This article was prepared by Noreen S. Raja as a part of Canvas Health’s APA-accredited Doctoral Internship in Clinical and Health Service Psychology Program. As part of their year-long internships, interns research and present two case conferences. In recognition of Autism Awareness Month (April), following is Raja’s research into communication deficits in Autism.
What is Autism Spectrum Disorder (ASD)?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), ASD is characterized by “communication and interaction with individuals, restricted interests and repetitive behaviors.” These symptoms affect the ability to function in school, work and other areas. The Centers for Disease Control (CDC) describes Autism Spectrum Disorder (ASD) as a neurodevelopmental disorder caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition and other causes are not yet known.
What are common symptoms of ASD?
As children with ASD transition into adolescence and young adulthood, they may experience difficulties with communicating with peers and adults, developing and maintaining friendships or understand what behaviors are expected of them in school or at work. Additionally, co-occurring disorders such as anxiety, depression or attention-deficit/hyperactivity disorder (ADHD) are more prevalent in individuals with ASD than in people without.
Communication deficits are one of the core symptoms of autism spectrum disorders. Some people with ASD can be slow to begin talking or may not learn to talk at all, and others may learn to produce words and sentences but have difficulty using them in social interaction with others. This heterogenous subgroup remains under-researched despite the fact that approximately 30% of children with ASD remain minimally-speaking or non-speaking into adulthood.
Features of non-/minimally speaking Autism
Although nonspeaking or minimally speaking can make communicating with others challenging at times, the absence of verbal communication does not indicate that an autistic person is not communicating. Some may require extra support to help them communicate effectively through other means. Some features of non-/minimally speaking autistic individuals include cortical structural changes which can impact the processing of language and speech production (Jack and Pelphrey, 2017).
Furthermore, some studies indicate visual processing impairment in minimally speaking children with ASD which can negatively influence the acquisition of language (Ortiz-Mantilla et al., 2019) Additionally, due to limited research in this area, there is no single mechanism that suggest underlying difficulties in learning to speak within minimally speaking individuals. Studies have also shown that impairments in pragmatic speech are a distinctive feature of ASD regardless of language level or age (Valle et al., 2020).
Things to consider when working with non-/minimally speaking autistic individuals
One way to accommodate these individuals is to provide access to augmentative and alternative communication (AAC), which allows them to communicate their thoughts and experiences. Recognizing the importance of valuing non-verbal forms of communication for this population is essential. For example, some studies have indicated that students prefer to use non-speaking modes of communication with their teachers because it helped to reduce feelings of stress and anxiety.
Additionally, be aware of the needs of diverse families in addition to the child. As Hanson and Lynch (2013) state: “Working as a culturally responsive educator requires professionals to be sensitive of families’ differences in beliefs, behaviors, languages, viewpoints, ways of thinking, interacting and worshipping; for they can create both texture and tension in the world.”
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC
U.S. Department of Health and Human Services, National Institutes of Mental Health (Updated 2022). Autism Spectrum Disorder. Retrieved from NIMH autism spectrum disorder (nih.gov)
Jack, A., & A. Pelphrey, K. (2017). Annual Research Review: Understudied populations within the autism spectrum–current trends and future directions in neuroimaging research. Journal of Child Psychology and Psychiatry, 58(4), 411-435.
La Valle, C., Plesa-Skwerer, D., & Tager-Flusberg, H. (2020). Comparing the pragmatic speech profiles of minimally verbal and verbally fluent individuals with autism spectrum disorder. Journal of autism and developmental disorders, 50, 3699-3713.
Ortiz-Mantilla, S., Cantiani, C., Shafer, V. L., & Benasich, A. A. (2019). Minimally-verbal children with autism show deficits in theta and gamma oscillations during processing of semantically-related visual information. Scientific reports, 9(1), 5072.