6 Social Communication And Language Issues People With Autism May Have

Autism is a huge spectrum, but it's not unfair to say that all autistic people will face some social communication issues. "Persistent deficits in social communication" represent the very first diagnostic criterion for autism spectrum disorder, after all. Speech and language are, in turn, essential parts of social communication — so challenges can arise in those areas, too. 

What does the DSM-5 say about social communication difficulties in autistic people? 

The fifth edition of the diagnostic and statistical manual of mental disorder, the very long document that US clinicians use as a guide when they consider whether a person may "qualify" for a diagnosis of any number of neurodevelopmental, mood, and mental disorders, tackles potential social communication difficulties people with ASD may have in criterion A. 

It offers up three domains in which such difficulties may emerge, noting that these must be present throughout a variety of contexts — so not, for instance, only at home or exclusively at work or school, adding that they must also be persistent, present over a long period of time:

• "Deficits in social-emotional reciprocity". Social-emotional reciprocity is basically the way in which someone turns relationships with other people into a two-way street. The DSM-5 says that autistic people may not know how to start conversations or approach someone socially the way a neurotypical person would, and that they may have trouble conducting conversations with others. This would include, for instance, knowing when it's your turn to speak, or not replying. Autistic people may also not like to talk about their emotions or not know how to respond to those of others — including knowing how someone feels by looking at their body language and facial expressions. 
• "Deficits in nonverbal communicative behaviors used for social interaction". This would refer to things like unusual body language, not making eye contact, staring, or not having typical facial expressions.
• "Deficits in developing, maintaining, and understanding relationships." Here, the DSM-5 is talking about things like finding it hard to make friends or maintain friendships, tailoring behavior to the situation at hand (such as, it's fine to joke around during a family dinner, but not at a funeral — my example, not the DSM's), or not being all that interested in forming new social relationships. 

1. Autistic people may have trouble with figurative speech, and prefer 'straight talk'

This could include anything from metaphor and common expressions ("What do you mean I got the wrong end of the stick? I don't even have a stick!"), to not getting puns. More subtle verbal communication, like, saying "that was great — but maybe try doing it this way next time" may also be far from clear to an autistic person, who is quite likely to take what you say literally and only hear "great" and "maybe" (completely optional). 

If you want to be sure you're understood, straight talk often works best. Say exactly what you mean. Autistic people are unlikely to take offense when you use blunt, direct, communication!

2. Scripting and echolalia are common

It's not unusual for autistic people to gain a whole bank of (what they believe to be) appropriate social responses by watching TV, reading books, and observing others. This can be quite helpful, as it can offer someone who was previously unsure tips on initiating conversations and responding to certain questions, since autistic people often really dislike small talk. Sometimes, however, a go-to phrase won't be entirely appropriate to the situation, or it may be said seemingly completely out of context. 

Some autistic people also repeat phrases others say involuntarily, a phenomenon known as echolalia. Someone may repeat some of what you just said right back at you, making some people wonder if they were confused about what was just said. This phrase may also crop up much later, however, leaving others wondering what that was all about. 

3. Autistic people may be unsure when it's their turn to talk

Whether in person or on the phone, this can be quite a difficulty to deal with — both for the autistic person, who now has to deal with awkwardness and weird reactions, and for other people in the conversation. 

4. Not all autistic people are verbal

Some autistic people do not speak, or hardly use verbal communication — but that doesn't mean they do not have a voice! Explore blogs written by autistic people, and you'll soon find out that some of the most eloquent writers are non-verbal. You wouldn't be able to tell who uses speech and who doesn't by looking at someone's writing. Besides the typed word, various augmentative and alternative communication aids — think Stephen Hawking, except there are tons of options out there — can help non-verbal autistic people get their message across. 

5. Some autistic people mainly or only want to talk about things they're interested in

I mean, really — don't we all? Hands up if you're bored by your neighbors', relatives', and coworkers' random chit-chat about the weather and how cute their baby or cat is. Autistic people tend to have a lower tolerance for small talk, and may be completely unable to do it. They may be extremely willing to tell you all about stuff they do think is worthwhile, however, perhaps finding it so interesting that they don't notice you're just not into K-pop, sub-atomic particles, or whatever it is that the person really likes. 

6. Autistic people are likely to have unusual facial expressions, intonations, and body language

This would include the notorious eye contact, but also an unusual voice — often described as monotone or unusually loud — no hand gestures or ones you're not used to, and facial expressions that are difficult to interpret. Autistic people may find that others believe they are angry or sad when they're actually rather content or excited, for instance. Avoiding eye contact can, in some situations, be interpreted as a sign of lying, when this is absolutely not the case. 

As you can imagine, these features of autism may also mean that autistic people cannot interpret what others are trying to say through their non-verbal communication. Since neurotypical people say one thing while meaning something completely different quite often, expecting others to pick their intended message up naturally along the way, this can lead to some tricky situations. 

A final word

We looked at a selection of social communication and language issues that autistic people may struggle with when communicating with neurotypical people — and that are bound to cause just as many challenges on the part of non-autistic people who just don't understand the autistic person. What we covered is far from an exhaustive list, mind you. 

With time and increased understanding, neurotypical and autistic people can learn to understand each other better, and gain insights into other communication styles. Knowing that an autistic person's way of communicating is the result of their neurotype — the way their brain works — and they're not just rude or inconsiderate can really help non-autistic people foster better relationships with people on the spectrum.