to deficits in functional object use and symbolic play, children with autism often perform at similar or sometimes even higher levels on nonsocial constructive play (e.g., using objects in combination to create a product, such as putting puzzles together) in comparison with typically developing children or children with language delays at the same language stage (Wetherby and Prutting, 1984; Wetherby et al., 1998).
Exploring developmental patterns in communication and symbolic abilities has contributed to better understanding of the nature of these problems in autism. Stone et al. (1997) and Wetherby et al. (1998) compared the developmental profiles of 2- to 4-year-old children with autistic spectrum disorders with that of children with delayed language who were at the same language stage. Using similar strategies for gathering communication samples, both researchers reported a similar profile in children with autistic spectrum disorders, characterized by a distinct constellation of strengths and weaknesses in parameters of communication. Specifically, the children with autistic spectrum disorders showed comparable use of communication to request and protest, but significantly less use of gaze shifts, shared positive affect, conventional gestures, and communication for joint attention. They performed at comparable levels of constructive play but significantly poorer levels of language comprehension and symbolic play. Correlational findings from the Wetherby et al. (1998) study showed that children who displayed a greater capacity to coordinate attention and affect were more likely to communicate for more social reasons, to use a larger repertoire of conventional gestures, to have a higher rate of communicating, and to employ better repair strategies. These findings underscore the importance of addressing these core deficits in interventions for children with autism and have important implications for predicting which children will benefit from specific intervention approaches.
Researchers and educators have debated the question of how communication goals and objectives for children with autism and related disabilities should be derived. The perspective espoused by traditional behavioral programs has been to establish goals and objectives a priori (e.g., Lovaas, 1981). Behavioral discrete-trial programs begin with general compliance training to get a child to sit in a chair, look at the clinician, and imitate nonverbal behavior in response to verbal commands. Speech is taught as a verbal behavior, and objectives are targeted beginning with verbal imitation, following one-step commands, receptive discrimination of body parts, objects, person names and pictures, and expressive labeling