1 - The most essential developmental task
Benasich and Tallal (2002) point out that mastery of
language is one of the major tasks of infancy, and that
language is a universal phenomenon across all
cultures [1]. Learning to speak is based on circuits in
the brain that do not exist in other species [2-4].
Neurological impairment must be severe to completely
extinguish language, thus even psychologists with a
special interest in development of higher cognitive
function (Freud, Piaget, Erikson, Gesell, Havighurst,
Kohlberg) have mostly taken language acquisition for
granted, and overlooked learning to speak as perhaps
the most essential stage of early human development.
Language disability should be considered the most
serious impediment to development for a child with
autism. Language is necessary for participation in any
human society. Without language, a person is totally
dependent on others – family or whatever public
support programs are in place to manage the burden.
Young children normally acquire language quickly –
too quickly to keep track of. It is therefore shocking
for parents to have a child who doesn't talk, or who
only recites phrase fragments from the speech of
others, and who doesn't try to participate in the give
and take of conversation.
Explanations that focus on underlying causes such as
“theory of mind” or therapies like “auditory integration
training” do not target the single most important
problem. Astington & Jenkins (1999) discussed
evidence that the lack of "theory of mind" and capacity
for shared attention in children with autism is the
result, not the cause, of the language disorder [5].
Therapies such as "auditory integration training" might
be more effective if the goal were to help a child detect
and make use of the distinctive features of speech
sounds [6].
The importance of communication led to the fad of
"facilitated communication," an approach that cannot
be considered benign [7-11]. I was accused of having
abused my son, Conrad, by a practitioner of facilitated
communication at the group home where he lived, and
finally died. I regret so much that I did not do more to
put an end to this evil practice.
Language learning should be recognized as the most
essential developmental stage of infants and young
children. Learning to speak may not be a task for
children who are neurologically intact, but it is a huge
task for a child with autism [12]. Language learning
should be the direct focus of therapeutic efforts to
help children with autism. Few would disagree that a
great deal more hope can be held out for a child with
Asperger syndrome because children with Asperger
syndrome are verbal. Likewise there is far more hope
for children with "high functioning" autism (HFA)
because they have acquired language. Parents are
often willing to admit that their child has Asperger
syndrome even if speech development is delayed,
because it helps maintain a sense of optimism.
Regardless of what professional autism experts
advise, language development remains the focus of
parental concern.
Education is dependent upon a child's ability to learn
through use of language. This would seem
unarguable. But euphemistic attempts to circumvent
serious problems like language delay and encourage
"acceptance" or to view "everything as beautiful in its
own way" get in the way of reason. Nothing is more
infuriating to parents of a child with a serious disability
than to be gently told they must be accepting.
Acceptance is a cruel admonition for those struggling
to deal with day to day management of an autistic
child. Anger is the only reasonable response. Efforts
to help a child learn language are crucial.
- Benasich AA, Tallal P (2002)
Infant discrimination of rapid
auditory cues predicts later
language impairment.
- Anderson SR, Lightfoot DW
(2000). The human
language faculty as an
organ.
- Lidz J et al. (2003) What
infants know about syntax
but couldn't have learned:
experimental evidence for
syntactic structure at 18
months.
- Jackendoff R (2003) Precis
of Foundations of language:
brain, meaning, grammar,
evolution.
- Astington JW, Jenkins JM
(1999) A longitudinal study
of the relation between
language and theory-of-
mind development.
- Sinha Y et al. (2006)
Auditory integration training
and other sound therapies
for autism spectrum
disorders: a systematic
review.
- Finn P et al. (2005) Science
and pseudoscience in
communication disorders:
criteria and applications.
- Dawson G, Watling R (2000)
Interventions to facilitate
auditory, visual, and motor
integration in autism: a
review of the evidence.
- Mostert MP(2001) Facilitated
communication since 1995:
a review of published
studies.
- Jacobson JW et al. (1995) A
history of facilitated
communication: science,
pseudoscience, and
antiscience.
- Hostler SL et al. (1993)
Childhood sexual abuse
reported by facilitated
communication.
- Havighurst, RJ (1972)
Developmental tasks and
education, 3rd edition.
- Benasich AA, Tallal P (2002) Infant discrimination of rapid auditory cues predicts later
language impairment. Behav Brain Res. 2002 Oct 17;136(1):31-49.
- Anderson SR, Lightfoot DW. The human language faculty as an organ. Annu Rev Physiol.
2000;62:697-722.
- Lidz J, Waxman S, Freedman J. What infants know about syntax but couldn't have learned:
experimental evidence for syntactic structure at 18 months. Cognition. 2003 Oct;89(3):B65-
73.
- Jackendoff R. Precis of Foundations of language: brain, meaning, grammar, evolution.
Behav Brain Sci. 2003 Dec;26(6):651-65; discussion 666-707.
- Astington JW, Jenkins JM (1999) A longitudinal study of the relation between language
and theory-of-mind development. Dev Psychol 35:1311-1320.
- Sinha Y, Silove N, Wheeler D, Williams K. (2006)Auditory integration training and other
sound therapies for autism spectrum disorders: a systematic review. Arch Dis Child.
2006 Dec;91(12):1018-22.
- Finn P, Bothe AK, Bramlett RE.Science and pseudoscience in communication disorders:
criteria and applications. Am J Speech Lang Pathol. 2005 Aug;14(3):172-86.
- Dawson G, Watling R. Interventions to facilitate auditory, visual, and motor integration in
autism: a review of the evidence. J Autism Dev Disord. 2000 Oct;30(5):415-21.
- Mostert MP. Facilitated communication since 1995: a review of published studies. J
Autism Dev Disord. 2001 Jun;31(3):287-313.
- Jacobson JW, Mulick JA, Schwartz AA. A history of facilitated communication: science,
pseudoscience, and antiscience. Am Psychol. 1995;50:750–765.
- Hostler SL, Allaire JH, Christoph RA. Childhood sexual abuse reported by facilitated
communication. Pediatrics. 1993 Jun;91(6):1190-2.
- Havighurst, RJ (1972) Developmental tasks and education, 3rd edition, New York: D.
McKay Co.