Sunday, November 24, 2019

Communicative Intent in Autistic Children

Communicative Intent in Autistic Children Communicative Intent is critical for developing communication skills. In typical children the desire to communicate wants and desires is innate: even if they have impaired hearing, they will indicate wants and desires through eye gaze, pointing, even vocalizations. Many children with disabilities, especially developmental delays and autism spectrum disorders, are not hard-wired to respond to other individuals in their environment.  They may also lack Theory of Mind, or the ability to understand that other people have thoughts that are separate from their own.  They may even believe that other people are thinking what they are thinking, and may get angry because significant adults do not know what is happening. Children Who Lack Communicative Intent Children with autism spectrum disorders, especially children with apraxia (difficulty with forming words and sounds) may even show less interest than skill in communication. They may have difficulty understanding agency the ability of an individual to impact his or her environment. Sometimes loving parents will over-function for a child, anticipating his (most often) or her every need.  Their desire to care for their child may eliminate opportunities for the children to express intent.  The failure to support building communicative intent may also lead to maladaptive or violent behavior, as the child wants to communicate, but significant others have not been attending to the child. Another behavior that masks a childs lack of communicative intent is echolalia.  Echolalia is when a child will repeat what he or she hears on the television, from an important adult, or on a favorite recording.  Children who have speech may not actually be expressing desires or thoughts, merely repeating something they have heard.  In order to move a child from echolalia to intent, it is important for the parent/therapist/teacher to create situations where the child must communicate. Developing Communicative Intent Communicative intent can be developed by letting children see preferred items but blocking their access to those same items. They can learn to point or perhaps exchange a picture for the item (PECS, Picture Exchange Communication System.) However the communicative intent is developed, it will be reflected in a childs repeated attempt to acquire something he or she wants. Once a child has found a means to express communicative intent by pointing, by bringing a picture, or by uttering an approximation, he or she has their foot on the first step toward communication.  Speech pathologists may support teachers or other therapy providers (ABA, or TEACCH, perhaps) to assess whether the child will be able to produce vocalizations that they can control and shape into understandable utterances. Example Jason Clarke, the BCBA in charge of Justins ABA therapy, was concerned that Justin spent most of his time in self-stimulatory behavior, and seemed to show little communicative intent during his observation of Justin in his home.

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