Communication is giving your opinions, expressing your thoughts, telling your stories. What motivates many of us to become speech therapists is the way that communication is how we connect with the people around us. Communication looks different for everyone.
This month as we celebrate Autism Acceptance month, we think two key points are essential. Firstly, all autistic people communicate in a wide variety of ways, using a variety of means or tools. And secondly, however that communication happens, communication is a two-way street and we need to be listening. We need to honor and respect their voice and their messages by learning to be good listeners and communication partners.
Communicating in different ways
Communication isn’t just the words and the sentences. Communication is the feelings and facial expressions and body language. So much can be said with a look and a gesture. Everyone communicates in different ways. Personally, I often text my father, or email my cousins, or telephone my mother. I love long, face-to-face conversations with my friends and husband. Sometimes, one look from me is enough for my children to know what I think! We call this multi-modal communication - using a variety of different modes - from spoken to written to nonverbal cues - to give and receive messages.
It is profoundly more complicated if you cannot rely on natural speech. Without reliable natural speech, we may also rely on an Augmentative and Alternative Communication (AAC) system like Proloquo2Go or Proloquo4Text. These tools provide a way to communicate many more things than may be possible with speech and gestures alone. They are a way to communicate when natural speech is not available. This extra way to communicate adds another layer to what it means to be a multi-modal communicator. Communication for an autistic person can look different for each individual. There can be wide variations in how they communicate based on the situation, the environment and what is happening. An autistic person may use a combination of vocalizations, words, word approximations, pointing to pictures or photos or objects, sign language, natural gestures, body language, and facial expressions, as well as their AAC system.
Every method of communication has its place. Within my field of speech therapy, we know that each one should be valued, respected and responded to.
An autistic person may choose to use their AAC system in some situations, yet fall back on less formal communication methods at other times. They may say some words using their AAC system (e.g. “I want that”), while pointing to the desired object. They may point to a picture on their visual schedule (e.g. “library”), while using body language and pointing to the door, to indicate they are asking about when they are going to the library. Maybe they use their AAC system to say something when their communication partner doesn’t understand their gestures and vocalizations. There are so many combinations and solutions that can make communication successful.
None of us like to unnecessarily repeat ourselves. Autistic people are no different. If an autistic person has given their message to us (using any means they have available to them), and we understood and acknowledged them, it is unfair to then expect them to say it again using their AAC system.
We forget this sometimes when we are trying to teach a student to use their AAC. For example, during lunchtime, Jack begins to reach for his lunch box on the shelf. It is clear to everyone that Jack is hungry and wants lunch. Rather than accept this nonverbal communication, instead Jack is made to get his “talker” (AAC device) and press buttons to say “I want lunch”. Rather than forcing the use of the AAC system, communication partners instead can use this as an opportunity to model and expand language. Perhaps you pick up the AAC system and say “Oh! You must be hungry! You want lunch”, while pressing words like “hungry”, or “want”. Avoid making an autistic person repeat themselves using their AAC.
Communicating at different times
Communication happens at different times and often there can be variability for us all. When my voice is tired and sore from too much talking, I stop speaking as much as I can to rest my voice. When I have had an argument with my husband, often I choose to not speak to him for a short while as I figure out what I want to say next. These are times when I choose to not speak at all. For many autistic people, it is more complex than that. There can be times when they cannot use their natural speech at all. Perhaps during times of anxiety or new and unfamiliar situations, their ability to use their speech diminishes. For this reason, many autistic people may be part-time AAC users. They need to use their AAC system at times when they cannot speak. Many people around them may find this confusing. They have heard the autistic person speak many times. They do not seem to understand why sometimes they “refuse” to speak. They may limit access to the AAC system, trying to force them to talk. This pressure to speak can then make talking even harder. We know as communication partners that we all need to respect an autistic person’s need to use AAC at different times. Whether they are able to speak or instead fall back to their AAC, we need to respect that communication. Whenever an autistic person communicates, we need to listen.
Communicating for different reasons
We all communicate for different reasons. Sometimes we want to ask a question and other times we want to give our opinion. There are many different reasons to communicate and we often call these communication functions. Unfortunately, autistic people are often not given the chance to communicate a variety of functions. Often people make presumptions that an autistic person only wants to ask for things, like their favorite movie or food. When presumptions like this are made, the AAC tools that are given to an autistic person are very limited. They may only have words to make choices. Another common practice is using AAC to test what an autistic person knows. They are given 2 words that they need to match and label to prove they know what the words mean. All these things limit language learning opportunities for an autistic person.
We must believe in their ability to learn to communicate for different reasons. And to do this we need to provide a system of AAC that has all the words. They can never communicate different messages if they do not have the words. We know autistic people need to have access to a full vocabulary and an alphabet. This gives them the best chance to learn how to combine different words in different ways. This allows them to develop real language so that they communicate for different reasons. With language comes the power to say whatever they think and feel, and the ability to connect with others.
Find a full list of communication functions in the AssistiveWare Core Word Classroom.
Read more to overcome being Stalled at choice-making and requesting.
Whatever you want to say
People who can speak are rarely censored. No-one stops you from saying what you think and feel. Even if you are saying something that people disagree with or find annoying, you can still say it. Autistic people often have this basic right taken away from them.
Perhaps they are using their AAC tool to explore the vocabulary. They are pressing buttons and listening to how they sound. The people around them think there is no meaning to what they are doing. The people around them think it is distracting others. So the AAC tool is taken away. Perhaps an autistic person has found the word “helicopter” in their AAC system. They love helicopters and want to talk about them. They say the word “helicopter” over and over. The people around them see no meaning in the word and so remove it from the page. Or again the AAC tool is taken away.
However, we need to treat the autistic person’s communication as meaningful even if we don’t immediately understand how it’s relevant. If they say a word for something that is not currently available, respond to that. Avoid assuming that communication we don’t understand is an accident. Also avoid assuming that all communication is purely to request something. And never remove someone’s AAC system.
In the “helicopter” example above, communication partners respond in an appropriate way. Perhaps you can say “I like helicopters, you do too” or “did you see a helicopter?”, while modeling words such as “like” and “see” on the AAC system.
Responding to all communication shows that we are really listening.
The right tools for the right time
Autistic people communicate in different ways. Whether they use a combination of speech and gestures and at other times use AAC, what they are saying is far more important than how they say it. What they can say using AAC depends greatly on them being given access to a communication tool that has all the words and an alphabet. Given the right tool and then given time and support to learn and use that tool, an autistic person can develop language skills that allow them to say what they think and feel. They can communicate so much more than choices. They can develop real connections and interactions with the people around them. And in every conversation, however they communicate, we should listen.