Autism is characterized by a wide range of symptoms and these symptoms tend to have a fascinating impact on behavior and are frequently linked to feelings and reactions to environmental and sensory cues.
Several common signs of autism are well-known, especially for the repetitive pattern that they produce, which are physically more apparent.
The repetition of words, phrases, or noises in one’s speech is known as scripting and this symptom is very common in speaking children.
To understand scripting autism, a person must have some knowledge about what autism is, and the behaviors associated with the diagnosis.
Autism Spectrum Disorder (ASD)
ASD or autism is a broad term that is used to describe a range of neurodevelopmental conditions. These infirmities are characterized by several factors like differences in social skills and communication.
Such symptoms are fairly evident during early childhood, between 12 and 24 months of age. The earliest symptoms include either delay in language or social development or communication issues which include difficulties in sharing emotions, and interests, or maintaining a steady conversation.
Repetitive Behaviors as a Coping Mechanism
An affected child might have trouble with nonspeaking communications, such as difficulties with body language, maintaining eye contact, and developing and maintaining relationships.
Children diagnosed with autism spectrum disorder also show signs of repetitive behaviors like rocking back and forth, jerking, flapping hands, and repeating speech patterns.
These repetitive behaviors are sometimes also called stimming. This is a clinical term for self-stimulatory behavior, which some autistic persons have adopted. However, some experts, on the other hand, are critical of the term “stimming,” as they claim that it could stifle the acceptance of repetitive behaviors. These behaviors are said to be a coping mechanism through which people with autism try to calm down during periods of high anxiety.
Learning how to speak might be harder for children with autism compared to children with normal neurological development. This is because autistic children tend to prefer minimal social contact during the first 12 months of their lives.
However, acquiring language skills for children with autism depends on their social and intellectual development. A few of them may have very limited speaking skills with a limited range of vocabulary but others may have an extensive vocabulary with the ability to speak in detail on specific topics.
Common disorders observed in people affected with autism
1. Speech Disorders
Language or speech disorders can coexist with emotional or behavioral disorders like attention-deficit/hyperactivity disorder (ADHD) or anxiety. A combination of these challenges can make it especially difficult for a child to succeed in school. It is critical to correctly diagnose a child’s disorder so that each child can receive the appropriate level of care.
2. Social Communication Disorders
All the people on the autism spectrum have social communication disorders. It refers to struggles associated with the social use of verbal and nonverbal communication. Individuals with traumatic brain injury may also have social communication disorders.
3. Cognitive-Communication Disorders
Difficulties in organizing thoughts, paying attention, remembering, planning, and/or problem-solving are known as cognitive-communication disorders. These disorders can be congenital, caused by a stroke, traumatic brain injury, or dementia.
4. Swallowing disorders
Swallowing Disorders (dysphagia) are difficulties faced while feeding and swallowing that can occur as a result of an illness, surgery, stroke, or injury.
5. Language Disorders
Another type of communication disorder observed is a language disorder. People who are unfamiliar with the term may believe it has something to do with speech. However, language disorders are characterized by difficulties in using and comprehending spoken language and it is frequently developmental in nature. It begins in infancy and continues into adulthood. It is also be caused by brain injuries or an illness.
Many people on the autism spectrum have difficulty understanding the meaning and rhythm of words and sentences due to their problems with language development. They may also have trouble deciphering body language and the meanings of various speech tones. These issues combined have an impact on children with ASD’s capacity to engage with others, particularly peers of their own age. Many autistic children may understand the language but are not conversant, and often tend to repeat lines from movies or have pat phrases.
Parents of an autistic child have probably heard of the terms “scripting” and “echolalia”. Or perhaps have overheard their child reciting lines from a TV show or a movie and wondered what it all meant. The practice of reciting lines, phrases, or melodies is what is known as “scripting” or “delayed echolalia” in medical language.
Echolalia and Scripting
In scripting autism, children use echolalia, which is the repetition of others’ words and sentences. They may repeat words they hear from peers and parents, or cartoons on the tv.
Immediate echolalia occurs when children repeat words immediately after hearing them. Delayed echolalia occurs in children with scripting autism when they repeat words at a later period, which may seem unusual because it occurs out of context.
For example, a child may appreciate a song that his teacher sang during circle time and later, state “It’s circle time” instead of the song’s name when they wish to sing it again.
Why do children with ASD restore to the behavior of scripting?
Scripting is a behavior found in children with autism. Like other activities, people on the spectrum are more likely to use scripting, as a coping mechanism, especially in situations related to mental health such as high stress or anxiety during social circumstances. Scripting phrases can also act as a backup for persons on the spectrum who are under pressure to come up with creative ideas or things to say, particularly in a group context.
Functional (or interactive) echolalia and non-interactive echolalia are the two types of echolalia found in children and people with scripting autism.
1. Interactive Echolalia
Functional echolalia in scripting autism is an effort at interactional communication that masquerades the communication with other persons.
For example, the person or the child with echolalia fills an alternative verbal exchange with phrases during an interaction. In verbal completion, speech here is used to complete known verbal routines started by someone else. When people with echolalia are asked to accomplish a task, they may remark “excellent work!” when they finish it, echoing what they’ve heard before.
Speech can be used to provide new information, but connecting the dots might be difficult. When a mother asks her child with scripting autism what they want for lunch, they may sing a tune from a luncheon meat commercial to indicate that they want a sandwich. A person or a child with echolalia can ask for their own meal by saying, “Do you want lunch?”.
2. Non Interactive Echolalia
Non-interactive echolalia is usually used for personal purposes, such as personal labeling or self-stimulation, rather than communication.
Children with autism repeat anything that has no relation to the situation, such as repeating dialogues of a TV show while walking around a classroom. This is known as non-focused speech. This practice may be self-stimulatory.
Speech is triggered by an activity or a situation, and it does not appear to be an attempt at communication. On seeing the brand name of a product in a store, the child may sing them something they’ve heard from the commercials.
The speaker may repeat the same phrase softly to themselves a few times before responding in an attempt to practice before speaking it out loud. These utterances may be used by people in an attempt to guide themselves, also known as self-direction.
To make a sandwich, they might tell themselves, “Turn on the water. Make use of soap. Hands should be washed. Turn off the water. Hands should be dry. Get some bread. Place bread on a plate. Get some lunch meat,” and so on until the work is finished.
In scripting autism, echolalia is diagnosed by having conversations with the affected person or child. Scripting autism is treated with the help of speech therapy, which is undertaken by speech-language pathologists.
What is Speech Therapy?
Children with scripting autism have language difficulties that frequently require extra assistance and special instruction. This is where the role of a speech and language pathologist comes into play. Their parents, caregivers, and teachers can all benefit from the services of a speech-language pathologist.
A child with a language or speech delay or disorder may be eligible for early intervention (for children under the age of three) and special education services if they are aged 3 years and older.
Communication is improved by using resources like speech therapy techniques. Depending on the type of speech or language disorder, these may include articulation therapy, language intervention activities, and others.
Mutual objectives are based on improving spoken language, learning signs or gestures, or learning to communicate through pictures and technology.
Who is a Speech and Language Pathologist?
Speech-language pathologists (SLPs) work with children with scripting autism and adults to suppress, evaluate, and diagnose scripting problems. They help in treating speech, language, social communication, cognitive communication, and swallowing disorders.
Scripting is a behavior that is difficult to improve since it is a sensory behavior. Such behaviors do not have any consequences. The child is not gaining anything tangible or avoiding doing something he dislikes. Internally, the behavior feels good to the child. There are several strategies used by a professional to help reduce scripting in children.
It is important to keep in mind that scripting isn’t harmful or dangerous. But, scripting autism limits further independence and the ability to talk properly to other kids. Not all of these behaviors are related to sensory stimulation. It can also be related to attention behavior or an escape behavior in children with scripting autism.
Speech-language pathologists tend to follow a pattern with their treatments and strategies to reduce scripting.
1. First step: Look for stressors
Behaviors in scripting autism are used to self-soothe as a response to stress or anxiety. Such behaviors are found in children and people with normal neurological development as well.
For example, a person may bite their lips, tap their pen and crack their knuckles when they are feeling nervous.
Hence, the first step is understanding situations in which scripting takes place and the resources that trigger the response. The pathologist may take a note of the stressors associated with the situation, make sense of why it is anxiety-provoking and see if this activity can be reduced.
2. Teaching where it is appropriate
The aim here is not to eliminate the behavior related to scripting autism. Instead, the child is taught where and when scripting is appropriate.
For example, taking your shoes off in the middle of a meeting and throwing them up in the air is inappropriate. Correspondingly, the child must be taught that scripting during math class is not appropriate.
By talking to them, showing them videos and other resources and concrete cues may aid in the comprehension of when they should or should not script.
Strategies like assigning a specific location as the “sensory spot” for the child in the classroom or at home are the first approach. It could be a particular chair, corner of the room, or section of the carpet where these scripting behaviors could be allowed.
They can also be taught how to do it quietly for example; when they are working by themselves or waiting in line in the cafeteria. It is acceptable to hum your favorite song quietly, but it is unacceptable to yell it. The child could also be assigned to work during scripting time.
3. Without Scripting, Reinforce Intervals
In scripting autism, providing high levels of reinforcement for time intervals without the behavior is a successful intervention for reducing scripting. The key is to provide exceptional reinforcement.
Asking the child to reduce a challenging behavior that they had a long history with will require strong reinforcements. This strategy may be functional for high-intensity or very extreme scripting that has a significant impact on the child’s development and mental health.
Again, they should be allowed to engage in this behavior at some point. This is the beginning of the process of teaching “when and where”. Determine an achievable time interval during which the kids with autism can go without scripting.
For example, Make the time interval 2 minutes if the behavior occurs every 3 minutes. The intervals should be brief and manageable. The child needs to be successful and gain support for the intervention.
There are several tips provided for this type of intervention here.
4. Teach Different Verbal Behaviors
Children with scripting autism engage in repetitive behaviors because they do not have an idea of how to respond to appropriate communications. Hence, strategies like devoting some serious time to honing other verbal abilities are important. Reward appropriate verbal behavior with strengthening reinforcement.
Model what the child should be saying and allow time for them to process how to respond. Praise them extensively once they respond accurately. Shaping can be used to reinforce if the response is not proper for closer responses to the correct behavior. It is a gradual process but leads to successful training.
Other sources and strategies in addition to speech therapy can also be used to help and support kids with scripting autism.
Applied Behavior Analysis (ABA)
It is a kind of therapy that focuses on the development of social skills and academics along with adaptive learning skills like fine motor agility, proper sanitation, grooming oneself, domestic abilities, punctuality, and job proficiency.
ABA has been shown to be useful in places ranging from schools, workplaces, homes, and clinics, for children and adults with psychological illnesses. Consistent use of ABA has also been demonstrated to considerably improve behaviors like scripting autism while reducing the need for special services.
When is it used?
ABA is often used as a therapeutic mediation for autistic people and children. When it comes to scripting autism, ABA is the most effective when used for 20 hours or more for a week before the age of four.
ABA can also assist elderly persons to manage the loss of memory, strength, and relationships that occur with age. This form of therapy can assist people of all ages to manage some of the lifestyle problems that come with many mental illnesses in addition to physical limitations.
How does it work?
ABA therapists have a thorough understanding of how human behaviors are learned and changed with time. The therapist analyzes a client’s conduct and comes up with a treatment plan to help them upgrade and refine their communication and behavior skills required for successful personal and professional development.
Parents and teachers can receive training from ABA therapists to ameliorate the behaviors associated with scripting autism at home and in educational institutions. ABA necessitates constant monitoring and evaluation to achieve the best results. Therapists and other health professionals analyze and modify the treatment as it progresses in settings such as schools, homes, and community centers.
Applied Behavior Analysis (ABA) treatment is a form of therapy that anchor’s on your child’s needs while also teaching them good coping and living skills.
ABA therapy can help your child with scripting autism get back on track by helping them meet developmental and behavioral milestones that will encourage them to achieve personal and academic success. When this is combined with positive reinforcement at home, your child can make significant progress in various sectors of life.
Hopefully, the article was able to shed some light on the different therapies that can be availed to help children cope with scripting autism.
Scripting autism may provide certain hindrances in the path of growth and development of a child but with the help of these methods and proper guidance and medication, the condition can be healed too.
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