Autism Interaction and Communication Guide

Communication tips and recommendations for engaging someone with Autism Spectrum Disorder (ASD).

Attention

• Use the person’s name at the beginning, so it’s clear you are addressing them.
• Help the person feel comfortable by talking about a special interest or topic.
• Be aware of your environment. A noisy, crowded room may make communication difficult.

Questions

• Give a longer window to respond to a question.
• Don’t ask too many questions.
• Keep them short and close-ended.
• Offer options or choices.
• Be specific–e.g. “What did you order for lunch?” instead of “How was your lunch?”

Body Language

• Don’t rely on non-verbal cues, such as eye contact, gestures, and tone of voice.
• Many with ASD report eye contact as difficult and uncomfortable.

Verbal Communication

• Use concise sentences to prevent word overload.
• Pause between ideas.
• Be literal. Avoid irony, sarcasm, figures of speech, or exaggerations.
• Explaining something complex? Write it out, make a visual, or number the topics.

Executive Functioning (EF) is a group of high-level mental processes that help us regulate, control, and manage thoughts and actions. They are comprised of Organizing Functions and Regulation Functions. These skills tend to be difficult for people with ASD.

Organizing Functions

Planning: Assess your own needs, come up with options, making a sequenced plan.

Examples of difficulty for a person with ASD:

• Double-booking an appointment.
• Difficulty accomplishing multi-step tasks, like cooking or laundry.
• Difficulty prioritizing.

Problem Solving: Can notice and overcome obstacles to a goal.

Examples of difficulty for a person with ASD:

• Difficulty coming up with a plan “B” for a get-together with friends when the restaurant is closed or the gathering needs to be rescheduled.

Working Memory: Can hold information in mind while completing a task.

Examples of difficulty for a person with ASD:

• Difficulty dialing a phone number as a person reads it aloud.
• Difficulty following multi-step directions when given verbally.

Shifting/Flexibility: Can change based on responses to the environment.

Examples of difficulty for a person with ASD:

• Difficulty switching to a task that needs to be completed immediately.
• Difficulty getting to work because usual bus route is delayed/re-routed.

Attention: Can focus on a task, even when uninterested.

Examples of difficulty for a person with ASD:

• Difficulty completing a task because of distractions or interruptions.
• Difficulty with being on time because of the inability to estimate how long it will take to get ready, given distractions.

Regulating Functions

Inhibition: Blocking an action or thought.

Examples of difficulty for a person with ASD:

• Talking about a topic, even when asked to stop.

Self-monitoring: Adjusting actions if something goes wrong.

Examples of difficulty for a person with ASD:

• Difficulty completing a task when in a different environment, such as remembering coping skills that are used effectively at home.
• Difficulty driving (awareness of speed, the location of the car to others, etc.).

Initiation: Getting started on a task.

Examples of difficulty for a person with ASD:

• Procrastination of a non-preferred task, possibly caused by not knowing how to break down a project into steps or not knowing how to begin.

What is autism?

Autism Spectrum Disorder(ASD) is a complex developmental disorder that can cause difficulty with how a person thinks, feels, communicates, and relates to others. A person with ASD may also engage in repetitive patterns of behavior and motor mannerisms, have restricted ranges of interest and/or inflexibility in adhering to routines or rituals.

Emotional Regulation

• Emotional Regulation (ER) is the process used to modify emotional reactions.
• ER is a common issue for those with behavioral health diagnoses.
• Common behavioral health diagnoses in ASD include Depression, Anxiety, and Obsessive
  Compulsive Disorder.

How do ER Problems Look in ASD?

• Issues recognizing emotions in one’s self.
• Goes from “0 to 100”; Unaware of emotional escalation until it’s too late.
• Unable to let go of an intense feeling.
• Meltdowns (can argue, make derogatory comments, be verbally aggressive, disrespectful, etc.)

What Can You Do?

• Does the person know when a meltdown is coming? Ask how you can help.
• Identify and minimize triggers.
• Have a meltdown plan in place for that person.
• Give them space and time.
• Reduce environment stimuli.
• Calming strategies (mindfulness, relaxation).
• Develop a system to help cue them to start using a coping strategy.

What is Executive Functioning?

Executive Functioning (EF) is a group of highlevel processes that help us regulate, control, and manage thoughts and actions. EF is not a symptom of ASD, but many people with ASD have it. Sometimes EF creates a gap between skill and performance.

How do EF Problems Look in ASD?

Difficulty with: being on time, prioritizing tasks, talking about a subject even when asked to stop, shifting to a task that needs to be completed immediately, shifting away from a preferred task, and following multistep directions.

What Can You Do?

• Breakdown multi-step goals (Chunking).
• Help find and use functional alternatives. Examples include: Making to-do lists, using a planner or digital app for scheduling, and setting own deadlines.

What is Theory of Mind?

Theory of Mind is the ability to understand other’s beliefs, desires, and intentions. Knowing that others have different thoughts than you and being able to predict them. The ability to show empathy at appropriate times and accurately take the perspective of others into account.

How Does Theory of Mind Look in ASD?

• People with ASD have delays in developing Theory of Mind and often continue to struggle.
• Examples include: Only seeing one option to solve a problem, becoming upset when
  someone doesn’t know the answer to a question, unintentionally making a comment that could be interpreted as rude, and an inability to understand sarcasm.

What Can You Do?

• Ask perspective-taking questions, like “How do you think that person feels in this situation?” or “How would you feel in this situation?”
• Use examples as teaching moments, like “What you said could be interpreted in this way.”
• Use movies and TV as examples to identify the emotions and motives of others.

Many individuals with Autism Spectrum Disorder (ASD) have challenges in sensory areas that affect their daily lives. They can be hyper and/or hyposensitive to any of the senses.

Hyposensitive Examples (Under-Sensitive)

Person may seek sensory input by:

• Banging objects loudly
• Spinning
• Rocking
• Showing a preference for spicy food or other strong flavors
• Smelling or sniffing objects

Hypersensitive Examples (Over-Sensitive)

• Bothered by loud places, particular noises (e.g., squeaky door), fluorescent lights, scented
  products, and certain fabrics or textures
• Food sensitivities (strong flavors or certain textures) may lead to limited diets
• Interference with hygiene (hair brushing and/or teeth brushing may be painful)
• Sensitivity to touch
• Fine motor difficulties (handwriting, buttons, shoelaces, etc.)

Signs of Sensory Overload

• Covering of ears/eyes
• Putting head down
• Wearing a hood, sunglasses, headphones, or hat indoors
• Appears stressed or anxious
• Appears to be in pain
• Marked change from usual behavior

How to Help

• Ask about sensory concerns
• When meeting individually and in groups, consider the space
• Try to use windows, lamps, or indirect lighting instead of fluorescent lights
• Consider a private room instead of a common area with background noise
• Provide “fidgets” for people to use during downtime (stress balls, fidget spinners, Koosh balls, etc.)