Graphic communication may support comprehension and use of spoken language in children with autism: A case study

By Stephen von Tetzchner, Department of Psychology, University of Oslo

Kristin Dille Øvreeide
Nordvoll School and Resource Centre for Children with Autism

Kirsten Kavlie Jørgensen, Birgitte Mørup Ormhaug,
Bente Oxholm, Ragnhild Warme, Trosterud Pre-school Centre

 Correspondence: s.v.tetzchner@psykologi.uio.no 
 

Long-term descriptions of individual courses of alternative language acquisition are rare. The present case study describes the development of a young boy with autism, “Robert”, from when he was first introduced to graphic communication at the age of three to his use of graphic sentences and emerging speech production when he was six years old. Because he did not show any comprehension of spoken language when the communication intervention with photographs and pictograms was initiated, implicit intervention strategies were used. The strategies were selected on the basis of a theoretical framework that emphasises social interaction, mediation and co-construction, child initiative, semantic role learning, and contextual knowledge in communication and language development. Robert seemed more able to cope better with the cognitive and attention demands of graphic communication than with those of manual signs and spoken language. Over a three-year-period, he made the important transition from single photographs and pictograms to utterances consisting of two and more items, in spite of the fact that his comprehension of spoken language remained limited to single words. He also increased his small vocabulary of manual signs, and towards the end of the intervention period described here, he had begun to imitate some of the spoken language he heard and to use a few spoken words and formulaic phrases functionally. A communication aid in the form of a book with a fold-out 'conversation page' had a core function in the intervention and he used this in both training sessions and spontaneous communication in a special unit in an ordinary preschool. The construction of graphic sentences on the fold-out page required limited cognitive resources and may thus have helped both Robert and his partners establish joint attention and a greater shared context. Robert’s achievements demonstrate that children with autism may develop complex expressive language skills independent of speech comprehension and that these skills may facilitate the comprehension and use of spoken language. They also point to a need for communication strategies that can promote the development of more complex utterances and a more varied communicative use of graphic communication systems.