New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 3: Education for learners with ASD
for communication 96 189 . Many children with
ASD find visual quasi-symbols, such as photos
and pictograms which are more static, easier to
comprehend than verbal language 96 213 .
5. Social pragmatic skills
Communication interventions have traditionally
focused on unusual aspects of speech, such
as echolalia (imitating the speech of others),
pronoun reversal and unusual intonation. More
recent research has emphasised the functional
aspects and social or pragmatic aspects of
communication, such as sharing attention (joint
attention) or using and noticing non-verbal cues
such as gestures and facial expressions 96 .
Children and young people who develop fluent
speech may still have difficulty with social
rules governing conversation 96 . Difficulties with
prosody, which includes rate, rhythm, inflection
and volume, also provide challenges which need
to be addressed 214 .
6. Echolalia
Children with ASD who learn to talk often
use echolalia as they start to communicate 96 .
Echolalia can be immediate (ie, an echo of
something just spoken) or delayed (ie, refer to
an event in the past). This speech initially serves
as a label for a particular situation but may at
later stages serve a variety of communicative
functions 215 . Many children eventually learn
to break these scripts down into smaller, more
meaningful chunks 189 . Even after children
have developed more fluent speech, echolalia
may reappear when the child is confused or
fatigued 215 .
7. Unconventional behaviours
Children who do not develop fluent
communication skills may use inappropriate
or unconventional behaviours such as
tantrums, aggression or self-injury as
means of communication. Improvements in
communication have been found to be a key
factor in improving and preventing problem
behaviours 96 189 .
There is strong support for functional
communication training – where the
communicative function of a behaviour is
identified and an appropriate communication
form (including signs, visual symbols or
language) is taught as an alternative to the
challenging behaviour. This intervention has
the advantage of teaching the individual to
communicate, as well as reducing undesirable
behaviours 96 189 192 213 (this is discussed in more
detail in section 3.2.e: Self-management skills and
addressing challenging behaviour).
Approaches to interventions
In the 1970s and 1980s, the developmental
pragmatic literature which looked at the
development of communication for social
purposes began to influence interventions for
children with ASD 192 .
Speech is only one form of communicating,
but in the past it has been seen as the main
focus for intervention for children with ASD 55 .
However, without a good understanding of
the social purpose of communication, the child
may never make use of the words they learn to
communicate with others 192 .
Most children understand a lot about
communicating before they learn to speak
and it is equally important for children with
ASD to develop this pre-verbal knowledge.
Very young typically developing children
begin to communicate using informal means
such as gestures – for example, raising their
arms to be picked up, or pointing. Young
children with ASD may have a limited
range or unconventional gestures for their
communication. They are likely to use
communication to regulate another person’s
behaviour, such as requesting something by
taking someone’s hand and leading them to the
object, and they are less likely to use the more
socially oriented functions such as pointing to
draw another person’s attention to something 215 .
Part 3
New Zealand Autism Spectrum Disorder Guideline 97