Increasing Conversation in People with Autism

Language and communication are often the biggest obstacles faced by individuals with autism. As a behavior therapist at a private school for children with autism, I observe the students' difficulties in verbally expressing thoughts and feelings. Repetitive behaviors such as repeating, or "parroting," and speech that lacks context can take the place of meaningful language. While a majority of these individuals do possess some degree of spoken language, social interaction skills are often severely lacking. Fortunately, thanks to increasing public awareness about autism and dedicated clinical research being conducted worldwide, more and more diagnosed individuals are learning to engage in meaningful conversation. This important skill enables them to forge stronger relationships and boosts self esteem. If you work with a developmentally disabled population, or someone you know has an autism spectrum disorder, here are two things to consider that I hope may aid in promoting social interaction skills.

Use Positive Reinforcement . One of the most important principles of Applied Behavior Analysis, perhaps the most successful teaching philosophy used with people who have autism spectrum disorders, is using positive reinforcement to increase the occurrence of a particular behavior in the future. Because many individuals with autism, especially younger children, face severe learning delays in communication , it is necessary to heavily reward the use of appropriate language, especially spontaneous conversation. Unlike typically developed individuals who take conversation for granted, these skills do not come naturally to those afflicted with autism. Therefore, it is important to reinforce their efforts enthusiastically, when even attempting to initiate conversation. Reinforcements do not have to be tangible (i.e. toys, candy) but can simply be verbal praise, high fives, pats on the back, or another form of attention that the person values. When using verbal praise, you may have more success if you keep it specific, such as "wow, nice talking, thanks for telling me!" as opposed to broader statements like "nice job!" Just remember, do not get frustrated when it does not happen overnight! Time and patience are key; even reinforcing the smallest successes can go a long way.

Use scripts. In their book Teaching Conversation to Children with Autism, Drs. Lynn McClannahan and Patricia Krantz discuss the overwhelmingly positive results that they have observed through decades of research and hands on programming using a process they pioneered called script fading. While the book delves into greater detail, the basis for scripts is written (or oral, for non-readers) cues that are paired with preferred activities or objects. For example, if a child likes to play basketball, a script that reads "Let's play basketball" or "I like to shoot hoops" might be placed in close proximity to the basketball. The child, before gaining access to the basketball, is guided to retrieve and read the script, effectively beginning a conversation. As s/he becomes more proficient in saying the scripts, the words are systematically faded, typically one at a time starting at the end, until the script is absent. So "Let's play basketball" would be faded to "Let's play," followed by "Let's," encouraging the child to create new and unique statements on their own. While conversing, it is important to model new language for the learner to imitate, as this will encourage them to use what they learn in future interactions. It is also helpful to model appropriate voice tones and facial expressions, as these are common skill deficits in people with autism. Create scripts that are compatible with the learners' reading skill level, and remember that recorded audio scripts are a great alternative for those with little or no reading ability. Keep in mind that scripts are not meant to teach people with autism how to speak, but rather to interact and engage with greater competency. And last, but certainly not least...be creative, and have fun!

Sources: Lynn McClannahan and Patricia Krantz, Teaching Conversation to Children with Autism