Even children who speak, and speak well, can have language problems. Pragmatic language deficits -- difficulty using language in context, such as in a conversation--are common in people with PDDs. The person's grammar, syntax, and conversational gambits may be limited, pedantic (as in Asperger's Syndrome), or unusual. The rate, volume, and rhythm of speech may be odd. Perseveration (frequent repetition of words or sentences, or getting "stuck" on topics) is not uncommon. The voice itself may be unusually raspy, hoarse, whispery, loud, or otherwise unusual. Speech therapists can address these problems, sometimes in individual sessions, sometimes in a group situation where the social aspects of language can be pointed out and practiced.
Two special language disorders are found primarily in people with autistic-spectrum disorders, and are also common in people with Tourette's syndrome. These are:
Echolalia: the persistent repetition of words or phrases just heard. Some books on speech disorders still say that echolalia is "meaningless," but it can have communicative intent. For many young children with PDDs, echolalia is the first or only speech to emerge before intervention is tried.
Palilalia: repetition of your own words or thoughts (similar to perseveration, but with more of a compulsive quality).
A third language disorder, coprolalia, is experienced by about one-tenth of all people diagnosed with Tourette's syndrome usually as a transitory phase. Coprolalia is the inadvertent blurting of obscene or derogatory language, usually unrelated or only tangentially related to the situation at hand. Some people with PDDs occasionally evidence coprolalia, with or without a co-morbid diagnosis of Tourette's. The most common methods for dealing with coprolalia are substituting an inoffensive but similar word for the offending term (saying "fudge" or "ship" instead of the similar obscene word, for example), holding back the urge until the vocal tic can be released in private, or using medication that reduces tics. It's important that parents and professionals understand that coprolalia is a tic--a behavior that occurs because of a short-circuit in the impulse-control system, not a truly volitional act. It is as difficult to control as an eye-blinking or finger-tapping tic, and it should not be punished.
Coprolalia causes extreme embarrassment, and most people who experience it are willing to try almost anything to make it disappear.
"Teach Me Language" A language manual for children with autism, Asperger's Syndrome and related developmental disorders. by Sabrina Freeman Ph.D., Lorelei Dake, B.A. Hard Cover: ISBN 0-9657565-0-5
5: November 21, 2001