Kitty4670 wrote:
I think I read this somewhere. I know Cerebral Palsy people have speech problems, I do.
The speech issues for AS and CP are quite different.
CP people have speech problems because the muscles of their mouth don't move properly. Depending on severity, it can cause slurred speech, drooling, slow effortful speech, and in severe cases they may not be able to speak at all. (I knew a kid with CP who had a normal IQ but could only moan and not speak because he had such poor control of his mouth muscles.)
For the autism spectrum, it's more higher-order planning and understanding. There's a number of issues that can happen.
Apraxia of speech is a motor-planning issue - unlike in CP where the muscles try to do the right movements but do them sloppily and slowly, in apraxia the brain tells the muscles to do well-coordinated movements that aren't exactly what the person intends to do. So for example the person might intend to say 'animal' and instead say 'aminal'. Young children normally make mistakes like this when they're still learning to talk, but they outgrow it, whereas a person with apraxia of speech has slower development in this area. However, since this issue can cause a speech delay (having first words/first sentences at an older age), chances are an autistic person with this issue would be diagnosed as having autism or PDD NOS instead of AS.
Word-finding difficulties are also common with autism. This is when the word is on the 'tip of the tongue' - you know you know the word, but you just can't bring it up from memory. If someone guesses it, you know immediately whether they're right or wrong. Everyone has this occasionally, but some autistic people have this more often, and they're less likely to successfully retrieve the word later. This can make someone talk too vaguely, because they substitute the word for a word like 'thing', or they might hesitate a lot when speaking. This doesn't cause a delay in early speech development, so you'll see people with this issue qualifying for an AS diagnosis.
Stuttering is also more common, and often exacerbated by overload. This also can be seen in people with no speech delay.
Lastly, receptive language issues can be a problem, and will often affect speech. (You can't learn to talk properly if you don't understand properly.) Firstly, many autistic people have a hearing problem known as central auditory processing disorder, where they hear the sounds fine, but their brain can't make sense of the sounds. It can make it hard to pick out a relevant sound from background noise, or to make out exactly what speech sounds the person is making (eg b and d might sound the same), or in severe cases can make it hard to tell the difference between speech and other sounds. Severe CAPD will generally cause a speech delay, while milder CAPD can cause pronunciation issues (because they hear the word wrong, so they don't know how to pronounce it correctly), or in some cases no obvious speech issues at all. (Just apparent inattentiveness when there's a background noise.) Many people with CAPD also unconsciously read lips, which they experience as hearing someone more clearly when they look at the person's mouth. (Awhile back, news outlets were making a big deal about a study that found autistic people tended to look at a person's mouth instead of their eyes. It never seemed to occur to them that this could actually be a way to compensate for poor language comprehension.)
In addition, many autistic people lack inner speech. Inner speech is a stream of constant mental chatter, narrating what a person is thinking. For many autistic people, this can be replaced by a stream of some other sensory impressions, such as pictures. This isn't technically a
problem, because it tends to make someone better at visual and/or spatial tasks, but it does mean that the person has to 'translate' their thoughts into words, and therefore speaking takes more mental effort. This also seems to contribute to word-finding problems. This pattern of thinking is more common in autistics with a speech delay (although we don't know if lack of inner speech causes a speech delay or if a speech delay causes lack of inner speech). But there are people with AS who have this thinking pattern, too.
There can also be problems with being slow to learn new vocabulary, or in some cases learning what speech is
for. But these are generally seen only in lower-functioning autistic people with severe speech delays, or in very young children. Often the vocabulary issue is marked by not going through the 'language explosion' in toddlerhood, where most toddlers go from knowing 5-10 words to knowing a couple hundred within only a few months - the fastest that most NTs will ever learn new words in their lifetime. During this stage, a kid can learn a new word after hearing it only once or twice in the right context. A kid who fails to go through this stage will end up extremely far behind. However, some autistic people find that they go through this stage later, at around 4-6 years old, and end up going from minimally verbal or nonverbal to normal or nearly normal speech in a couple of years or sometimes even a few months.
21 Jan 2016, 7:29 pm
