Word Finding

Describe the word finding skills of children with autism? Describe the methods & findings of a research article on auditory processing. How will this impact ability to initiate a social exchange during a play based activity? What is 1 treatment strategy given the findings.

Word Finding Difficulty in Autism

I covered a research article on auditory processing in my last blog. In this blog, I would share my thoughts on “word finding” in autism.

Verbal communication is one of the cornerstone issues in Autism. Many children with Autism are struggling each moment as we speak to find the word, to portray the meaning they want to.

Its not as if children with autism do not want to communicate, its just that they lack the skills, and need environmental exposure, adult guidance, and reassurance in the form of gaining result/response to their “word” use.

Literature indicates that children with autism have difficulty with auditory verbal processing, and the preferred learning medium is visual. (If the “word” can be represented through a symbol, there is a better chance of expressing it. Particular difficulty arises for ASD children when attempting to express words that describe “internal feelings”, such as “I Wish”, “miss you”, or prepositions such as “After, before, yet, until”.

Such difficulty with word finding can have enormous impact on the ability to initiate a social exchange such as during a play based activity. A child may not for instance be able to convey her disinterest in the activity, or using a specific sequence of activities such as “first do this, and then do that”.

One of my middle school students with Autism had terrible time explaining to me that it’s not that he did not want OT; it’s just that he wanted me to come back “after lunch”. He is mostly non-verbal, uses “springboard”, but even with the AAC its not always easy to “find the word” one wishes to use.

We non-ASD folks, have almost unlimited vocabulary and a vast mental library to pick the best suiting word from, in contrast to our ASD children that struggle every moment to get the right word!

Two practical strategies in such circumstances would be co treatment sessions with Speech and language pathologists (drawing on the expertise), and having the availability of “visual forms” of communication devices. Using PECS system for basic level communication and the more advanced alternative communication devices such as the Dynavox, or other voice output devices (to be discussed in details in later postings). In any case, keeping “total communication approach” is the key, making sure we put play, socialization and language all fostered at the same time. There are no words to describe the feeling you get when you have helped a child find the right word!

Reference:

Lecture Notes, class material (Amy Lynch, Anne Van Zelst), 2011.

Book reading, Miller-Kuhaneck, 2^nd edition, 2004, chapters 12, 8, and 3.

Communication- Auditory Processing in children with Autism

8        Communication: Consider communication with respect to the functional occupation of social interactions with others during a play based activity. Describe the auditory processing challenges in children with autism that you see clinically.  Describe the methods & findings of a research article on auditory processing.  What is 1 treatment strategy given the findings?

We have heard through different discussions and readings, that ASD population may have auditory Processing Challenges.

AP issues can have great impact on functional communication during play based activities for children with autism. I found an interesting article on this very same topic but first let me go over what I see in the clinical setting.

Anna is a verbal 8 year old child with autism on my caseload who is “Lost”-unable to excel during group interaction or activity, and yet when seen individually, her tolerance, attitude and performance on specific understanding questions is much better.

The more I think of it, the more I remember using visual information presentation during our one to one sessions, and she performs better. Is it the background noise that’s cut off? Is it the proximity to another adult and ability to lip read, basically using visual cues instead of “auditory” that helps her make sense of things?

Anna always appeared shy and avoided joining fun play groups, until one day during the class Valentines’ dance party, when I trialed my ipod Nano with her with children’s songs! Anna was dancing with quite elaborate moves, right in the middle of the dance floor, not at all shy, looking rather confident. Is it the pitch changes and rhythm of music she is comfortable with rather than the decoding of speech sounds of people around?

In my search for answer to “What is exactly different in Anna’s auditory processing?” I found this great article in the journal of developmental science that compared group of children with ASD to group of normally developing “control group” with similar IQ.

I particularly like the methodology used since it seemed very simple. At first they tested each subject on visual Pairs of shape and color differences, the child had to look at the two cards with similar or different “color” or “shape” and say “Different”, or “similar”. This was just to get them acclimated to understanding how to answer.

After achieving 80% accuracy on the visual “pair- difference” recognition, now they were then given the “Pair of sounds”, and asked if they could tell if the sound bite is similar or different. “Music-Music”, “Speech-Speech”, and “Music-Speech” were the different categories.

What the study found is to me ALARMING! ASD children had a hard time differentiating between “Music” and “speech” sound, or speech –speech sounds! The control group children not on the spectrum were pretty comparable to ASD on “Music-music” category, but significantly better in recognizing differences on “Music-Speech” category.

Interestingly ASD children seem to be able to catch the “difference” in the PITCH changes, within “Music-Music” sound bites, demonstrating evidence that ASD children hold similar perceptual processing ability as the control group.

Could it be then this focus on detail of difference between pitch, is probably what is keeping them away from identifying the overall difference of the two sound bites? (Complementing the Weak Central Coherence theory findings.)

Now looking back, I can see that the reason ANNA avoided group was not because she was shy, rather she was overwhelmed with multiple verbal interactions, unable to categorize witch ones to take notice of. Anna looked lost because she could not process what some one said to her, given her difficulty filtering the background verbal input.

She enjoyed the Music pitch changes because she could differentiate, and did not HAVE to even make meaning out of it, just had to coordinate spatial body movements resonating with the music.

As a treatment strategy, I would recommend presenting same information in visual form, if possible or giving one SHORT verbal instruction at a time, speaking in slow speed.

Would love to blog more on “Communication and autism” topic, look for the next weeks posting if you are interested!

The reference for the article is:

Anna Jarvinen-P., Heaton, P., Evidence for reduced domain specificity in auditory processing in autism. Developmental science, 10:6 (2007), pp786-793, UK.

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