(Part VII in a series of posts that will soon take us to a highly contagious and dangerously inaccurate meme about what autism is.)
In my previous posts, I’ve made the following points:
–How much language you acquire, including how much language you comprehend, is correlated with how much attention you’ve paid, over the years, to other people’s speech and to what they are looking at and doing when speaking.
–Deficits in these attention behaviors, which are examples of what’s called Joint Attention, are among the core symptoms of autism. (If you don’t have deficits here, the diagnosis doesn’t apply).
–Therefore, the ability to acquire language and understand what other people saying is correlated with the severity of autism.
What all this means is that, if you understand most of the spoken or written language that surrounds you–from concrete labels to sophisticated psychological vocabulary; from simple, direct statements to jokes, innuendos, and other forms of figurative language–then, assuming you’re on the autism spectrum at all, you’re way far out on the mild end of it.
Now, as I discussed earlier, you might have a person who looks severely autistic even if they can do all these things. But the reason they look severely autistic isn’t because their autism is severe, but because they face additional challenges that limit their ability to actually produce language–to produce their own phrases, sentences, psychological vocabulary, jokes, innuendos, and figurative turns of phrase.
The most common culprit, as I noted, is apraxia of speech. Speech apraxia can severely limit one’s ability to produce spoken words. But it doesn’t affect writing and typing. I’ve witnessed a number of individuals on the autism spectrum who barely speak–if they speak at all–but can still produce phrases and sentences through independent typing.
(Most of these kids are still severely autistic–their joint attention behaviors are limited, and when they type they produce only a limited range of phrases, sentences, and vocabulary–but their comprehension skills are still significantly ahead of their oral skills).
However, as I noted earlier, it’s theoretically possible for there to be additional motor-control or body-awareness difficulties that prevent a person from producing written language, even if she has long been regularly attending to speakers and understands a great deal of the language that surrounds her.
Such people–profoundly apraxic, profoundly motor-impaired, yet only mildly autistic–are probably extremely rare. But that doesn’t diminish the tragedy of their situation: that of being full of language and thoughts but completely unable to communicate them. To the extent that we can help these “locked in” individuals, it’s urgent we do so.
One way would be to devise some sort of physical assistance that eliminates the motor-control or body-awareness barriers to writing or typing. Perhaps if some sort of human facilitator were to provide such assistance, a profoundly apraxic, motor-impaired person would suddenly be able to communicate all the thoughts they’ve had locked up inside.
Such barrier-surmounting assistance is purported to exist already: it goes under the name of “facilitated communication.” More on this anon.