I recently received an upsetting phone call from a good friend. She was in tears because her daughter, Sarah (I’ve changed her name for anonymity), had just been diagnosed with autism the previous day. As a Speech-Language Pathologist, this is not the first phone call I have gotten from a friend, colleague, or a potential client’s parent, so before attempting to empathize with her, I asked her whether her daughter was the same daughter as the day prior to the diagnosis. It took her a moment to process my question, but she responded with a resounding “yes.” “So, the only thing different between two days ago and today was her diagnosis of autism? The only thing that changed was her label, but she is still the same Sarah, right?” I finally heard a sigh of relief from my friend.
Autism is exactly that, a label. When someone has difficulty breathing, they may go to a doctor and be diagnosed with asthma. They are still the same person as before, but their difficulty breathing gives them a label that applies to their condition, a label that may help them and others more easily deal with that condition. Autism is a bio-neurological development condition that impairs the processing abilities of the brain in the areas of social interaction, behavior, and communication skills.
She asked me what she could do to help Sarah. I urged her to avoid doing a Google search on “autism” (as the seemingly endless ‘authorities’ on the condition can offer misleading, sometimes conflicting information), and instead spend time with Sarah and try to figure out what skills her daughter may need some assistance with. After all, autism exists on a spectrum, and the effects on each individual can vary wildly. The help one child needs may be very different from what another child needs.
How does Autism Spectrum Disorder (ASD) impact communication and what can parents do?
1. Language and interpersonal communication
Interpersonal communication involves the verbal (such as turn-taking, using spoken language meaningfully) and non-verbal (for example, interpreting facial cues, self regulation, understanding other points of view) exchange of ideas between two or more people.
What parents can do to help their children.
Use clear language when speaking with your child. Don’t assume that they will understand the non-verbal language you are using.
2. Flexible thinking
Flexible thinking is vital for understanding different perspectives, following agreed upon rules for discussion (we may disagree with the student who is speaking, but we must let them finish), modifying one’s own ideas (when appropriate), understanding the point of view of two or more characters, participating in collaborative discussions, understanding “shades of gray” thinking, and understanding figurative language.
What parents can do to help their children.
Pause a movie or show to talk about feelings
Research has shown that one of the struggles that neurodivergent individuals have is understanding the intention behind social movement. If this is the primary area of challenge, videos may be an effective tool to address many of the subtleties involved in everyday interactions. Pause a movie or TV show/clip and talk about how the characters may be feeling. I have found that some of my clients spontaneously express “I felt like that character today.” This will help them talk about feelings. Building on this, it can be very helpful to use short clips with no dialogue, this way the child has to focus on the nonverbal cues.
I am not suggesting that you should use only this method. Carol Westby’s research makes it clear that neurodivergent individuals may be more vulnerable to excessive screen use. Parents should thus weigh the risks and benefits when exposing a child to screen-time.
Proactively teach flexibility.
Make sure to vary activities and environments. Parents can do anything from taking alternate routes to the park or going to a different park to changing up the dinner routine (for example, taking a bath prior to dinner and the following day, taking a bath after dinner). Parents can show how there are varying ways to do different activities or perform different tasks, helping their children understand this when they see the positive results of their actions.
Play games.
A good game can teach children to be flexible and feel comfortable with the uncomfortable, along with other skills children need. For example, the game Chutes and Ladders can elicit a lot of feelings. A child may be close to winning and then go down a chute, providing an opportunity for that child to regulate the feelings that may be provoked. The chutes represent a part of everyday life and the inevitable pitfalls we encounter on our paths, even when you plan accordingly. There will always be chutes in life, but there will also always be ladders. Other games you can try include Rummikub, Monopoly, and Risk.
3. Abstract concepts or shades of gray
Abstract concepts are concepts that cannot be seen, heard, or felt. For example, “love,” “anger,” “success,” or “despair,” and often prove to be difficult for neurodivergent individuals to comprehend or articulate. Additionally, neurodivergent individuals often have “black and white thinking,” meaning, for example, the word “no” may be interpreted as “never” instead of “not now, but maybe another time.” This skill difference can also lead to difficulty understanding jokes and figurative language.
What parents can do.
Define the gray area for your child.
If your child comes home from school and says they had a “bad” day because they did poorly on a test, inquire more. What else did they do today? Were those events bad? Just because they did poorly on a test, doesn’t mean they had a “bad” day. The key is to elaborate on the sensations your autistic child feels and establish a sense of perspective.
4. Collaborative skills
Collaborative skills are needed to follow agreed upon rules for discussion (for example, you must allow the speaker to speak without interruption, even if you have a really good, or better, idea), respond to the comments of others, continue conversation through multiple exchanges (even if you lack interest), and build on the other’s ideas.
When collaboration takes place, a child’s idea can change and morph with other children’s ideas, and flexibility is essential to allow these changes to take place.
What parents can do.
Play games.
Playing games can be a fun way to teach many skills, including collaborative skills. These games can also allow for casual conversation, increase participants’ toleration of other opinions or ideas, encourage flexibility and the acceptance of mistakes, and help develop self-regulating techniques - all skills that can be helpful when collaborating. Examples of games that can assist in learning this skill include Twister, Hanabi, and Codenames.
5. Understanding feelings and regulating emotions
Feelings are the core of relationships and play a fundamental role in creating social bonds. I like to describe feelings as scoops of ice cream to many of my younger clients. You can have more than one scoop; some scoops are smaller than others; and no scoop lasts too long. You can be a little angry or very angry, you can be angry and scared, or you can be very happy.
What parents can do.
Talk about feelings while pausing a movie or show.
As discussed earlier, this can be helpful in broaching the topic of feelings and is an excellent tool to help understand the perspective of an autistic child.
Talk about your own feelings.
As a parent, it is important to be open and talk about your own feelings with your child. When you get frustrated or excited, you can label that feeling, which will help your child make distinctions between emotions.
Teach coping skills.
Identifying feelings isn’t going to help you if you cannot cope with those feelings. Neurodivergent individuals need to be provided with a variety of coping skills to deal with emotions when feelings become overwhelming. What makes them feel calmer? Is it a toy, a hug, a safe place to unwind?
Model your own coping skills.
Are you feeling frustrated right now? Model what you would do to cope with those feelings in front of your neurodivergent child, thereby demonstrating functional coping mechanisms that can be imitated.
Process the emotional event afterward.
Following an emotional event, process what happened. What worked? What didn’t work? What can we do differently next time?
Read books together.
I really like Dawn Huebner’s books, but any book with characters that have emotions can be useful. You can talk about the feelings of characters while reading the book or at the end of a reading session. Once the book is finished, you can ask your child what he or she would do in the same situation. Would they be just as angry? How would they cope?
6. Making inferences
An inference is a conclusion reached on the basis of evidence and reason. We make inferences every day. For example, when we look outside and see people in heavy winter coats, we can infer it’s cold out without being told.
What parents can do.
Read books together.
Read books with your child that require inference skills. Some books I like to use with my clients include: I Went Walking by Sue Williams and Julie Vivas; My Lucky Day by Keiko Kasza, or Piggie Pie by Margie Palatini.
Play games together.
Headbandz and Clue are great games to bolster your child’s inference skills.
One of my all-time favorite actors was recently diagnosed with autism. Wentworth Miller, who played “Michael Scoefield” in Prison Break, was diagnosed with autism in 2020.
I’d like to conclude with one of the more powerful quotes he articulated: “This isn’t something I’d change… immediately being autistic is central to who I am. To everything I’ve achieved.” Wentworth attributes his success in part to autism. Let’s remember this when we look at our children. Remain open-minded to the side of autism that is often not discussed – the talents, successes, and positives of this complex condition.
About the author:
Stephanie Jeret is a Speech-Language Pathologist and the owner of Speak with Stephanie LLC. She obtained her Bachelor's and Master's degree from the City University of New York. She has practiced speech therapy in a number of settings including outpatient rehabilitation, telepractice, skilled nursing facilities, schools, and a private practice. She specializes in the evaluation, diagnosis, and treatment of a variety of communication disorders including articulation disorders, receptive/expressive language disorders, and fluency disorders. Information is available by emailing her at stephanie@speakwithstephanie.com or by visiting www.speakwithstephanie.com.
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