Autism, in the general sense, is often defined as a disorder involving deficits of communication. This is certainly true for nonverbal autistics, as well as for those who cannot be “reached” even though they are capable of expressing speech. What about those autistics who are fully verbal and capable of language, though? Since diagnostic criteria were expanded in 1994 (with DSM-IV), these probably constitute the majority of the autistic population. Surely they have no problems with communication. Or do they?
In fact, nothing can be further from the truth.
When I was diagnosed on the spectrum in 2000, Asperger Syndrome had just started to gain significant media attention, with newspaper and magazine articles about AS and autism suddenly proliferating. Asperger Syndrome began to be referred to as the “little professor syndrome” because children (usually very young) who are on the spectrum often perseverate about a specialized area of intense interest in which they demonstrate great expertise. Additionally, they often speak with an extensive vocabulary (at least concerning the specific interest) as well as flawless grammatical usage of language. In fact, this is just what I was like at a very early age (as was documented by my family). Such a child cannot possibly have difficulty with communication, can they? At least, that is the typical reaction to these individuals.
What is often not taken into account is that language is only a means of communication and not its final objective. The fundamental purpose of communication is to convey some form of meaning, be it factual information, an idea, a feeling, or (perhaps most significantly) an intention. The language, be it English or any other, is nothing more than a vehicle through which these are conveyed. It is therefore a great mistake to regard competency, or even great proficiency in such, as indication of a comparable ability to communicate with another person. There are many other considerations involved.
The Real Nature of Communication
As an engineer who has studied and worked in the field of electronic communications, I am very familiar with the theories upon which these are based. The fundamental problem is for a transmitter, or sender, to convey a message over a channel that can distort or even corrupt information to a receiver that then examines the resulting signal and reconstructs, with a minimum of error, the original message that the transmitter intended to send. In addition to forming the basis of most digital communications that are widely used today, these same principles have been applied in other areas such as psychology and even philosophy to analyze many aspects of human communication. Errors in communication have been responsible for countless human misunderstandings, often result in lawsuits (or so I have been told by attorneys), and have probably even started wars. As such, this is an essential skill for living in human society and even for survival itself.
Modern communication systems are designed such that the sender can anticipate how the transmitted message might be corrupted, and how it could be read by the receiver, and thus sends the signal in a manner that minimizes the probability of error in its reception. The receiver then uses similar knowledge to interpret the received signal such that it most likely corresponds to the intended message. In human communication, this requires the person communicating to understand the state of mind of the other person and how they will respond to the communication. It also requires the second person to be receptive to all of the “signals” sent by the first. This requires the first person to have a “theory of mind” of the second, and the second to perceive and understand the nonliteral and nonverbal expressions of the first.
Autistics, even when fully verbal and perhaps highly articulate, often have considerable difficulties in precisely these areas. Unfortunately, these deficits often go completely undetected by those who equate language ability with the ability to communicate. Such heightened expectations can lead to just about everything ranging from exasperation with the autistic person when miscommunications happen but are at least recognized, to serious misinterpretations that can have adverse and even severe consequences for the autistic. This is yet another of the many autistic challenges in areas that most neurotypicals require at most a modest effort to master (when they are not natural and instinctive) and, as such, cannot understand why they are so formidable for many autistics.
Misidentification of Deficits
Autistics have long been known to have deficits in theory of mind. Also, according to research on the psychology of communication, verbal articulation constitutes a small part of human communication – much meaning is conveyed by facial expression, body language, and vocal intonation. Autistics are well-known to have difficulty with all of these, both interpreting them in others and expressing them as well. Even with verbal language, autistics are famously known to interpret and use words in their most literal sense and have difficulty understanding subtextual and metaphoric language (the same things that always baffled me in my English classes many years ago!), or for that matter any figurative expression the actual meaning of which they are not familiar with. Much of spoken and written communication requires that one “read between the lines” to properly understand it. I always loved this expression – taken literally, I was never able to see anything between two lines of text other than blank white space! As such, autistics can have significant deficits with verbal communication even when there is no deficiency in their language usage.
Formal education in both English and foreign languages consists primarily of vocabulary, spelling, grammatical usage, and most generally learning how to read and write. In particular, standard reading examinations usually test for little or nothing besides literal understanding of the passage presented (and perhaps occasionally the subject, idea, or concept that the passage deals with). As such, any autistic who is able to perform above a minimal level, let alone excel in these areas, will not be identified as having communications deficits even though these may be quite significant. Once again, this actually happened with me, especially since knowledge about autism was nonexistent at the time. It is essential that all autistic students be identified as such so that they can be properly assessed for deficiencies in other types of communication skills which can then be properly addressed using whatever means are appropriate. Failure to do this can result in a lifetime of misunderstandings between the autistic and family, teachers, friends, acquaintances, or just about anybody. These can have especially serious consequences when employers, law enforcement, or other officials or authorities are involved.
To make matters even worse, autistics are now believed to often suffer from alexithymia – a condition in which the ability to identify and articulate emotional and other internal states is impaired. This not only results in yet another deficit of self-expression but can affect the ability of autistics to communicate with medical and mental health professionals, psychologists, counselors, and others whose job it is to help them with the very difficulties that they are as such unable to accurately describe. For example, one of the most typical questions that many therapists ask their patients is “what are you feeling?” Is it any wonder that, with the exception of Cognitive-Behavioral Therapy, most forms of psychotherapy have long been known to be ineffective for autistics?
The upshot of all of this is that many autistics live with significant communications deficits that are often not recognized. More extensive efforts need to be made to better identify those who are living with these challenges so that they can be properly treated, and all necessary services and accommodations made available to them. This in turn will require greater public awareness of these issues, particularly among those who work with or are otherwise involved in the lives of people on the autism spectrum.
Karl may be contacted at firstname.lastname@example.org.