This post is in the Communications category

Communications are a central point of difficulty or impairment for people on the autism spectrum. In particular, the social aspects of communication are affected and these are the focus of the diagnostic criteria. While language delay is specifically excluded in the DSM-iv criteria for Asperger’s Syndrome, and many people in the high functioning end of the spectrum have good vocabulary and technical language skills, (Ghaziuddin & Mountain-Kimchi, 2004; Paul, Orlovski, Marcinko, & Volkmar, 2009) both verbal and non-verbal language can be affected both syntactically and qualitatively. At the lower functioning end of the ASD spectrum, where individuals are severely impacted and also show intellectual impairment, language can take different forms than speech, including sharing through touch or idiosyncratic sign language. Olga Bogdashina in particular (Bogdashina, 2005; Bogdashina, 2006) has done much work looking at the ways that such individuals interact with their world without the use of our language, and encourages families educators and support people to do more to engage with the individual language of the autistic person. Other recent studies have called for a broadening of the concept of language beyond the purely syntactic when dealing with autism (Bartlett, Armstrong, & Roberts, 2005) and other cognitive differences.

As mentioned above, language at the high functioning end of the autism spectrum, verbal language is usually good, with strong vocabulary and semantic understanding. However its use is often qualitatively different. Spoken language may include any number of “oddities” including unusual prosody, volume (either too loud or too soft), inappropriate tone or force, frequent neologisms, echolalia, unusual or “foreign” accents, constant interrupting and inappropriate quantity (too much or too little). The role of prosody (the intonation and rhythmic patterns of spoken language) in the communication of affect has been the subject of considerable attention. Thompson et al have shown that musically trained adults are more able to decode emotion in speech than those with no musical training (Thompson, Schellenberg, & Husain, 2004), and there is considerable interest in the use of music lessons to improve both reception and delivery of emotional meaning (Bhatara et al., 2010; Drapeau, Gosselin, Gagnon, Peretz, & Lorrain, 2009; Patel, 2008).

It is also common to find that conversations with individuals with Asperger’s Syndrome will suddenly change direction or divert onto tangents  (Attwood, 2008, p. 209).   Such sudden changes of topic, may be due to local focus on a particular word or idea rather than the gestalt meaning of the conversation.  In addition to suddenly directing onto a different, sometimes apparently illogical train of thought, this focus can also tend to lead to a more literal interpretation of spoken language, as meaning is taken from each word in a sentence, rather than the sum of the parts. The phenomenon can also account for “sticking” on partial meanings in a sentence. For example “Johnny please empty the dishwasher and set the table” will lose the second half of the request. Parents reading this will probably not find it so unusual, but add thirty years and a distractor such as a rhyme “turn right after the white house, then left” just might get me lost – I knocked on the door of the white house. Working memory may also be a factor in this type of comprehension and audio processing (Alloway, Rajendran, & Archibald, 2009).

Communication, whether verbal language or non-verbal, requires high levels of reciprocity and engagement with social “rules” most of which are unwritten and contextual (Attwood, 1998; Attwood, 2008; Gray & Attwood, 1999). Some of the verbal characteristics mentioned above may be subtle, but are enough to earn the descriptor of “odd”.

However, it is the non-verbal aspects communication in high functioning ASD that is I particularly wish to deal with. In young children psychomotor mirroring is a key indicator of social competence and empathy (Pfeifer, Iacoboni, Mazziotta, & Dapretto, 2008).   Such mirroring of such physical aspects as facial expression, gesture and body position are significant in the development of “connections” in social groups and in learning to receive and transmit non-verbal communication (Bogdashina, 2005). Autistic lack of gaze to the face is reflected in poor facial expression (Tantam, Holmes, & Cordess, 1993), so the communication is poor in both directions. The observation of poor facial communication has led to a slew of research into the ability of Asperger and HFA children and adolescents to “read the mind” from the face or from the eyes (Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001; Bhatara et al., 2010; Drapeau et al., 2009; Golan, Baron-Cohen, Hill, & Rutherford, 2006; Patel, 2008; Rutherford, Baron-Cohen, & Wheelwright, 2002; Thompson et al., 2004). These studies have concluded that this is a significant problem for communication and social inclusion.

Musicians are great users of gesture. The motor and aural centres of the brain are significantly connected (Calvo-Merino, Jola, Glaser, & Haggard, 2008; Chen, Penhune, & Zatorre, 2008; Phillips-Silver & Trainor, 2005; Phillips-Silver & Trainor, 2007; Zatorre, Chen, & Penhune, 2007) and the impulse to move in response to music is of significant value to many therapies (Schneck, Berger, & Rowland, 2006). In addition, the largely “impulsive” form of movement for the playing of many instruments provides many clues to force and intensity of the player’s intent (Levitin, 2006, p. 137). These are things I can see when I watch video recordings of musicians. It is much harder however to read when the musician is in front of me. I have not been in a position to do the statistical study of autistic traits in the musical community that I originally intended, but observation and anecdotal evidence suggests that Asperger musicians are more likely to be lone or strongly independent musicians, or drawn to the systematic sides of music such as composition or recording arts than those areas that rely on physical communication such as chamber music or jazz ensembles.

Reading body language can be learned. I personally recall making a study of an illustrated guide to body language (Pease, 1981) in my high school years. This was many years before my own diagnosis, but I was already aware that my abilty to interpret non-verbal communication intuitively was weak compared to my peers, and was seeking a more cognitive method. In the process of reviewing video recordings during this research, I have been extremely conscious of how much non-verbal communications I have missed at the time, but can pick up in a more objective and removed analysis. This has been at times confronting, and brought about some surprises with implications for how I conduct my practice.

In the arena of non-verbal communication and music, it is worth looking at the use of written text and non-synchronous modes, and this is the subject of the post Macbeth by fax.

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