Looking at the Whole Child for Identification & Intervention of Autism Symptoms

Operation is a game that has been a major part of many people’s childhood experiences.  It takes such precision to remove the bones and organs from the body without setting off the buzzer.  Each piece is important.  If a player takes out a leg or arm bone, the man on the operating table is not whole.  He needs all of his body parts to function.  They are what make him tick.

The autistic child is sometimes treated like the man in the game.  Scientists reduce the child to his ability to produce words.  They sometimes disregard the other qualities or developmental factors that compose the whole child.

It is understandable why they hone their attention on speech production. Early identification and intervention have reduced the number of people with autism who speak fewer or no words from 50% to 25%.  But there is still a subgroup within the autistic population that does not improve their verbal skills.

Autism is an enigma that scientists have been trying to solve.  Once a child is identified as autistic, he or she becomes a puzzle. The most important piece is the absence of spoken words.  Research and interventions target the goal of increasing the production of spoken words.  Scientists are now examining other factors, such as motor skills, joint attention and memory, as other pieces of the puzzle.

Scientists are also trying to improve the method they use to define silence.  They have relied on research to determine a specific number of words that would identify a child as minimally verbal.  Scientists also consider the age and the IQ of the child.

Now scales are being developed and tested to assess nonverbal components.

Nancy Brady, an assistant professor of speech, language, hearing sciences and disorders at theUniversityofKansas, is one of the researchers working on a new measure.  Her test, The Communication Complexity Scale, factors in the assumption that an autistic child’s IQ may be low based on their speech production.  It examines the gestures of the child in helping him or her communicate while doing simple tasks such as opening a jar to retrieve a toy.

Other scientists are conducting treatment trials that deal with nonverbal communication.  Even though some disagree with the use of aids such as the Picture Exchange Communication system, iPads, or speech generating devices, Connie Kasari has found an unpublished study that proves their usefulness.

The UCLA professor of human development and psychology states,

“There are a lot of people out there who don’t want to use some sort of augmentative system, because they think the kid won’t talk,” Kasari says.

But in fact, the opposite may be the case. Kasari has unpublished data showing that minimally verbal children who also used a speech-generating device early in therapy have more socially communicative utterances after six months than those who get the device later. It’s not clear why, but “it seems to augment their own ability to talk,” Kasari says.

Other treatment trials include an auditory-motor mapping method that has been used with people who have language impairment after a stroke.  JASPER is also an intervention that works with movement and play skills.

Kasari explains how examining nonverbal communication can help improve verbal skills:

“Most kids look to their parents; they look to objects; they show toys; they point to things; they do all of these things before they ever learn words,” says Kasari, a developer of the therapy. “So I think teaching those particular skills helps fill in those gaps, and helps kids learn language faster.”

As scientists shift their attention to the whole child, they can develop interventions that will not only increase speech production, but also motivate its use by autistic children.

*DeWeerdt, Sarah.  “Study of nonverbal autism must go beyond words, experts say.”  SFARI. Sept. 2, 2013.  http://sfari.org/news-and-opinion/news/2013/study-of-nonverbal-autism-must-go-beyond-words-experts-say


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