Communication

All people diagnosed with autism will have some degree of communication difficulty, including children and adults.  Like other differences in autistic people, these difficulties exist across a broad spectrum and each person will have a different profile of speech, language and communication skills.  

Some autistic people may be verbal (communicate with speech) or non verbal (communicate in ways other than speech).  Communication difficulties are not only the way the autistic person communicates with others; it also includes the way the autistic person understands and interprets others’ spoken words and unspoken messages.

The common areas of communication difficulty for individuals are:

Social Communication

The autistic person may:
- Repeat (echo) what people say (echolalia)
- Have difficulties understanding/using abstract language such as idioms (‘get your skates on’), sarcasm (well that was worthwhile!), abstract jokes.
- Take things literally
- Need extra time to process spoken information

Social Interaction

The autistic person may:
- Not seek and/or respond to attempts to interact with them, or may become distressed by this.  
- Become easily overwhelmed by interactions with other people.
- Want to interact with others, but be unsure of the ‘hidden rules’ e.g. when to speak/listen, taking turns, use of gesture/body language.  The person may also have difficulty interpreting these things in other people.  
- Actively interact with others but have difficulty with forming or maintaining friendships or relationships.

The autistic person’s skills in any of these areas may change depending on internal factors (degree of emotional regulation, mental health, wellbeing) and external factors (the environment, who they are speaking with).

Autism and Co-occurring Speech, Language and Communication Needs (SLCN)

Difficulties in the areas above are key to an autism diagnosis. However, an autistic person may or may not have other speech, language or communication needs (SLCN) in addition to this.  A Speech and Language Therapist will be able to help make the correct diagnosis. Autism may co-occur with:
·       Speech sound or articulation difficulties
·       Stammering (stuttering)
·       Selective Mutism
·       Late talking (under 5s)
·       Language Disorder (but not Developmental Language Disorder)
·       Feeding or swallowing difficulties
·       Voice disorders

Autistic people are entitled to receive support for any of these areas above, in addition to any support received for their social communication or interaction difficulties.

Non-verbal profiles of autism

Some autistic people may be non-verbal (do not communicate with speech).  This does not necessarily mean the autistic person does not understand what people are saying.  An assessment from a Speech and Language Therapist will help to build a profile of what language the person can understand.  The Speech and Language Therapist will work with the person and their family to find the best ways of supporting communication and reducing any frustration.  This may include using Alternative or Augmentative Communication (AAC).  This may include some of the following:
·       Signing (Makaton, Signalong)
·       Picture Exchange Communication System (PECS)
·       Objects of Reference
·       ‘Low-tech’ communication support e.g. communication boards, symbols
·       ‘High-tech’ communication support e.g. iPad apps, specialist devices.

Communication and behaviour

Communication difficulties can be frustrating.  By understanding the communication differences and challenges experienced by autistic children and adults, we can put strategies in place to help.  This can reduce behaviour by helping the person express their thoughts and feelings in a different way.

Getting support for communication

A Speech and Language Therapist (SLT) can offer advice and support for all types of communication difficulties in autistic children and adults.  Just because a person can speak doesn’t mean that they don’t have a communication difficulty.  The SLT can work with the autistic person, their family and education staff to provide support, training and ways of communicating effectively together.

Examples of support that Speech and Language Therapists can provide includes:
- Visual support (visual schedules, task planners, apps)
- Social understanding (social situations, perspective taking)
- Learning specific social skills- Understanding and expressing thoughts and emotions
- Parent-child interaction interventions (PACT, Hanen)
- Group work to develop communication with peers (Lego-Based Therapy, or ‘Social Thinking’ by Michelle Garcia-Winner)

Further information and contacts:

1.      Autism Factsheet – Supporting Autistic Children and Adults:
https://www.rcslt.org/wp-content/uploads/media/Project/RCSLT/rcslt-autism-factsheet.pdf 

2.      National Autistic Society – Communication Tips and Tools: https://www.autism.org.uk/advice-and-guidance/topics/communication 

3.      Northamptonshire NHS Children’s Speech and Language Therapy Services:
https://www.northamptonshire.gov.uk/councilservices/children-families-education/SEND/local-offer/health-services/14-childrens-therapy-services-speech-language-therapy-nhft

4.      Northamptonshire NHS Adult Speech and Language Therapy Services:
https://www.nhft.nhs.uk/salt/venue/adult-speech-and-language-therapy-services-highfield-clinic-94/

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