The effects of improved auditory feedback on the verbalizations of an autistic child.

Failure to use expressive language is a defining characteristic of juvenile autism (Ricks & Wing, 1975). Indeed, the fact that some 90~ of autistic children end up in institutions seems directly caused by two languagerelated problems--the child's inability to communicate with others, and the child's failure to learn to use "self-talk" as a means of establishing selfcontrol over his thoughts and behaviors. By use of a device called the Phonic Ear, which allows the autistic child to selectively screen out auditory inputs the child does not wish to hear, we sought to increase spontaneous communication in two autistic children. The most popular types of therapy for autistic children--the use of behavior modification techniques (Lovaas, 1977), teaching the child to use sign language, and intonation therapy--have produced only limited communication in some children. These therapies probably fail because they put the child under increased environmental stress in order to "break through the child's resistances," or because they seldom motivate the child to learn more appropriate behaviors. There is a growing body of evidence, however, that suggests that the most appropriate therapy for autistic children may involve a decrease in stress rather than an increase (Schechter, 1969). That stress can cause autisticlike symptoms has been documented by Goldfarb and Braunstein (1968). When these investigators subjected schizophrenic children to a delay in auditory feedback of .16 seconds, the children displayed such autisticlike behaviors as screaming, covering the ears, and attacking the equipment. Furthermore, as Hutt, Hutt, Lee, and Ounsted (1964) have shown, the reduction in stress that accompanies sleep is accompanied by normal EEG patterns in sleeping autistic children.