Monday, October 12, 2009

Why Do Children With Autism Lose Words?

Today, I needed to think about why it is so common for a child with autism to lose vocabulary.  I saw it happen in the course of an hour in one therapy session and during the next session, a mother described her frustration with having her child regress into yelling rather than calling her as he was doing the week before.  The situation was strikingly similar between children which helped me develop a theory.  If you know other theories about why this might occur, please share them in the comments section below but here is my theory.

First, I have seen children and adults with autism lose the motivation or the ability to communicate and perhaps they lose both.  I got called in a few years ago to consult with the staff at a group home where a young woman had not spoken in several years--at least not to the staff.  Her mother was frustrated because her daughter had, at one point, talked quite a bit.  In school and while living at home, she requested food and activities.  She protested using specific words to describe things she did not like or want.  She told her family that she loved them.  But even on weekends when she often went home to be with her family, she rarely spoke anymore.  More recently, I worked with a little boy who had a diagnosis of Asperger Syndrome, and in the process of getting this diagnosis, his father concluded that he, too had Asperger Syndrome.  His father was a researcher and as sweet a man as one could imagine.  His wife, who clearly loved her husband, complained that when they were courting, they had often talked together for hours.  Now, she lamented, he rarely came out of his office and often responded to her conversational bids with single word answers. 

Clearly, it is more difficult for individuals on the Autism Spectrum to communicate, even after learning the words, sentences, and situation where communication is expected and useful.  Last week, a little boy was calling his father, saying Dad! and then trying to say Come here!   Over and over we practiced this skill and it appeared to be getting easier and easier.  Today when we started, this little guy was back to yelling angrily to get his dad to come.  Helping him call his dad again required reminding his dad not to come when he yelled, modeling the words we expected him to use again several times and showing him how it all worked again, and getting the timing between dad and son just right so that it all made sense.  It was going well again and then suddenly, it just did not seem worth it to this little boy and he did not want to play the calling game any more.  He seemed to lose motivation and I felt perhaps whe had practiced too long so that it was not really interesting to him any more.  Wow!  We needed to put a lot of pieces into place to create the "just right" situation for this little boy to communicate! 

It is not surprising that in a group home, where staff changes are frequent and no ongoing training about autism occurs, an adult with autism would lose motivation.  The communication partners just don't play their part correctly and it becomes to hard to figure out how to communicate.  It is not surprising that after the excitement of initial courting is over, an adult with Asperger Syndrome would find it hard to engage in recreational conversation.  Communication occurs when there is a perfect alignment of linguistic ability and social motivations--this is true for all of us.   This alignment does not naturally occur very often for individuals with autism--when it does, we are often surprised by an unexpected word, phrase or entire story seemingly popping out from nowhere.  If we want children or adults with autism to keep communicating at their highest ability, we need to work to create motivating social situations.


Randall K said...

Well from some of the things that neurologists and I talked about in tests they had done on me long before I was diagnosed with Aspergers... they often noticed in my eeg tests that my brains signals seem to jam up and misfire. I think the communication problems come from that type of phenomena. My brain often does it to me, for example when I'm typing I often will think one word and yet type something completely different that I'm not consciously thinking of at all. Its taken many years to retrain myself to proofread what I type multiple times so I can correct them all.

Tammy said...

I've seen this with a lot of things that my son has done. He would do something new and it would seem like he had mastered the task, and then refuse to do it. It's like the initial fascination with the task has gone away and now he can't be bothered with it. It's frustrating as a parent to go through this with your child. Motivation is such an important key to getting my son to do anything.

A great example of ths is his dressing himself independently. If we are going some place that he wants to go to, he will get himself dressed quickly. If we are going someplace that he doesn't want to go or I am just trying to get him to dress himself after a bath, he is so slow. I have to keep nagging him until he has everything on. Even then, he trys to get me to do it for him.

Elizabeth said...

Here is my theory.

It's not so much about motivation as it is about purposefullness.

You can teach a child to say "daddy come here" in a controlled setting. Every time the child says "daddy come here" the parent responds by approaching the child. Return home and attempt to duplicate this and it will not happen. Depending on the child, it may take a single instance of no response or an undesirable response for them to decide that the task (saying the words "daddy come here") does not serve a purpose. They will return to something that has consistently worked for them. Like yelling or throwing a tantrum.

The group home is another good example. If the woman were to request something like a snack during a time that snacking was not permissible, it would quickly become clear that using words to ask for something serves no purpose (being told not right now is not the desired or anticipated result - getting the snack is). If communicating stops being purposeful, there is no reason to continue attempting it.

Most things are quite black and white. There is no gray. It is yes or it is no. It isn't maybe. Something works or it does not. Depending on how interested one is in getting something accomplished, another approach may or may not be tried. THAT is where motivation comes into play. If there is not enough motivation to return to something that has worked in the past (or nothing has worked), then there is withdrawal.

Thank you so much for your wonderful blog!

Tahirih said...

Great comments! Randall, I have had other adults with ASD tell me that they experience brain jam ups too. The more I learn about the brain, the more I wonder why everyone does not have misfires. Maybe we do but not as many. Elizabeth, your theory also makes a lot of sense to me. All or nothing thinking is so much a part of ASD. And Tammy, I think that the novelty of a newly learned concept can be motivating and kids will make an extra effort but then it just gets boring and not worth the effort. Kids on the spectrum (maybe adults too) can't seem to make themselves do boring stuff. I am kind of like that but social expectations motivate me through otherwise boring stuff (sometimes). Social expectations do not seem to have the same motivating power for kids on the spectrum.