Teen Autism

Yesterday I wrote about non-verbal communication and Nigel’s development in that area. I ended that post with an anecdote about his emerging ability to read others’ non-verbal communication so that he would not say inappropriate things. On the flip-side of that, I also want to discuss the appropriate things that need to be said, because he often has just as much trouble with those.

“I’m sorry.” Nigel has just recently begun to comprehend the importance of this phrase. I’m sure there were many times that I tried to get him to say it, to parrot it, when he was younger, but the time that I remember the most was when he was 6 and we had some friends’ children visiting at our home for a barbeque, and he was running around chasing them. In retrospect, I should have known that he was too ‘escalated,’ too wound-up to register anything that I said to him. But I was still learning about autism and how it affected him. So he was being chased by a 3-year-old, laughing, probably enjoying the interaction because he always craved it, and Nigel ran into his bedroom and shut the door quickly, not realizing that the 3-year-old’s fingers were already in the door frame. I immediately took the little boy into the kitchen to have someone soak his hand in cold water, and then I went to tell Nigel that he needed to say he was sorry. Again, I was still learning about how autism affected him and I didn’t realize that he couldn’t say sorry because he could not comprehend the word. So when I told him to say it, he just said, “No sorry, no sorry.” I demanded that he say it or he would have to stay in his room the rest of the day. He repeated his “No sorry” mantra and then began screaming.

Two years later, a neighborhood girl verbally provoked him beyong his level of coping, and he allegedly “punched” her. The girl ran to tell me what Nigel had supposedly done, so I took him inside and told him that if someone is bothering him or making him mad, he should come and tell me instead of doing something to them that would get him in trouble. Later, he said he wanted to say he was sorry to her, so I walked him to the driveway and he went up to her and did it on his own. Then, while walking back home, he asked me, “Why do we say ‘sorry’?” He knew what he was supposed to do socially, but he still didn’t understand why. I think that now, at 13, he understands why, because he says it readily and remembers to do it on his own.

“Thank you,” however, he often forgets to say. Often, as in on a daily basis. I know that he understands the reason for saying it, but he just doesn’t do it unless prompted, much to my dismay. I could understand having to prompt him when he was younger, but he’s now a highly verbal 13-year-old! I guess I have to just keep doing what I’m doing, keep up with the repetition, and hope that one of these years he’ll get it.

Greetings are another gray area for him, and always have been. He often greets a household guest by walking up to them and showing them his latest Lego creation. I have to remind him, “Say ‘Hi, Grandma’ and give her a hug!” and then he does. He has to be coached on the phone as well.

I think the reason why these words and phrases are hard for him is because they are vague. They’re not nouns or adjectives or verbs (with the exception of thanking). There’s nothing to visualize. And for someone who is a visual learner, that makes it difficult. For someone who’s also trying to learn, at the same time, how to be socially appropriate, it’s a lot to absorb and apply. He’s mastered sorry, finally. I still have hope for thank you and hello.

Language acquisition is, of course, not just about learning to talk. Non-verbal communication is another confusing realm that autistic people must enter if they wish to interact appropriately.

Initially, Nigel’s non-verbal communication skills were limited to how he could make his needs known non-verbally, since he was not functionally verbal until about age 7. He could talk prior to that age, but most of the words that he spoke were echolalic. If he wanted me to get him something out of the refrigerator, he would take hold of my hand and lead me to the refrigerator and put my hand on the door handle. I would have to guess what he wanted, and a wrong guess would be met with a scream. This was the extent of his non-verbal communication at the time.

He progressed to using PECS, both for his expressive and receptive communication, which was a blessing for both of us, reducing the screaming at least while at home (in public, with his extreme sensory issues, the screaming continued). Once he started uttering one-word need-based requests, his use of PECS at home decreased, and then he moved on to two- and three-word combinations. At that point, the concept of non-verbal communication changed from expressive to receptive.

He started making eye contact. It was fleeting, of course, at first, and only reserved for family members and the most familiar of therapists, but it was there. He started to notice and interpret facial expressions, mostly limited to smiles, but gradually he could interpret the more obvious manifestations of sadness and anger. His favorite one to interpret, still to this day, is tiredness with its unmistakable yawn. “Go sleep?” he would say at age 6. Now, at 13, we hear the beautifully correct and appropriate, “Are you tired?” and even “Why are you putting your head on the desk?”

Nigel’s greatest accomplishment with interpreting non-verbal communication still astounds me, and always will. It happened about six months ago, when his NT friend Riley was at our house for a sleepover. Earlier that week, Nigel had seen me taking my daily birth control pill and asked what it was. I told him in simple terms that it prevented babies from forming in my uterus. Riley’s mother had had a baby a year and a half ago, and now Riley was telling us that his mother was going to have another baby. My sixth sense kicked in, or mother’s intuition, and I knew that the wheels were quickly turning in Nigel’s head. I was seated at the other end of the dinner table from him, and I looked at him fiercely, willing him to look at my wide eyes telling him Don’t say it! Don’t say what you’re going to say! And he started to say, “She should’ve –” and abruptly stopped as soon as he saw my face. It was the first time he caught himself before making an inappropriate comment because he had successfully interpreted non-verbal communication! I was so relieved, and equally amazed. Later I talked with him about the fact that I was glad he stopped himself from saying, “She should’ve taken birth control pills!” I told him that would not have been a polite thing to say. “But I don’t like ‘polite,’” he said, which is what he says when he doesn’t understand something’s purpose. At least if he can continue to interpret non-verbal communication (and not just his mother’s), he stands a chance of learning what’s not polite, and avoiding it.

Nigel’s language development has always intrigued me. I have written previously about his use of echolalia to communicate and how it progressed through different stages over the years (stages that I identified and labeled on my own: please note that they are not “official”). The teachers and therapists who have worked with him at various times, especially in the early years, but even now, have often commented on his ability to take lines from videos and use them within the context of a situation.

Nigel has always loved the Disney movies, especially the animated ones, but at the age of five he began watching some of the live-action films. He loved The Swiss Family Robinson, and still does. One day, his behavioral therapist, unaware that he had been watching that movie at home, told me that when Nigel got angry at her he had said, “It’s my gun, you’ve got no right to take it!” Imagine the awkwardness as I tried to explain to her that he had taken that line from a movie. I wonder if she was thinking that I routinely left guns laying around the house and reprimanded my children when they picked one up. The movie scene in question was when the older brother took the younger brother’s gun away from him, and the younger brother was angry about it. Nigel said the line as a way to indicate that he was angry about being told to do something he didn’t want to do. When I explained the movie scene to Nigel’s therapist, I could see the relief wash over her face. Then she said, ”I understand now! That’s part of why we call him ‘Mr. Association,’ because he’s so good at associating things like that.” 

Quoting lines from videos is no longer Nigel’s primary means of communication, although he still likes to do it occasionally. He also likes to take words or phrases that he remembers from movies, TV shows, or something he picks up online, and try to use them appropriately. Sometimes he is successful with this, other times not. Today during homeschool, while working on subtracting mixed numbers, he did it seamlessly.

Nigel: I don’t want to do subtraction. It’s not really my bag.

Me: Cleaning cat vomit off the carpet is not really my bag, but it still needs to be done.

I think he got the picture.

There has been so much research done on music as autism therapy that I couldn’t possibly address the multitude of positive effects from it in one post. What I will do here is discuss the effects that I have seen with Nigel, including increased verbal skills, better sensory integration, and calming influences.

According to the Autism Research Institute, “Autistic children have also made enormous strides in eliminating their monotonic speech by singing songs composed to match the rhythm, stress, flow and inflection of the sentence followed by a gradual fading of the musical cues.” In his early years, Nigel watched a ton of Disney videos from which he learned to use echolalia as a means to communicate. These Disney videos also had songs that he would memorize that taught him rhythm and voice inflection, and from them he gradually gained the verbal skill of using his own words.

As he got older, Nigel began to pay more attention to the music I listen to, which is a mix of classic rock, alternative, techno/dance, world, celtic, and more. I noticed that the categories that feature harder, faster beats (some rock and techno) seemed to help with his sensory integration. He learned how to filter sounds that previously had caused him to go into sensory overload, like air hand driers in public restrooms and other loud, mechanical sounds. And now, he likes the music for its own sake; he rotates his favorite CDs on his own stereo (mostly movie soundtracks like Twister, Back to the Future, and Cars) and sings along.

When he wants to unwind and relax, he turns to some more of my music. I am happily employed by a company called New Earth Records, a spiritually conscious music label specializing in New Age, world, trance, healing music, and Osho meditations. Nigel enjoys the beat and different instruments (sitar and sarangi) of James Asher’s Tigers of the Raj, the relaxing trance rhythms of Cybertribe’s Immortality (Nigel says: “It relaxes away the stress of the day”), and the beautiful melody of Lisa Lynne’s harp on Love & Peace. When I put on Deuter’s Sun Spirit, Nigel commented how much he liked the cover (Van Gogh’s “Olive Trees”) and said that the music made him feel “like you’re in the Renaissance.” Another title of Deuter’s that I play is Earth Blue, which makes Nigel say, “I feel like I want to sleep.” For someone with occasional insomnia, that’s invaluable, as are all the benefits of listening to music.

I highly recommend playing music for an autistic child (and every child), not only as an effective therapeutic device, but also for the soothing value of it. Music adds to the quality of one’s environment and life in so many ways.