Development of Symbolic Language in Children with ASD

This text-based course is a written transcript of the course, "Development of Symbolic Language in Children with ASD", presented by Emily Rubin on January 20, 2011.

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>> Amy Hansen: Welcome to the Nancy McKinley Lecture Series focusing on Autism Spectrum Disorders and Asperger Syndrome. All events this week are in cooperation with the University of Wisconsin Eau Claire and we are very pleased that you could join us today. Today's expert seminar titled, "Development of Symbolic Language in Children with ASD" is presented by the highly talented Emily Rubin. Emily is the Director of Communication Crossroads, a private practice in Carmel, California. She is an SLP specializing in autism, Asperger Syndrome and related learning disabilities. As an adjunct faculty member and lecturer at Yale University she has served as a member of their autism and developmental disabilities clinic. She is also a co author of the clinical manual for the SCERTS Model and comprehensive educational approach for children with autism spectrum disorders. She recently participated as a member of ASHA's ad hoc committee on autism spectrum disorders, a committee charged with developing guidelines related to the role of SLP in the diagnosis, assessment and treatment of ASD. She lectures internationally and provides consultation to educational programs serving children and adolescents with autism and related developmental disorders. So welcome, Emily, and thank you for sharing your expertise with us today.

>> Emily Rubin: Thank you. It is a pleasure to be here. It's quite an honor to be asked to participate in the Nancy McKinley Lecture Series. I have great respect for Nancy and all the contributions to our field. It is also a pleasure to be lecturing to you on the topic of symbolic language development and development of language disorders and I truly hope those of you in attendance will leave here with some practical strategies and new ideas regarding goal areas as well as techniques to help children with autism become more competent communicators.

Overview

I'm going to go ahead and just briefly review the session description. My hope is that this course will outline a unique developmental pattern that we see in children with Autism Spectrum Disorder (ASD) particularly with their symbolic language development. I also will be talking about the impact of the neurological differences that we often see in children with autism and on their language development with an emphasis on determining appropriate intervention objectives for different developmental stages. I'm going to be breaking down today's lecture into a section on those children with autism that are using pre symbolic gestures such as just taking your hand and pulling you somewhere, to those that are beginning to use single words. Still others are beginning to use echolalia and different things that children with autism use that are language development based. Finally, I will discuss how to develop practical strategies to increase word combinations and conversational discourse.

Unique Neurological Differences 

I'd like to highlight the unique neurological spectrum of autism disorders. This is a starting point to think about. When we think about symbolic language differences it is tied into the unique neurological processing that our individuals with Autism Spectrum Disorder have. What we have learned in the last 10 or 15 years shows us that individuals with Autism Spectrum Disorders have neurological differences that truly make it difficult to predict the actions of other people. While there are many different neurological studies being conducted internationally, many of the studies have come together with recognition that there are patterns which lead individuals with Autism Spectrum Disorders to process social stimuli, like faces and emotional expressions and speech sounds, in regions normally used to process our non-biological stimuli.

This makes predicting another person's actions, intentions and emotions quite difficult. If we're being processed as non-biological stimuli or, if you will, "people objects" in the environment - that truly is a neurological difference. It becomes disabling because objects are inanimate. They don't act on other objects or do anything. It makes it hard for children with autism to think, "Wait a second that object is planning to do something". "That object has an intention to help me." "That object has an intention to soothe me." Whatever the case might be. Therefore, figuring out what somebody else's perspective is going to become quite difficult.

What we've learned is that when neurotypical children look at people's faces, regions in the limbic system light up with endorphins and reward that child for looking towards people's faces. Ultimately the children begin to really get hooked on gaze, follow gaze and anticipate the actions of other people. Clearly there is a wiring predisposition to really understand that's a stimuli and I have an intuition about what that person is thinking or feeling.

When children with autism look at or toward people they tend not to look at their faces; rather they look at the mouths of the speaker. When you're looking at the mouth of the speaker you end up missing gaze shifts between people and objects. That lack of gaze shifting between what somebody's face is oriented toward plus what they're looking at makes it difficult to predict what they're going to do next. Similarly when you have neurotypical children and they hear speech sounds in the environment, like their mother's voice, those are processed as social or intentional stimuli. While children with autism simply hear sounds, making the intentions of individual words a bit more ambiguous. Again if we're being processed as non biological objects in the environment when children with ASD hear speech sounds the newest research coming out is actually showing those sounds are being processed kind of like non biological sounds in the environment at least initially. So they're not thinking like a neurotypical child. That is, someone trying to talk with me, someone with an intention.