Communication difficulties in Aspergers Syndrome

• Interpreting comments literally (e.g. "pull your socks up", "looks can kill" or "hop on the scales")
• Using an usual tone of voice (e.g. sounding monotonous or like a foreign accent).
• Does not appear interested in your side of the conversation (e.g. does not ask or comment about your thoughts or opinions on the topic)
• Using less eye contact than you would expect in conversations
• Expressive language is over precise, formal or pedantic (e.g. like a walking dictionary)
• Has problems repairing conversations (e.g. does not ask for clarification when does not understand, but switches to a familiar topic, or takes ages to reply)

Other communication difficulties

• Expressive language skills are often superior to comprehension skills.
• Difficulty with verbal reasoning tasks (Why, What if, How can you tell questions, drawing inferences from verbal and written material, etc)
• Inability to "get the big picture" (home in on isolated or irrelevant details rather than extract meaning from situations)
• Semantic difficulties (understanding and using word meanings). These can include word-finding difficulties or creating "neologisms" (new words)
• Difficulties with the concepts of space, time, sequencing and prediction.
• Impaired understanding and use of body language (posture, gesture, facial expression etc.).  Inability to follow the rules of conversation (listening, turn-taking, being relevant and concise). Often goes off at a tangent to the topic or "perseverates" (gets stuck) on other topics.
• Might talk at length about obsessional interests or ask repetitive questions.
• Cannot adjust his content and style of speaking to fit different people in different situations.

Strategies

• Before you give instructions make sure you have got the child's full attention, e.g. say his name; gently turn his head towards you (but remember that some children with AS will not be able to look at your face and listen at the same time)
• Keep any language you use simple, short to the point and make sure it is at or only slightly above the child's level of understanding. NB Many verbal children with AS are very deceptive in that they can produce more language than they can understand). Pause (for up to 10 seconds) after any instructions you give to allow the child time to process the language and respond. Some children with AS are slow processors of verbal information. Give one instruction at a time rather than a sequence. Supplement verbal instructions with visual ones (pictoral or written)
• Encourage the child to ask for clarification if he does not understand what you have said or for help if he is stuck. (e.g. Model "I don't understand" and "I need help")
• Do not assume that a child has understood what you have said because he "parrots" back what he has heard. This sort of "echolalia" usually means that your language has not been understood.
• Make any necessary changes to the daily routine in a gradual way. This will give the child order, predictability and security.
• Prepare the child for any changes to his usual routine well in advance with simple explanations and visual supports (e.g. pictures, photos, written words)
• Use visual props when introducing new activities and topics (e.g. before starting a science experiment, take the materials over to show the child). If possible take photos of venues etc. in advance when going on trips out.
• Give limited choices of activities/tasks to limit decision making difficulties. If the child does not want to carry out a particular activity give him the choice of that one or his least preferred activity (e.g. maths worksheet or science worksheet)
• If you are leaving the room with the child always say WHERE YOU ARE GOING, WHAT YOU ARE DOING AND WHY, to make him feel secure.
• Make sure instructions are not ambiguous.

Resourced from Strategies to Help Communication in Children with Aspergers Syndrome. Ann Hewitt. Specialist Speech and Language Therapist. May 2002