Early Years Communication

“Zoe doesn’t talk a great deal, when she does she tends to repeat phrases or questions that others ask her.”

Why does this happen?

• Repeating words, phrases or questions is known as echolalia. It is a common characteristic of children with autism. Some children will go on to develop functional use of language.
• The child with autism may enjoy hearing the sounds of the words repeated over and over, in the same way that a baby will babble to hear her voice.
• Echolalia may be an indication that the child hasn’t understood what is being said.
• Higher functioning children may be able to mimic whole sentences, together with the speaker’s accent and inflections. This mimicking can give a false impression of a child’s verbal comprehension.
• Echolalia can be positive as it shows the child is ‘tuned-in’ to language.

What you can do

• Respect the child’s attempts at communication.  Echolalia should not be discouraged, but moulded to give the child’s speech more purpose.
• Encourage early speech with turn-taking activities. When playing board or card games make comments such as, “Your turn, my turn, Sally’s turn”
• Encourage early speech with music and song. Songs that are short and repetitive are best at first, as the child learns to anticipate words and actions.
• For children with minimal vocabulary, speak clearly in a happy voice. Keep your voice expressive and interesting, with an emphasis on key words. Play games that use repetitive phrases, “Ready, steady, go!” Leave the last word out, see if the child will fill the gap.
• If the child is reluctant to ask for what she wants, encourage her to communicate by making choices from picture cards. Repeat the name of the desired object, then encourage her to use “I want…”
• The child may repeat full sentences but not understand the meaning of individual words. Keep sentences short and simple. Give the child adequate time to respond then check that she has understood what she has heard.
• Simple gestures and sign language can reinforce comprehension. Talk to the child’s speech pathologist about using sign language.

Use a consistent style of language

• Keep facial expressions and gestures simple and clear
• Be specific
• Be direct
• Use yes/no questions
• Give the child time to respond
• Speak in a calm voice
• Limit vocabulary
• Be detailed with instructions
• Avoid sarcasm
• Break tasks down into simple steps
• Practice social skills (e.g., starting a conversation, maintaining a conversation)

What you can do

• It is very important for the child to learn these critical social skills.
  Children with autism will always lack a natural ability to read facial expressions but with time and repetition they can be taught how to respond in various situations.
• Encourage eye contact by prompting the child to “look at me.” The child does not have to look directly into your eyes, but at least in your direction. Reward with “good looking.”
• Children with autism may need physical cues and prompting regarding personal space. The child with autism may either want to sit far away from others or may be touching others and standing too close. Mark on the mat a space for the child to sit. Teach the other children in the group how to remind the child with autism about personal space if they are standing too close.
• To reinforce personal space you may have to physically position or cue the child to stand about an arm’s length away from others.
• Social stories are an excellent tool for teaching and re-enforcing social skills and an understanding of social situations.
• If the child with autism is anxious or upset, be particularly aware of your facial expressions, tone of voice and use of gesture as this extra information may get in the way of the child understanding the message you are trying to get across.
• Help the child recognise emotions and facial expressions through play. Activities such as role play or drawing faces can encourage understanding of facial expression and gesture. Using a mirror, take it in turns to guess each other’s facial expressions.
• A speech therapist will recommend games and aids to teach and encourage non verbal language skills.

“Elli is a great talker, but doesn’t introduce a topic of conversation; she just chats away as if we must know what she is talking about!”

Why does this happen?

• Children with high functioning autism may have extensive vocabularies but these skills can mask their communication difficulties. A particular area of difficulty is in the social use of language, known as pragmatics.
• For example, the child may not automatically know what to say in everyday social situations. A friend may say hello, and the child may not return the greeting or even acknowledge they were spoken to. The child may require a prompt to respond appropriately.
• Children with autism also have limited ability to convey and understand the meaning of words, known as semantics. They interpret language in a very literal and concrete way. They have difficulty understanding metaphors, sarcasm or jokes because they usually do not grasp the underlying meaning or intention of a conversation.
• Sometimes children with autism use words or phrases that seem inappropriate. They can make comments that are very blunt or even rude because they lack social awareness and don’t understand the feelings of others.
• Children with autism interpret phrases literally, e.g. they may interpret “you all need to pull up your socks” as an instruction to actually pull up their socks.
• Children with autism don’t have intrinsic motivation to conform to social norms and fit in to the conversation or the social situations occurring around them.
• Children with autism will talk for hours on their preferred subject as they may not know how to engage with other people on any other topic.

What you can do

• Use the child’s interests to practise starting and maintaining a conversation.
• Be aware that an extensive vocabulary can mask serious comprehension deficits. You may need to repeat and simplify instructions. Keep your language as simple as possible. Give the child time to respond to instructions, and then check that he or she has understood.
• Avoid using sarcasm, abstract concepts or innuendo.
• Tell the child exactly what you need them to do and be specific. The child with autism will miss the point of things that are merely implied.
• Be aware of the language that you use. Ask yourself whether it could be misinterpreted. Avoid literal phrases that may cause distress, such as “Has the cat got your tongue?”
• Teach the child a standard phrase to use when she hasn’t understood an instruction.
• Teach the child some topics or a social script to talk about with friends. Social stories can support this.
• Use role play to develop the child’s social language skills. These scenarios can be used to help the child understand when someone is joking or teasing, how to initiate a conversation and how to respond to the emotions of other people.
• Social stories can be very useful to teach turn taking, topics to talk to friends about and understanding the feelings of others.
• Discuss some common metaphors and explain what they mean. eg. “Pull up your socks!” and “I’m feeling a bit under the weather today.”
• Work with a speech therapist to gain assistance with appropriate games to play to encourage social language skills.

“What can I do to get Sean to look me in the eye?”

Children with autism may never directly look their parents or teacher in the eye.  This is because:

• Children with autism may feel very uncomfortable looking directly at someone when speaking or being spoken to. Eye contact has been reported as feeling “painful” or “exhausting”.
• Direct eye contact can be quite threatening for children with autism.
• Eye contact is a non-verbal skill that children with autism do not develop naturally.
• Children with autism may not understand how long they should hold their gaze.
• Many children with autism find it difficult to listen and look at the speaker at the same time.

What you can do

Children with autism may never develop eye contact, but it is important they learn to orient their body towards the person they are listening to.

• Children with autism can still learn without looking directly at a person who is speaking to them.
• You can support the child to learn to look at your face or in your general direction instead of looking directly into your eyes.
• Make sure the child is listening by touching them on the elbow and making sure their body is facing to you.
• Make sure the child is not distracted by other things in their environment or engaged in self-stimulatory behaviour.
• Check for a response to your instruction.
• Support and reward when the child is orienting their body towards you or looks in your direction with “good looking”.
• Do NOT force eye contact- this can be very distressing and cause the child to shut down and not listen.
• Games such as peek a boo, face painting, mirror play and other activities involving shared attention can encourage the child to look at you or what you are doing.

“Sometimes I think Hayden must have a hearing problem – although I’m told his hearing is fine – but he doesn’t listen to what I say, in fact sometimes he does the complete opposite”.

Why does this happen?

• Auditory processing may take longer in children with autism. They may need more time to respond to an instruction. Too many instructions at once can be overwhelming and confusing to the child with autism.
• Most children with autism have poor receptive language skills.
• Higher functioning children may have difficulty with group instructions. Possibly they do not think of themselves as part of the group, so they don’t realise the instruction also applies to them.
• Children with autism have an overriding desire to do what they want to do, not what they are told to do. This behaviour can make it hard for them to stop what they are doing.
• Children with autism can become easily distracted and irritated by even a moderate level of background noise. This makes it very difficult for them to interpret instructions and distinguish your speech from other sounds. Therefore children with autism can attend to only one stimulus at a time ie visual, auditory or tactile.

What you can do

• When in a group situation always address the child by name when giving instructions. This should gain the child’s attention and help him understand that the instructions are intended for him as well as others in the group. Alternately, ask an assistant to repeat the instructions to the child individually.
• Approach the child directly and try to gain attention and eye contact before giving an instruction. You may need to gently touch the child on the arm and say their name to gain their attention.
• Give the child sufficient time to respond to an instruction, perhaps ten seconds, before repeating it.
• Use simple clear instructions. Give only one instruction at a time. Auditory processing difficulties may result in the child missing parts of an instruction.
• Use maximum visual cues to assist the child in fully understanding instructions.

“Jake constantly asks the same questions over and over. It makes no difference to him that we give the answer – he asks again a few minutes later.”

Why does this happen?

• Children with autism may ask questions repeatedly because it helps relieve anxiety. Questions about ‘what will happen next’ may be due to anxiety about the future; children with autism have difficulty anticipating what might happen next. Some young children with autism are reassured by hearing the same response to their question over and over. They may become distressed if the answer differs in any way from what they want to hear or what they heard the first time.
• Higher functioning children may want to engage in conversation but lack the necessary skills to do so. Questioning may be their only way of holding a conversation.
• Children who talk incessantly may miss the cues from others that it is inappropriate to continue with a conversation that is boring or repetitive. They may also interrupt conversations because they have difficulty recognising how or when to join in.
• Repetitive questioning may be an attempt at mimicking the conversation of others – “What are you doing?” ,“What’s that for?”

What you can do

• Be sensitive to the child’s attempts at communication. Questioning is often a phase children with autism experience before they develop more meaningful communication. Remind yourself that the questioning may be the child’s method of remaining calm by helping predict what will come next.
• If the child appears very anxious, examine the causes and try to direct the child toward other means of relaxation, eg. a quiet space, listening to music with headphones, reading a favourite story, watching a video or playing a computer game.
• Create a visual timetable for the child. If the child knows what will happen each day the child will be less likely to keep asking.
• Try www.boardmakershare.com for some ideas.
• On a visual timetable, list the times that the child is allowed to ask questions. You may need to place a limit on the number of times you will answer the same question. Make a clear rule – “You can ask that question only three times.” After that, suggest more appropriate conversation, “Ask me about ….”
• You could limit the questioning to a particular location, for example only in the playground.
• Tell the child you will respond to his questions when he has performed a certain task. This might be an activity he wouldn’t normally try.
• If the child constantly interrupts during group time, use an object to signify who can speak. Only the person holding the object may speak.
• The child may need help learning when it is appropriate to join a conversation, ie when there is a pause or gap, and may need to be taught specific phrases such as “Excuse me”.

“One minute Bailey’s OK, the next minute he’s crying and having a big emotional outburst.”

Why does this happen?

• Children with autism become more easily frustrated than other children. Their inability to express feelings, understand social situations and process sensory information can lead to some intense emotional outbursts.
• Children with autism have limited social awareness. In most typically developing children this awareness inhibits their behaviour. Children with autism lack this constraint, so they may have frequent emotional outbursts and display inappropriate behaviour.
• Children with autism seem to have fluctuating mood swings; these may be associated with their obsessive thoughts or reactions to their environment.
• Children with autism have difficulty understanding and accurately interpreting the feelings and emotions of others. They may also struggle to understand their own feelings.
• Children with autism have less ability to describe and communicate what they are feeling. Complex emotions and frustration are difficult for children with autism to verbalise, resulting in a higher likely hood of becoming over emotional or lashing out.
• Children with autism will become more emotional when overtired and out of routine.

What you can do

• Help the child understand emotions by interpreting how they feel and giving that feeling a label. In time, the child will learn to recognise emotions and understand the feelings that lead to each emotion.
• Encourage the child to tell you and others how they are feeling.
• Make sure the child knows how to seek help and who to turn to when feeling overloaded.
• Using role play, teach the child how to act in certain situations, such as an appropriate way in which to say ‘leave me alone’, and how to react if the child doesn’t get what they want.
• Cut photos from magazines to make a poster that displays a variety of emotions, or use photographs of the child.
• Monitor the child’s emotional state and check whether their mood coincides with any environmental change, such as bright light or background noise.
• Structured routine is important both at home and at kinder/playgroup/daycare. Have consistent meal times and bed times.
• Social stories can support learning about feelings, the feelings of others and about appropriate behaviour when angry, sad or upset.