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Lesson 1: Overview of Speech, Language, and Communication
Qualitative Differences in ASD
DR. JOANNE GERENSER: So now what we're going to do is we're going to talk about what the qualitative differences are. What differentiates a person with autism spectrum disorder from somebody who just has mental retardation, or is just developmentally delayed but not on the spectrum.
So to begin with, we'll kind of go through these the areas of language, communication, socialization, repetitive behavior. The first on this list, I think, is one of the most clearly differential, and that's this lack of communicative intent. So if you think about kids who don't talk-- so let's say you're dealing with two three-year-olds and both of them are nonverbal-- but one of them is deaf and that's why he's nonverbal. And one of them is artistic and that's why he's nonverbal. The difference between the two is that the individual who has autism will lack communicative intent. Meaning he won't try to accommodate for his lack of speech.
If you watch a child who's deaf, who's not talking, he will be gesturing and communicating. He compensates for the fact that he's not speaking. And so this lack of communicative intent makes people with autism so challenging to work with.
Another interesting differentiation is that many individuals on the spectrum may actually have better expressive speech than receptive speech. That's very, very unusual to be better at the expressive side than the receptive side. The repetitive or stereotypic use of speech is also quite qualitatively unique. And then this notion that they have this sort of-- some would describe it as robotic speech, some might describe it as pedantic. So it's on both ends. They're overly formal or they're very robotic, meaning they have difficulty with their use of suprasegmental aspects of speech.
If you take a look at this video, you'll see a couple of kids from my program. And if you just listen to the different ways in which they're speaking, you'll hear what I'm talking about.
Some of the other areas that I think are quite differential is this lack of abstract language. So they're very concrete, many of them, in their ability to understand. Somebody just was telling me this story which I thought was great, where her son is in college now, and she lives in southern California. And her son is in northern California up in San Francisco. And she knew he was out of money, out of food money, and it was it finals week. So she called him and she said I'm going to order pizza for you to your dorm. And so he called about an hour later and he said you know I know it's not here yet but how long do you think it's going to take to come from Los Angeles.
So here is in college, getting a college degree, but thinking that she actually called the Domino's in Los Angeles to deliver a pizza to the Domino's in San Francisco, not really understanding that there's actually a Domino's about 10 minutes from his house, or from his dorm.
So it's this sort of, it's not consistent with their IQ, this concreteness. These conversation deficits that you're going to see, echolalia is another very unique component of the language impairments in people with autism, so this repetitive speech where they'll actually repeat back what you say. I'm going to talk about that in a lot more detail in a little bit. And then this sort of lack of spontaneous language. They're very often not initiating, but maybe pretty good responders.
In the video that's below this clip, you'll see, I think, a video that highlights this issue with abstract and non-literal language.
Some other qualitative impairments that you're going to see are issues with pronoun reversal. I'll get into more detail in these so I'm going to kind of go through these quickly. There's this issue with lack of imagination, lack of the ability to play with imagination or spontaneous play. In fact, you often see play deficits for a long, long time. I tell my families not to worry because as their kids get older, play gets more concrete. It gets more, I'm going to play a video game, I'm going to play a board game.
And they also have this inability to use gestures, but also to comprehend gestures. They may misinterpret facial expressions. In terms of the social area, they aren't developing peer relationships. Oftentimes, you'll see individuals with autism engaging-- it's funny, because the kids in my program often engage better with adults. But kids that are higher-functioning often engage better with younger kids. That's why we frequently will leave the kids behind a year.
They don't come up and show you things. There's sort of this lack of spontaneous seeking to share enjoyment. And then there's this lack of social emotional reciprocity. There's this difficulty understanding emotions, but I think a lot of that is tied to the difficulty understanding intonation, which is how we express emotion, and facial expressions. So I think that they would understand emotion, but they have difficulty with the two vehicles for which we convey emotion.
Then oftentimes, people will say, oh, they have lack of empathy. But again, empathy means they have to understand emotions. If you were to walk up to somebody who looked overtly sad and was clearly sad and you just started talking about some very insensitive topic, it would look like you're not empathic, but you're just really having a difficult time reconciling their emotions.
Sarcasm and humor are very difficult for individuals on the spectrum. But again, you have to understand intonation. You have to understand multiple meanings, which are often very difficult for individuals on the spectrum. So take a moment to complete the quiz that's at the bottom of this. And again, see how you did with understanding what we talked about in the lecture. If you ended up not doing so well, go back and review it again, because I think it's really important that you understand the kids that you work with.
Students at Eden II
Two Characters Interacting