How Do Autistic People Communicate?IN BRIEF
Autistic people often have difficulties communicating and interacting with others. Communicating is not just about speaking: it includes facial expressions, gestures, and the intonation of the voice. Jokes, words with double meanings, and other more complex details of language can be difficult to understand, so imagine the challenge for autistic people. There are also several autistic people who do not speak, or who speak in a different way. A non-speaking (non-verbal) autistic person might use other modes of communication such as gestures or images (pictograms). The neuroaffirmative approach teaches us that the autistic person does not have "broken" communication, but simply a different one. To understand each other well, both the autistic person and the non-autistic person must make an effort to adapt to the other.
Autistic people can encounter many challenges in terms of communication. Language is a subtle art that involves a vast number of variables. Communicating is not just about sending and receiving a message. The difficulty in understanding and being understood can generate a great deal of frustration and socially isolate the person. In a neuroaffirmative perspective, it is recognized that communication challenges do not rest solely on the autistic person. This is what is called “double empathy”: difficulties often arise because two people with different types of brains try to adjust to one another without possessing the same social instruction manual. It must be remembered that each autistic person is unique and that their challenges can vary based on many factors, notably age, support needs, and individual skills. Difficulties in communication and social interactions are one of the pillars of an autism diagnosis according to the DSM-5.
Spoken language
A portion of autistic people do not use spoken language. For many, language can arrive late and become fully functional afterward, and for others, not. Among autistic people not using verbal language, communication can happen through other channels, such as natural gestures, pictograms, Animated Hands (Mains animées), or electronic tablets. Many autistic people are verbal and can even possess a rich and sophisticated vocabulary. This elaborate language can sometimes mask their social challenges, but these difficulties become perceptible as the exchange progresses. It happens that very young children are impressive in their use of advanced technical terms and are very comfortable explaining concepts they care about, especially if it involves their specific interest. Yet, communicating is much broader than simply transmitting information unilaterally.
Going furtherINFORMATION PROCESSING
A processing delay is often necessary. The autistic person must sometimes "translate" social codes before responding, which requires a natural pause.
Initiating a conversation
Approaching a person, entering a conversation already underway, approaching a group, knowing when and at what pace to interact in a discussion (turn-taking management), especially if it contains several interlocutors, all these things can be obstacles at the start and during the pursuit of a conversation.
Leaving the conversation
Many autistic people will not notice that their interlocutor has had enough. If they are enthusiastic about the subject of the discussion, especially if it is close to their specific interest, they may not know how to stop and may not see signs of impatience. If they wish to leave the exchange themselves, they may encounter difficulties knowing when and how to do it. Saying goodbye in the right way, interrupting or not, using the right words, the challenges are numerous.
Knowing how to choose the right words
Language is also a question of context. The vocabulary used will vary from one situation to another, whether one is with family, with friends, at work, in a public place or elsewhere, the language will change.
- Politeness formulas
- Formal vs. informal address
- Degree of intimacy of shared elements
- Appropriate subjects
- Duration of exchanges
- Everyday language or formal language
Implied meanings, irony, and sarcasm
Autistic people often understand the literal meaning (first degree) at the expense of the subtleties of the second meaning of words. Once the meaning of a phrase is learned by heart, it is possible they may be able to understand it, but it may continue to make them uncomfortable.
My mother always said she had a cat in her throat (un chat dans la gorge). When I was little, it made me panic and she would laugh. Now I understand what it is, but I find it disgusting. I imagine the cat stuck, the taste of litter, its claws, it really makes me uncomfortable!
Non-verbal communication
The non-verbal part of communication is essential to its smooth progress. Someone deprived of this information will have a major gap in the interpretation of what is said.
Modulation and intonation of the voice
For autistic people, modulating their voice and its volume can be arduous, especially in noisy environments or in groups. They may not be aware of the volume of their voice or experience difficulties modulating it when there are too many stimuli. They will therefore speak too loudly, or not loudly enough, regardless of the context. Also, intonation is sometimes monotonous among autistic people. That is to say, some use little variation in the tone of their voice.
"I received a phone call that made me very joyful. When I was taking the information down in notes, the secretary asked me why I was angry with her. I realized it was because I was too happy. This made me speed up my flow and made my voice higher-pitched. From an external perception, I could therefore seem angry. When I experience emotions, I have difficulty managing my intonations."
Body language
During exchanges, people make gestures that contribute to enhancing communication. It can be difficult for an autistic person to understand body language in others.
"I am very attentive to micro-movements and other clues that people may let show during exchanges. Yet, often, I understand everything wrong. We were on the road and I was surprised to see a man dancing joyfully on the crosswalk. My friend pointed out to me that he was actually angry because a motorist was blocking his path."
Autistic people can also move in a particular way, which can result in them being misunderstood. Some do not move at all, or very little.
Eye contact
Many autistic people have difficulty enduring looking someone in the eyes. Some will opt for strategies, such as looking to the side, and others will be incapable of it or will do it very little. Many were forced, even trained very young to do it, but as this is not natural for them, they may do it too much and it may be confrontational for the interlocutor. It can even happen that it causes fear, as it is unusual. It is harmless, but a real discomfort can result.
Important
Not looking often allows the autistic person to better listen and to concentrate.
Facial expressions
It is frequent that autistic people have somewhat particular facial expressions such as a frozen smile, permanent neutrality of expressions, or an inconsistency between what is said and what is seen. Others have exaggerated facial expressions, a forced laugh, or a caricatured face. It must be understood that for an autistic person, it is often not natural to communicate this way, so they must make a conscious effort to use this method, which may appear a bit artificial to an external eye. Understanding and interpreting facial expressions is not an easy task. This may seem obvious for laughter and crying, but a face has many more nuances than that. It happens that a person experiences frustration at an autistic person’s lack of reaction to their feelings, but they must remember that it is possible the autistic person did not realize their interlocutor was experiencing something particular.
Echolalia
Echolalia is the repetition of words or phrases heard from someone, on the radio, in a cartoon, etc. It is today recognized as an important stage of the Gestalt language learning style. Autistic people using functional verbal language can also use echolalia.
Functions of echolalia
It serves for self-regulation, maintaining social connection, processing information, or expressing a need via a learned phrase (“scripting”).
The two forms according to the “timing” of repetition
Immediate echolalia
The person repeats the information at the very moment they hear it, like a direct echo. They understand the meaning or not, depending on their abilities.
"If someone surprises me with a phrase that makes me uncomfortable, I will have a tendency to repeat what the person said word for word, sometimes several times. I can guarantee you that if it's something bad, it creates big discomfort. It is better to laugh about it."
Delayed Echolalia
The person repeats memorized words later, sometimes hours, days, or even years after having heard them. Non-autistic young children can also repeat words or phrases heard when they are in language learning. It is the memory that stores the sounds and tests them, even if they do not necessarily understand the meaning. Among many autistic children, this occurs later.
"During intense stress or pain, I repeat, 'darn, the ball ricocheted, darn the ball ricocheted,' it's like that, it's delayed echolalia."
The three forms according to “function”
These three forms can be either immediate or delayed. They explain the intention behind the sound.
Functional echolalia (interactive)
It serves to communicate with the other. For example, repeating the question to say “yes” or to show that one is participating in the exchange.
Self-regulation echolalia (non-interactive)
It serves the person themselves. It is a tool to calm down, manage stress, or simply “hear oneself think” to better understand a command.
Scripting
This is the use of blocks of language (like movie lines) to navigate socially. It is a securing strategy to have a ready-made response in a given situation.
Situational mutism (previously called selective)
Some autistic people are unable to express themselves verbally in precise contexts. For example, a child might be able to speak at home and not be able to do it at school. It must not be believed that the child is being oppositional or doing it voluntarily. It is very often the mechanism of speech that is literally blocked. In a person who has access to speech in most contexts, a stimulus that is too strong, a stress factor, or another factor can temporarily deprive them of speech. The speech is there, but it is temporarily inaccessible.
References
For double empathy: Milton, D. E. (2012). On the ontological status of autism: the ‘double empathy problem’. Autism, 16(5), 883-887.
For Gestalt learning and echolalia: Blanc, M. (2012). Natural Language Acquisition on the Autism Spectrum: The Journey from Echolalia to Self-Generated Language. Northern Speech Services.
For functions of echolalia (Interactive vs Non-interactive): Prizant, B. M., & Duchan, J. F. (1981). The functions of immediate echolalia in autistic children. Journal of Speech and Hearing Disorders, 46(3), 241-249.
For situational mutism: Katsiadaki, G., & Logotheti, A. E. (2019). Selective Mutism and Autism Spectrum Disorder: A Review. International Journal of Culture and Mental Health.
For eye contact and sensory overload: Hadjikhani, N., et al. (2017). Look me in the eyes: constraining gaze in the autism spectrum disorder. Scientific Reports, 7(1), 3163.
