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Autism and the Effectiveness of Augmentative and Alternative Communication


Our understanding of Autism Spectrum Disorders has advanced rapidly in recent years. Autism spectrum disorders (ASDs) are a family of neurodevelopmental conditions characterized by unusual patterns in social interaction, communication, and range of interests and activities. While this profile is generally applicable for the entire ASD population, much variation actually exists. No two individuals exhibit the exact same symptoms and as such, ASD is a heterogeneous disorder.

Autism spectrum disorders can often be reliably detected by the age of 3 years, and in some cases as early as 18 months. Studies suggest that many children eventually may be accurately identified by the age of 1 year or even younger. The appearance of any of the warning signs of ASD is reason to have a child evaluated by a professional specializing in these disorders.

By age 3, most children have passed predictable milestones on the path to learning language; one of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he hears his name, points when he wants a toy, and when offered something distasteful, makes it clear that the answer is “no.”

Some children diagnosed with ASD remain non-verbal throughout their lives. Some infants who later show signs of ASD coo and babble during the first few months of life, but they soon stop. Others may be delayed, developing language as late as age 5 to 9. Some children may learn to use communication systems such as pictures or sign language.

Children who do speak often use language in unusual ways. They seem unable to combine words into meaningful sentences. Some speak only single words, while others repeat the same phrase over and over. Some ASD children mimic what they hear, a condition called echolalia. Even though there are children with no ASD who go through a stage where they repeat what they hear, it usually is gone by the time they are 3.

Some mildly affected children may have minor delays in language. Some seem to be very verbal with unusually large vocabularies, but have great difficulty in sustaining a conversation. The usual “give and take” of conversation is difficult for them. They often carry on a monologue on a favorite subject, giving no one else an opportunity to comment. They have other difficulties including the inability to understand body language, tone of voice, or “phrases of speech.” Sarcastic expression might often be misinterpreted. For example, if someone tells them, “Oh, that’s just great,” they would take the words literally, believing the speaker meant to tell them that it really IS great.

The body language of ASD children is also difficult to understand. Facial expressions, movements, and gestures rarely match what they are saying. Also, their tone of voice fails to reflect their feelings. A high-pitched, sing-song, or flat, robot-like voice is common. Some children with relatively good language skills speak like little adults, and do not pick up on the “kid-talk” approach so common with their peers.

People with ASD are at a loss to let others know what they need because they cannot make understandable gestures or lack the language to ask for things. Because of this, some may simply yell or just take what they want without asking. ASD children have great difficulty learning how to get through to others and express their needs. As ASD children grow up, they become more cognizant of their difficulties in understanding others and in making themselves understood, which can result in more anxiety, depression or maladaptive behaviors.

Studies show that augmentative devices are a great help in fostering language in children with autism and other disabilities, and have achieved remarkable results.

Augmentative communication is all of the ways we communicate other than speech. It includes:  Gestures  Sign Language  Vocalizations  Facial Expression  Communication Displays (boards)  Communication Devices A group of aids, starting from simple, notebook-size plastic boxes to more high-tech devices that resemble an IPod or BlackBerry, has been developed to help those with autism to express their needs. These devices range in price from about $100 to several thousand dollars. Most are portable and the simpler ones are also very durable and well-constructed, a real advantage for children with autism.

Augmentative and alternative communication (AAC) devices are tools to allow people with severe or significant speech impairments to express themselves. These devices are used as a method to allow children to exactly say what they want and as fast as they can. It’s a valuable communicator that allows them to express their feelings, thoughts, ideas and get their needs met. These devices can range from low tech picture cards to high end speech generating devices.

However, regardless of low or high tech, the most important questions about the suitability of an AAC Device is: • can the person say precisely what they want • can they say it quickly

About the Author: Joshua Weinstein has been an educator and administrator for over four decades. He holds a Ph.D., two Masters Degrees in Educational Administration and Supervision and an MBA in Executive Administration. He has been the CEO in healthcare, social services, and business corporations. He’s the president and founder of Shema Kolainu-Hear Our Voices, Tishma for children with autism in Jerusalem and ICare4Autism- International Center for Autism Research & Education- a global leader in autism research & education. He can be reached via email at jweinstein@skhov.org.


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More Articles from Dr. Joshua Weinstein

The newest addition of the DSM-5 manual is scheduled for publication in May 2013. The DSM is used by clinicians to determine whether a client or patient meets or does not meet the criteria for a particular diagnosis.

Our understanding of Autism Spectrum Disorders has advanced rapidly in recent years. Autism spectrum disorders (ASDs) are a family of neurodevelopmental conditions characterized by unusual patterns in social interaction, communication, and range of interests and activities. While this profile is generally applicable for the entire ASD population, much variation actually exists. No two individuals exhibit the exact same symptoms and as such, ASD is a heterogeneous disorder.

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