Understanding an autistic person’s communication 

Communication happens when one person sends a message to another person. This can be verbally or non-verbally. Interaction happens when two people respond to one another - two-way communication.  

Most autistic people experience difficulty with:  

• interacting with others

• initiating interactions, responding to others, or using interaction to show people things or to be sociable

• understanding and relating to other people

• taking part in everyday family, school, work and social life. These can be harder.  

Non-verbal communication  

Some autistic children are delayed in their use of language, and some autistic adults don't use speech. In those cases, other methods of communication need to be established.  

An autistic person may appear not to hear what you say to them, not respond to their name, or appear indifferent to any attempts you make to communicate.  

They may use some of the following to communicate with you:  

•  gestures  

•  crying  

•  taking your hand to the object they want  

•  looking at the object they want  

•  reaching

• using pictures

• distressed behaviour 

• echolalia (the repetition of other people's words).  

Echolalia  

Echolalia can seem like a person repeating words they don’t understand, rather than trying to communicate.  

The person might repeat what you say because they don’t understand the question or how best to respond. Check their understanding and support them by using visual support or offering choices. Tell them that it is okay not to know the answer sometimes, and encourage them to ask for help.  

They may memorise the words that were said to them when they were asked if they would like a drink, and use them later, in a different situation, to ask a question of their own.  

An autistic person might use phrases that they frequently hear in their favourite TV programme. Watch the programme with them to try to understand what they might be trying to communicate to you when they use these phrases.  

Stages of communication  

The stage of communication that a person has reached depends on three things:  

•  the person's ability to interact with another person  

•  how and why they communicate  

•  their understanding.  

Communication may be:  

• pre-intentional - saying or doing things without intending to affect those around them. This type of communication can be used by someone to calm themselves, focus themselves or as a reaction to an upsetting/fun experience  

• intentional - saying or doing things with the purpose of sending a message to another person. This type of communication can be used to protest about something or to make requests.  

Intentional communication is easier for a child once they have learned that their actions have an effect on other people. The move from pre-intentional communication to intentional communication is a big step for an autistic child.  

The four different stages of communication, as defined by The Hanen Programme are as follows: 

1. The own agenda stage. The person appears uninterested in others and tends to play or do activities alone. Their communication will be mainly pre-intentional.

2. The requester stage. The person has begun to realise that their actions have an effect on others. They are likely to communicate their wants and what they enjoy by pulling you towards objects, areas or games.

3. The early communicator stage. Interactions will begin to increase in length and become more intentional. The person may begin to echo some of the things that they hear to communicate their needs. Gradually, they will begin to point to things that they want to show you and begin to shift their gaze, beginning to engage in a two-way interaction.  

4. The partner stage. The person will be using speech and will be able to carry out a simple conversation. While they may appear confident and capable when using communication in familiar settings (eg at home), they may struggle when they enter an unfamiliar environment (eg a new school). In these places, they may use memorised phrases and appear to be ignoring their communication partner, speaking over them and ignoring the rules of turn-taking.  

Supporting communication development  

Here are ideas you can try to support communication development that you can use alongside our quick communication tips.  

Follow their lead  

Follow the person's lead, rather than directing them. They will be more likely to pay attention to the activity, more likely to focus on the same thing as you, and will learn how to make choices for themselves.  

The early stages  

If the person has only recently started to talk, use single words to communicate with them. For example, label their favourite toy and repeat that word when they reach for it.  

Use expansions  

And add in one more piece of information to what they say. For example, if they say ‘car’, you can reply ’yes, blue car’. That way you are only giving them one more piece of information to process.  

Build in time for communication  

When someone is unable to communicate their needs, it's tempting to help by constantly doing things for them. For example, fetching their shoes and tying their shoelaces, bringing a biscuit. However, this may reduce opportunities for the person to communicate.  

When at the own agenda stage, it is particularly difficult to decide how much to do for the person. Spare an extra few minutes for these tasks to help them understand what's happening around them and to think about what they can say during these activities. Ask if they need help, wait and then ask a second time before giving the help.  

Be face-to-face  

Be face-to-face with the person so that you can more easily observe what they are interested in. Being level with them will allow them to see the variety of facial expressions that are used in communication. But be aware that having to process this visual information at the same time may make it more difficult to process any verbal information.  

The person may eventually become used to you playing or interacting with them and will begin to anticipate your presence, fetching you if you are not there.  

Imitate  

Imitate the person's actions and words. If they bang the spoon on the table, and you do the same, it is likely that they will pay attention to you. You could also imitate sensory behaviours such as hand-flapping and spinning.  

Once the person has noticed that you are imitating their actions, they may begin to imitate back. This creates the opportunity for you to add something new to the exchange for the person to copy.  

Try gestures and visual supports  

When offering a drink, gesture the action of drinking by pretending to hold a glass in one hand and bringing it your mouth.  

Nod/shake your head for "yes" and "no". Wave your hand for "hello" and "goodbye".  

When talking about people, eg "grandma is staying", show a photo of who is being spoken about.  

Other visual methods that can be used to increase understanding include picture timetables, line drawings, cue cards and object/picture schedules.  

Use songs and role play  

Sing songs with them, pausing to see if they can sing the next part. You may need to prompt them with a sound cue.  

Use role play to model social interaction and explore how things can go wrong/what to avoid.  

Give feedback  

Reward attempts to understand and communicate. By doing this you can increase the likelihood that they will try and do it again. By using praise and commenting on what has been achieved, the person can make a connection between their own actions and your specific words.  

Give a reason to communicate  

You can engineer situations to create an opportunity for communication and interaction.  

Encourage requests 

 Place a favourite toy/food/DVD in a place where the person can see it but is unable to reach it, eg on a high shelf. Alternatively, place the favourite object in a container which is difficult to open, eg an old ice-cream tub or an old jam jar. This will encourage the person to ask for help and result in an interaction.  

Offer a toy or game that is difficult to operate 

Some toys and games will be difficult for some children and adults to operate alone. Once given the toy/game, allow them some time to work out how to use it. If they become frustrated, step in and help them.  

Provide a ‘high-interest’ object 

Balloons and bubbles are high-interest items and can be easily adapted to involve two people. Blow up a balloon and then let it go so that it flies up in the air. Then blow up a balloon part-way and wait for a response before blowing it up to its full capacity. This could enhance interaction. A similar thing can be achieved with bubbles. Blow a few bubbles towards the person. Once their attention has been captured, close the container and wait for a response from them before you blow any more.  

Let the autistic person decide when to end an activity 

Once engaged in an activity, carry on until the person indicates that they have had enough. Look out for facial grimaces or the person pushing away the activity. If they do not use language to indicate they have finished, accompany their form of communication with words such as "had enough" and "stop”.  

Find opportunities to interact 

When an autistic person isn't interested in doing any of the activities presented, you might still be able to find opportunities for communication and interaction.  

For example, if a child is lining up their cars in a row, you can join in the activity by handing them the cars one by one. This way, you play a part in the game and the child includes you in what they are doing. If they are only interested in throwing the toys on the floor, you could use a basket to collect them before giving them back, establishing a pattern of interaction and communication with the child. They may begin to learn that interaction with another person can be fun.   

Using Augmentative and Alternative Communication (AAC) supports  

AAC is any form of language other than speech that can help a person in social-communicative interactions.  

Autistic people who have no spoken language can become very distressed if their needs are not met and they are unable to express their feelings. The use of an AAC device can give them another way of communicating.  

There is a large range of AAC devices. It is essential that a team of appropriate professionals evaluates different AAC options with the person before making a decision about what to use. Things to be considered include cognitive and motor abilities, learning style, communication needs and literacy ability.  

Examples of AAC devices:  

• Picture Exchange Communication System (PECS), where the person hands over a picture to request or express something.  

• Sign language, eg British Sign Language (BSL), Makaton, Sign Supported English, or as part of a total communication approach (where a combination of methods is used, eg a person might receive information via speech and signs but express themselves using signs and symbols).  

• Communication boards and communication books, where the person can point to words, photos and/or symbols. 

• Communication cue cards, used primarily with people who are verbal, can be a reminder of what to say and provide an alternative means to communication in stressful situations.

• Conversation books, which can use text, pictures or photographs to support conversation.

• Voice output communication aids, eg BIGmack, generate digitised speech when the person presses a symbol or button. The person will need an understanding of cause and effect to use these devices.  

For some forms of AAC, there is no evidence to show whether they are effective or ineffective, safe or harmful.  
   
For others, there is some evidence of harm or ineffectiveness. For example, we do not believe that facilitated communication is an appropriate intervention for autistic people, as there is evidence that it is ineffective and can lead to significant harm.  

Communication in schools  

There are many autistic pupils within mainstream schools and specialist units. It’s important for education staff to consider their communication differences and needs.  

Often, an autistic pupil can give the appearance of having ‘mastered’ communication. However, it’s important to understand that communication and social skills need to be taught and practised.  

Negative experiences of social interaction can damage an autistic person’s confidence. Social interactions are likely to bring increased anxiety and be exhausting to participate in.  

An autistic person’s ability to understand or use spoken language can vary depending on their anxiety or stress levels. For example, someone who is normally able to communicate well may have reduced ability due to underlying anxiety or sensory differences   

Read our quick communication tips.  

Further information and resources  

• AbilityNet  

• Inclusive Technology   

• The Play Doctors

• Tom Tag picture schedules for visual communication supports.