Elsevier

Research in Autism Spectrum Disorders

Volume 5, Issue 3, July–September 2011, Pages 977-983
Research in Autism Spectrum Disorders

Review
Spontaneous communication in autism spectrum disorder: A review of topographies and interventions

https://doi.org/10.1016/j.rasd.2010.12.005Get rights and content

Abstract

Lack of spontaneous communicative initiations appears to be a consistent problem in individuals with a diagnosis of autism spectrum disorder (ASD; Fujiki & Brinton, 2009). Spontaneous communication is emitted at a much lower frequency compared to individuals with language impairment and typically developing persons. Deficits of spontaneity in social interaction have been identified explicitly in the diagnostic criteria for autism, regardless of communication level or ability (American Psychiatric Association, 1994). In addition, without intervention 21–66% of children with ASD do not develop communicative speech (Lord & McGee, 2001). Individuals with autism rarely initiate appropriate speech and often fail to engage in typical social interactions such as asking questions, requesting information, expressing affection or requesting interactions (Carr & Kologinsky, 1983). This paper provides a review of the communicative topographies used to ameliorate spontaneous communication functions in individuals with autism and addresses the behavioral interventions that are used to induce such spontaneity.

Research highlights

▶ Communicative topographies in autism spectrum disorder. ▶ Spontaneous communication in autism spectrum disorder. ▶ Augmentative and alternative communication strategies. ▶ Behavioral interventions to establish and increase spontaneous communication.

Section snippets

Conceptualizing spontaneity

Spontaneous communication is creative, generative, and conventional. While there is general agreement regarding the importance of spontaneous communication, spontaneity as a construct has not been clearly or consistently defined in the wider literature (Ivey, 2009). In general, spontaneous communication is defined as communicative behaviors that occur in the absence of prompts, instructions or other verbal cues. Using such a conceptualization, individuals diagnosed with autism are said to lack

Interventions to increase spontaneous communication

Various interventions have been reported in the literature on Applied Behavior Analysis to increase spontaneous communication in individuals diagnosed with ASD. Speech may be targeted using a number of procedures, including discrete-trial training, time delay/prompt fading, milieu language teaching, direct instruction, script fading, and fluency training. Interventions can be peer-mediated or adult-mediated. Many individuals with autism may fail to develop speech and language skills (Lord &

Augmentative and alternative communication strategies

Augmentative and alternative communication strategies (AACs) are a successful communication intervention for many individuals with ASD that have not developed speech. AACs can be used to either supplement existing speech or to serve as the primary method of expressive communication (Mirenda, 2003). These strategies can be divided into two broad categories, namely unaided AAC and aided AAC strategies. Unaided AACs do not require any equipment that is external to the body, and include manual

Interventions aimed to establish and increase spontaneous communication

A wide variety of interventions have been used to establish various communicative topographies in individuals with ASD. Some appear more successful than others in terms of establishing spontaneous communication. While it is not possible to present an exhaustive overview of interventions in the current paper, the aim is to describe a number of approaches that reflect current trends in the literature.

Traditional behavioral interventions teach communication in highly structured programs, often

Conclusion

Individuals with autism spectrum disorder present with impairments in social interaction and communication (APA, 1994). One key deficit appears to be related to spontaneity of communication, which is, at best, lacking, and, at worst, non-existent. While it is a persistent problem, there is no “gold standard” in terms of intervention. Rather, researchers suggest that efforts to enhance communication should be based on an individual's abilities (e.g., Mirenda, 2003) and should adopt

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