Hearing
Assess for decreased sound tolerance causing pain or fear (Williams et
al., 2021ab). Consider music for autistic children’s recreation
(Boerebach et al., 2012; McMurray, 2012; Williams, 2012) and
developmental growth (Paul et al., 2015), such as singing with
synchronised drum-playing to learn speech (Chenausky et al., 2022).
Consider toning down the exaggerated pitch of baby talk to autistic
children (Ochs, Solomon, & Sterponi, 2005; Solomon, 2011), as the
intonations may distract from the meaning of language. Autism-typical
(Rosenhall et al., 2003; Russo et al., 2009) auditory hypersensitivity
in infancy predicts difficulty with speech and an autism diagnosis
(especially for social interaction traits) at age three (Cohen et al.,
2013). Enhanced perceptual processing of speech in autistic children may
interfere with processing the linguistic components (Järvinen-Pasley,
Pasley, & Heaton, 2008; Norbury, Griffiths, & Nation, 2010), even in
tonal languages, as autistic children may experience enhanced simple
perception of melodies but poor processing of spoken language (Jiang et
al., 2015).SpeechMany autistic children (about two-thirds in early life) may have
under-recognized difficulties forming speech sounds (apraxia of speech),
which may require assessment (Tierney et al., 2015).
Encourage lip-reading as a strategy to build speech and communication.
Autistic people with and without language impairment from infancy
through adulthood have shown communicative benefit from attention to
speakers’ mouths (Elsabbagh et al., 2014; Falck-Ytter et al., 2010; Klin
et al., 2002; Norbury et al., 2009; Tenenbaum et al., 2014). This may
occur because the speech sounds and lip motion provide auditory-visual
integration (Klin et al., 2009) – an area of challenge across
autistics’ lifespan and speech abilities (Iarocci et al., 2010; Saalasti
et al., 2012; Smith & Bennetto, 2007).
Additionally, avoiding eye contact when listening may support autistic
people’s speech processing. When perceiving auditory-visual speech, the
auditory component has shown more influence for autistic children than
typically developing peers (Iarocci et al., 2010). Autistic people can
process high loads of visual (Remington, Swettenham, & Lavie, 2012;
Remington et al., 2009) and auditory (Remington & Fairnie, 2017)
information independently (Mottron et al., 2006), but they may find
speech’s movements challenging to process alongside sounds. Avoiding eye
contact may help autistic children concentrate on the words when
listening to speakers, which may explain their pattern of averting eye
contact in response to another’s speech but not when speaking
(Doherty-Sneddon, Riby, & Whittle, 2012; Falck-Ytter, 2015). Similarly,
looking away helps autistic and non-autistic people perform cognitively
demanding tasks (e.g. math problems: Doherty-Sneddon et al., 2012; Riby,
Doherty-Sneddon, & Whittle, 2012). It may also especially help autistic
people in emotionally demanding contexts (Dalton et al., 2005; Kleinhans
et al., 2010; Tottenham et al., 2014).