Expressive vs Receptive Language

I was working with a young man called Jack this week and wanted to share with you my experience with him. Jack is a 20 year old man and resides in a residential home for autistic adults. When you first meet Jack he comes across as very confident young man, happily talking to anyone that will listen to him. He sometimes does things that he shouldn’t and gets chastised by those around him in a typical neuro typical fashion. Generally this does not work and people around him get very frustrated that he doesn’t listen and continues to make the same mistakes. I had to take Jack to college and I had never done this before so was a little stressed out. Before we left I asked Jack did he need to take anything to college with him, he replied ‘No’. So we drove to college, which was interesting in itself because he found a CD in the car ‘Elton John’s greatest hits’ and for the whole journey he proceeded to play ‘Rocket Man’ over and over and over and over again. This was coupled with his standard conversation piece about music which is ‘Do you like this’? ‘Is it an old song’? If you spend enough time with Jack and pay attention you realise very quickly that a lot of what he says is very standardised or scripted. I mentioned pay attention because if you don’t pay attention you get dragged into the belief that he is your every run of the day 20 year old who is doing all this just to annoy you. As we got to college Jack said to me ‘I need my bag and ID’, Me ‘You said you didn’t need them’, Jack ‘I do, I do otherwise they won’t let me in’. For a second I was talking to a typical 20 something, I could feel the frustration building and then I remembered Jack has autism, he lives in a residential home and then I remembered a line that I say to parents all the time ‘Does it really matter’? And then I thought so what if we are late to college it’s not going to be the end of the world. Although to be honest a little part of me was feeling jaded. So we drove all the way back home and whilst we were driving home Jack talked about how he doesn’t like going to college on Mondays because the day is too long 10am till 3pm and that he can’t cope with being at college for that amount of time. I talked to him about the fact that he went to college last year and did 9am till 2pm and he was fine with that and he replied ‘yes’ I can cope with that length of time. Me ‘But Jack it’s the same length of time’, Jack ‘No I can’t cope with 10am till 3pm’ Jack couldn’t grasp it and all of a sudden I was feeling the frustration build up as I tried to explain that he had to go to college during this time and if he didn’t go on a Monday he would not be allowed to go to college anymore (the colleges words not mine). Round and round the conversation went with both of us becoming frustrated with the other. When I realised we were going round in circles I ended the conversation ‘We will have to discuss this with Sue, when we get back home’. The car was silent for a few minutes. Jack ‘Are you hungry’? me ‘No, not at the moment’, Jack ‘I am, rather than go to college this morning can we go to Greggs and get a stake bake’? Me ‘No, we need to go to college’, by the time we get there you will only have 30 minutes until lunch’, Me ‘Do you like college Jack’, Jack ‘Yes but I’m hungry’. So we get to college Jack says hello to everyone tells the tutor that he has just scratched his bottom, tutor tell Jack to go wash his hands, we go to the toilet and Jack locks himself in the toilet until lunch time. During lunch we get into the same conversation about college on Mondays and how he doesn’t like working 10am till 3pm as it is too long a day but he would be happy to work 9pm till 2pm as he can cope. I visually draw it out for him and show him that the amount of time is exactly the same i.e. 5 hours. He looks at me and says ‘I don’t understand’. Bam it hits me, omg his receptive (what he understands) is a mile apart from his expressive (what he says) language. How could I have been so stupid, I was aware of the gap but I didn’t think it was as vast as it is. During the afternoon session the void was becoming more and more apparent. Jack attends college with individuals with learning difficulties and what hit me in the afternoon is that the groups expressive and receptive language was at a much higher level than Jacks. Jack could not engage with his peers at an appropriate level. When he said things they were often in appropriate such as telling a girl that she was beautiful and then not understanding why she was so embarrassed because it was in front of the whole clash or bursting into song at any given moment or calling to someone in the class and when they responded he just ignored them. It was really interesting because when I’m writing it down you can see the void it’s like Jack is two different people. But when you meet Jack you see this very confident young man, happily talking to anyone that will listen him. So to the point, with some individuals try to remember that their use or expressive or receptive language can be at very different levels and to communicate effectively with them you may need to put things in a way that fits their receptive language capability.