Thursday, 7 September 2017

Autism: Verbal/Non-Verbal. A False Binary

The strange myths and illogical beliefs around autism include verbal/non-verbal.  The idea that either we can totally not speak, or can always speak.  It's nonsense.

For a start, if we look in the DSM V diagnostic checklist for autism, speech, or lack of speech, isn't even part of autism now.  It's a different classification.

A number of autistic people, me included, also have speech and language difficulties of some sort. 

What do we mean by speech/useful speech?
Do we mean that a child has no ability at all to say a single word?
Do we mean that they also cannot write or type words?
Do we mean that they can speak sometimes to say individual things, but are non-verbal at other times?
Do we mean that they can speak for a short time in a social conversation, then cannot manage to speak further?
Do we mean that they can repeat individual words over and over?   Or, perhaps phrases over and over?
Do we mean that they can put phrases together, for example ones learned from TV or radio, and attempt conversation that way?
Do we mean that their difficulties with speech mean that they cannot defend themselves in an argument, or ask for things they need in shops and at the Doctors?
Do we mean that they have difficulty with some language, e.g. social concept words?
Do we mean that their voice tone and pacing is so unusual that people cannot decode it easily?
Do we mean that they have delayed answers to things - perhaps responding minutes or hours later?
Do we mean that they go to build a friendship with others using words, but it goes horribly wrong?
What do we mean by 'non-verbal', and why are so many insistent on describing language as just this strange binary :  "Verbal/non-verbal". 

Me, generalising....I could sometimes repeat individual words as a young child.  I could repeat individual phrases.  I learned to copy down words and phrases.  Eventually, I could piece together enough words and phrases to write stories.  I could sometimes read out words and sentences, without really understanding what it meant.  Mostly, if asked, I'd hide.  I could also attempt to say very short answers with others, e.g. yes, no, please, thank you.  But in any conversation, up to age 10, I was baffled.  And anxious.  And mostly non-verbal.

I would try to decode what the other person said.  My brain thinks in pictures, so I had to visualise it.  Then, I'd visualise my answer.  Then, my brain would have to try to find the right combination of words and phrases to respond. That took a long time.  Sometimes, nothing would happen - I'd go to talk, and there was no response from my body.  Or I'd say something garbled.  Or I'd say a response so late that it made no sense to anyone; the conversation had moved on.

People thought I was shy.  Or rude.  Or both.  I spent two years in a class in secondary school, and the teacher during Parent Evening had no idea I was one of his pupils.  He had never heard me speak.  I mostly didn't.  I was too anxious to attempt it, because it would go horribly wrong most of the time.

Some days, as an adult, I'm hardly verbal.   Even though I'm an extravert and love being with people, sometimes I cannot speak.  I can nod.  Maybe I can say the short word answers - yes, no, thanks, please.  Maybe I can think of some stock phrases to say.  (Hoping they're the right ones).

Other days, I can talk really well.

Much depends on how exhausted I am.  Whether I feel well.  Whether I've overloaded myself with sensory/social input.
Can I in theory ask for things in shops?  Yes. 
Can I always ask for things in shops?  No.
Can I in theory explain an illness to a Doctor?  Yes.
Can I always explain an illness to a Doctor?  No.
So, am I verbal?  Am I non-verbal?  Yes.  It's a yes to both things.

The moment I'm in a conflict situation with an angry person, I'm stuck. I go to speak, nothing happens.  Nothing at all.  The moment I'm in sensory distress, I go to speak, nothing happens.  The more tired I get, the more I put the wrong words in sentences, or mispronounce words randomly.

I find workarounds.  Making sure I'm in a good sensory environment.  Resting before and after a speaking engagement.  Talking on subjects I know, where I already know what to say and how to say it.

Most people would never know of my struggles with language, because they are unaware of the absolutely huge effort I put into disguising it.

I wish more professionals would understand that autism is not a set of binaries; "high functioning/low functioning", "verbal/non-verbal".  Everything is a four-dimensional spectrum of abilities, which change over time and can vary day by day/hour by hour.

Be aware that some people - autistic or otherwise - will struggle with some speech ability.
Be cautious about picking on people to read something out, or contribute verbally.

Allow people to contribute in ways they can handle.  It might be sign language.  It might be written.
And, be aware that young people who are 'quiet' may actually be struggling to speak.

The picture shows a representation of a group of diverse people.  The ability to speak is just as diverse.