Deficits Associated with Autism
Autistic deficits cluster into three groups: communication-related, social and physical deficits. Communication deficits include people with autism's difficulty using spoken language and gestures, inability to initiate and sustain appropriate conversation and use of inappropriate, repetitive language. Social deficits manifest as people with autism's tendency towards isolation, difficulty making eye contact, inability to develop appropriate peer relationships and apparent lack of empathy. Physical deficits take the form of stereotyped repetitive movements and unusual body posturing. These and other specific deficits associated with autism are described in greater detail in the following sections. We refer to children experiencing these deficits in the discussion, primarily because the disorder is first identified and most aggressively addressed in childhood. However, please note that these specific deficits apply equally well to adults with autism.
Sound Perception Deficits. Children with autism do not respond to sound appropriately. For example, many do not respond when others call their names. They may cry inappropriately as a reaction to normal sounds, or they may be completely indifferent to unusual or loud noises. Parents tend to notice these oddities of perception first, before any other symptoms of autism are identified. Many parents of children with autism initially mistake these perceptual issues for problems with hearing.
It is common for children with autism to confuse speech sounds, especially hard consonants. They may not be able to distinguish between the sound "ba" and "ka", for instance. As a result, words like "bat" and "cat" may sound identical to some children with autism. Many hear only the first part of a word or the last part of a word, making words like "rectangle" and "triangle" indistinguishable. Many children with autism are not able to parse spoken language (e.g., recognize that sentences are made up of separate words). They may also blend words together so that the phrase "ready, set, go" might end up as "redsetoe".
Language Development Deficits. Children with autism have great difficulty understanding spoken words. They have trouble understanding that words relate to objects and activities. Abstract words are extremely challenging because they are not linked to something tangible that can be inspected and pointed to. For example, the word "from" has no meaning to autistic people. Without concrete visual connections to objects or activities, words are nearly impossible for them to understand.
The inability to process sounds properly profoundly interferes with language development. Language is not spontaneously acquired in autism. Traditional methods for teaching language are thus not adequate or useful, as they take for granted children's ability to spontaneously make associations between sounds and concepts and to learn how to form sentences by mirroring what mature language users do. These assumptions are, unfortunately, not true for autism. Instead, children with autism must learn language as an effortful intellectual exercise. Verbal and nonverbal aspects of language all have to be taught deliberately and systematically. Nouns must be taught by direct reference to the things they signify. All children require this sort of association in order to learn how to read, but autistic children require it in order to learn how to speak. Likewise, other parts of speech such as prepositions and pronouns have to be introduced purposefully and as visually as possible. The entire process of language acquisition becomes a gigantic undertaking, instead of the natural and relatively effortless process it usually is.
Children with autism tend to use the language they do learn in odd ways. A common and odd practice is echolalia. Echolalia is a verbal behavior in which children with autism repeat what they hear over and over and over again. Echolalia is not uncommon behavior in normal language development. However, typically when children echo phrases and words, they do so for a social purpose. In contrast, children with autism repeat phrases, words or whole paragraphs without the intention of interacting or communicating with other people.
Nonverbal forms of language are also negatively affected by autism. Children with autism have great difficulty understanding nonverbal forms of communication. They don't recognize the meaning inherent in other people's facial expressions, for example, and they don't learn to use facial expressions to convey meaning. Children with autism often have blank expressions or they make inappropriate expressions. They do not instinctively know that a frown represents displeasure or that a smile communicates pleasure. In a normal developmental process the meanings of such facial expressions are picked up spontaneously as language is acquired. This does not happen in autism. Any recognition of the meaning of nonverbal expressions must be explicitly taught.