Impaired communication is one of the primary defining characteristics of children with autism. Many of these children do not speak at all and often withdraw when approached by another person. This is a problem because they can't ask for things they want or need. This limitation and the frustration it causes can negatively impact their relationships with others and lead to problem behaviors such as tantrums, hitting, and hyperactivity.

A well-designed program to develop and improve language and communication for children with autism should, therefore, be one of the most important intervention goals for special educators and parents.

To address language problems, it is necessary to directly teach the skills these children are missing. Instruction should begin as early as possible and be as intensive as possible. Communication needs to be "functional" in terms of meeting the child's needs.

More progress is likely to occur if the child is in a "language-based" environment in which language is the key feature of the program and is a part of all activities, including self-care and play. Other components of a successful program include:

- Individual assessment that pinpoints current ability and identifies missing skills
- A curriculum that progresses to more complex forms of verbal behavior
- A foundation in applied behavior analysis (ABA)
- Collecting data daily to determine progress
- Targeting speech, but also using sign language and picture exchange systems
- A fun and rewarding learning environment that encourages cooperation with the instructor
- Creating opportunities for language and focusing on a variety of verbal behaviors (see below)
- A separate learning area, away from the distractions of other children
- Staff who are trained in language instruction techniques, including the use of shaping, prompting, and positive reinforcement

Below are listed the types of verbal behavior and examples of annual goals that should be part of the program curriculum. This information is based upon the work of Mark Sundberg and James Partington and is the foundation of May Institute programs in western Massachusetts.

" Requesting: Teach the child to use language to request items he or she wants. We begin by teaching the child to point, sign, use a picture, or speak. To encourage requesting, we use each child's particular favorite "rewards" that are not available at other times, such as pretzel pieces, bubbles, or a special book. A typical goal is to teach the child to request up to 10 different items.
" Motor imitation: A child will learn many skills if he or she can readily copy an adult's actions when told, "do this." We often start by teaching the child to clap, open a book, stack two blocks, and shake a maraca. We will work on as many as 50 different imitations.

" Vocal imitation: Once progress is made in motor imitation, we add in imitation of mouth movements and small sounds.

" Vocalizations: Speech is the most desired response. Every effort should be made to reward any vocalizations the child makes with attention, physical contact, or other special items.

" Receptive language: We want the child to listen to, understand, and respond to the language of others. Therefore, we encourage him or her to follow instructions such as "stand up," "jump," "come here," and to point to items and pictures. Our goal is to teach the child more than 200 words.

" Labeling: Similarly, we want the child to state the name of items. We select words that are important to him or her and work towards 200 words.

" Advanced responses: After a child learns approximately 50 words receptively and with labeling, we begin to teach the functions of items (what you can do with an item), the features of items (size, color, texture), and their general categories (animals, foods, clothing).

When a child has mastered the skills listed above, we encourage him or her to participate in conversations with other people. Helping children with autism develop the ability to converse with others and make their needs and feelings understood is vitally important to improving their overall quality of life.

May Institute operates schools for children and adolescents with autism and other developmental disabilities in Chatham, Randolph, Woburn, and West Springfield, Mass., and in Freeport, Maine. We also provide residential and day services for adults. For more information, contact us at 800-778-7601, or at www.mayinstitute.org. Dr. Harchik can be contacted in West Springfield at 413-734-0300, or at aharchik@mayinstitute.org.

The information presented on this site is intended solely as a general educational aid, and is neither medical nor healthcare advice for any individual problem, nor a substitute for medical or other professional advice and services from a qualified healthcare provider familiar with your unique circumstances. Always seek the advice of your physician or other qualified healthcare professional regarding any medical condition and before starting any new treatment.