Being “Nonverbal” Doesn’t Mean I Can’t Think

Not long ago I had a conversation with an autistic young man I know. Noah, who likes watching football and playing video games, uses an iPad to communicate. When I told him I was writing a post about how people use the term “nonverbal,” his eyes lit up, and he started typing. He told me that one of the most difficult things in his life is how often strangers assume that he is mentally deficient. “Tell them that just because I can’t talk,” he wrote, “doesn’t mean I can’t think.”

I have found that many providers also make that incorrect assumption about children who are nonspeaking. When I studied psychology in graduate school decades ago, I was taught that more than half of “nonverbal” children diagnosed with autism were “mentally retarded.” Both terms have since come out of favor (nonspeaking is more accurate than “nonverbal” since many individuals who don’t speak communicate by other means), but many people still assume that individuals who don’t have the ability to speak are “low functioning”–that children without access to spoken language have weak minds.

I have learned through my clinical experiences and from stories shared online by countless teens and young adults, that this correlation is not only false, but harmful. For instance, when educators automatically equate nonspeaking with “low functioning,” they underestimate student’s intellectual capacities, often removing children from inclusive programs to place them in separate special education classes that may not be appropriate or academically sufficient.

Of course, the truth is that autism and other forms of neurodiversity vary along a wide spectrum, and no two individuals are alike. Professionals and teachers should recognize that, and value and support each child with fresh eyes and open minds.

A small but growing number of scientists, including Elizabeth Torres, Ph.D. and Anne Donnelan, Ph.D, have argued that autism primarily affects motor control (movement), with many variations and permutations. The more severe the sensory and movement challenges, the more “low-functioning” the individual appears—on the outside. But we need to look below the surface to discover a person’s true capacities.

Viewing autism as a sensory and movement disorder radically changes how we support children in daily life, therapy, and the classroom. It forces us to find new ways of evaluating underlying functions and capabilities in sensory and movement issues.

Most traditional tests of cognitive function are designed with the assumption that the person being evaluated has an intact motor system, so these tests underestimate children with motor challenges. To offset this bias, evaluation teams should include experts in sensory integration and motor functioning (typically occupational therapists with specialized training) as well as speech and language therapists who specialize in augmentative and facilitated communication.

When we focus on a child’s individual differences—including sensory and motor capacities—we shift our priorities from focusing on teaching simple skills to helping children to overcome challenges to communication.

Ido Kedar, a teen with autism, articulated the mistakes professionals make when he described his own experience with Applied Behavioral Analysis, the most common treatment approach for children with autism:

“ABA believes autism is a severe learning disability that is treated by drills, rewards and baby talk. This makes recognition of the motor challenges nearly impossible because all the data from the child’s success in performing the drills is interpreted as a measure of how much the child understands speech, and not of whether the child can get his body to move correctly.” (Ido Kedar, 2015)  (http://idoinautismland.com)

If you work with children or teens with autism or related challenges, reconsider how you use terms such as “nonverbal” and “low-functioning.” If we broaden our thinking to understand individual differences better, we will move the intervention fields forward. Together, we can engage in a dialogue and learn what it means for a child not have access to spoken language. As Noah taught me, just because a child can’t talk, it doesn’t mean that he can’t think.

I explain the importance of presuming competence in early intervention in this book on social and emotional development.