Growing Up on the Spectrum

by Lynn Kern Koegel

  4. Talks in a monotone. When people don’t vary their tone or voice inflection during conversation, they sound boring, no matter how interesting their subject matter is. Although we all dread the moment in scary movies when a loud and sudden noise makes us jump out of our chairs, it does add a bit of a thrill to the flick. Similarly, variation in voice keeps our interest. When an actor gets a sudden high shrill in her voice, we know she’s scared. When a parent sternly admonishes his child, we know he’s serious. When you chuckle a little while telling a story, we know it’s going to be funny. But kids on the spectrum often speak in a perfect monotone, with seemingly no emotion. Like anything else, we can teach people to break that monotone habit. Here’s how we do it:a. Break it down. Start with one type of speech area, like exclamations—pick ones that kids use at school a lot, like “Awesome!” or “Cool!”—and model how they should be said, then have your child repeat them with lots of inflection in his voice. Have him keep doing it until it sounds natural, not forced. I usually have kids repeat each expression several times before moving on to the next.

  b. Do it alone. Now see if your child can use the right voice inflection on her own. You can write down the words, or just prompt her by talking about situations when the expression would come up, then ask her to use it on her own—not repeated. If, for example, you’ve practiced using the response “Awesome!” you could ask her what she thought of this week’s episode of her favorite show. Do this several times for each expression.

  c. Practice during everyday activities. Once your child is able to use better intonation on expressions, you’ll need to work on his using them in everyday contexts. You can play games and have him say “Oh no!” with plenty of expression when he gets a bad spin or loses a game. Practice this until it becomes a habit and you don’t need to remind him.

  d. Check his use in other natural settings. Next, you’ll need to check to make sure he’s using the right intonation in everyday settings without your prompting. If not, keep practicing. If necessary, recruit friends, teachers, or peers to help in natural settings.

  e. Move on to the next area. Next you can practice with greetings, questions, and comments. Do it the same way you did the expressions and remember to go through all the steps while paying particular attention to whether your child is using the right intonation in his everyday settings—not just with you when you’re practicing.

  It’s important to remember, with all these interventions, that kids progress at different rates. Sometimes a few practice sessions then reminders are enough. Other times it takes many months to relearn to talk using the right prosody. So be patient and provide lots of positive support for your child. But be consistent and practice as often as possible. If reminders don’t work, try self-management. Don’t worry if you need to go back a step for your child to be successful. As long as you’re making gradual but steady progress, she will sound better.

  Read on for a case history example of a young adult whose speech was quickly but dramatically improved by these interventions.

  Diane’s Program

  Diane was an extremely intelligent person whom I met when she started college here at UCSB. She had a diagnosis of autism and had started talking at a very late age and had also had some social difficulties throughout her life. Diane was probably the smartest undergraduate computer science major in the whole university and she had no shortage of guys asking her out (the nice thing about college is that people value intellect and are well past the adolescent gotta-be-cool stage). But Diane talked in a monotone, and I was concerned that it would make people lose interest in what she was saying.

  I started working with her on asking questions with the right intonation patterns. Most questions have rising then falling intonation, like “How are you?” and “What are you doing?” To give her a visual, I drew a diagram with the rising then falling pattern. Next, we practiced dozens of flash cards with questions I’d written out by hand—first I had her imitate how I did it but soon I had her try it alone.

  It didn’t take Diane long to get the idea. Next we had to bring it into the real world. We started out taking short walks and having her ask questions of fellow students and staff around the Center. Interestingly, she told me that she felt awkward using the nonmonotone voice. She said it sounded so exaggerated to her that it almost felt as if she were a cartoon character! But she sounded great to me. Because of her reluctance to use the new intonation patterns, it took about six months of daily practice until it began to feel natural for her, but it was worth it: it made a huge difference in how she sounded and ultimately in how people responded to her.

  CLAIRE

  For many years, I was so relieved that my son could speak at all that it took me a while to realize that his speech was still strictly literal: he could exchange information very well and deliver pleasantries, but the second the dialogue veered into anything even vaguely witty, it confused him. When his younger brother started getting an edge to his tone, it hit me: I had to teach Andrew how to be sarcastic. Yes, sarcastic—the very thing we parents usually try to get our kids to stop being.

  The thing is, teenagers communicate almost entirely with sarcasm. It gives them emotional distance from what they’re saying, which feels safer than just being straight and serious. Not just kids, either—I’ve seen a fair number of teachers use sarcasm in the classroom (“I don’t suppose it occurred to anyone to actually do the work I assigned?”), and I definitely didn’t want my son to be bewildered or wounded by it, or to take it too literally.

  So I set out to “teach” sarcasm. I started by using it gently with Andrew and then immediately commenting on it. I might say something like “Guess that plate is too heavy for you to clear, huh?” and then I’d quickly say, “I’m being sarcastic. I really just want you to clear the plate.” As he got the idea, I was able to fade out the explanation. I also pointed out when other people were being sarcastic. Now he laughs when I say something sarcastic, knowing immediately it’s a joke. He’s still less likely to use sarcasm than, say, his younger brother (who, at fourteen, hardly ever says anything that isn’t sarcastic), but he recognizes it when he hears it, he gets it, and he knows not to take everything literally.

  DR. KOEGEL

  Strategies for Improving General Conversation Skills

  Here are some strategies for actively promoting your child’s ability to interact with his peers.

  Carpooling—Yes, I Said Carpooling

  The truth is that playing chauffeur can be a great way to learn what your child’s peers are thinking and talking about. The fact that the kids are buckled into one place for a period of time means your child gets a real opportunity to be part of a general conversation with you around to monitor and observe.

  I learned so much about my kids’ and their friends’ lives when I drove in the middle school carpool. They would get so engrossed in their conversations that they would completely forget a mom was in the car. From those daily twenty-minute drives, I gathered an abundance of information about peers (such as who was drinking and smoking), siblings, exes, dates, grades, tests, and just about any other topic a parent would or wouldn’t want to know about. The experience really helped me get to know what qualified as “normal” thought and behavior for kids that age.

  If you dread the carpool because your child is having trouble making appropriate conversation, try to tough it out by remembering that it is your chance to learn ways to help him. Pay attention to what your child’s peers are talking about, how they initiate conversation, what types of questions they ask, and so on, and then work on those areas with your own child. I would suggest starting to work on them at home (priming) first and then making suggestions to him just before you pick up his classmates, for example, “When the others are in the car, maybe you could tell them about the movie we saw last night.” If your child still isn’t participating, you can try giving some help after everyone’s in the car by saying things like “Jeanne brought some doughnut holes today” or “Bradley,
did you want to tell the kids about the songs you downloaded on your iPod last night?” But only step in if talking with your child beforehand isn’t working—you don’t want to do too much of this. Even little things like having your child ask which CD the other kids want to listen to can help start a conversation (make sure the CDs are their music, not yours).

  One sixth grader we worked with seemed to be totally uninvolved in any social group whatsoever. His mother tried and tried to get him with a group of friends, but he repeatedly resisted. By chance, she volunteered to drive on a field trip. Jamie’s mother astutely noticed that when he was buckled in with a group of peers, he had totally appropriate conversations with great turn taking. Armed with this information, she volunteered to drive in the carpool. After a few weeks of driving the kids home, she asked them if they would like to go out for ice cream. Of course, she chose a special ice cream parlor on the other side of the city to create an extra twenty minutes of conversational opportunity. Shortly afterward, the carpooling turned into study sessions then expanded into the kids’ hanging out. In this way, Jamie’s mom capitalized on a successful situation to develop a peer group for him.

  Practicing and Priming

  Every time you speak with your child, you have another opportunity to help her improve her conversational skills. Prompt her to ask you questions and then help her learn to respond to your questions the way she should with anyone else.

  A conversation practice session between you and your child might go something like this:

  YOU: “Ask me how my day was.”

  YOUR child: “How was your day?”

  YOU: “It was great! Now ask me what was so great about it.”

  YOUR child: “What was so great about your day?”

  YOU: “I went out to lunch with a friend.”

  YOUR child: “Cool!” (Prompted by you if he doesn’t say anything immediately)

  YOU: “Can you ask me another question about my lunch?”

  YOUR child: “What did you eat?” or something like that. (If your child can’t come up with anything on his own, give him some suggestions, like, “Do you want to know where I went?” or “Do you want to know who I went out with?”)

  You get the idea. Your child will need practice. And in order to help your child, you’ll need to figure out which areas are difficult for her. That way, you can work on one or even a few things at a time in the specific area that your child needs the most help in.

  Priming works very well for phone conversations. We often have the child on the spectrum call our staff members and relatives before making an actual phone call to a friend. Even practicing ordering pizza or takeout can be helpful in preparing him for a future social call.

  Priming also works great for outings. For example, if your child is going to take a date to a special exhibit at an art museum, it’s helpful to go there beforehand so he or she is familiar with the show and has something to talk about—you can suggest some ideas for topics while you’re there. We had one adult who went to a car show and accumulated a vast amount of information about the cars, then invited a friend. Unfortunately, he proceeded to correct his friend every time she said something that was inaccurate about the car! So remember to teach your child how to use knowledge in a helpful and kind way. Individuals on the spectrum are often very bright, and like any bright person, each one needs to learn how to share information without sounding superior or like a know-it-all.

  Remember, these conversational strategies take time to learn. Keep practicing with your child and also ask friends, family, and instructors to practice with her and give her feedback. Breaking old habits takes a lot of time and practice, so be patient. Keep your tone supportive and encouraging: remember, you want your child to enjoy talking with others, not see it as a chore that she always gets scolded about for messing up. Commit some real time to this. You, she, and all her present and future friends will be glad you did.

  Self-Management

  Self-management can be very effective in reducing speech habits that need to be broken or encouraging new habits that will vastly improve conversational skills. Read on for an example of how it helped one young man improve his ability to make conversation.

  Tristan was an amazing kid, very self-sufficient and perfectly able to communicate. Unfortunately, social conversation wasn’t his favorite activity, and he had figured out that when he answered someone’s question, she would probably just ask him another one, which was the last thing he wanted, so he found it easiest not to respond in the first place.

  To solve this problem, we bought him a little wrist counter and taught him to click the wrist counter every time he responded when someone asked him a question. We practiced it with familiar adults and staff from the Center until he regularly answered questions from all of us. Shortly after that, we sent him out into the real world to see how he would fare (we had people he didn’t know there for support in case he ran into a problem). He did amazingly well. Once we sent him into the grocery store to buy a few items, and the bagger asked if he wanted paper or plastic. When Tristan responded, “Plastic,” he immediately gave himself a point! Before the self-management, he had rarely responded at all, but with the self-management he learned to answer without having a therapist or parent nagging him. After several months of improvement, we were able to gradually start fading the counter.

  I’ve kept in touch with Tristan and he continues to be responsive to others, and is quite conversational, even after many years. And this was a kid who, when he was younger, at best only answered half the time.

  Video Modeling

  Video modeling is another great way you can help your child work on conversation skills. To use it specifically for promoting conversational skills, you would videotape your adolescent or adult having a conversation with someone, then locate the sections where there is good conversation going on as well as the sections where your child needs more help. You and your child can then go over the clips and discuss better ways of responding in the situations that are causing her difficulty. And remember, start with a positive example and end with a positive example. We always want to emphasize the positive, especially in the beginning. You can then practice increasing the successful interactions and decreasing the negative ones, videotape again, and review it all again.

  Video modeling is a rapid and effective way to improve conversation skills, and we generally see pretty quick changes with it, as we did with Jake. Jake was a young adult we worked with who, although tall and good-looking, felt very insecure about his ability to talk to others. We videotaped him conversing with peers, and when we were watching the tapes, we found that most of the conversation went fine, except for one problem: he rarely asked any questions. He was able to make comments and engage in long, back-and-forth interactions, but because he didn’t ask questions, there were long, awkward pauses in the conversation. For Jake’s video-modeling program, we showed him short clips of the few times he did actually ask a question and contrasted that with clips of long silences.

  We then suggested different types of relevant questions he could ask during future conversations. For example, we said that if a friend mentioned liking Italian food, Jake could then ask him what his favorite Italian restaurant was or if he also liked to cook Italian food. Or if someone said she liked to read, he could ask her what books she had read lately or what genre of books she preferred.

  Because we were able to pinpoint the problem, and because Jake was bright and motivated, it only took about three or four videotape feedback sessions before he was able to get the idea. And without those uncomfortable pauses, Jake was a perfectly fine conversationalist.

  CLAIRE

  We’ve found that most of Andrew’s minor verbal differences have improved with simple reminders. He’s so motivated to be part of the social mainstream that a simple “You’re talking a little loudly” will instantly inspire him to modulate his voice. (In fact, he’s become so sensitive to volume control that he often—and quite accurately—tells
his younger siblings they’re being too loud.)

  Back when he was in middle school, we needed to remind him fairly frequently that it’s okay sometimes just to listen. Because most of Andrew’s interests were different from his peers’, we noticed that he would sometimes use any break in the general conversation to swing the subject away from what they were talking about—World of Warcraft, say, or some TV show he hadn’t seen—and onto something that interested him more, like theme parks or people’s relative heights. The problem was, a lot of times the group wasn’t ready to move on to a new topic, and even if it had been, his topics probably weren’t the ones they would have chosen, which meant they would all ignore him or roll their eyes at one another. Obviously, we didn’t want that, so we had several discussions about how, when a group of friends are talking about a subject you can’t contribute to, it’s really okay to listen and take in what they’re saying and maybe ask a relevant question or two—and not worry about contributing.

  Here are his thoughts on the subject of making conversation:

  ANDREW

  Whenever I am trying to communicate with someone, it always feels like I am playing a game of operator. Operator is another name for the game telephone. In that game, you are supposed to come up with some phrase and pass it down all the way (by whispering) around until the person before you gets the message. People always misunderstand what phrase is getting passed on to them. In my opinion, that is what conversations are like for me a lot of the time. What I mean by this is that sometimes it is hard for me to fully understand what someone else is saying in a conversation. I tend to think that someone is saying something else that he/she is not trying to say. Sometimes during conversations with a big group of people, I misunderstand what topic people are talking about and whenever I try to jump in to talk about the topic I think they are talking about, other people end up getting frustrated with me and ignore me.