Rhea Paul and Donia Fahim
Therapy Tips 
Rhea Paul and Donia Fahim, authors of Let's Talk: Navigating Communication Services and Supports for Your Young Child with Autism, have offered to answer questions from Friendship Circle readers on how to help your child with autism learn, play, communicate, make friends, succeed at school, and get the best services. Today, we're happy to feature the first two questions and answers. If you'd like to submit a question, add it in the comments here or on our Facebook page, and you may find the answer in a future blog post.
My son wants to have the same short conversation over and over. I know this is common with kids with ASD, and I've heard it's a way of communicating. But I don't know what he's trying to communicate. Should I say my lines the same every time, or try to change it? Should I ignore it? I try to be patient, but it does get frustrating sometimes. — Elizabeth
Dear Elizabeth —
While you are right that this kind of behavior is quite common in ASD, it can also be really frustrating for the people who talk to the child most often. Very often there IS a reason for the child to repeat a conversation, and we think you are right to believe that he does mean something by this behavior that you may not yet have recognized. This is often called perseveration, which means being stuck on an idea or repeating the same words or questions over and over.
So one thing we might suggest is to pay attention to what he is talking about (topic) and when the behavior appears (context). It may be that something is triggering it, or it is a personalized way for him to express an emotion.
Leo Kanner, who first identified autism, tells a story about a young boy with ASD who would say, "Don't throw the dog off the balcony" whenever he felt an impulse he knew he should resist. It stemmed from a time he and his parents were at a hotel and he went out on the balcony with his stuffed dog and looked as if he was about to toss it over the rail when he father exclaimed, "Don't throw the dog off the balcony."
So for your son the conversation may be a way of managing a feeling that is difficult for him. Alternatively, it may be a means for him to initiate interaction with you that feels safe and familiar due to its predictability. Here are some things you can do when this happens:
• Try giving a slight change in your response, maybe at first changing just one of the words you would usually say and gradually adding more variation as he is able to tolerate it. For example, if he says, "Are we going to school?" and you usually answer "Yes, we are," you might instead say, "Yes, it's Tuesday. Tuesday is a school day. Where do you think we are going?" or you might encourage him to check his daily schedule, if he has one, for what comes next.
• If you think it might be the topic he is stuck on, you might try expanding or changing the subject slightly by bridging to a new idea. For example, if he says, "Are we going to school?" you might answer, "Yes, and you have soccer after school today. You love soccer. Do you remember anything about the game you watched on TV with dad yesterday. Who won?"
• If you think that he might be doing this out of anxiety or excitement to help him regulate his emotions, you might try adding to your rote answer some recognition of what the emotional underpinning of the scripted talk might be. For example, if he says, "Are we going to school?" and you suspect he is worried about a test that day or a child who's bullying him, you might say, "Yes, we are. I know sometimes things happen at school that are hard. Can you tell me one thing at school that is hard for you?"
You can use the answer to try to understand what might be behind his perseveration. If you get a hint of what it might be, you can acknowledge the feeling ("I know that school can sometimes feel scary on the days you have a test. What could you do to make yourself feel better?" and suggest strategies: "Could you talk to your OT?" "Is there a friend in class who would listen?" "Can you do your yoga breathing?"
• if you are not very sure of the root of the behavior, ask him to write your answers on a card, a notebook, or a tablet computer. Then, the next time he asks, you can refer him to his written answer and ask him to tell you. Eventually, you can just refer him to his "answer file" without any other interaction. This may remove some of the reward he is getting from the repetition.
A good thing to remember is that this behavior shows that your son really wants to communicate with you. He may not have all the skills he needs to communicate effectively, but the impulse is a good one and one you want to cultivate. You might try some games with him to allow him to converse about some more diverse topics.
For example, you can write a series of topics that interest him (like Minecraft, Star Wars, subways) on slips of paper and put them in a bowl and take turns choosing one. For each topic, he has to say two things about it, then stop and ask you a question, then listen to what you say before another topic can be chosen from the bowl. Or you could use the topics to come up with questions you can research together online.
I have a young adult daughter who has struggled for years with speech issues. Her language is still delayed, but she has gotten very good at copying things that her peers are saying. Sometimes she does it right, but other times, especially with figures of speech, she misses the meaning. When we correct her, she gets frustrated, but I don't want her to embarrass herself in front of her peers. Is there a good way to work on this? — Richard
Dear Richard —
First, it is great that your daughter is trying to emulate her peers. We don't want to discourage that. On the other hand, we don't want her to be embarrassed. So one way to start is to help her understand that people do not always mean literally what they say, and this can be very confusing sometimes.
You might start by talking about some very simple figures of speech (and we would use that term and talk about it with her), such as "I pigged out last night" and ask her if she thinks if really means you were a pig last night. Then ask what it might mean and why someone might say it (it's more colorful and fun than just saying "I ate too much"). You could add drawings with speech and thought bubbles if you think that might help her understand.
Try doing this for a few minutes a few times a week. Remember each time both to introduce a new figure of speech and to talk about the idea that people sometimes talk figuratively, not meaning exactly what they say, in order to be more entertaining. You can also point these out when they occur on TV shows, YouTube videos, etc.
Sometimes, too, kids like to use words and figures of speech in special ways that adults may not always get. This can help the kids feel more like a group or clique, and they use their special language to make them feel more part of the peer group. You might suggest that she keep a notebook of some of the things she hears her friends say that she would like to use too. Instead of saying them, you can suggest she bring them to you and you can talk about them and look them up on the Internet together to make sure you understand the right way to use them. You can model appropriate ways to use them, and then you can practice together and make a note of their meaning or draw a picture of it in her notebook.
If she does use a figure of speech in your presence and you feel it is not used appropriately, instead of correcting her you can suggest she look it up in her notebook or on the Internet and practice it again with you.
Experts on Helping Children with Autism Communicate Answer Your Questions
Rhea Paul and Donia Fahim, authors of Let's Talk: Navigating Communication Services and Supports for Your Young Child with Autism, have offered to answer questions from Friendship Circle readers on how to help your child with autism learn, play, communicate, make friends, succeed at school, and get the best services. Today, we're happy to feature the first two questions and answers. If you'd like to submit a question, add it in the comments here or on our Facebook page, and you may find the answer in a future blog post.
Coping with Perseverative Speech
My son wants to have the same short conversation over and over. I know this is common with kids with ASD, and I've heard it's a way of communicating. But I don't know what he's trying to communicate. Should I say my lines the same every time, or try to change it? Should I ignore it? I try to be patient, but it does get frustrating sometimes. — Elizabeth
Dear Elizabeth —
While you are right that this kind of behavior is quite common in ASD, it can also be really frustrating for the people who talk to the child most often. Very often there IS a reason for the child to repeat a conversation, and we think you are right to believe that he does mean something by this behavior that you may not yet have recognized. This is often called perseveration, which means being stuck on an idea or repeating the same words or questions over and over.
So one thing we might suggest is to pay attention to what he is talking about (topic) and when the behavior appears (context). It may be that something is triggering it, or it is a personalized way for him to express an emotion.
Leo Kanner, who first identified autism, tells a story about a young boy with ASD who would say, "Don't throw the dog off the balcony" whenever he felt an impulse he knew he should resist. It stemmed from a time he and his parents were at a hotel and he went out on the balcony with his stuffed dog and looked as if he was about to toss it over the rail when he father exclaimed, "Don't throw the dog off the balcony."
So for your son the conversation may be a way of managing a feeling that is difficult for him. Alternatively, it may be a means for him to initiate interaction with you that feels safe and familiar due to its predictability. Here are some things you can do when this happens:
• Try giving a slight change in your response, maybe at first changing just one of the words you would usually say and gradually adding more variation as he is able to tolerate it. For example, if he says, "Are we going to school?" and you usually answer "Yes, we are," you might instead say, "Yes, it's Tuesday. Tuesday is a school day. Where do you think we are going?" or you might encourage him to check his daily schedule, if he has one, for what comes next.
• If you think it might be the topic he is stuck on, you might try expanding or changing the subject slightly by bridging to a new idea. For example, if he says, "Are we going to school?" you might answer, "Yes, and you have soccer after school today. You love soccer. Do you remember anything about the game you watched on TV with dad yesterday. Who won?"
• If you think that he might be doing this out of anxiety or excitement to help him regulate his emotions, you might try adding to your rote answer some recognition of what the emotional underpinning of the scripted talk might be. For example, if he says, "Are we going to school?" and you suspect he is worried about a test that day or a child who's bullying him, you might say, "Yes, we are. I know sometimes things happen at school that are hard. Can you tell me one thing at school that is hard for you?"
You can use the answer to try to understand what might be behind his perseveration. If you get a hint of what it might be, you can acknowledge the feeling ("I know that school can sometimes feel scary on the days you have a test. What could you do to make yourself feel better?" and suggest strategies: "Could you talk to your OT?" "Is there a friend in class who would listen?" "Can you do your yoga breathing?"
• if you are not very sure of the root of the behavior, ask him to write your answers on a card, a notebook, or a tablet computer. Then, the next time he asks, you can refer him to his written answer and ask him to tell you. Eventually, you can just refer him to his "answer file" without any other interaction. This may remove some of the reward he is getting from the repetition.
A good thing to remember is that this behavior shows that your son really wants to communicate with you. He may not have all the skills he needs to communicate effectively, but the impulse is a good one and one you want to cultivate. You might try some games with him to allow him to converse about some more diverse topics.
For example, you can write a series of topics that interest him (like Minecraft, Star Wars, subways) on slips of paper and put them in a bowl and take turns choosing one. For each topic, he has to say two things about it, then stop and ask you a question, then listen to what you say before another topic can be chosen from the bowl. Or you could use the topics to come up with questions you can research together online.
Figuring Out Figures of Speech
I have a young adult daughter who has struggled for years with speech issues. Her language is still delayed, but she has gotten very good at copying things that her peers are saying. Sometimes she does it right, but other times, especially with figures of speech, she misses the meaning. When we correct her, she gets frustrated, but I don't want her to embarrass herself in front of her peers. Is there a good way to work on this? — Richard
Dear Richard —
First, it is great that your daughter is trying to emulate her peers. We don't want to discourage that. On the other hand, we don't want her to be embarrassed. So one way to start is to help her understand that people do not always mean literally what they say, and this can be very confusing sometimes.
You might start by talking about some very simple figures of speech (and we would use that term and talk about it with her), such as "I pigged out last night" and ask her if she thinks if really means you were a pig last night. Then ask what it might mean and why someone might say it (it's more colorful and fun than just saying "I ate too much"). You could add drawings with speech and thought bubbles if you think that might help her understand.
Try doing this for a few minutes a few times a week. Remember each time both to introduce a new figure of speech and to talk about the idea that people sometimes talk figuratively, not meaning exactly what they say, in order to be more entertaining. You can also point these out when they occur on TV shows, YouTube videos, etc.
Sometimes, too, kids like to use words and figures of speech in special ways that adults may not always get. This can help the kids feel more like a group or clique, and they use their special language to make them feel more part of the peer group. You might suggest that she keep a notebook of some of the things she hears her friends say that she would like to use too. Instead of saying them, you can suggest she bring them to you and you can talk about them and look them up on the Internet together to make sure you understand the right way to use them. You can model appropriate ways to use them, and then you can practice together and make a note of their meaning or draw a picture of it in her notebook.
If she does use a figure of speech in your presence and you feel it is not used appropriately, instead of correcting her you can suggest she look it up in her notebook or on the Internet and practice it again with you. 
