Highlights from this month’s ASHA conference

A couple of weeks ago, before the Thanksgiving festivities, I went up to Boston for the American Speech Language Hearing Association Convention, to present, along with Bronwyn Hemsley, Howard Shane, and Ralf Schlosser, a talk entitled “Conceptualizing and Upholding a Communication Bill of Rights for Individuals who are Minimally Speaking.” These rights, of course, include the right to evidence-based communication methodologies, as opposed to one or another variants Facilitated Communication.

While there, I attended a few other talks. One of these was an alarmingly jam-packed talk on a fashionable new theory of language learning known as Gestalt Language Processing. Some individuals, especially those with autism, are purportedly a type of person known as a “gestalt language processor,” otherwise known as GLPs. What this theory adds to the long-standing recognition that many language-impaired individuals with autism resort to echolalia before acquiring basic vocabulary is… unclear to me.

Except in as much as Gestalt Language Processing Theory insists that echolalia is a building block of the language acquisition process, as opposed to a product of associative learning that clever therapists have long tried to shape into more meaningful communication—long before Gestalt Language Processing proponents started telling them that that’s what they should be doing.

And except in as much as Gestalt Language Processor purportedly means something more mystical than someone who takes a while to get beyond associative mappings between oral patterns and situations to intentional, linguistic communication.

But these days, we’re all about Gestalt: holistic thinking, the Whole Child, the big picture. So Gestalt Language Processing resonates. And it’s therefore not surprising that the two GLP talks were very well-attended—one of them even filling up the overflow room—even though the empirical data offered up in support of any of the various non-obvious claims was exactly zero.

Another popular presentation topic, at least as far as ASHA’s gatekeepers were concerned, was Structured Word Inquiry. A group of SWI proponents were awarded three different sessions. I only attended the last one, which had been assigned to the latest time slot and therefore was not perhaps as well attended as the others. Here I heard the usual evasions regarding how exactly SWI’s trademark learning tasks—morphological analysis and investigations via etymological dictionaries—help novice readers decode basic words like “cat” and “mat”, as well as the usual confusion of decoding skills with encoding skills (spelling), and the usual failure to explain what exactly students get out of using word matrices to “build words.” Taking words apart may help understand their meanings, but what does building words up do?

I was tempted to ask two questions, but refrained:

1.       Why does SWI make a distinction that no one else makes between historical roots and what it calls “bases” (such that the historical root in “electricity” is Latin “electrum” or Greek “ēlektron”, meaning “amber”, while the “base” of "electricity", which most people consider its route, is “electric”) at the same time that it broadens the concept of etymology to include stuff that no one else would include: that is, not just the origin of words, but contemporary coincidences like the “ear” in “hear”?

2.       How does SWI’s “word sums” (re + sign + ation à resignation) handle ambiguous words like “unlockable”?

Another overflowing talk I attended was “The Conundrum Behind the Missing Autistic Girls: Masking, Double Empathy, and Theory of Mind.” This talk echoed the oft-heard claim that girls are underrepresented in autism diagnoses because they’re better at masking. While critiquing the DSM for including Theory of Mind deficits in its latest criteria for autism (Is that true? I’m not seeing this anywhere), it finds justification for the notion that masking is common in autism in the following statement that is included in the DSM:

Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life).

“Masked by learning strategies”, of course, is not the same as the deliberate masking of social eccentricities in order to “pass” as “neurotypical”—the latter sense of “mask” being that promoted by those who claim that girls are underrepresented in autism diagnosis. The underlying assumption, to the extent that there is a coherent, underlying assumption, seems to be that autistic girls are more driven/able to “pass” themselves off as typical girls than autistic boys are driven/able to pass as themselves off as typical boys.

The talk also discussed the research on Double Empathy, which, as I discuss in my book Students with Autism, to the extent that it holds up at all, holds up only with high functioning individuals who share similar interests.

The general thrust of the talk seemed to be the increasingly popular notion that autism, for all the masking, does not involve social deficits, but rather anxiety and an insufficient sense of “safety” (the purported basis for the restrictive, repetitive behaviors). As evidence for this, the presenters cited late-diagnosed women who seemed to have no trouble empathizing with the needs of their toddlers. Hmm.

The term “presuming competence” also came up, which pretty much tells us everything we need to know about where these people stand with respect to disability rights and autism. As Howard Shane pointed out in our presentation, citing Jason Travers, presuming competence risks undermining the rights of individuals with autism, particularly those who are minimally speaking.