Word Finding

Describe word finding skills of children with autism. Describe the methods & findings of a research article on auditory processing. How will this impact ability to initiate a social exchange during a play based activity? What is 1 treatment strategy given the findings.

Children with ASD have a difficult time recognizing words. They see parts rather than wholes. This affects comprehension. An individual with ASD has difficulty maintaining attention. Weak Central Coherence (Pellicano et al. 2006, p. 78) also mention “poor performance by those with autism when integration of information in context is required.” Frith and Snowling (1993 in Lopez and Leekham, 2003) had an experiment that used homographs. The children with ASD understood a sentence better if the homograph was at the end of the sentence as it didn’t interfere with the sentence’s meaning. Lynch (2009) mentions how attention can be impacted in those with ASD. This in turn affects memory and hence the ability to retrieve a word upon demand. In simpler terms, their word finding abilities can be poor or inaccurate. Benson, Seaton and Johnson, (1997 in Sharma et al., 2009, p. 706) reported that teacher and parents describe school-age children as” children who are distracted by background sounds, do not follow multiple instructions, take longer to comprehend simple auditory directions, occasionally misconstrue what is being said, or appear to have “selective” hearing.” This sounds like they are discussing children with ASD, correct?
Sharma, Purdy, and Kelly (2009) researched how or if auditory processing, language and reading disorders were interconnected. They did not focus on children with ASD. It was interesting to note, however, that “at least 43% had another family member- such as a parent, sibling, or first cousin – who had a diagnosis of Asperger’s Syndrome, autism, APD, attention-deficit/hyperactivity disorder – attention deficit disorder, or reading/learning disorder.” (p. 708). It would be nice to have the number isolated although we are learning that attention plays a part in processing in those with ASD.
Sharma, Purdy and Kelly have defined the three conditions which they will investigate if they are related:
-Auditory Processing Disorder (APD): “ problems in one or more of the following auditory behaviors: sound localization and lateralization, auditory discrimination, auditory pattern recognition, temporal aspects of audition, and auditory performance decrements with competing acoustic signals and degraded acoustic signals.” (American Speech-Language-hearing Association Task Force on Central Auditory Processing Consensus Development, 1996 in Sharma, Purdy and Kelly, 2009, p. 707).
-Language Impairment (LI): “significantly poor language (receptive or expressive) when intelligence and hearing sensitivity are within normal limits, and there are no other physical or emotional difficulties” (Bishop, 1992 in Sharma, Purdy and Kelly, 2009, p. 707)
-Reading Disorder (RD): “Problems with written language in the presence of average nonverbal intelligence and having received adequate instruction to acquire written and spoken language” (McArthur and Bishop, 2001 in Sharma, Purdy and Kelly, 2009, p. 707).
Sixty-eight school age (7-12) children took part in the study where 65% were boys and 35% were girls (p. 708). The procedure involved an extensive list of assessments. The authors have a Table of the diagnostic tests on page 709 of the article. Almost one half of the study population had difficulty in all three areas. This study found significant correlations also to auditory memory and attention (p.716). Upon further discussion, it is also suggested that “If there is an underlying ability that links auditory processing, reading and language, another possible candidate is perceptual learning. (Moore, Amitay, and Hawkey, 2003 in Sharma, Purdy and Kelly, 2009, p. 716). This, however, this has not been explored in conjunction with ASD, LI and RD.
See Venn diagram with study results.
This will impact the child’s ability to initiate a social exchange in a play based activity by interrupting the process of functional communication. Green (2004, p. 177) cites that children with ASD have:
-inability to predict what someone will do next
-difficulty explaining one’s behavior
-not comprehending how others see their behavior
- issues with emotions
-inability to interpret social cues, facial expressions and body language
- limited use of social cues, facial expression and body language
-not knowing what information the peer may already possess
-issues with perceiving another child’s interests
-focusing on one thing and excluding others
-inability to appropriately use turn-taking in communication
-lack of comprehension concerning pretend play
-poor eye contact
This is quite a list of things that could impede a social interaction during play. Even a higher functioning child, will have aspects of this. Not to mention, the child will have to battle with the environment, external and internal stimuli and possibly the inability to self-regulate in order to attend to playing with a peer and communicating socially and functionally.

Bellis and Anzalone (2008) cite that a multidisciplinary team is essential for those with a central auditory processing disorder. This is also true for those with ASD in order to promote optimal functioning. Any intervention should first allow the student to experience success. Approaches should include both top-down and bottom up (p. 145). Environmental modifications play a large role. As discussed in Module 3 (Lynch and Van Zelst, 2010), the environment can either be complex or structured for intervention. To enhance information gained from auditory input, interventions can include architectural changes for acoustics, assistive technology, noise reduction, special seating so the child can also see the speaker. Other environmental interventions could include checking comprehension often, hands- on activities, repeating, using visual aids to compliment learning, rephrasing is less complex mannerisms, having directions in writing for the student, pre-teaching, and providing a note taker if necessary. (p. 145). Preparing the peer for the interaction is suggested as OT services are not only direct. The play environment should be structured with a limited amount of toys and visual boundaries that help guide the play interaction with minimal distractions. (Green, 2004). A social story or “social autopsy” (Green, 2004, p. 180) prior may help the child with ASD learn expectations of interaction with a peer and how to play with specific toys. Turn taking, understanding body language and facial expression and other communication issues should be taught.
With a team approach, it will be optimal if the team functions in the appropriate way. Even using the same key terminology with an individual with ASD can make a difference; especially if discrete trials and manding have been used. With key supports, it is possible for those with ASD to function in appropriate ways and to interact with others.

Bellis, T. and Analone, A. (Fall 2008). Intervention approaches for Individuals with (Central) Auditory Processing Disorder. Contemporary Issues in communication Science and Disorders, 35, p. 143-153.
Green, S. (2004) in Miller-Kuhaneck. Autism: A Comprehensive Occupational Therapy Approach. Second edition. Chapter 8: Social skills Intervention for Children with an Autism Spectrum disorder. Bethesda, MD: American Occupational therapy Association, Inc.
Lynch, A. (Spring, 2009). Attention and Performance in Autism. Misericordia University. PDF.
Lynch, A. and Van Zelst, A. (Spring 2010). Autism and Pervasive Developmental Delay. Misericordia University. Course notes and discussion.
Pellicano, Mayberry, Durkin, and Maley (2006). Multiple cognitive capabilities/deficits in children with an autism spectrum disorder: “Weak” central coherence and its relationship to theory of mind and executive control. Development and Psychopathy, 18, p. 77-98.
Sharma, M., Purdy, S., and Kelly, A. (June 2009). Comorbidity of Auditory Processing, Language, and Reading Disorders. Journal of Speech, Language, and Hearing Research, 52, 706-722.