How to teach children with autism to speak.

(Some children with autism will not need this method but it can be useful for those who are seriously speech delayed). 1. I went to all the church and school fetes and brought up as many children's books as I could. Mainly second hand copies of the Little Golden books series. These were very cheap.

2.

Then I obtained large blank page art books. The pictures from the books were cut out and put one to a page. I broke down the structure of the English language to it very essence for my daughter. Then I went through the books with her on many occasions and described with great emphasis slowly each picture in terms like this. "RABBIT COOKS DINNER" "BEAR MOWS LAWN" etc. 4. The format of my speech was very slow and deliberate". The grammar was simply Noun verb noun. All the trimming were left out. 5. It would have been futile to Say something like. The rabbit is mowing the overgrown grass with his brand new lawnmower. Doing that to an autistic who is struggling with language problems will probably lose their attention and confuse them. It would even have been worse to say these words in a normal speed and level of voice. 6. The idea in this is not to teach English or English grammar but to give to a child with autism a chance to understand the very beginning of language in this case English. 7. If the child with autism has this mode of learning to talk will they continue to speak like a newcomer to the USA or Australia or even worse than the beginner in the English class?

3.

8. The answer is no. Because they can pick up a fuller grasp of the language later on from their parents, and those around them and from T.V. radio etc.

9. Believe me my daughter's speech is fairly complex now but she needed this very basic stuff for a long period of time to get her brain started on the ideas of speech. 10. Autism muddles the communication section of the brain and if you overload it with normal flowing language the poor kid sometimes can't cope and then won't make any progress in language/speech/understanding.

Using Picture Language

1. Many times autistic kids are visually oriented. 2. Sometimes nonverbal children are able to communicate using sign language or by pointing to pictures in a special book put together to help them communicate. 3. Even autistic kids who speak may benefit by making a visual chart for the schedule for the day. 4. If you're trying to teach your child how to do something it may help to make a picture chart. 5. Some autistic kids can even repeat verbal instructions word for word but still lack the ability to turn those instructions into actions in their head. Pictures may somehow help them to do that

Daddy Says She got them all from "Papa's School" (IE: me). 2. I have one or two sessions with her every day using games, shape sorters, flash cards, puzzles, songs, books, actual objects and other tools. 3. She has gone from no words, no recognition of her name, no significant cognitive skills 6 months ago to 80-90 words, recognition of who she is and cognitive skills that are above her age group.
1.

Do a lot of generalizing on the concepts we were working on when I was on my own with him

I wrote a summary of *'s strengths, weaknesses and what I felt he needed in school to succeed.

Parents at home must remember to take the time and reinforce what is taught at school.

Consistently disciplining our autistic children opens more opportunities for them to enter a better learning environment. Discipline teaches our children to listen and follow directions better, hence increasing their learning ability; and it teaches them about parameters, respect and order. Music therapy
Melodic or tonal memory in a musical contest is the strongest for most children at the time of their language development. This experiment has shown that music as an additional tool for learning new vocabulary is a good motivator and reinforcer. Also singing songs may provide multisensory experience for children. Music has an ability to make children listen, concentrate, and make the lesson more fun. In the music-gesture group, phrases with nonsense words were sang; in the gesture only group, phrases were spoken. The number of words learned was greater for the music-gesture treatment group than for the gesture only treatment group. Moreover, in the music-gesture group, children looked at the experimenter more frequently, smile, and participated in singing.

Picture Exchange Communication System (PECS)

[By Kalen (AC)]

PECS was developed 12 years ago by Andrew S. Bondy and Lori Frost at the Delaware Autistic Program as an alternative communication for autistic children. The system has achieved world-wide recognition for its focus on the initiation component of communication. PECS is now used with people of all ages spanning a wide variety of communicative disorders. The basic principle of how the system works is easily understood and highly adaptable. The cards used have a simple line drawing of an object, idea or action, with the meaning or word printed on the card. The child is taught to approach another person and exchange a picture symbol for an item. Initially, the pictures are simply exchanged for a particular item. Later, by using a series of pictures, the child can form "sentence strips" to make requests or comments in order to communicate more complex needs and ideas. The Picture Exchange Communication System Training Manual Andrew S. Bondy, Lori A. Frost (1996) ISBN: 1928598013

First of all, it is important to consider whether the child has been given an opportunity to improve his speech through more traditional forms of speech therapy. If this has been attempted unsuccessfully, the most important thing to keep in mind is successful communication. Most of us don't realize it, but 72% of everything we communicate is NOT communicated through words, but rather through non-verbal means; this includes facial expression, body posture, proximity to other speakers etc. Try turning the sound down on your television and see how much you can understand without hearing a word!! This is particularly true for your favorite programs because you are familiar with the characters and setting. Communication is the essence of our interaction with the world. And, as such, it includes not only words but also nonverbal strategies. Children who do not speak intelligibly often become frustrated. This is a danger signal that it is time to try some other strategies. Research tells us that by using these "augmentative" strategies to support speech, not replace it, children become more effective communicators and can participate in all aspects of life more independently and confidently. They may develop normal speech. If these strategies are not adopted to augment the communication, children may have delays in reading and writing in addition to being ineffective communicators. "Augmentative" strategies can help get these kids on track without replacing speech, but instead emphasizing speech as a part of the larger whole--communication. ANSWER: The majority of preschoolers go through a period of dysfluency, usually between their second and third birthdays. They may repeat entire words, the first sound of a word, or the first syllable. Sometimes they interject "uhs" and "ums" or revise their sentence halfway through. Usually this occurs when the child is very excited, fatigued, or perceives that he does not have the listener's attention.

There are many reasons for children's dysfluencies. They seem to coincide with periods of rapid language growth when the child is learning new grammatical forms, such as how to ask a question or use the past tense. Since he lacks much experience in these grammatical structures, he may hesitate, back up, revise what he is saying or stumble on a word. Most children will outgrow this in three to six months. If the stuttering behavior gets worse where the child is struggling to speak and obviously very frustrated, or if the parents feel very anxious about the speech, I would recommend seeking a professional opinion from a licensed speech-language pathologist.

QUESTION: My 2-year-old son just started to stutter. The pediatrician said that this is just a phase and he will out-grow it. Should I be concerned? ANSWER: Many little boys go through a "stuttering-like" phase between the ages of two and three. The majority of them do out-grow it. I would be more concerned if your child did this for more than six months, it got more severe over time, he became frustrated while speaking, or he did not want to talk. As a parent it is important to give him plenty of time to speak so he does not have to rush. Keep good eye contact with him and let him know that you are interested in what he has to say. It is generally felt that this "stuttering phase" is due to the child's rapid growth in language and ideas and it is almost as if he does not know how to organize his thoughts and say what he wants. In other words, his mouth just cannot keep up with his mind. If your child continues to experience fluency problems for over six months or his stuttering becomes progressively worse, it would be advisable to get him screened by a speech-language pathologist. This service is usually free in most practices. What is the advantage of getting my child's speech problem corrected before she starts public school? ANSWER: There are several reasons for getting speech and language problems corrected prior to enrollment in kindergarten. First of all, a child with articulation problems will have difficulty with phonics. For example, a child who substitutes "w" for "I" or "r" will have difficulty sounding out words in reading; spelling will also be affected. Children with expressive language problems (for example, verbally expressing what they want, what happened or asking a question) will also have difficulty with literacy skills. Being able to express oneself in complete sentences using correct pronouns, regular plurals, possessives, and verb tenses is important in learning how to read.

Children of five or six years are also aware of their communication problems and may feel self-conscious and anxious in speaking situations. They may be hesitant to share in "Show and Tell" and avoid answering the teacher's questions. Teasing on the playground can also occur. Finally, speech and language problems can often be corrected in a shorter length of time during the preschool years than later on. So if you feel your preschooler has a problem, make an appointment to have him screened. QUESTION: My preschooler has recently been diagnosed with a speech and language disorder. Is there a relationship between early speech and language disorders and later learning and academic problems? ANSWER: First I commend you for identifying your child's speech and language problems early and not waiting until school to see if it will "clear up". Developmental speech and language problems left untreated can many times be related to later reading, writing, and spelling problems as well as the more obvious problems in oral expression. To learn how to read and write, children must auditorily learn to develop explicit phonological or sound awareness of the consonants and vowels in the English language. Early examples of phonological awareness include knowledge that words rhyme, begin and end with same/different sounds, and that words have a certain number of syllables. This early sound awareness is one of the better predictors of early reading ability. Conversely, if a child has numerous articulation errors and problems with spoken language, it is highly likely that he will have difficulty with printed letters and words. Other problems beyond word recognition include poor processing and decoding necessary for reading comprehension and fluent oral reading skills as well as poor short-term verbal memory skills. The speech-language pathologist plays an important role in early identification of potential language-based learning problems. Early remediation is the key to reading readiness and later academic success. Parents can also be good speech models and promote reading and sound awareness at home by reading nursery rhymes, Dr. Seuss books, and doing sound play and syllable-sound blending games. QUESTION: My eight year old child seems to "misread" social situations. At times he doesn't understand that a person may be joking or being sarcastic. Other times he does not seem to catch facial expressions that give clues that the speaker is angry or sad. Idioms such as "You're killing me" really puzzle him. What can we do? ANSWER: Your child seems to be having difficulty with pragmatic language. Most children develop pragmatic language in a routine and progressive way without being taught intentionally. However some children with language learning disabilites, attention deficit disorders, and autism spectrum disorders may need to

have direct teaching of pragmatics. These children need to learn to watch speakers' faces and body language for clues about emotions. They also need to be taught to listen for the speaker's pitch and intonation patterns for additional clues. These children benefit from role playing situations that bewilder them. The meaning of common idioms will also need to be directly taught as well. This type of problem responds well to language therapy.

How can I help my child to learn to speak clearly? Answer: Parents play an important role in teaching their children to speak. The most important thing that you can do is to model good speech. Speak to your child slowly and clearly. Set aside a special time each day- when you are not rushed and encourage your child to talk about his day. Ask questions and show that you are interested in what he does. Some families find the dinner table a good time for talking about what everyone has done during the day. It is important that everyone have a turn talking and that no one is interrupted. When your child makes errors in his speech, repeat his message correctly, but don't ask him to repeat after you. If he hears the correct way to say a word, he is more likely to say it right the next time. Children enjoy having stories read aloud to them. Make this part of the bedtime ritual. All children develop favorite books. Sometimes let them help you read a familiar story by finishing a sentence or telling what they think is going to happen on the next page. If you make speaking fun and give your child plenty of opportunities to talk, he is more likely to develop into a good, clear speaker.

QUESTION: My four year old seems to be delayed in language development. His sentences are much shorter than those of his friends and he does not speak as clearly as they do. Are there any software programs I can use to help him speak better? ANSWER: First of all, it would be wise to have him screened by a licensed speech language pathologist to determine if indeed he is delayed for his age. Preschool age boys generally develop speech a bit slower than girls; girls usually talk earlier and have larger vocabularies than boys, but by kindergarten age the boys catch up. So if we compare boys to girls at age four, we do see some real differences. However, your son may still be well within the normal range for his age and sex. This is why it is so crucial to have a professional with experience in pediatric speech and language development observe your child.

If your child does have delayed speech and language development the therapist will give you specific exercises to do with him on a daily basis. These exercises are fun and you will see real changes from week to week. There are also wonderful software programs that you can mount on your computer; these are geared to young children and reinforce the new skills that they are learning in therapy. Your therapist will help you select software that is appropriate for your child. We have a variety of programs that are appropriate for children of different ages with a variety of speech and language disorders. QUESTION: The little fellow next door stutters quite a bit when I talk to him. Is there anything I can do to help him? ANSWER: There are several things that you can do to make him feel more comfortable. First of all, do maintain eye contact when he is blocking; some people mistakenly look away, but this gives the message that you are embarrassed or uncomfortable with his speech. Secondly, do not finish his words for him, even if you think you know what he wants to say. And thirdly, give him ample time to speak; do not act as if you need him to hurry up. If you can make conversations a pleasant experience, you will probably find that he is more comfortable and therefore more fluent when speaking with you. Good luck! Don't repeatedly drill a task into the child. Autistic people in general strongly resist any transitions or changes in routine. Forcing the child into doing something can prove to be traumatic for them. Instead, give them choice and let them know what task follows the next. This will give them a sense of control and stability.

Direction Development

Follow My Directions Have your child listen carefully as you give him/her a direction. For example, say "put your hand on your head." Gradually make the direction more complicated ("put your hand on your head and smile.") to increase the fun and challenge. Picture Book Questions Share a story with your child. Help to sharpen his/her skills by asking questions about the story as you read along. For example,"What is the name of the dog in the story?" "Where did the dog run away to?" "What is the name of the boy in the story?" Is my child on the right track? As a general rule:

- 2 years Speaks in 2-word phrase. (E.G. Mama up; car bye-bye) - 3 years Speaks in sentences of 3-4 words in length; begins saying "K" and "G" sounds; uses plurals - 4 years Uses sentences of 5 words in length, good vocabulary and grammar. Speech is understandable. - 5 yearsSpeech is well understood. Sentences of over 5 words in length are used. Enrich your child's speech and language development Although time is precious, it is the quality more than the quantity of time spent with your child that counts L'tilize the time you do spend with your child. For example: Mother and child are waiting in a parked car' count the red cars that pass by. describe what people are wearing, call attention to various street sounds, etc. When Dad takes his son to the store, he can talk about what they see and hear and then later help his son relate the experience to Mom. Mom's washing clothes Have your child "help" sort the laundry - white in one pile, red in another, etc. The child can also match like clothing articles - socks in one pile, shirts in another, etc. Encourage your child to hold and feel things: talk about how things feel- cold, hard, rough, soft. sticky, smooth, etc. Self-Talk Young children need to HEAR language to LEARN it. We can help them by SAYING the words for objects and actions by using self-talk: Use short sentences to talk about what you are doing while the child watches. For example: As you tie your shoe, say "I'm tying my shoe. Tie the shoe. Make it tight. Tie the knot." Or, as you wash the dishes, say "Wash the dish. Dry the spoon. Put the plate away."

Self-Talk is most helpful to children 12-24 months of age. From The Mailbox Dear TLC:Summertime is here and soon my children 'will be complaining of boredom. What are some activities that would provide learning experiences to develop their speech and language skills? Summer Mom Dear Summer Mom: An excellent request. Here are some fun ideas. Outdoor Activities What animal am I? Here's a language game to play in your own yard. Take turns thinking of an animal and acting out its actions. Try to guess the animals that are acted out. Hide and seek Take turns hiding a small ball in your yard. The person who does the hiding gives directions to the others to find the ball: "Go to the edge of the house and turn left. Look in front of the bike." Whoever finds the object first gets to hide it next time. Indoor Activities Silly pictures Cut up old magazines and make silly pictures. Glue a car in the air. Glue a winter coat on a child playing at the beach. "Your child will have fun talking about why the pictures are silly. Food for thought Have your child tell you what's needed to make lunch. Ask your child to describe each step as you do it (opening, pouring, slicing, spreading, cutting, mixing, etc.). Ask what would happen if the steps were reversed. "Can I spread the jelly before I open the jelly jar?" Travel Activity Find this While in the car, you can play an alphabet game. Look for things beginning with the letter A, all e the way to Z. Or, your child can focus on colors. How many things

are green or red? Or, find animals, things made of wood, or items in any common category.

Look for TLC in local medical locations across town.

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A speech disorder may affect your child's self-esteem Even a mild speech disorder can create big problems for a child. The cruel remarks of classmates can leave lasting psychological scars. Kids with speech problems often do poorly in class because they are afraid to speak out. Some common speech disorders include: Delayed Language. A child should develop first words by age 1 and two-word combinations by age 2. Poor Articulation. Children sometimes distort and omit sounds or they substitute one sound for another. Some sounds (s, l, r, th, sh, ch, j, v & z) may not be mastered until age 6 or 7. If a child is unintelligible at age 3, intervention by a speech therapist is recommended. Stuttering. Repeating or prolonging sounds and syllables breaks the normal flow of speech. Most children outgrow this but some become tense and frustrated, indicating a need for help. Unusual Voice Quality. Hoarseness, volume and/or pitch problems could mean medical problems or vocal abuse. Screaming on the playground could be a cause. Contact a licensed Speech Pathologist if you suspect that your child has a problem. Stuttering: A Family Issue Characteristics of the Various Levels of Stuttering Normal Dysfluency (ages 1 - 6) 10 or less dysfluencies per 100 words worse when child is excited or competing to be heard usually whole word and phrase repetitions associated with rapid language development may be affected by environmental stresses (moving, divorce, new sibling) no secondary behaviors child is unaware of dysfluencies

Borderline Stuttering (ages 1 - 6) more than 10 dysfluencies per 100 words prolonged sounds are present few secondary behaviors (increased tension) child may be surprised by dysfluencies but not embarrassed or angered caused by combination of heredity and environmental factors Beginning Stuttering (ages 2-8) repetitions are rapid and irregular increased tension causes a pitch rise more prolongations uses fillers and starters (uh, um, etc.) child is aware of stuttering no fear, anticipation or negative self image child is annoyed, frustrated, embarrassed, and feels helpless while stuttering visible muscle tension when stuttering Intermediate Stuttering (ages 6-13) blocks are most frequent behavior more tension in the lips and tongue more secondary behaviors avoids words, situations and environments beginning to have negative self image and displays uneasiness when speaking to others Examples of Behaviors - Part-word repetition: "do-doggy" - Single-syllable word repetition: "I-I want juice." - Multisyllabic word repetition: "Puppy-Puppy ran away." - Phrase repetition: "I want a-I want a lollipop." - Interjection: "He went to the-uh-park." - Revision: "I lost my-Where's Mommy?" - Prolongation: "I'm sssssseven years old." Observable Behaviors (Danger Signs) Block: obstruction of the airflow for speech (attempting to speak, no sound is heard) Pitch rise: a rise in pitch and/or loudness when trying to speak Tension: mental, emotional, or physical strain, which interferes with speech Tremor: the small muscles around the mouth and jaw tremble or vibrate when

stuck on words Avoidance Behaviors: postponing a word, unusual number or length of pauses, substituting words or noises Escape Behaviors: head nod, eye blinks, body jerks, grimaces, hand/foot tapping, etc. Struggle Behaviors: tension, noises added to words, pitch changes

YOU CAN HELP YOUR CHILD BY: Provide the child with adequate time to respond to questions and/or express wants and needs. Use simpler language when speaking to the child. Use a slower rate of speech when talking to the child. Reduce the number of questions asked by approximately 50%. Reduce the excitement level of activities. Plan silent periods during play activities. Avoid "show and tell" display speech. Develop better listening skills: listen to what they are saying - not how they are saying it. Avoid criticism of child's speech. Pause before speaking or responding to questions. Try to eliminate situations that create tension for your child. Avoid calling attention to the child's dysfluency, as this may decrease speaking confidence. Parents should take time every day to spend solely with the child modeling simpler, more relaxed speech during conversation. If possible, observe conditions under which your child does his/her most fluent and most dysfluent speaking and attempt to alter the environment to fit the child's most fluent speaking times. Most importantly, let your child know that you will always love him/her and that he/she can always count on your support.

Pamela, Are You Listening? Here are some activities that will help to sharpen your preschooler & questioning and listening skills. They are easy to play and fun to share! Give Me a Rhyme! Introduce your child to a group of rhyming words (star, car; toy, boy; cat, hat). Then say a word and ask your child to respond with a rhyming word. Then let your child turn the tables. Have him/her say a word and you supply the rhyme.

Follow My Directions Have your child listen carefully as you give him/her a direction. For example, say "put your hand on your head." Gradually make the direction more complicated ("Put your hand on your head and smile.") to increase the fun and challenge. Picture Book Questions Share a story with your child. Help to sharpen his/her skills by asking questions about the story as you read along. For example, "What is the name of the dog in the story?" "Where did the dog run away to?" "What is the name of the boy in the story?"

From The Mailbox Dear TLC: My son is in the first grade. He was referred for a speech evaluation last August. He was evaluated recently and placed as a &ldquospeech only&rdquo child, meaning that he only needed speech therapy. It is November 22 and therapy still has not begun. What are my options other than having it provided through the school system? Concerned Mom Dear Concerned: Asheville Speech Associates can provide speech therapy for children who are in school. We provide speech therapy on a year round basis - during the summer, holidays, etc. We move with the child, if needed, to be sure that there is minimal interruption of services. We can see your child at home, after school, at our office, or if the school allows, we can go to his school. Please feel free to call for a consultation. Good luck. Look for TLC in local medical locations across town Is your child gifted? Characteristics of gifted children: 1. A longer attention span 2. A persistent curiosity 3. A desire to learn and the ability to learn rapidly 4. A good memory 5. An awareness and appreciation of people

6. A wider range of interests 7. An ability to solve problems 8. A tendency to prefer the companionship of older children or adults Gifted children will not possess all of the above characteristics to the same degree. Parents, please remember that your gifted child is first of all a child. The need is great for play, outdoor exercise, creative activities and relationships with other children. Your gifted child has emotional, social and physical needs and may progress more slowly in these areas than in intellectual development.

How to read a book to your child Show delight and enthusiasm as you read. Try to read to your child each day. Read when relaxed, such as bedtime or after a nap. Let your child choose the books to read. Point to the pictures as you talk about them. Let the child help hold the book and turn the pages. Tell a familiar story, but leave out words or parts of sentences for your child to fill in. Let your child describe the pictures and tell the story to you. Write down your child&rsquos homemade story and read it to him. If your child does not show an interest in reading, continue to read to him as he plays quietly. Eventually he will be eager to participate in reading. So many times new parents hear people say, Your baby does not know what you are saying, why bother reading to them as such a young age? It is such a waste of time. The answer is simple. Though your child does not understand the contents of the book you are reading to them, this does not mean they are not learning. It is quite the contrary. They are learning how to pay attention, as well as different voice tones. Babies also love the sound of their parents voice, be it reading a book or carrying on conversations. If you take advantage of this early on, it will become part of your babys routine they will love right along with taking a bath every night or singing lullabies. As your baby grows older, interactive reading will come more into play by you as the parents. Rather than reading to your child purely for their enjoyment of hearing your voice, begin utilizing hand eye coordination with each paragraph and each page. Point out colors, objects, pictures and specific words using your fingers. Have your child follow along with your finger with their own while you read the words, then have them turn the page at the end. This will teach them to read from left to right and to turn pages from right to left.

When you read to your child, do so with enthusiasm and excitement. Your goal is to keep your childs interest. Remember, you are sharing something with them they otherwise cannot explore on their own. Pick from a wide variety of books relating to subjects that your child is interested in, including adult sized books without pictures. If reading becomes the high point of you and your childs day, later struggles to keep your childs interest in books and reading will be minimal if at all. If you, yourself struggle to keep your interest in reading it is very important not to influence your children in this direction. A child growing up hearing, Mommy does not like to read, will most likely not like to read either. Our children are very impressionable and often follow our lead, including, but not limited to reading. Some tips to broaden your interest in reading would be to read short articles, rather than long books where your interest falls rapidly. You also may want to try audio books at first while following along with printed publications. Try anything to develop a better appreciation for books and reading so your children will grow to do the same. Next to showing affection to your children, reading ranks high up there on the scale of importance. It is fun to teach your child the language, vocabulary and communication skills. You are also entertaining them while acting out the voices and actions of the characters in the books you are reading. Reading aloud to your child not only jump starts their imagination, it also develops their listening and concentration skills. By stimulating these skills early on, your child will feel encouraged to venture into creative writing and, possibly, journal keeping later on.

DEAR TLC: My 3-year-old grandson has difficulty pronouncing R, S and L sounds. Rabbit sounds like "wabbit" and sun sounds like "thun." Should he be seen by a speech pathologist? Signed, Concerned Granny DEAR CONCERNED GRANNY: The R, S and L sounds are usually developed at a later age than 3 years. Your grandson does not presently need speech therapy. If the problem persists past age 5, then he should be evaluated by a speech pathologist. Dear TLC: My son is in the first grade. He was referred for a speech evaluation last August. He was evaluated recently and placed as a "speech only" child, meaning that he only needed speech therapy. It is November 22 and therapy still has not begun. What are my options other than having it provided through the school

system? Concerned Mom

Should We Insist on Eye Contact with People who have Autism Spectrum Disorders Contributed By Rozella Stewart When and whether students who have autism spectrum disorders should be required to make eye contact is a controversial issue. It is possible to become very confused about this issue when one works with a number of differentusually very differentstudents who have autism. Some people who have autism actively avoid eye contact and appear confused and anxious when it occurs. Some seemed to make eye contact relatively early but later reported they were actually looking at something that fascinated them (such as their reflection in one's eyeglasses). When cued "Look at me," some make eye contact that recipients experience more as a staring gaze than as a communicative exchange. Some gradually learn to make eye contact and to read simple meanings that they have come to understand through experiences with what happens to them when a particular person's eyes have a specific look. Mothers often report that their family member who has autism watches his mother's eyes and, having had experience with certain looks before, anticipates what is coming next. Few mothers report having a sense of sharing mutually meaningful socioemotional messages through such encounters. Some folks who have autism gradually learn to think about social expectations around eye contact and to make an effort to use it periodically. Many appear to become more adept at making eye contact as comfort and competencies in social situations increase. Some report that their ability to make eye contact depends on context. For example, when an individual is comfortable and feeling relatively competent, he may be able to tolerate such exchanges. When in confusingly complex, overloading and other anxiety prompting situations, the same individual may overtly avoid eye contact. Some individuals appear to use eye contact from a young age; it is difficult to determine the extent to which those individuals are able to read subtle social messages that are typically conveyed via the eyes. Many seem to become more comfortable with eye contact, as well as better at reading some of the messages, over time. Few, it seems, report that eye contact ever becomes a really useful means for either receiving or sharing mutually understood messages. Few appear to feel confident concerning their abilities to read messages that may be conveyed via the eyes of various people in their lives. In determining where we stand in the midst of ongoing controversy, it seems reasonable to consider what our purposes for expecting or "requiring" eye contact

really are. Having defined our purposes, we need to ponder whether those purposes are best served by strategies that we employ. Educators have been taught that it is essential to get individuals' attention before beginning instruction and to recapture attention to task when peoples' demeanors suggest that their attention is waning. To accomplish this task, teachers often first attempt to get attention by cuing "Look at me." They also often assume that they have individuals' attention when they "get eye contact" and that those who do not conform cannot be paying attention. Thus, when individuals who have autism seem to avoid looking into the eyes of teachers and others with whom they interact, the strategy that comes most naturally and is often pursued quite intently is the verbal cue "Look at me." If an individual who has an autism spectrum disorder fails to respond within what is viewed as a reasonable length of time, the cue may be repeated more forcefully. If the person still fails to look as directed, misinterpretations of why the person isn't "complying" may fuel futile power struggles that only frustrate everyone concerned and further thwart the abilities of individuals with autism to respond. Whether requesting eye contact is a wise approach to focusing attention depends both on the person who has autism and on circumstances surrounding the expectation. Sometimes getting an individual to "make eye contact" becomes a high priority that falls under the rubric of "compliance and direction following" training. Individualized education programs often include objectives such as "will make eye contact when requested 80% of the time". Some goals and objectives seem to be stated in context of assumptions that students with autism spectrum disorders have sufficient understanding of social conventions to make routine judgments about where, when, and with whom eye contact is appropriate and expected and/or that they are consistently able to spontaneously initiate and selectively maintain eye contact in social situations. As an example, consider an objective that states, "Will increase eye contact when in social situations with peers. Student will make eye contact X number of times every 10 minutes when involved in shared activities." Folks who write and strive to achieve such goals and objectives may be as naive in their understanding and interacting with individuals who have autism as individuals with autism are naive at understanding and using social conventions. We need to re- examine assumptions that undergird choices among instructional/interactive strategies, to define purposes that we hope to accomplish, and to candidly assess whether hoped-for outcomes are being met. While attempting to maximize adaptive behaviors on the part of individuals who have autism spectrum disorders, we too must adapt when observed responses clearly indicate that our purposes are not being achieved. A number of "higher functioning" folks who have autism have described difficulties with making eye contact. One of the more humorous explanations was shared over lunch with a brilliant, well- educated, 45-year-old man who has Asperger's Syndrome. With a mixture of cynicism, good humor and pleading for understanding, he discussed his difficulty with making eye contact, but even more

to the point, with expectations that he "read" and respond to the subtle socioemotional messages conveyed via the eyes. In summarizing his message, he said, "If you insist that I make eye contact with you, when I'm finished I'll be able to tell you how many millimeters your pupils changed while I looked into your eyes." Several individuals who have autism have described similar difficulties, if not such analytical approaches. Some candidly share exasperation with folks who insist on eye contact while demonstrating considerable ignorance concerning ways interactive sensory, motor, social and emotional anomalies impact one's abilities to orient and make sense of environments and expectations. People who have autism spectrum disorders have difficulty with reading even the most overt social cues in context. They have extraordinary difficulty with reading more subtle body language, including messages often conveyed via the eyes. In addition to difficulties with attending to and interpreting information that is embedded in social context, some have great difficulty with attending to and coordinating two sources of sensory input at once. For example, astute teachers often observe that a student with autism "looks out the window all the time, just doesn't appear to be paying attention at all, but then can tell me everything I said." It appears likely that the described student has difficulty with coordinating listening and looking behaviors and, perhaps, with receiving and processing information coming in from multiple sensory channels. Insisting that he make eye contact might well render him unable to take in and store auditory input. Or... he may be able to coordinate looking and listening in some situations but not in others. Educators who are relatively unfamiliar with autism are often understandably perplexed by inconsistencies evident in an individual's response patterns. There appears to be a natural inclination to assert that, "if he could do it in that situation, I know he can do it in the other...". In fact, learning styles of students who have autism spectrum disorders, as well as of other students, vary tremendously across tasks. We adults often view dissimilar tasks as if they were similar or even the same. Once learning (change within the individual) has occurred, subsequent tasks, though they appear similar, are never the same. Learning builds on prior learning and each successive challenge occurs in context of change that has occurred in response to past challenges. Each subsequent learning task is assimilated in context of changed comfort levels, values, attitudes, and/or behavioral competencies affected by prior experience. Each new task, even though it appears similar to us, is likely to be perceived as a new challenge to a person who has autism. There are many reasons why we simply cannot assume that because an individual with an autism spectrum disorder did something a month ago, a week ago, or yesterday, he can also do it today. This "leap of faith", as opposed to efforts to better understand possible difficulties that the person may be having, too often characterizes attitudes regarding individuals' abilities to make eye contact either spontaneously or "on demand." Figuring out how different individuals take in, store, coordinate, plan and execute behavioral responses, as well as what may detract from this process, and how they

perceive the actions of others, involves both art and science. If we are lucky (and, hopefully, also skilled facilitators of learning), instructional efforts impact behavior in ways that render subsequent tasks and expectations easier than initial trials. Consider the individual who looks out the window with apparent disinterest (if not to "get someone's goat") but later demonstrates that he knows the basics of what was going on and has, indeed, memorized auditory input. Given familiarity and some acquired agility with the auditory information he has learned and having achieved greater comfort, he may (or may not) now be able to make eye contact in context of that familiar body of information for some individually idiosyncratic length of time. However, whether he intuits anything meaningful during that encounter is more than a rhetorical question. We don't know what he sees; we should probably suspect that messages he is reading, if any, are very different from those we think we are conveying. Jean-Paul Bovee is a 30-year-old "high functioning" man who was diagnosed with autism at age three and a half. He has described his difficulties with eye contact in words that are echoed by many individuals who have the disorder: "Eye contact is something that I have always had trouble with. It does not come naturally to me and I do not appreciate having to give it all of the time, especially to people that I do not know. All of the stress that is put on doing it makes me more nervous, tense, and scared. Doing it also assumes that I can read the message in another person's eyes. Don't count on it! I can look at a person's eyes and not be able to tell what they are saying to me... ...as a child, my eye contact was much worse than it is right now. People without autism could not understand why I would not look them in the eye... just because I am not making eye contact with you does not mean that I am not listening to you or paying attention to you. I can concentrate better not having to keep eye contact at the same time. I tell people, 'You have a choice. Do you want a conversation or do you want eye contact? You will not get both unless I am comfortable with you and do not have to concentrate so much on the eye contact'." When developing strategies aimed at focusing and maintaining attention on the part of folks who have autism spectrum disorders, we need to consider idiosyncratic ways that individuals take in and process information. We need to recognize how conventional social expectations may, in fact, interfere with learning for some. Guiding individuals in focusing and engaging in tasks specifically related to the activity at hand is often more effective than trying to obtain attention through eye contact and then expecting that the person can quickly shift attention to a set of task-related stimuli. When, where, with whom, and whether to insist on eye contact with people who have autism spectrum disorders remains controversial. But... the need to define the purposes we wish to achieve through our instructions and expectations, and to assess (through individuals' responses) whether those purposes are being served is clear. Eye contact is a very social, almost intimate, type of interaction. When, whether, and why to insist that individuals engage in that

exchange are questions that, to answer wisely, require ongoing scrutiny, understanding, and flexibility on the part of people who interact with folks who experience challenges common to autism spectrum disorders. Source Comparisons of discrete-trial and normalized behavioral language intervention for young children with autism. Delprato DJ. Department of Psychology, Eastern Michigan University, Ypsilanti 48197, USA. Psy_Delprato@online.emich.edu This critical review examined a series of 10 controlled studies in which traditional operant behavioral procedures were compared with more recently developed normalized interventions for teaching language to young children with autism. Main characteristics of the older treatments include highly structured direct teaching sessions of discrete trials, teacher initiation, artificial reinforcers, and response shaping. Normalized interventions consist of loosely structured sessions of indirect teaching with everyday situations, child initiation, natural reinforcers, and liberal criteria for presentation of reinforcers. The main conclusion was that in all eight studies with language criterion responses, normalized language training was more effective than discrete-trial training. Furthermore, in both studies that assessed parental affect, normalized treatment yielded more positive affect than discrete-trial training The facilitative effects of incidental teaching on preposition use by autistic children. McGee GG, Krantz PJ, McClannahan LE. In a comparison of incidental teaching and traditional training procedures, three language-delayed autistic children were taught expressive use of prepositions to describe the location of preferred edibles and toys. Traditional highly structured training and incidental teaching procedures were used in a classroom setting, and generalization was assessed during free-play sessions. Results clearly indicate that incidental teaching promoted greater generalization and more spontaneous use of prepositions. These findings have important implications for language programming and teacher training, suggesting that incidental teaching should be included as a standard component of language development curricula for autistic and other developmentally delayed children. Generality in the verbal tacting of autistic children as a function of "naturalness" in antecedent control. Woods TS.

Two autistic children were taught to emit verbal tacts under two conditions--one employing verbal antecedent stimuli in the training process and the other employing so-called naturalistic antecedent stimuli. Although acquisition was more rapid when verbal antecedents were used, the generality of learning was substantially better for language taught under naturalistic stimulus control. Implications of these findings for the instruction of autistic children are considered in the context of current information on stimulus control. PMID: 6470154 [PubMed - indexed for MEDLINE] Generalization by autistic-type children of verbal responses across settings. Handleman JS. Generalization of verbal behavior by autistic-type children across physically different settings was assessed. Four boys learned responses to common questions in two settings at school and were probed to determine transfer of learning to home. Three of the children demonstrated little generalization to home when trained in a cubicle. Greater generalization was indicated when they received training at varied locations. The fourth child generalized most responses to his home regardless of training setting. Simple manipulations of the school environment to more closely simulate home conditions may facilitate transfer of training to the natural environment. Learning through observation: the effects of peer modeling on acquisition and generalization in autistic children. Charlop MH, Schreibman L, Tryon AS. The purpose of this study was to systematically determine whether low-functioning autistic children [MA of approximately half of their CA or less] could learn through observation by the use of a peer modeling procedure. Since modeling is less structured than traditional one-on-one procedures, it was also thought that modeling might facilitate subsequent generalization of tasks learned through observation. Four autistic children were taught two receptive labeling tasks. One task was taught by a traditional trial-and-error procedure, while the other task was taught by a modeling procedure wherein the models were other autistic children. Results indicated that all four children learned through observation of their peer model. Additionally, generalization and maintenance of correct responding were superior when the children learned through observation rather than by trial and error. These results are discussed in terms of the modeling literature, generalization issues, and implications for designing teaching settings for autistic children. PMID: 6643856 [PubMed - indexed for MEDLINE]

The effects of echolalia on acquisition and generalization of receptive labeling in autistic children. Charlop MH. This investigation, consisting of two experiments, was designed to assess the effects of autistic immediate echolalia on acquisition and generalization of receptive labeling tasks. Experiment 1 addressed whether autistic children could use their echolalia to facilitate acquisition. The results indicated that incorporating echolalia (echo of the requested object's label) into the task before manual response (handing the requested object to the experimenter) facilitated receptive labeling. Experiment 2 was designed to determine the effects of incorporating echolalia into task response on acquisition and subsequent generalization. These results indicated that echolalia facilitated generalization for echolalic autistic children but not for functionally mute autistic children. The results of the experiments are discussed in terms of stimulus control. Additionally, it is proposed that perhaps in certain cases, echolalia should not be eliminated, but used to advantage in receptive responding. Echolalia and comprehension in autistic children. Roberts JM.

Autistic Association of New South Wales, Sydney, Australia. The research reported in this paper investigates the phenomenon of echolalia in the speech of autistic children by examining the relationship between the frequency of echolalia and receptive language ability. The receptive language skills of 10 autistic children were assessed, and spontaneous speech samples were recorded. Analysis of these data showed that those children with poor receptive language skills produced significantly more echolalic utterances than those children whose receptive skills were more age-appropriate. Children who produced fewer echolalic utterances, and had more advanced receptive language ability, evidenced a higher proportion of mitigated echolalia. The most common type of mitigation was echo plus affirmation or denial. Echolalic and spontaneous phrase speech in autistic children. Howlin P. The study investigated the syntactical level of spontaneous and echolalic utterances of 26 autistic children at different stages of phrase-speech development. In children using very brief utterances, echolalic phrases were significantly longer than their spontaneous speech. At higher levels of language development there were no significant differences between the lengths of echoed and spontaneous utterances. The frequency of echolalic phrases in children's speech was also found to be significantly less than the frequency of their spontaneous remarks, and the

frequency of echolalic utterances declined as children advanced in linguistic competence.

Bedtime soliloquies and linguistic competence in autism.

Baltaxe CA, Simmons JQ. This study investigates the linguistic competence of an autistic child by means of her bedtime soliloquies. It suggests the usefulness of such monologues as a diagnostic tool and addresses the question of the interrelationship between echolalia and language development. Three bedtime soliloquies of an eight-year-old echolalic autistic child are analyzed along the dimensions of echolalia versus propositional speech, types of ungrammaticality produced, and analysis of connected discourse. The results are compared with those of a normal child reported earlier in the literature. The present analysis demonstrates the difficulties in the judgement of propositional versus echolalic speech. The types of ungrammaticality were found to be useful indicators of apparent differences between the acquisition process in the normal and the autistic child. They revealed that the autistic child may use specific linguistic strategies only minimally utilized by the normal child. The discourse analysis points up additional differences as well as similarities in the way the autistic subject organizes her utterances in connected discourse. It also shows that the autistic child has specific but limited linguistic competence. It is hypothesized that the autistic subject acquires more functional, useful language by a process of gradually breaking down echolalic patterns. In terms of therapy, these findings would support the use of echolalia as a basis for language training. PMID: 881820 [PubMed - indexed for MEDLINE]

Early social, imitation, play, and language abilities of young non-autistic siblings of children with autism.
Toth K, Dawson G, Meltzoff AN, Greenson J, Fein D. UW Autism Center and Center on Human Development and Disability, University of Washington, Seattle, USA. Studies are needed to better understand the broad autism phenotype in young siblings of children with autism. Cognitive, adaptive, social, imitation, play, and language abilities were examined in 42 non-autistic siblings and 20 toddlers with no family history of autism, ages 18-27 months. Siblings, as a group, were below average in expressive language and composite IQ, had lower mean receptive language, adaptive behavior, and social communication skills, and used fewer words, distal gestures, and responsive social smiles than comparison children. Additionally, parents reported social impairments in siblings by 13 months of age. These results suggest that the development of young non-autistic siblings is affected at an early age and, thus, should be closely monitored, with appropriate interventions implemented as needed.