Autism and Communication

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Hannah Patrick
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1 Autism and Communication Summary Autism affects communication and social interaction to varying degrees. Some people with autism do not use speech to communicate, whereas others may be very articulate it may not be immediately apparent that somebody has autism Many people with autism share a number of communication and social interaction characteristics, all of which can impact upon the interview or court process. Being aware of what these are and using effective strategies to address them will maximise the likelihood of achieving best evidence Unexpected or unfamiliar events can cause severe anxiety and distress for people with autism, and can lead to a breakdown in communication. Effective planning of interviews and court testimony can significantly help to reduce anxiety and distress Asking a person with autism what helps them to communicate and what makes communicating difficult, can give interviewers/questioners valuable insight into the communication needs specific to that person Consulting with parents, professionals and an intermediary can facilitate communication during interviews and throughout the court process Communication in people with autism Autism is a spectrum condition that affects communication and social interaction in many different ways and to varying degrees. Some people with autism are considered to be low functioning and do not use speech to communicate. Instead, they may use an alternative/augmentative form of communication, such as a picture board or electronic device. Other people with autism may be described as high functioning. This means that they have average or above average intelligence and are more likely to use speech to communicate. People with high functioning autism or Asperger s Syndrome (a form of high functioning autism) are often very articulate. However, they may have difficulties processing and understanding things that are said and done during conversations this may not be immediately apparent. As such, this condition is sometimes regarded as hidden. It is important to know that each person with autism is unique, but many people with this condition share similar characteristics and difficulties in the way that they communicate and interact. Examples of communication characteristics that can sometimes be seen in some people with autism Poor listening and concentration skills

2 Literal interpretation of language (e.g., jokes, irony, sarcasm and metaphorical speech) Use of formal or pedantic language, sometimes appearing to be rude or blunt Difficulty using personal pronouns (I, you) and may speak to you in third person Delay between hearing something, understanding it and responding to it Repeating words and phrases (also known as echolalia) Talking obsessively about something which has no relevance to the topic of conversation (sometimes this may be about a special interest that they have) Not recognising when they do not understand something, or failing to say so Being over compliant A reliance upon visual, rather than verbal styles of communication Examples of social traits and other factors that can affect communication Heightened anxiety or distress this is often caused by unexpected or unfamiliar situations A preference for set routines and rules anxiety or distress may occur when these are not adhered to Speaking in monotone or with other unusual traits such as shouting or screaming Use of prolonged eye-contact, alternatively, this may be fleeting or even avoided A lack of theory of mind this means that a person with autism may have difficulty predicting or understanding other people s point of view and behaviour, and their underlying intentions Difficulty understanding causal chains of events, particularly foreseeing or understanding the consequences of their words and actions Misunderstanding or failing to recognise social cues (e.g., personal space a person with autism may unknowingly invade yours or may require more themselves) Presenting repetitive physical behaviours such as rocking, hand flapping or pacing Sensory difficulties (see Sensory processing in autism ) Unique memory processes (see Memory and eyewitness testimony in autism ). Strategies to use when planning to question somebody with autism Being interviewed by the police or giving evidence in court can be a very stressful experience, especially for somebody with autism. With appropriate planning, and by applying the following strategies, it is possible to reduce the level of stress that can occur and minimise breakdowns in communication: Meeting the person with autism: Try to make an initial meeting in a familiar place or setting prior to the interview or court testimony doing so can help to build rapport and familiarity with you in a safe place

3 Explain how long each meeting will take; what will happen and when doing so will help the person with autism to know what to expect Arrange for a pre-interview or pre-trial visit to occur at the location where the interview or trial will take place this can help to build familiarity with the setting Ask the person with autism what helps them to communicate and what makes communicating difficult. People with autism are often very aware of their own abilities and difficulties, and may be able to tell you themselves about what helps them to communicate Gather as much information about the individual s characteristics and communication abilities. Speaking to parents, carers and professionals familiar with the person can give you valuable insight Ensure that the person with autism knows that it is okay to say I don t know when they do not understand or know the answer to a question making a rule called no guessing is very effective in avoiding over compliance. It is better for this rule to be established prior to interview or court testimony When using police or courtroom terminology, check that the person understands what these words means if they don t, explain it in clear and simple language, and check understanding When possible, plan for interviews or testimony to take place at a time and day that minimises disruption to typically routine Using communication aids: Draw or write down a timetable of events or things to do during each meeting. Make regular reference to this and tick items off with the person as they happen this provides a useful visual cue of what to expect and can help to manage anxiety Include the use of pictorial symbol cards. Providing symbol cards that indicate stop, break time and toilet, gives the person with autism an element of control within interview settings Create a visual rating scale (1 calm 5 highly anxious) that the person with autism can point to throughout the interview or court appearance. This is useful to monitor anxiety levels and to establish when a break is necessary Offer the person a quiet, calming object (e.g., blu tak or a stress ball) to fiddle with during meetings/interviews/court appearances this can help to maintain focus and reduce anxiety Explore the use of drawing or sketching to aid communication. Drawing or sketching to assist explanation of concepts and evidence is very effective for people with autism Strategies to use when questioning somebody with autism The way that questions are phased and delivered is paramount to the quality and accuracy of the responses that are given. By taking into account the communication

4 needs and social traits of people with autism and by applying the following strategies, it is possible to maximise best evidence. The delivery of questions: Speak clearly, in a calm manner and at a steady pace Make regular use of the person s name this will help to maintain focus and concentration Regularly check understanding and summarise what has been said, offering the person with autism the opportunity to correct any misunderstanding(s) Allow breaks at least every 20 minutes during questioning concentrating for longer than this can lead to unreliable answers The language and phrasing of questions: Keep questions and sentences short, simple and concise be clear about what you need to know Use clear, concrete and non-abstract language. Don t use expressions such as Have you changed your mind? or Were you and James close? These are likely to be interpreted literally Avoid the use of tagged questions. A tagged question is a statement that has a question at the end and implies the answer (e.g., It was raining that day, wasn t it? ) Do not phrase questions in a negative manner these types of questions are extremely difficult to process and respond to. Questions like You didn t do that, did you? could be rephrased as Did you do that? Allow extra time for questions to be processed and responded to counting to 10 in your head before rephrasing or asking a question again is helpful Open questions may be used, but aim to keep these direct (e.g., Tell me what happened when you were at the toy shop with Peter? ) You may need to make regular reference to the particular occasion When asking option posing questions (e.g., Was it blue or red? ) offer a third alternative such as Was it blue or red, or a different colour? Consider creating a visual timeline and using coloured post-it notes to represent multiple events and incidents these can provide helpful visual cues, minimise confusion and keep responses on topic Consider having an intermediary appointed to the case An intermediary is an impartial and neutral person who facilitates two-way communication between witnesses, defendants, and any other participants in the criminal justice process. They come from a number of professional roles such as speech and language therapy, occupational therapy, psychology, social work and teaching. They bring the skills and experience gained in their professional work to their role as an

5 intermediary. Their role is to ensure that communication with the person being questioned is as complete, coherent and accurate as possible. After conducting an assessment of the vulnerable person s communication abilities and providing a report, the intermediary is allowed to explain the questions or answers, so far as is necessary, to enable them to be understood by the vulnerable witness, defendant or the questioner. Importantly, this is done without changing the substance of the evidence. Many intermediaries specialise in working with people with autism and are well equip to advise and facilitate appropriate communication techniques in order to achieve best evidence (see the Advocates Gateway for more information on the scheme). Further reading: Tager-Flusberg, H., Paul, R., & Lord, C. (2005). Language and communication in autism. In F. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (3rd ed., pp ). New York: Wiley. O Mahony, B. M. (2009). The emerging role of the Registered Intermediary with the vulnerable witness and offender: facilitating communication with the police and members of the judiciary. British Journal of Learning Disabilities, 38, Paul, R., Miles Orlovski, S., Marcinko, H. C., & Volkmar, F. (2008). Conversational behaviours in youth with high-functioning ASD and Asperger Syndrome. Journal of Autism and Developmental Disorders, 39, By Dr Michelle Mattison Lecturer in Psychology University of Chester

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