Verbal communication and autism

On first glance, you may not notice any difficulties in verbal communication among autistics who are highly verbal and can speak in complex sentences, often coming across as very articulate and verbally intelligent.

It is important to note that having a high verbal IQ is not the same thing as being good at verbal social communication. My verbal IQ as recently tested is very high, between 138 and 144, and this means that my social communication issues are masked beneath this high compensatory intelligence.

The difficulties exist on the pragmatic level, or the way in which language is used in a social context, and this is why it is the social aspect of communication that is affected, as opposed to the communication of non social information that might be intact. After all, I am communicating information right now, and am hopefully doing a good job of it, but imparting one way information is different to communicating reciprocally. Even someone who is highly verbal can experience significant difficulties with understanding figurative language, jokes , irony and verbal instructions.

These problems understanding verbal communication in a social context can affect how an autistic child learns in the classroom, potentially resulting in anxiety and learning difficulties.

To give a personal example of what this might look like, I developed severe anxiety and OCD as a teenager because I could not contextualise the information I was given in food technology about food safety and hygiene. The teacher told the class about the importance of cooking chicken thoroughly to avoid salmonella, and showed a graphic video about what happens if hygiene rules are not followed. I became incredibly anxious about handling raw meat, and I avoided eating meat and eggs for years. It would have benefited me if the teacher had explained to me in a detailed way how to cook chicken safely and reassured me that I would not catch salmonella. However I was not diagnosed autistic until age 21 and could not express my needs or what I needed help with, which is why it’s so important for teachers and other carers to be aware of autism and the possibility that a an autistic child might be in their class, so that they adapt material in an autism friendly manner. Adapting the material would mean that they check understanding, provide enough detail so that students are not left confused and anxious, and avoid the use of ambiguous or vague instructions.

Using clear verbal communication is especially relevant now with the Covid situation. It’s important to explain clearly what is going on, and to reassure your children that they are safe. It can be useful to write down the information and, depending on the child, use pictures or visual information because this can be easier to process than the spoken word. You might need to go over the information many times with the child, and it’s important to try and stay calm when talking to them about Covid because autistic kids can be very sensitive to emotional displays in other people, and they could pick up on your anxiety. Autistic teenagers are very vulnerable to developing mental health conditions such as OCD, and this can often start with poor communication and a black and white thinking style. They might think that everything is unsafe and dangerous, and this is a real and genuine fear. Do not belittle their fears or make them do things that cause extreme distress, but reassure them regularly with clear, unambiguous language. For example, some of my germ OCD developed when my class was told to wash their hands before lunch. I did not know how much to wash my hands, so I over compensated by washing them way too much. I also developed OCD around getting sick and catching disease off other people, which I still struggle with to this day. Being sick can be very scary because you are out of control and it’s unpredictable. We can’t totally avoid getting sick, but helping your child feel safe by explaining what will happen if they or their loved one gets sick can be helpful. You could write a social story for them where you write out what might happen in steps and what coping strategies they can use.

Verbal communication difficulties can make it hard for autistic kids to tell their parents or teacher about what is troubling them or if they feel anxious. They can find it hard to know exactly what they need or what might help them. I suffered in silence at school with extreme anxiety because I did not feel confident enough to talk to my teachers, and I was also in denial that I had a problem. So it’s important to check in with your child often and not expect them to tell you.

Problems with verbal communication can also impact reading comprehension, particularly when reading fiction, which can make English lessons difficult. As a child, I was tested by an Educational Psychologist because of my problems learning in the classroom, despite being otherwise intelligent. The assessment showed that my comprehension lagged significantly behind my verbal reading age, which was advanced. I could read very well but without always understanding the plot because of difficulties working out what was being communicated between the lines, or the non verbal information, as I will talk more about soon.

Autistic students very often struggle with processing speed, which means that it can take them a lot longer to understand or process spoken or even written information, and this processing lag can be more pronounced when there is a lot of sensory input. Low processing speed can make them appear slow, clumsy and disorganised, or less bright than they actually are. Teachers might be confused if a child appears advanced in some areas but at the same time struggles to carry out simple tasks or does not follow instructions, but the child is most likely overwhelmed and can’t keep up. It’s important to give such students more time and to not make assumptions based on how quickly they process information. Because of difficulties with processing speed, key information might be missed, resulting in confusion and anxiety. My processing speed, as recently tested, is severely impaired in contrast to my high verbal IQ, and this can affect learning and social communication. For example, I found it really hard to write down homework quickly enough at the end of the lesson. Teachers tried to help by writing it down for me, but this meant I had to wait in a line of other kids for my homework to be written up, making me stressed because I worried I would not get to the next lesson on time. It would have been better if teachers had given me the homework already written out at the start of the lesson, and they should also check the pupil’s understanding of what the homework requires.

Because of difficulties with processing speed, group work can be particularly difficult. Groups are noisy, and it can be hard for an autistic person to shift their attention as the conversation changes, resulting in confusion and missed dialogue. It can be hard to put thoughts into words when the environment is noisy and fast paced, so it can be all too easy for autistic pupils to be left out of groups. I hated group work at school, and I was often told by teachers that I needed to contribute more in groups. But I think it would be more inclusive if pupils who struggle with groups (regardless of autism diagnosis) are not put under pressure to perform in these environments. It could also help if they are given a clear role in the group so that they know exactly what is expected of them.

Difficulties with verbal communication can also make it hard to know what to talk about in social settings, and this can make it harder to form friendships. In particular, there can be difficulties with small talk. These difficulties are caused by problems picking up the ”common knowledge” that non autistics pick up via theory of mind, or the ability to work out what they are expected to say or not say in social situations. Because autistics struggle to understand mental states, it can be hard to access the common narrative pool that non autistics use to guide verbal social communication. I found it really hard to know what to say to my peers, but this difficulty can be masked in the classroom because the pupil might appear very quiet and well behaved. Girls in particular often mask or camouflage their difficulties by imitating their peers, which means that on the surface they can appear neurotypical. It’s important to note, though, that some boys also mask, and there are girls who don’t mask, so this is just a generalisation. Masking does not mean they are not struggling, it just means that they are spending a lot of time and effort trying to blend in via observation and mimicking, or learning via rote what non autistics do naturally, which is very exhausting. The teacher might therefore not notice the difficulty, if the pupil is polite and appearing to follow the more explicit social rules. It’s important therefore to be on the lookout for any student who does not appear to be fully integrating with their peers, who often sits quietly on their own, and who might appear confused as it’s possible that they might be autistic. I often put on the ”quiet, nice girl” persona, so I would often smile and speak softly, as I tried to emulate other well behaved girls in my class. But I could not get beyond the basic introductions in a conversation, and would be left feeling tense and unsure of what was happening next in a conversation because of difficulties navigating theory of mind. And this brings me on to the next aspect of communication, the non -verbal component.

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