Communication in action

Communication in action

A parent contacted me about their child who is due to be discharged from Speech & Language Therapy. Child has done a (generic) programme and can answer all the questions on the worksheets. However, the same child still struggles to start and keep conversations going. 

My response was:

Tests and assessments are not ‘communication in real life’. Test results tell us something about the knowledge the child has about the tests or worksheets. It also gives us an idea of what they might understand and how they process information. It does not mean they can use the communication skills independently. 

For any other parent whose child can ‘talk the talk’ but does not ‘walk the walk’, here are the steps to becoming an independent communicator: 

1. (with others) experience the situation.

2. (with others) experience communication about the situation.

3. (with others) think about the communication and the situation using words and pictures.

4. (with others) practice words, language, and communication in structured situations.

5. on your own, practice communication BUT think about the situation afterwards with others who know you well. 

6. communicate independently. 

These steps are what ‘transferring skills’ is all about. So often people are expected to make the transition from step number 3 (reflecting on communication) to number 6 (independent communication). 

Being supported to go through all the steps is ‘communication in action’. It is practical and it is functional communication. It is what Speech & Language Therapists do and what they can support others to do when they are commissioned to spend the time (properly) with everybody involved. 

Let’s get back to basic

Predictability and routine go ‘hand in hand’. They help us feel safe and calm.

Visual time tables, calendars, objects of reference, ‘talking through the day or week’ are in my mind pretty fundamental stuff. Knowing what happens next communicates some sort of predictability.

If you can’t predict what happens next, or if anxiety means you are uncertain about next steps; someone showing you (visually) helps anchor you to the ‘here and now’.

In my work (with children and adults), having ‘visual structure’ to the day is more often the exception than the norm. We have seen anxiety and mental health problems for autistic people and people with social communication disorders soar.

I am making a tentative link between the ‘loss of structures’ and reduced wellbeing. If the importance of predictability and routine is forgotten, we are expecting people to navigate their routine on top of everything else that may be unsettling them.

Helping a person make sense of their day is pretty fundamental stuff, yet somehow it has gone off the radar everywhere.

Let’s get back to basics!

Did you know your brain is a detective?

We all work out what people mean by what they say. However, there is a slight difference in how autistic and non-autistic people make sense of communication.

Non-autistic people generally only need some (not all) information to work out the gist of a situation. It is a sort of ‘saver mode’. It helps ignore what is less relevant and focus attention on what is considered important. The name of this processing ‘trick’ is ‘central coherence’ (a lot of you hear me go on about it!). Central to working out the gist of a situation is the ability to make inferences about other people’s thoughts and intentions.

The non-autistic brain generally tends to focus on social information. Somehow social and emotional information is interesting and important to our brains. What goes in comes out; a lot of what is communicated is therefore social stuff.

Some autistic people may pay attention to detail but not necessarily the social detail. Or they may pay attention to everything and then deduct what is not necessary as they go along. This is possibly why some people find it easier to reject information in order to work out what they want, rather than being able to tell you off their own back.

In communication, I so often see autistic children and adults who have to hear and think through absolutely everything to work out what is meant by what is said.

For example, the class teacher might say:

“Thankfully we got Ella in our class to tell us all what we did wrong”.
Working out if the teacher is stating a fact, is sincere, joking, or sarcastic, the autistic child has to:

Work out any previous information that indicates Ella is particularly knowledgeable.

Work out if there was any social rules broken leading to the teacher’s comment.

Work out the teacher’s facial expressions and the way the sentence has been said.

Work out what his or her peers’ reaction mean.

Most of the time, deductive processing works effectively and other people will not necessarily notice a systemising approach has been used. Sometimes the result of this process ends with a conclusion that is different to what was intended by the situation or the other person.

This is a genuine misunderstanding, but misunderstandings can be seen as lazy, wilful or obstructive by others. However, if you work out the line of thinking (and how the deductions are made) you can see that the conclusion makes perfect sense. Even if different from what is intended.

Another aspect that is generally not appreciated is how effortful deductive processing of non-autistic communication can be. It is why people fatigue, have meltdowns, or look as if they are disengaged. These negative behaviours communicate the person is ‘full to the brim’ in terms of processing communication.

The problem is also that the effort put in to making sense does not really get acknowledged by other people. It is not appreciated that the person works harder at something non-autistic people take for granted. The result is the person feels or is made to feel stupid rather than feeling they have reached a fair limit. That time out is needed!

It makes for more diverse experiences if we acknowledge the difference in how autistic and non-autistic people make sense of information. We can use this to tell autistic kids: you are not stupid, your brain has to work like a detective. It is not wrong, it is just different.

Let’s not be stubborn…

Black & white thinking

Ever thought about why some people seem so set in their views and opinions? 

We use the term ‘black and white’ to talk about clearly defined and opposing information. It is also used derogatorily to talk about people who won’t or don’t change their mind. 

‘Black and white thinking’ has in the past been associated with autism; many autistic people talk about ‘binary thinking’ instead. ‘Black and white thinking’ is often used by non-autistic people as a short hand term for ‘rigid thinking’. 

Linking binary thinking with rigidity is unfair but probably happens because it is also associated with (autistic) logical style of communicating thoughts and ideas. 

To be able to think flexibly (and not be so ‘darn black and white in our thinking’) requires a broad selection of higher level language skills. The core language skill needed is our ability to make sense of the words in context. Understanding language in context helps us detect ambiguity and ambivalence, we work out inference and appreciate the nuances of what people say. 

Words in context is what we speechies call ‘pragmatics’ and its impact on the person’s understanding and thinking is frequently underestimated. This in turn can affect the person’s emotional well being. 

Let me put this to you: if you struggled to work out what a person means by what they say. If you struggled with how the same cluster of words means different things depending on the situation and who speaks them; we would all more than likely prefer neat and clearly defined information. 

Lack of ambiguity makes us all feel secure and makes the world appear more certain. So when a person looks set in their views; think anxiety, think insecurity and consider that the person may need for predictability rather than it being a matter of rigidity of thinking only.