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.