Tag Archives: Speech

My Autistic Experience: Repetitive and Steretoyped Speech and Language

I’d almost forget it, but this month, I’d actually intended to share my autistic experience for #Write31Days. I failed at the challenge, but that shouldn’t be an excuse not to share my experiences. Today, I’ll talk about speech and language.

I was originally diagnosed with Asperger’s Syndrome under DSM-IV. Asperger’s is basically autism without an intellectual disability or speech delay. The communication impairments criterion in autistic disorder does not appear in the criteria for Asperger’s. That doesn’t mean Asperger’s people don’t have communication impairments. I could’ve easily met the communication impairment criterion in autistic disorder if I’d been more articulate back when I was diagnosed in 2007. You see, I was asked to name examples of speech and language stereotypies I displayed and could come up with only one, which was dismissed. In truth though, my speech and language can be quite stereotyped.

The most noticeable form of steretoypical language for me is my use of particular words or strings of words in an apparently irrelevant context and/or in a repetitive way. For example, in around 2005, I’d say “Hey folks!” to practically everyone. Later, I also used to say “banana spider” at every opportunity. In time, between my husband and me, it got the meaning to communicate boredom or disinterest. As such, it’s become a kind of script.

My repetitive use of language can be helpful in my interactions with my fellow clients at day activities. My fellow clients are all severely intellectually, often multiply disabled. None of them can speak and many have severely limited comprehension of speech, but they respond with joy to my repetitive use of their names or nicknames in a particular tone of voice.

Speaking of tone of voice, I do not seem to have a monotonous voice, but I do know that my tone of voice can be steretoyped too. For example, I speak to each fellow client at day activities in a different tone when echoing their names.

I rarely if ever experience true echolalalia, in the sense that I’d repeat another person’s entire sentence. I do often find myself repeating one or two words though. I also regularly repeat my own words. Lastly, I do repeat sounds people make.

I have an interesting preference for complicated words over simple ones. Refer back to “banana spider” here. Also, the first word I ever spoke, at ten months of age, wasn’t “Mama” or suchlike, but “aircraft industry”.

Another interesting experience happened at my last psychological evaluation last spring. Not only did I name “Banana spider” as one of the first animals in a naming task, but on the IQ test, one of the questions was who was Mahatma Gandhi. Years back, I’d had the same question on an IQ test and accidentally said that he “fighted” for India’s independence. Now I knew I had to say he “fought”, but again, “fighted” slipped off my tongue. It isn’t that I didn’t know the past tense of “fight” in Dutch, but that the situation elicited this particular brain fart.

I’m sure most people use language in some steretypical ways. After all, the example of steretoypcal language I came up with in 2007, was my frequent use of expletives. That’s not uncommon, which may be why the assessor dismissed it. My use of repetitive language also doesn’t impair me that much and, like I said, it can be an asset. However, that doesn’t mean it’s not there.

Spectrum Sunday

Communication in Autistic Children #AtoZChallenge

Welcome to day three of the A to Z Challenge, in which I focus on autism. Today, I want to focus on one of the core areas of impairment in autism: communication.

Children and adults with autism have problems in non-verbal and/or verbal communication. Some individuals with autism do not speak at all or speech development is delayed. Others on the surface have great speech with an extraordinary vocabulary, but have problems with the social use of language (pragmatics).

Some common problems with communication in autistic individuals include:

  • Rigid and repetitive language. People with autism may say things that have no meaning in the conversation they’re having. They may repeat the same words or phrases over and over again, or they may repeat what another person has said (echolalia). Immediate echolalia occurs when a person repeats what has just been said, for example, answering a question with the same question. Delayed echolalia means that a person repeats what they’ve heard earlier. For example, they may ask “Do you want something to drink?” whenever they want a drink. Some people with autism use what they’ve heard on television in regular conversation.

  • Talking in a high-pitched, sing-song voice or in a monotonous tone of voice.

  • Being able to talk about certain topics only. Some people with autism can hold lengthy monologues on a topic of interest even though they cannot carry on a two-way conversation on the same topic or cannot talk at all about other topics.

  • >Uneven speech and language development. Some children will not speak at all then start speaking in full sentences. Others will develop a large vocabulary about a specific topic of interest, as I said above. Some children can read before the age of five but do not comprehend what they’ve read (a condition known as hyperlexia). Some people with autism cannot speak but can type.

  • Poor non-verbal communication. Many peopole with autism avoid eye contact, though some can learn to stare at another person’s eyes to fake eye contact. People with autism also often won’t use gestures to give meaning to their speech, such as pointing to objects.

In order to help an autistic child reach their potential in communicative abilities, parents and carers will need to pay attention to a child’s strengths and needs. For example, some children will not use any speech but will be able to learn sign language or learn to communicate using a speech app.

When a child repeats other people’s words, usually at first it has no meaning. However, echolalia can be a pathway to communicaiton, because a child will often ultimately start using repeated word in communicative scripts that do have meaning.

There are many stratgies parents can use to enhance an autistic child’s communication development. For example:

  • Take on the role of a helper and teacher. When a child is still particularly non-communicative, it may be tempting to do things for them without asking whether they need help. It is better to ask whether the child needs help and give them an opportunity to try for themselves first.

  • Encourage the child to do things with others. Again, it is tempting to let the child be completely in their own world, because many parents view this as independence. However, autistic children (and all children!) need interaction to improve their communication. Try to join the child in whatever activity they’re involved in. When the child shows anger, this is a sign that they are interacting and it is better than no interaction at all, so persevere.

  • Slow down and give the child a chance to communicate. Many children with autism are slow to process information, so it helps to slow down. It is tempting to rush, because, after all, as a parent you can’t attend to the child 24/7, but slowing down will ultimately encourage the child to communicate.

  • Give the child a reason to communicate. If you give in to a child’s every demand immediately, they will not learn to interact. It is important to create situations in which the child is encouraged to communicate more than just their immediate needs and wants.

As the child matures and develops more communicative skills, it is important to move from the helper/teacher role on to a role of a partner and to even follow the child’s lead. That way, a child will learn increasing reciprocity in communication.

The Realities of an Asperger’s Diagnosis

A few weeks ago, I read an article in a women’s magazine about autism. It started out by explaining that autism is a spectrum and then went on to say that Asperger’s Syndrome is the mildest form of autism. Someone sent in a response saying that Asperger’s can be severely disabling too and, because it is often misunderstood, may be more severe in some ways than classic autism.

I have an Asperger’s diagnosis. I also have a high IQ. I can attest to the common misconcetpions surrounding an Asperger’s diagnosis. For one thing, the ability to speak does not necessarily mean that someone can communicate effectively. Even if speech on the surface makes sense, that doesn’t mean the Aspie’s words come out of their mouth as they were intended. However, because we have normal to above-normal intelligence, we’re assumed to “know better” and our miscommunicatin is understood to be willful misbehavior.

Speaking of behavior, it is a common misconception that Aspies don’t have as severe or as frequent aggressive or self-harming outbursts as those with classic or “low-functioning” autism do. H.L. Doherty, a father of a child with classic autism and an intellectual disability, often makes this mistake. He does so again when he talks about shards of severe autism reality. In this post, Doherty describes the consequencces of his son’s self-injurious meltdowns, and accuses autistic advocates of ignoring this reality. He connotes that those with “high-functioning” autism, ie those who can disagree with Doherty on the Internet, do not have these experiences. I, for one, do.

When I still lived in independence training, I had meltdowns almost everyday. An experience like the one Doherty describes is quite familiar to me and occurred regularly until I went on medication in 2010. My last episode of severe self-injury was two months ago, and it was so scary that I went into seclusion for a night.

Now I for one agree with Doherty on some controversies. I disagree on others. My agreeing or disagreeing and how eloquently I can put this into writing, does not change anything about my functioning level in any other area than written communication about a specific topic. I am too ashamed to write about some of my Aspie realities. The details of my severe self-care difficulties, for example. I know that Doherty and his supporters would not believe me anyway. After all, I’m so intelligent. Yes, I am. Relative intelligence is required for an Asperger’s diagnosis. That does not cause any of my difficulties to go away.

Father’s Day

This Sunday is father’s day. In our family, we haven’t celebrated it since I was in elementary school and making little gifts for my father there. This is in a way good, because it is hard to think of gifts he’d appreciate – usually, when he needs something, he buys it himself. I remember one day in like 2006 or 2007 having a bad argument with my father over what I’d give him for his birthday. He was sure I’d buy him a pen or some other cheap excuse for a gift, and when I said I’d bought a reasonably-priced gift the year before, it wasn’t about the price but about knowing what he’d appreciate getting. I can now say I’ve sort of made up for this lack of consideration, because two gifts I gave him for his birthdays in I think 2011 and 2012 are still part of his reference library when discussing the area my parents live in.

My father was the one to insist most on socially appropriate behavior, in his own Aspie style. He could teach me in a kind of harsh way, but at least I learned basic social skills. He was the homemaker when I grew up. Besides, he was on my level intellectually, so, unlike I did with my mother, I didn’t outperform him verbally.

My father taught me to speak. He often told the story of how I’d touch his lips when we were riding the Rotterdam subway, and learned to speak that way. He also taught me my first academics. If my mother counted to four, I’d finish her sentence with a nursery rhyme. If my father counted to four, I’d finish off with “five”. To my mother’s credit, she was the one who taught me to read. At least, she was the one who made little books for me using huge rub-on letters.

My father taught me math. I remember learning squares and squareroots using little square shapes. I taught an acquaitnance’s fifteen-year-old daughter when I was around eight. My father also taught me geography. When I was around eight, we’d sit in the living room, map on our lap, and he’d teach me about various places.

When I got older, entering secondary school, my father seemed to push me the hardest. I recently found out that my parents had always agreed on my schooling, but it appeared that my father was the one insisting most on my reaching my academic potential. About half a year after I entered secondary school, my father took a job there (fortunately not as a teacher). It was good to have my father support me, for example when I wanted to participate in debating contests. It was sometimes tough, because he was in easy reach when I’d exhibit one of my quirky behaviors.

When I decided to postpone going to university for first one year and then two, my father was the one who was most disappointed, or at least, showed it the most. My father was the one essentially kicking me out of the house when I informed my parents about the second delay. This was, he said later, because I was verbally attacking my mother. My mother was the more emotionally expressive and manipulative parent, while my father was the more rigid, rational one. I inherited a little of both.

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Ten Patches This Autistic Person Could Use

The Golden Spoons

This is my first time participating in the Tuesday Ten. I’ve been wanting to for a while, but usually I found other things to blog about on Tuesday. Either that, or I simply forgot. The theme for this week is “I need a patch for that”, because this is the weird holdiay celebration tomorrow. Lisa of The Golden Spoons, one of the hosts, wrote ten patches every mother needs. I got thinking about that. I’m not a Mom, so I can’t really expand on those. Then I got thinking: what would I like patches for? And here’s a list of pathes this autistic person would need. Some of them can be seen as “cures” for certain symptoms of autism, while others are work-around patches and still others are patches for the social stigma and misunderstanding I encoutner.

  1. An anti-overload patch. Even though traditional autistic advocates say they would never take medication to hear or feel less, I certainly would. The thing about a patch, however, is that I can put it on and take it off again, unlike the daily medication I currently take for overload-caused irritability.

  2. An energy patch. Stole this one from Lisa, but I too think I could benefit from it. Living as an autistic can be quite exhausting, after all.

  3. A tolerance patch. To put on others when they have a strikingly intolerant attitude. Mostly staff, that is, so I don’t know how I’d get them to put it on, given that their attitude would prevent them from seeing they need it.

  4. A translation patch. I usually misunderstand people and, rather than putting on a “communicate like a neurotypical” patch, I’d like a translator that sits between me and the neurotypical.

  5. An easy text-to-speech patch. While we’re communicating anyway, I’d like to be able to write rather than speak. While text-to-speech apps are already available, I’d like one that I can easily use and that doesn’t make me look like a weirdo. I’d also like it to translate from speech to text (or braille, in my case). I’ve honestly been thinking of wanting a Communicator, which is a device used by deafblind people, but they’re very expensive and I’m not eligible for funds. i’m verbal, after all.

  6. A patience patch. Again, this one is stolen from Lisa, and I’d like to put it on others again, though I could myself use some patience at times.

  7. A perseveration patch. The good thing about patches again is the ability to put them on and take them off. Today, I’ve been looking everywhere for some perseveration, while at other times, I’m totally immersed in my special interest.

  8. An antidepressant patch. I don’t suffer from clinical depression, but I do have days when I’m very depressed. Again, like the anti-overload patch, this would seem like a better alternative to my current daily antidepressant.

  9. A patchwork weighted blanket: Lisa said patches can be any sort, so patchwork quilts are included. I’ve always wanted a weighted blanket, but never took the effort to find myself one.

  10. An executive functioning patch: something like an anti-procrastination patch, but it’ll also break down difficult tasks into smaller, easy-to-follow steps.

Note that every autistic person is different. This is why I referred to “this autistic person” in my post title rather than “every autistic person”. If you’ve met one autistic person, you’ve met one autistic person, after all. If you’d like to contribute what patches you could use in life, write a list of ten and hop over to Lisa’s blog to submit it.

"Use Your Words."

Last Friday, Neurodivergetn K wrote a post on the phrase “Use your words.”. I only read it today and, partly because I got triggered by this post, I am going to blow off some steam about this phrase. A lot may seem like a repetition of what Neurodivergent already said, but well, there can’t be too many autistics speaking up against NTs putting their own arbitrary standards of normalcy ahead of our needs.

As readers who’re familiar with me and my blog will know, I reside in a psychiatric institution. Its aim is rehabilitation. I’ve been on a ward that had an even more open rehabilitation-focused vision at least on paper, but staff there were much more willing to bend the rehab paradigm a bit to accommodate me than the staff on this ward are. Note that rehabilitation has two meanings in psychiatry, one in which the client is as much in charge of their care as possible, and the other where the client is trained to become (or appear) as normal as possible. I’m talking about the second meaning here, as I have absolutely no problem with the first.

“Use your words.” As I wrote in a comment on Neurodivegent’s post, this phrase is often accompanied by “You’re intelligent” or “I know you can do it” or some variation on this theme. Let me address these follow-up phrases too.

“You’re intellignet.” And now what? Firstly intelligence is not the same as speaking ability. Second, what if I weren’t intelligent? Would I be cut some slack then, or would my needs just not matter as much? A variation on this theme which I’ve come to hate almost as much is “You’re an adult”. It has its own implications in light of my multiplicity, discounting part of me that actually isn’t an adult. If I act like a child, maybe it’s because at that particular point I am a child? I know the staff aren’t going to buy into that since they’ve thrown out my DID diagnosis, but it’s not like I’m any less or more multiple now that we call it BPD.

On a related note, telling me that my abilities are incongruent, isn’t going to help me. I know they are. I know I’m sometimes able to do things that I can’t do at other times. I know I’m able to do seemingly complex tasks but not simple ones sometimes. I know I can have quite spontaneous-looking, appropriate conversations sometimes and barely make any sense of my words at other times. Telling me this is not possible is denying the obvious. Telling me this is not appropriate is like telling a blind person to look harder because they can hear fine or telling a person who is night blind that they should be able to see in the dark because they could see fine during the day. (I know many night blind people are also partially sighted, but I’m simplifying the situatioon a bit.) It’s not like developmetal disabilities like autism are any less real than visual impairment just because they’re more difficult to understand and seemingly easier to overcome through behavior modification.

Let me talk about that now: behavior modification. I was going to write a separate post on that, and maybe I will write one more. Here’s the thing: telling me to “use my words” will most likely get me to pull out a script. You didn’t know I had them, clueless neurotypical who knows me just enough to see my non-autistic appearance but not well enough to truly listen? I may have somewhat more elaborate scritpts than the example Neurodivergent gave, but I do have them. This is why, when I’m interrupted or distracted while executing the script for telling the staff I’m distressed and need help, I often end up having a meltdown. And this script gets interrupted a lot of the time, oftentimes even by staff. They want exact explanations of what I want or need from them, even if they know pretty well what I need. I’ve sometimes gotten to ask for my PRN when that’s not what I needed just because it was the shortest script in that part of my brain I could access. Asking for some quiet time with a staff member, which is what mostly helps me, is a much harder script to execute. Please know: “Can I say something/ I’m distressed,” is not okay. It’s got to be: “Can I please speak to you in a quiet place for a bit when you’ve got the time? I’m distressed.” Sometimes I think it’s NTs who are literal-minded.

Autism and Selective Mutism Symptoms

I have not yet finised reding or even scanning Aspergirls, but I know that in it is a part on mutism in (Asperger’s) autistics. I also recall that in 2003 or 2004, I was on an autism discussion board and selective mutism was regularly discussed. Not necessairly in the context of autistic kids or adults, but as a similar disorder.

Indeed, many autistics, myself included, have symptoms that could minmic selective mutism, where a person is able to speak in certain situations but not in others. A person cannot technically be diagnosed with both selective mutism and an autistic spectrum disorder, since when a person is autistic, their selective mutism symptoms are chalked up to that.

I do not know what the literature says about this, so I can only speak for myself, but I often get “locked up inside” out of anxiety. For example, in high school, when my tutor raised topics that hit too close to home, I shut down. However, I can also experience mutism when my thoughts get interrupted or I’m overloaded. Then, my brain shuts down in another respect.

So what can parents and teachers do about selective mutism in an autistic? What they did to me, both my parents and my teachers, was force me to speak. I remember one night when I was about sixteen, being made to stay up until I’d told my parents a certain rather personal thing. Let me say, thhis is not the way to go. Anxiety may play a factor in selective mutism symptoms. When you use force, this anxiety will only get worse. Also, if your child does not trust you enough to talk to about personal issues, that’s something to work on first.

When the root of the mutism is not anxiety, still, force will not work. When a person is overloaded, the words and actions you use to make them speak, will often only overwhelm them more. Let them quietly think for a bit instead. You might want to ask what the autistic needs – quiet time to process, an alternative communication modality, etc. -, and the person may be able to indicate this in a way even if they don’t use words. Sometimes, asking questions will help, at least with me, but sometimes, this will distract me only further from what I wanted to say.