As an autism consultant with qualifications in teaching, linguistics, sociology, one of my lecture topics as a public speaker is the spectrum of communication disorders and part of my consulting work is helping people understand which communication disorders may be occurring in specific children and adults diagnosed on the autism spectrum.
Communication disorders occur on and off the autism spectrum. Late speech occurs in non-autistic children and it is not uncommon that some children won’t speak until age 3 and sometimes as late as 6. Those who actually have communication, speech, language disorders may be autistic or not and many communication disorders can be commonly called ‘the autism’ when in fact they are merely co-occurring with it, or being confused with it.
There are even adults with Aspergers in the neurodiversity movement who are so highly invested in ‘autistic identity’ they have given up speech, preferring to use typed speech, and identify themselves with speechless people with autism. So its worth exploring which form of speechlessness are identifying with because it may be that no form of communication disorder is actually specifically ‘autistic’?
Tumbled speech can occur because of cluttering or in those with expressive Aphasia. A stammer can progress to become so severe that the person may give up speech or easily develop secondary Selective Mutism compounding the stammer.
Immediate Echolalia (repeating of words) is a normal part of speech development but can occur in those with meaning deafness – Verbal Agnosia – and may also take the form of delayed echolalia in which the child will use advertisements, jingles, songs, lines from DVDs or TV shows because of word retrieval and language sequencing issues associated with growing up meaning deaf. If they also have visual agnosias as well as verbal agnosia then acquiring comprehensible speech will be very hard until they are assisted to directly address those agnosias through the strategies used specifically to do so.
PRIMARY Selective Mutism commonly occurs in those with Avoidant and Dependent Personality Disorders where the child struggles to speak due to anxiety and progressively gives up their speech, leaving carers to speak for them. This can occur with autism or without it. SECONDARY Selective Mutism occurs in those with severe speech, language and communication disorders who become so ashamed and socially/emotionally intimidated by speaking that Selective Mutism as a psychiatric disorder then sets in.
Certain personality disorders are associated with inhibition in communication, such as Avoidant and Dependent personality disorders but those with Schizoid personality disorder may struggle with social-emotional communication and be naturally self protective against engaging in chit chat and personal or social chat, especially when face to face or even over a phone so may prefer to chat online through typing or texting. Those with Schizotypal personality disorder may commonly have such idiosyncratic speech they may be difficult to comprehend and more easily slip into self directed chatter, losing track of the fact they’ve wandered off topic or lost track of the listener. Those with Narcissistic Personality Disorder may be so self obsessed they may initially impress others but progressively easily alienate others when conversing with them through their constant grandiosity and persistent assertion of their specialness and rights over others. Those with Obsessive Compulsive Personality Disorder may fixate conversationally on details, be so perfectionist and controlling that they may struggle to find others patient enough to hear them out as they indulge in what to others may come over as obsessive, pedantic or boring.
Those with Social Emotional Agnosia have difficulty reading facial expression, body language, intonation and so will generally be poor if not fail to pick up the non-verbal cues of the person they are speaking with, commonly leading to misunderstandings or assumptions the person with social emotional agnosia isn’t sensitive or empathic or not listening or tuning in. Those with Aprosody may lack the variations usual to speech – tone, speed, varied emphasis. Then there’s those with pragmatic language disorder who take speech literally and this occurs in those with neuropathies, encephalopathy (brain injuries) as well as a byproduct of auditory processing disorder which can develop for many reasons including things like dyspraxia and recurrent ear infections associated with immune suppression.
Those with face blindness and simultagnosia will commonly speak to people whilst looking at anything else but their face or stare through the person or focus on one part of the face which can confuse the recipient. Those with these visual perceptual issues may also be more likely to talk to themselves or objects as faces hold no particular significance and they have grown up experiencing most people as either visually unfamiliar, only as familiar as objects, or conversely finding everything and everyone familiar when they are actually not.
Those with Tourette’s may have vocal and verbal tics which if severe and persistent could present as a communication disorder. Those with the compulsive involuntary self protection response of Exposure Anxiety who experience compulsive avoidance, diversion, retaliation responses can have communication that is unreliable, difficult to comprehend or contradictory.
Personally, my communication disorders have included Verbal Agnosia with associated Auditory Agnosia and Visual Agnosias so I had immediate and delayed echolalia and acquired functional speech by late childhood. I also had vocal and verbal tics as part of Tourette’s triggered in part by primary immune deficiencies. My progression to functional speech in late childhood coincided with high social anxiety and a stammer which regularly lead to episodes of Selective Mutism which lasted sometimes days, sometimes weeks, sometimes months. Tending toward being quite Schizoid/Schizotypal growing up (now just solitary and idiosyncratic) I also tended toward self directed (often not comprehensible) chatter or preferred typed communication and developed typed communication around age 9 around the same time I developed functional verbal communication. Living with Exposure Anxiety my verbal communication even after acquiring functional speech in late childhood was regularly driven by ‘diversion communications’ and negations when I meant to agree and agreements when I meant to negate.
Whilst I was diagnosed at age 2, and again in my 20s and am aware that my communication disorders are part of my diagnosis of autism, and contributed to autistic withdrawal, development and behaviors, personally I distinguish them from my ‘autism’.