Understanding & Developing Communication

Communication happens when one person sends a message to another person. They might use spoken words or other means. Interaction happens when two people respond to one another – two-way communication.

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Autistic people often communicate differently from allistic (not autistic) people. This can lead to allistic people failing to understand them, or to autistic people feeling a great deal of pressure to change how they communicate. Because of this, many kinds of social interactions can cause stress and anxiety for autistic people.

Non-speaking communication
Overview
Echolalia
Overview
Early stages of communication
Overview
Some autistic children don’t use spoken words until they get older, and some autistic adults use speech minimally or not at all. However, this does not mean that they do not have or understand language, and it is important to support their communication in ways that work for them.

Autistic people don’t always respond in ways allistic people expect. For instance, they may not look up when you say their name, or acknowledge that they’ve heard what you said. If you’d like a particular response, it can help to ask for that directly.

Depending on the person and their age, an autistic person might use many different means to communicate with you other than spoken words, including gestures, echolalia, or pictures. If they’re distressed, that might also be apparent in their behaviour.

There are many reasons an autistic person might use echolalia or the repetition of other people’s words. It could be a sensory stim or a way to enjoy something interesting to them, like reliving a favourite line from a video they like. It might be a form of scripting, a phrase they’ve memorised and are using in a different situation.

It could also be that they have been asked a question and they’re a bit stuck on how to respond. If that’s the case, you can check in with them using whatever support they prefer. You can also just give them a little time to process if that’s what they need.

Early stages of communication depend on three things:

  •  interaction with other people;
  •  the purpose and method of communication;
  •  understanding.

Communication may be:

  • pre-intentional - this is communication for some purpose other than affecting other people. It could be self-soothing or just for fun.
  • intentional - this is communication with the goal of affecting or informing other people. It could be a request, for instance, or letting someone know they’re upset.

At some point, most children learn that their communication affects other people, and they start using intentional communication. This is an important step, for both autistic and allistic children, but they might reach that step at different points in their development.

  1. The Hanen Programme, an early language development charity, defines four stages of communication in young children. They emphasise that nearly all children progress through these stages, although those with communication difficulties might progress more slowly, or might not reach every stage. The four stages are:
  2. The Discoverers – The child exhibits a tendency to keep to themself, including playing alone. They appear uninterested in interacting with others and primarily respond to their own emotions and the events occurring around them. However, they have yet to acquire the capacity to communicate with a clear intention or purpose. Communication at this stage is generally pre-intentional.
  3. The Communicators – The child starts to notice how their actions affect other people and starts to communicate some wants and needs without using words. For example, they might employ nonverbal cues, such as pulling an adult towards a game or a toy to convey their desire to engage in play.
  4. The First Word Users – The child starts to engage in longer, more two-way interactions. They might echo words to communicate what they want using single words, signs, or pictures.
  5. The Combiners – At this stage, the child begins combining words into sentences and starts to have basic conversations. However, autistic children may face challenges in unfamiliar environments, even if they feel more at ease at home. In such cases, they may rely on memorised phrases as a communication strategy and might encounter difficulties in remembering to take turns during conversations.

Supporting communication development

If you are supporting an autistic person with their communication development, here are some tips you might find helpful.

Let them lead
Simple language in the early stages
Expand on language
Give them a chance to communicate
Get on their level
Imitate them
Sing and play 
Respond to them when they make an effort
Create opportunities
Work together on toys or games
Play with balloons and bubbles
Don't wear out your welcome
Find ways to connect
Instead of trying to direct them, just follow their lead. If you join them in their interests, you can share their world a little, and they’re more likely to pay attention to you in return.
Use language appropriate for the stage they’re in. If they’re just starting to use speech, just use single words instead of whole sentences.
If they’re in an early stage of language, you can take what they say and expand just a little bit. A cat can be a black cat, or a train can be a big train.
If you are used to anticipating someone’s needs, it can be hard to remember to give them a little space to try out new and developing skills. It can help to build in extra time for routine tasks, so you can take it slowly and even ask them if they want your help. Just giving someone the chance to communicate can help. For instance, you can ask them if they want some help before reaching out immediately to tie their shoes. Then give them a little time in case they want to answer.
Get on the same level as the person so you can be face-to-face. It’s a good way to connect, and it can help the person to study facial expressions. Just be aware that if they need to process that extra visual information, they may have more trouble in that moment processing audio or verbal information.
Just like letting them lead with their interests, you can let them lead by copying their words or actions. Spin with them, flap your hands with them, and repeat lines from a favourite video with them. They might enjoy you joining in their fun and start copying you in return.

As with anything, this depends on the person, however. Be sure to pay attention to whether they’re enjoying this game, and stop if it seems like it’s upsetting them.

Add gestures and other visuals to your words

Add visuals to your words to support your communication. You can mime drinking when you say “drink”, nod your head for “yes”, or wave your hand for “hello”. You can also point at pictures or use other visual supports, like social stories or visual timetables.

If the person you’re supporting likes music, you can sing songs with them, letting them sing parts on their own if they want to.
If they like to play pretend, you can use that to role-play social interactions.
Make it rewarding for them to communicate by responding positively. Some people might also feel motivated by praise, but it’s worth noting that autistic people often prefer natural consequences and intrinsic motivation to rewards that seem artificial. So if they ask for a cup of water, they may be more motivated by you immediately giving them a cup of water than if you praise them for asking.
Maximise the chances for communication. Depending on what the person enjoys, it could be looking for birds on a walk to the park, or watching a video together, or just playing with rubber ducks at bathtime.
If they need some help with putting a toy together or playing a game, it can be a good chance to work together and communicate.
Balloons and bubbles can be great fun and encourage loads of interaction – even if the communication is just plenty of laughter and hollering for “more”! If the person you’re supporting isn’t as interested in balloons or bubbles, anything similarly high-interest will do.
Make sure everyone’s having fun, and watch for signs that the person you’re supporting has had enough. Don’t try to push them to do more than they want to. If they don’t use spoken words reliably, you can work out a way for them to signal their feelings to you in other ways – the important thing is that you listen to them and respect them wanting to stop.
Even if you can’t seem to catch the interest of the person you’re supporting, you can watch for ways to make small connections. This goes back to the idea of letting the autistic person take the lead – watch what they’re doing, notice what they’re interested in, and join in on their terms. Hand them the pieces they need, and pick up the toys they throw. Just be present and supportive.

Using Augmentative and Alternative Communication (AAC) supports

AAC simply means any language besides spoken words that someone might use to communicate.
For an autistic person who doesn’t reliably use spoken language, it can be incredibly distressing not to have access to communication. An AAC device means they can still express their needs and feelings.

Since AAC includes a large variety of devices and techniques, it’s important to work with a team of professionals to decide on the best communication support. It will depend on communication needs, motor ability, literacy, and obviously the preference of the person using the supports.

Examples of AAC devices:

  • Picture Exchange Communication System (PECS), a trademarked system using simple pictures to make basic requests by physically handing them to someone else. Communication is more than just requisition, so in the long run, using PECS may restrict communication. Instead of encouraging natural language learning, PECS encourages communication partners to withhold highly desired objects and/or food until the desired behaviour is performed. This approach doesn’t focus on building a strong connection with the learner.
  • Sign language, such as British Sign Language (BSL) or Makaton.
  • Communication boards and communication books, which feature a large variety of pictures and symbols people can point to.
  • Communication cue cards, which can support people who have some spoken language by giving them a quick reference, or something to point to if they prefer.
  • Conversation books, which can use text, pictures or photographs to support conversation.
  • Voice output communication aids (VOCAS) include a wide variety of systems for generating digital speech when the user presses a button. They can be fixed phrases or changeable, and range from single messages to a longer sequence.

There is some controversy around some forms of AAC. Facilitated communication, for instance, is considered ineffective and even harmful by many professionals, and the National Autistic Society recommends against using it, although some nonspeaking autistic people have said it helped them.

Communication in schools

Many autistic children in the UK attend school, including mainstream schools and specialist units. It is vital that educators understand and support autistic communication needs in these settings.

In school, autistic children can sometimes appear to have strong communication when they are in fact struggling. This is called “masking”, and it can mean their support needs get overlooked. Even if they usually have a strong and reliable spoken language, they might be struggling with social, sensory, and processing issues that can be exhausting and stressful. Often the anxiety and stress of masking build to the point where the child can’t manage at all any more, and in that case they can burn out very quickly. They may also lose reliable access to spoken words if their anxiety is high or they are distracted by negative sensory input.

If teachers are aware of the possibility of masking, they can help prevent burnout by providing support before the child reaches that point.

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