Written by Shadia Hancock
As defined by Merriam-Webster dictionary, communication involves developing rapport, and individuals exchanging information through a shared system. This system may include oral or written symbols, signs, and behaviour. All individuals communicate and receive information in a range of ways. This is also known as multimodal communication and can include using oral speech (sharing information and communicating ideas through the spoken word), gesturing, facial expressions, spelling, writing and speech-to-text software.
People communicate for a variety of reasons. Firstly, communication enables us to express our wants, needs, feelings, and opinions. It also allows us to request and share information and make choices in our lives. Communication can also facilitate social closeness and develop and maintain relationships. All of us deserve to be able to communicate when, how, and with whom we want to (Brady et al., 2016).
The communication styles of Autistic people are defined in the DSM-5-TR as ‘Persistent deficits in social communication across multiple contexts’ (American Psychological Association [APA], 2022). However, the neurodiversity paradigm reframes Autistic traits as differences rather than impairments, with the double empathy problem suggesting that Autistic and non-Autistic people experience shared challenges when interacting with one another (Kapp & Kapp, 2020; Milton et al., 2022).
A key aspect of Autistic communication is commonly termed ‘special interest’, with Autistic individuals often opting for other terms such as ‘passionate interest’ or ‘SpIn’. In the DSM-5-TR, this is described as “restricted, repetitive patterns of behavior, interests, or activities” (APA, 2022). It is thought that Autistic peoples’ tendency to devote in-depth attention to specific interest areas is related to monotropic attention styles, wherein focus is devoted to one thing at a time (Dunn et al., 2023; Murray et al., 2005). Historically, Autistic interests were thought to be restricted to narrow topics; however, Autistic people have reported having multiple intense interests either at the same time or in cycles (Grove et al., 2018; Wood, 2021). Indeed,
Autistic individuals have indicated that engaging in passionate interests has a positive effect on Autistic identity, well-being, quality of life, motivation, and social interactions (Grove et al., 2018; Wood, 2021).
It is not surprising then that many Autistic people tend to engage in interest-based conversations or activities with others, affectionately known as ‘infodumping’ in the Autistic community (Dunn et al., 2023).
While non-autistic people often prioritise social norms in an interaction, such as engaging in small talk and following a linear, reciprocal, conversation, Autistic people tend to value direct conversations and the ability to share ideas and information inherently interesting to them (Dunn et al., 2023).
Moreover, Autistic individuals may not recognise social hierarchies or non-autistic social communication such as body language, eye contact, equal turn-taking styles, abstract language, and vocal tones (Dunn et al., 2023). Autistic individuals can also process information at a different rate, and may require more time to contribute to the conversation. This is particularly relevant for Autistic people who cannot use oral speech alone to communicate.
Additionally, Autistic individuals may interrupt others due to innate turn-taking differences and the tendency to notice ideas of interest rather than non-autistic social cues. This may result in misinterpretations between Autistic and non-Autistic people, with Autistic individuals often misconstrued as rude despite this often not being the intention (Milton, 2012).
Furthermore, Autistic individuals have discussed how we may express empathy through sharing a similar experience or repeating scripts specific to a situation or feeling (Blanc et al., 2023). A non-Autistic person may misinterpret this as being self-centred. However, this may be related to how Autistic people tend to recall elements of an experience in an entire chunk, rather than isolate specific aspects of that situation (Blanc et al., 2023).
It is important to note that forms of social interaction may look different in Autistic people. Autistic people can have a range of social goals, with some content connecting with others with shared interests or during structured activities.
For some Autistic people, silent interactions are preferred, which may look like parallel play, imitation, or gaming (Pritchard-Rowe et al., 2024). For other Autistic individuals, they may have a strong desire to form connections with others, to the degree that socialising is a passionate interest. This challenges the stereotype that Autistic people are inherently antisocial or uninterested in forming relationships with others.
For some Autistic people, they may mimic the behaviours of others or adopt non-autistic social norms. They may be doing this consciously or unknowingly and can include maintaining eye contact, engaging in small talk, and participating in non-preferred activities despite this being uncomfortable or distressing. Terms commonly used to describe this include adaptive morphing, masking, and camouflaging (Lawson, 2020). It is thought that Autistic people do this as a coping mechanism to either be accepted socially or avoid an uncomfortable social situation.
Moreover, alexithymia (difficulty describing internal feelings) and interoceptive differences (ability to recognise internal body states) are common in the Autistic community and may impact our ability to recognise dysregulation and self-advocate (Gaddy & Crow, 2023).
Acting against our natural way of communicating is often exhausting and may be associated with reduced mental well-being (Cook et al., 2021). Unfortunately, for many Autistic people, especially Autistic people of colour, adaptive morphing is a necessary survival skill.
Within the Autistic community, an estimated one-third of Autistic children are minimally speaking (Brignell et al., 2018; Tager-Flusberg & Kasari, 2013). Some Autistic individuals are non-speaking, in that they may not use oral speech at all. Non-speaking Autistic individuals prefer this term over ‘non-verbal’ as the latter implies that they have no expressive language skills. Other Autistic people may have some oral speech, but it may not match their intended meaning or preferences. Some Autistic individuals may be able to speak in some situations, but not all the time. Some Autistic people may have oral speech, but it may not fully meet their daily communication needs (Donaldson et al., 2021; Zisk & Dalton, 2019). For instance, an Autistic person may be able to use oral speech with familiar people but may struggle to access speech in moments of distress or when describing feelings.
Just because an autistic person cannot express their thoughts in the spoken word, does not necessarily mean that they are unable to comprehend language. Similarly, while a person may be able to communicate using oral speech, they may nevertheless have differences with their receptive language skills (the ability to process and understand language).
Research suggests that there is significant variation regarding expressive language (the ability to communicate thoughts using words and other strategies) and receptive language development in the Autistic community (Pickles et al., 2014).
Co-occurring communication differences appear to be more common in the Autistic population. An example of such a difference that is commonly reported in Autistic people is echolalia, also known as gestalts. This means that Autistic people may repeat spoken language in the form of scripts, vocal patterns, songs, and lines from television shows (Blanc et al., 2023). These may be repeated straight away (immediate) or at a later time (delayed). In gestalt language processors, language development occurs by breaking down the gestalts, or chunks, into single units.
In contrast, most Non-autistic people follow analytical language development, wherein communication starts at the single-word level and progresses to sentences.
While echolalia was originally viewed as functionless ‘empty’ vocalisation, studies by speech pathologists like Dr Barry Prizant, Dr Ann Peters, and Marge Blanc demonstrate it is indeed a meaningful and natural way of communicating (Blanc et al., 2023; Prizant, 1983; Prizant, 1982).
Differences in vocal tone, rate, volume, and pitch appear to be more frequent in Autistic people (Loveall et al., 2021). Autistic people may sound more monotonous than typical speakers or have unusual pitch variations and stress levels. An Autistic person may speak at a louder volume than is typically accepted in a particular environment. Speech dysfluencies also seem to occur often in Autistic individuals, such as stuttering and cluttering. Stuttering occurs during speech and may present as repeated syllables or words, prolonged sounds or lack of movement, or behaviours that do not match the person’s intended meaning such as grimacing. Cluttering is characterised by an irregular speech rate, with the person sounding like they are speaking rapidly. People who clutter may also say words that do not match their intent (Briley & Ellis, 2018; Pirinen et al., 2023). This may manifest in the form of incomplete sentences, multiple revisions of phrases or sentences (e.g. “Yesterday I did shopping at Cole… or was it Woolworths… hmm”), or word substitutions. People who clutter have also described feeling like they do not have sufficient time to communicate their thoughts (Too Fast for Words, n.d.).
Moreover, apraxia, also known as developmental coordination disorder, appears to be more prevalent in the Autistic community (Micai et al., 2023). This condition is neurodevelopmental and impacts a person’s motor skills (DCD Australia, n.d.).
This co-occurring condition can impact Autistics in a range of areas, but importantly Autistic advocates with apraxia have described its impacts on the ability to accurately produce speech, organise thoughts, and recognise emotions (Emma, 2022).
Traditionally, Autistic communication styles have been framed as deficits with therapies aiming to reduce or remediate traits. However, this framing has often failed to consider the impact of co-occurring communication differences or the shared mismatch between Autistic and non-Autistic communication (Gaddy & Crow, 2023; Milton, 2012). To date, while typical developmental milestones exist, there seem to be no equivalent communication ‘norms’ for the Autistic population (Gaddy & Crow, 2023).
Therefore, while typical developmental stages may be utilised as guides, it is unsuitable to expect an Autistic person to progress through them linearly. For instance, many language evaluation methods have been based on analytical language development and fail to adjust for gestalt language processors in the early stages (Blanc et al., 2023). Similarly, many standardised tests require oral speech to complete them, which may misrepresent the language and cognitive skills of non- or minimally speaking Autistic people (Gaddy & Crow, 2023). Social communication measures are commonly based on non-autistic social norms, therefore assuming that conventional conversation styles, social interactions, turn-taking, and friendships are the only valid ways of interacting.
Being the minority neurotype has meant many Autistic people have had to learn non-autistic social communication, with fewer non-autistic people learning about Autistic culture. It is time that we acknowledge that Autistic people have Autistic social skills, not an innate communication deficit. Perhaps more non-autistic people can learn to communicate Autistically and meet us halfway.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th edition, text revision. ed.). American Psychiatric Association Publishing.
Blanc, M., Blackwell, A., & Elias, P. (2023). Using the Natural Language Acquisition Protocol to support gestalt language development. Perspectives of the ASHA Special Interest Groups. https://doi.org/10.1044/2023_persp-23-00098
Brady, N. C., Bruce, S., Goldman, A., Erickson, K., Mineo, B., Ogletree, B. T., Paul, D., Romski, M. A., Sevcik, R., Siegel, E., Schoonover, J., Snell, M., Sylvester, L., & Wilkinson, K. (2016). Communication services and supports for individuals with severe disabilities: Guidance for assessment and intervention. American Journal on Intellectual and Developmental Disabilities, 121(2), 121-138. https://doi.org/10.1352/1944-7558-121.2.121
Brignell, A., Chenausky, K. V., Song, H., Zhu, J., Suo, C., Morgan, A. T., & Song, H. (2018). Communication interventions for autism spectrum disorder in minimally verbal children. Cochrane Database of Systematic Reviews, 2018(11), CD012324-CD012324. https://doi.org/10.1002/14651858.CD012324.pub2
Briley, P. M., & Ellis, C., Jr. (2018). The coexistence of disabling conditions in children who stutter: Evidence from the national health interview survey. Journal of Speech, Language, and Hearing Research, 61(12), 2895-2905. https://doi.org/10.1044/2018_JSLHR-S-17-0378
Cook, J., Hull, L., Crane, L., & Mandy, W. (2021). Camouflaging in autism: A systematic review. Clinical Psychology Review, 89, 102080-102080. https://doi.org/10.1016/j.cpr.2021.102080
Developmental Coordination Disorder Australia. (n.d.) DCD Overview. Developmental Coordination Disorder Australia. https://dcdaustralia.org.au/what-is-dcd-2/
Donaldson, A. L., corbin, e., & McCoy, J. (2021). “Everyone Deserves AAC”: Preliminary study of the experiences of speaking Autistic adults who use augmentative and alternative communication. Perspectives of the ASHA Special Interest Groups, 6(2), 315-326. https://doi.org/doi:10.1044/2021_PERSP-20-00220
Dunn, D., de la Garza, J. D., Jones, D. R., & Sasson, N. J. (2023). Awkward but so what: Differences in social trait preferences between Autistic and non-autistic adults. Neurodiversity, 1. https://doi.org/10.1177/27546330231203833
Emma. (2022). Autism: Not such a hidden disability with apraxia. Neuroclastic. https://neuroclastic.com/autism-not-such-a-hidden-disability-with-apraxia/
Gaddy, C., & Crow, H. (2023). A primer on neurodiversity-affirming speech and language services for Autistic individuals. Perspectives of the ASHA Special Interest Groups, 8(6), 1220-1237. https://doi.org/10.1044/2023_PERSP-23-00106
Grove, R., Hoekstra, R. A., Wierda, M., & Begeer, S. (2018). Special interests and subjective wellbeing in Autistic adults. Autism Research, 11(5), 766-775. https://doi.org/10.1002/aur.1931
Kapp, S. K. (2020). Autistic community and the Neurodiversity Movement: Stories from the frontline (1st 2020. ed.). Springer Nature. https://doi.org/10.1007/978-981-13-8437-0
Lawson, W. (2020). Adaptive morphing and coping with social threat in autism: An Autistic perspective. Journal of Intellectual Disability – Diagnosis and Treatment, 8, 519-526. https://doi.org/10.6000/2292-2598.2020.08.03.29
Loveall, S. J., Hawthorne, K., & Gaines, M. (2021). A meta-analysis of prosody in autism, Williams syndrome, and Down syndrome. Journal of Communication Disorders, 89, 106055-106055. https://doi.org/10.1016/j.jcomdis.2020.106055
Micai, M., Fatta, L. M., Gila, L., Caruso, A., Salvitti, T., Fulceri, F., Ciaramella, A., D’Amico, R., Del Giovane, C., Bertelli, M., Romano, G., Schünemann, H. J., & Scattoni, M. L. (2023). Prevalence of co-occurring conditions in children and adults with autism spectrum disorder: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 155, 105436. https://doi.org/https://doi.org/10.1016/j.neubiorev.2023.105436
Milton, D., Gurbuz, E., & López, B. (2022). The ‘double empathy problem’: Ten years on. Autism, 26(8), 1901-1903. https://doi.org/10.1177/13623613221129123
Milton, D. E. M. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883-887. https://doi.org/10.1080/09687599.2012.710008
Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139-156. https://doi.org/10.1177/1362361305051398
Pickles, A., Anderson, D. K., & Lord, C. (2014). Heterogeneity and plasticity in the development of language: a 17-year follow-up of children referred early for possible autism. Journal of Child Psychology and Psychiatry, 55(12), 1354–1362. https://doi.org/10.1111/jcpp.12269
Pirinen, V., Loukusa, S., Dindar, K., Mäkinen, L., Hurtig, T., Jussila, K., Mattila, M.-L., & Eggers, K. (2023). A comprehensive analysis of speech disfluencies in autistic young adults and control young adults: Group differences in typical, stuttering-like, and atypical disfluencies. Journal of Speech, Language, and Hearing Research, 66(3), 832-817. https://doi.org/10.1044/2022_JSLHR-22-00265
Pritchard-Rowe, E., de Lemos, C., Howard, K., & Gibson, J. (2024). Diversity in Autistic play: Autistic adults’ experiences. Autism in Adulthood, 6(2), 218-228. https://doi.org/10.1089/aut.2023.0008
Prizant, B. (1983). Language acquisition and communicative behavior in autism: Toward an understanding of the ‘whole’ of it. The Journal of Speech and Hearing Disorders, 48, 296-307. https://www.researchgate.net/publication/16575340_Language_acquisition_and_communicative_behavior_in_autism_Toward_an_understanding_of_the_’whole’_of_it
Prizant, B. M. (1982). Gestalt language and gestalt processing in autism. Topics in Language Disorders, 3(1), 16-23. https://doi.org/10.1097/00011363-198212000-00006
Too fast for words. (n.d.). Sentence revisions in cluttering. Too fast for words. https://toofastforwords.com/symptoms-cluttering/main/sentence-revisions/
Tager-Flusberg, H., & Kasari, C. (2013). Minimally verbal school-aged children with autism spectrum disorder: The neglected end of the spectrum. Autism Research, 6(6), 468-478. https://doi.org/10.1002/aur.1329
Wood, R. (2021). Autism, intense interests and support in school: from wasted efforts to shared understandings. Educational Review, 73(1), 34-54. https://doi.org/10.1080/00131911.2019.1566213
Zisk, A. H., & Dalton, E. (2019). Augmentative and alternative communication for speaking Autistic adults: Overview and recommendations. Autism in Adulthood, 1(2), 93-100. https://doi.org/10.1089/aut.2018.0007
Shadia is the proud owner and founder of Autism Actually, and enjoys presenting and consultancy. They are also an ambassador of the Autistic-led organisation, Yellow Ladybugs.
Shadia has completed a Bachelor of Speech Pathology (Honours) degree, and a Cert IV in Animal Behaviour and Training. They have professional interests in Autism, communication access and supports, and animal-assisted services.
Shadia was formally identified with Autism at the age of three and ADHD combined type at 23. Being non-binary, they enjoy discussing the intersectionality of Autism and the LGBTQIA+ community.
As an Autistic ADHDer with experience accessing therapeutic supports, Shadia is passionate about sharing how to view Autism from a neurodiversity-affirming perspective.
The Reframing Autism team would like to acknowledge the Traditional Owners of the lands on which we have the privilege to learn, work, and grow. Whilst we gather on many different parts of this Country, the RA team walk on the land of the Amangu, Awabakal, Bindjareb, Birpai, Whadjak, Wiradjuri and Yugambeh peoples.
We are committed to honouring the rich culture of the Aboriginal and Torres Strait Islander peoples of this Country, and the diversity and learning opportunities with which they provide us. We extend our gratitude and respect to all Aboriginal and Torres Strait Islander peoples, and to all Elders past and present, for their wisdom, their resilience, and for helping this Country to heal.
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