and may not react to their own names.
-Difficulty with non-verbal language skills
Children with ASD are often unable to use expressive gestures such as pointing at an object. Often they avoid eye contact. Without meaningful gestures or other non-verbal skills to improve their verbal language skills, many children with ASD fail to communicate their feelings, thoughts, and needs.
How to Handle Language and Speech Problems in ASD?
If a doctor suspects that the child has ASD or another developmental disorder, they will usually refer the child to various specialists, including a speech and language therapist. The speech and language therapist makes a comprehensive assessment of the child's communication and language skills, creates an appropriate therapy program and guides the family in this regard. Teaching children with ASD to improve their communication skills is essential for helping them reach their full potential. While there are many different approaches, the best intervention program begins early in preschool years and is adapted to the child's age and interests. Parents and caregivers can increase the chances of reaching this goal by paying attention to the child's language development early on. Just as young children learn to crawl before walking, children develop their pre-language skills before they start using words. These skills include using eye contact, joint attention, association, gestures and facial expressions, affects, and other vocalizations to help them communicate. These skills are evaluated by a speech and language therapist and are addressed within appropriate individual therapy approaches.
Lecturer Betül ÖZSOY TANRIKULU
