Conversation with an Adult with High functioning autism

Social language is not the same thing as correct language. It includes body language (use of eye contact, hand gestures, body stance, etc.), pragmatic language (socially meaningful use of language), idioms, slang, humour and an ability to modulate tone, volume and prosody (ups and downs of the voice). It also requires the speaker to correctly decide which type of speech is appropriate in a particular situation (polite at work, sometimes loud with friends, etc.). All of these skills presuppose an understanding of complex social expectations, coupled with an ability to self-modulate based on that understanding.


People with High functioning autism (Hfa) generally lack those abilities. Their intense preoccupation with a narrow subject, one-sided verbosity, restricted prosody, intonation, and motor clumsiness are typical of the condition. This failure to react appropriately to social interaction appears as a disregard for other people's feelings and comes across as insensitive.


The cognitive ability of adults with Hfa often lets them articulate social norms in a laboratory context, where they may be able to show a theoretical understanding of other people’s emotions; however, they typically have difficulty acting on this knowledge in fluid, real-life situations.  People with Hfa may analyze and distill their observation of social interaction into rigid behavioral guidelines and apply these rules in awkward ways—such as forced eye contact—resulting in demeanour that appears rigid or socially naive.


The abnormalities of Hfa speech include:

  • verbosity
  • abrupt transitions
  • literal interpretations and miscomprehension of nuance
  • use of metaphor meaningful only to the speaker
  • auditory perception deficits
  • unusually pedantic, formal or idiosyncratic speech
  • repetitive speech and oddities in volume, pitch, intonation, prosody, and rhythm
  • echolalia (repetition of what has been said to them)
  • inappropriate response or non-response
  • speech is immature and unimaginative

Three aspects of communication patterns are of clinical interest: poor prosody, tangential and circumstantial speech, and marked verbosity. Although inflection and intonation may be less rigid or monotonic than in autism, people with Hfa often have a limited range of intonation; speech may be overly fast, jerky or loud. Their speech may convey a sense of incoherence; the conversational style often includes monologues about topics that bore the listener, fails to provide context for comments, or fails to suppress internal thoughts. Individuals with Hfa fail to monitor whether the listener is interested or engaged in the conversation. The speaker's conclusion or point may never be made, and attempts by the listener to elaborate on the speech's content or logic, or to shift to related topics, are often unsuccessful.

People with Hfa may have an unusually sophisticated vocabulary at a young age and have been colloquially called "little professors", but have difficulty understanding metaphorical language and tend to use language literally. Individuals with Hfa have particular weaknesses in areas of nonliteral language that include humor, irony, and teasing. They usually understand the cognitive basis of humor but may not enjoy it due to lack of understanding of its intent.

 

Consequences for conversations

Adults have with High functioning autism (Hfa) have an expressive/receptive language delay along with further developmental delay in higher order speech, listening and language skills. They use basic language to instruct, educate, dominate or manipulate, in order to control their world view and keep their social anxiety in check.
Their listening and responding skills are flawed by the nature of their developmental delays along with their obsessive need to “appear” normal and to fit in with social gatherings and conversations.


They are expert at talking about their own special interest and failing to see that the other party has lost interest. They have difficulty monitoring their own speech and can let loose with a convoluted barrage of poorly connected words and thoughts. They can put words together in pedantic and strange ways:  such as

“Do you do that yearly?”
“Oh no, annually.”

They use language to educate and pontificate about themselves and their interest only. They will subtly change the topic away from the person speaking to bring it back to them and their own interests.

They listen only to the first few words of a complex sentence and extrapolate what they assume or believe the speaker will or should say, to fit their own world view, and then if they do comment at all it will be to interrupt, speak over the top of the other person, cut them off midsentence and continue with their own interpretation or to tell the other person what the rest of the sentence should be.

They frequently use contradictory and logically inconsistent statements along with subtle lies which can easily escape detection.
Words out of our mouth are the end product of very complicated mental activity. In people with Hfa their speech is poorly regulated by moral or ethical considerations and not bound by conventional rules.

In most people the two separate sides of the brain have different specialised functions.

People with Hfa’s speech represent the way their brains are organised and their lack of connections between words and emotions. They are slow at processing aural language. Language centres are located in both sides of the brain so perhaps disconnect between the two sides of the brain may also make a variety of difficulties in understanding and processing language.

People with Hfa know the dictionary definitions of words but fail to comprehend the emotional significance of them. Experts have said; “They know the words but not the music”. “Form without substance” is the essence of their speech. The language is two-dimensional lacking emotional depth. They lack emotional experience that others use to describe experiences which those with Hfa cannot understand. Neutral words convey less information than emotional words…compare the word ‘plate’ with the word  ‘death’ which has dictionary meaning as well as emotional impact and unpleasant connotations. Emotional words have more punch than other words. Emotional responses occur quickly with emotional words…a split second emotional response along with slightly later thinking and interpretation. For people with Hfa a word is just a word.

Her words of love could not be anything but hollow, for she lacks the capacity to impart real feeling to them. (Hare, 1999)

The role of “inner speech” in the development and operation of conscience is extremely important. It is the emotionally charged thoughts, images and internal dialogue that give the “bite” to conscience and account for its powerful control over behaviour to generate shame, guilt and remorse for transgressions.

For people with Hfa the conscience is little more than an intellectual awareness of rules others make up – empty words. The feelings needed to give clout to these words are missing. For people with Hfa emotions are divided and unfocussed resulting in a shallow, colourless life: an emotional robot. They also have only a vague comprehension of their emotional poverty.

Many people attempt the search for inner understanding and getting in touch with their feelings. People with Hfa who search this way are doomed to failure. Their self -image is defined most by their possessions, obsessions and other visible signs of success and power than by love, insight and compassion, which are abstract and have little inherent meaning for anyone with Hfa.

Hand movements during speech help not only to illustrate a point, but help the brain facilitate speech by assisting us to put our thoughts and feelings into words. Watch the frantic movements of the hands next time someone is trying to find the right word. Try sitting on your hands when you are talking and it will be very difficult to be coherent.

Beats of the hands tell us something about the “thought units” or mental packages that underlie speech which can be a single word, a phrase, a sentence, or more complex groups of ideas, sentences or complete story lines. Large thought units are well integrated and tied together in a logical, consistent manner. Beats appear to mark off these thought units. The greater the number of beats the smaller the units.

People with Hfa often use more hand beats than normal people particularly when talking about emotional subjects. Their thought packages are organised into small mental parcels and moved around easily into alternate contexts, which is where lack of truth and apparent lying happens. However they are not always skilled liars, and fail to integrate the pieces into a coherent whole. Their truth line will be fragmented and patchy. Their mental packages are not only small but two-dimensional, devoid of emotional meaning. Their words can be used illogically because they are unencumbered by emotional meaning like the rest of us. They feel there’s nothing wrong with telling us they love us then beating us up. They see no connection between the two thoughts. They don’t see the illogical connection between the two actions.

They won’t answer questions posed to them or they answer in a way that seems unresponsive to the question. They make it difficult for their listener to understand parts of their narrative. They change pronouns or call everyone “he” so the listener loses track of who did what. Minor breakdowns in communication happen all the time to everyone, but in people with Hfa it seems to be most of the time, much more serious and shows an underlying condition where the organisation of mental activity…not its content… is defective. It is how they string words and sentences together not what they actually say that shows abnormality. Their responses, as a result, appear evasive or glib.

During a professional diagnosis session a conversation that is contradictory, tangential or poorly connected is bound to influence clinical judgement in the listener and confuse as to what the real outcome is or was or should be.

Their speech and narrative can sound monotone and lacking musicality. Echolalia, the repeating back of what has been said is a feature people with Hfa use when they are unable or unwilling to respond. (Zapor et al., 2001). They have difficulty with voice volume regulation according to varying circumstances. Their speech lacks a natural rhythm, normal inflection and can be very stilted and formal.

People with Hfa lack an understanding of the give and take of everyday conversation.

Loose associations, contradictory statements and lies may reflect little more than mental carelessness, be part of a strategy designed to confuse the listener or sometimes people with Hfa may be unable to prevent producing this kind of ineffective communication.

REFERENCES:

  • Synapse autism spectrum disorder fact sheets
  • Adapted from the work of Robert D. Hare PhD
  • Worcestershire Speech, Language and Communication Pathway www.worcestershire.gov.uk/slcnpathway

J.A.Morgan BEd Grad Dip NSWTFRTA©2014