Communication
Deficits in communication include the delay or lack of spoken language, impairment in the ability to initiate or sustain conversation, stereotyped use of language, and lack of make-believe play. Children may use alternative forms of communication if they are non-verbal or need assistance with pragmatics.
Impairments in use of non-verbal communication and expressive language significantly affect the child’s ability to initiate and sustain communication. Perseveration on a topic, issues initiating communication, difficulty using unwritten communication rules, inappropriate interrupting, and inflexibility in style of conversation all contribute to difficulties in sustaining appropriate conversation.
A restricted vocabulary can also present a severe issue in communication. Children with autism may have a vocabulary that is dominated by nouns and are often confined to requests or rejections to regulate their environment. Typical communication is dominated by verbs and adjectives which can be complex and abstract. These differences between these two forms of communicating lead to an inevitable breakdown of communication.
Echolalia, scripting, and stereotyped use of language may indicate an attempt to communicate. The upside of this is the indication of the ability to imitate and produce speech and it may serve a communicative or cognitive purpose for the child.
The lack of imaginative play may arise from the inability for some children with autism to take the perspective of others.
Moderate to severe behaviors may arise from the inability to communicate effectively. The child may feel confused and frustrated by not being able to get their point across or not understanding what is being communicated to them. It should be the goal of all educational programs to assist children in developing an effective form of communication to decrease the likelihood of them becoming frustrated by not being able to communicate.