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Preventing Pronoun Reversals

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by Kathie Harrington, MA, CCC-SLP
Autism Asperger’s Digest
| November/December 2012

What Is Pronoun Reversal?
Pronoun reversal is a language twist that is common in children with autism spectrum disorder (ASD). These children refer to themselves as he, she, or you, or by their own names. Pronoun reversal is closely associated with echolalia. Since children with ASD often use echolalic speech, they refer to themselves as they have heard others speak of them and misapply pronouns. Thus, we hear speech like:

“Are you hungry, Sam?” (adult’s question)
“Are you hungry, Sam” or “Sam is hungry.” (child’s possible responses)

Typical Pronoun Usage
In order to understand pronoun reversals, it is important to have an appreciation of pronoun development in typically developing children. This helps refresh our knowledge of norms to identify children whose skills fall outside of the mainstream.
According to Dr. Louis Rossetti (1990), children from 21 to 24 months of age refer to self by name; early pronouns (me, my, mine) occur occasionally at this age. By 27 to 30 months of age, the child refers to self by pronouns consistently, using I, me, and mine.
Overall, research finds that typical children understand pronoun usage from 22 to 28 months of age. Children at this stage commonly stake claims to their toys, food, and drinks by saying “mine.” They are also able to recognize their image in the mirror as “me.”
Even typically developing toddlers get pronouns confused during this acquisition period. After all, pronouns come with tough rules to learn and even tougher ones to teach: I, me, you, he, him, she, her, they, them, we, and us. Most children glean this information as they mature and are exposed to English; however, children on the spectrum do not learn this by osmosis.

How Does a Spectrum Kid Use Pronouns?
Young children with ASD and other developmental disabilities usually don’t use pronouns. They refer to themselves in third person such as “Katie want milk,” or “Joey get ball.” Or, the child might not refer to the other person in any verbal manner, instead pulling an adult by the hand to attain his need, or grunt, or partially look in the adult’s direction.
When pronouns are used, they are usually echoed back from what was said by the adult to the child:

“Do you want a cookie?” (adult’s question)
“Do you want a cookie?” or “You want a cookie.” (child’s response—Either response means, yes, the child wants
a cookie.)

Preventing Pronoun Reversals
I look at the following process as preventative of possible pronoun reversal as used with young, nonverbal children with ASD. As I use pronouns with children in my own expressive speech, I interchange them with proper nouns. This way the child hears both forms associated with the same person. I do this when taking turns during therapy, and I teach parents to use this technique on a daily basis. Here is how it looks and sounds:
Building Blocks Activity. During each turn-taking event, Kathie pats her own hand on her chest to indicate her turn or takes the child’s hand and pats it on Susie’s chest. (Proper nouns [given names] and pronouns—I, me, my, mine, you, and your—are all interchanged.)

Kathie: “It’s your turn to put the first block on the table.”
Kathie: “Now it’s Ms. Kathie’s turn.”
Kathie: “Susie is next.”
Kathie: “My turn.”
Kathie: “You can put the blue block
on top.”
Kathie: “Mine is the red block.”
Kathie: “Your turn.”

Read Alouds. Reading a picture book together does not always have to include the words on the page with young children. Pointing, naming, and turning pages can all be completed while interchanging pronouns with proper nouns in turn-taking events. Brown Bear, Brown Bear by Bill Martin Jr. (Henry Holt, 1996) is my favorite book for young children. It is turn taking at its best and has proper nouns and pronouns built into the vocabulary.
During each turn-taking event, Kathie pats her own hand on her chest to indicate her turn or takes the child’s hand and pats it on Darin’s chest.

Kathie: “Darin, Darin, what do you see?”
Kathie: “I see Ms. Kathie looking at me.”
Kathie: “Ms. Kathie, Ms. Kathie, what do I see?”
Kathie: “I see the lamp looking at me.” (go around the room naming items)

Or, simply name the animals in the book:
Kathie: “I see a brown bear.”
Kathie: “Darin points to a blue horse.”
Kathie: “Ms. Kathie likes the yellow duck.”
Kathie: “We both see all the children.”

Concluding Thoughts
It’s hard to teach the concepts of I, me, mine, and you because it’s confusing to refer to the child and then to yourself using the same words. I use the same hand-to-chest technique as described earlier and advise parents to use this as well. Children with ASD who are more verbal pick it up more quickly. Drill is good, but I’m a believer in natural settings to solidify specific language skills, such as proper pronoun usage
on a daily basis.
Obviously, it is not a quick process to change pronoun reversals if the child is already using them. Be consistent and persistent, and teach other significant people in the child’s life to use the same technique.
Prevention of developing the language twist of pronoun reversal is my goal for using this technique with nonverbal children with ASD. When nonverbal children begin speaking, pronoun reversals will, we hope, not be an issue because they have repeatedly heard and experienced both proper nouns and pronouns in a variety of settings.

Follow Kathie Harrington, MA, CCC-SLP,
at www.kathiesworld.com and check out her two new books on autism: Tears of Laughter–Tears of Pain and I Never Told My Son He Could Dance.

Rossetti, L. 1990. The Rossetti Infant-Toddler Language Scale. East Moline, IL: LinguiSystems.


Copyright © Autism Asperger’s Digest. 2012. All Rights Reserved. Distribution via print is prohibited without written permission of publisher.

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