Speech, Language, and Autism: When Definitions Matter

Hey guys! Welcome back for round two of this blogging adventure, and I hope you all enjoyed the first one back in June J For those of you just tuning in, here’s a brief synopsis: I am a speech-language pathologist who helps people with Autism learn to communicate via spelling on a series of letterboards. I LOVE my job and count myself among the lucky few for whom it does not feel like work! My hope and ambition with this little project is to spread the word on the awesome things these kids and adults are capable of (and currently ARE) achieving, and to educate friends, families, and community members on the changing landscape that is Autism. I wanted to start on the education piece by talking about WHY people like me are called speech-language pathologists, and why those two terms are so important to understand!

For most of us, words like “speech”, “language”, “communication”, and “talking” are mostly used interchangeably to mean the same thing: a way of getting your message across and expressing your thoughts. So why, then, do I have to call myself a speech AND language pathologist, and not just use one of those terms? Well, it has to do with the fact that they both actually refer to very different systems and processes within the brain.

The first system we’ll talk about-the language system-consists of areas responsible for helping you understand messages from others (i.e. receptive language, in purple) and coming up with appropriate responses with the right vocabulary and grammar (i.e. expressive language, in blue). Together, they interact with your pre-frontal cortex (represented by the green circle) to put your thoughts into language and figure out the best way to use that language in a given situation (i.e. social skills!).

This process is a COGNITIVE one: it has to do with a person’s mental ability to take in new information and make sense of it based on their thoughts, experiences, and information from their sensory systems. This system can be in use without anyone else knowing! Have you ever had to sit through a particularly boring class, or listen to someone drone on in a conversation you hoped would end? Did you have some rather unpleasant thoughts pass through your mind, but continue smiling politely and patiently waiting for a break? You were using your language and cognitive system there!

Now, having language is great, but it doesn’t mean much if you don’t have a means of expressing it to others. For most of us, that means is speech, and speech is a MOTOR based process: a way of planning, organizing, and executing movements of our mouths to express our messages. This involves areas of the brain that plan the movements (the pre-supplementary motor area in red), execute the movement (i.e. the motor strip in orange), and help give feedback on how the movements went (i.e. sensory strip in yellow, among other areas). However, speech isn’t the only motor action you can take to express a message: options like typing, gesturing, writing, drawing, or even changing facial expressions can all be used to let others know what we are thinking or feeling. For some people, these non-speech options are their primary way of communicating!

So what’s the take away here? Well, basically, that a MOTOR issue (like weakness or an inability to plan and execute sequenced movements) can affect a person’s physical ability to express him or herself, but that does not mean that there are no thoughts to express! In my time working with and learning from kids and adults with ASD on the letterboards, this point has been driven home time and time again. Autism, we are learning, is the epitome of being unable to judge a book by its cover as people with this diagnosis are ultimately experiencing an issue with motor planning, not language or intelligence.

Spelling to Communicate has been essential in revealing this and in guiding us toward changing the definition of Autism. I will forever be humbled that I am able to participate in the beginnings of such a breakthrough for our kids, teens, and adults on the spectrum, and can’t wait to share more of this journey with you next time! Talk to you soon!