Speech deficits don’t explain tantrums in kids with autism

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Speech or language impairments may not be the cause of more frequent tantrums in children with autism, a new study suggests.

Children with autism experience more tantrums than children without, and speech and language problems often take the blame for the frequent outbursts. Some children with autism spectrum disorder aren’t able to speak or have speech that is not clear or well-understood by others.

For a new study, published in the Journal of Development and Physical Disabilities, researchers looked at the relationship between language and tantrum frequency in 240 children with autism between the ages of 15 and 71 months of age. The children’s IQ, their ability to understand language, and their ability to use words and speak clearly, explained less than 3 percent of their tantrums.

“We should stop telling parents of children with autism that their child’s behavior will get better once they start talking or their language improves…”

“We had children in our sample with clear speech and enough intelligence to be able to communicate, and their tantrums were just as high in that group,” says Cheryl D. Tierney, associate professor of pediatrics at Penn State College of Medicine, and section chief, behavior and developmental pediatrics at Penn State Children’s Hospital.

Further, children who spoke at the level of a two-year-old with normal development had more tantrums than children with lower speech skills.

“There is a common pervasive misbelief that children with autism have more tantrum behaviors because they have difficulty communicating their wants and their needs to caregivers and other adults,” Tierney says.

“The belief is that their inability to express themselves with speech and language is the driving force for these behaviors, and that if we can improve their speech and their language the behaviors will get better on their own.

“But we found that only a very tiny percentage of temper tantrums are caused by having the inability to communicate well with others or an inability to be understood by others.”

Tierney and co-investigator Susan D. Mayes, professor of psychiatry, addressed the limitations in previous research by including a larger sample of children and capturing more measurements. The new study measures IQ and separates speech and language as different variables that might affect tantrum behavior in children with autism.

“IQ is extremely important because a child that has the mental capacity to understand and use language may display different behaviors compared to a child who doesn’t have the mental capacity and comprehension to use language,” Tierney says.

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Understanding the difference between language and speech is an important consideration, she says.

“Language is a child’s ability to understand the purpose of words and to understand what is said. Speech is their ability to use their mouth, tongue, lips, and jaw to form the sounds of words and make those sounds intelligible to other people.”

The study doesn’t answer the question of what causes tantrums in children with autism, but mood dysregulation and a low tolerance for frustration—two common traits—are likely factors that should be studied further. Enough evidence has accumulated to shift the emphasis from improving speech to improving behavior, Tierney says.

“We should stop telling parents of children with autism that their child’s behavior will get better once they start talking or their language improves, because we now have enough studies to show that that is unlikely to happen without additional help.”

Help should come in the form of applied behavior analysis, and having a well-trained and certified behavior analyst on a child’s treatment team, Tierney says.

“This form of therapy can help children with autism become more flexible and can show them how to get their needs met when they use behaviors that are more socially acceptable than having a tantrum.”

Source: Abby Sajid for Penn State