來源：http://www.autism.org.uk/living-with-autism/communicating-and-interacting/communication-and-interaction.aspx
Communication and Interaction
溝通和互動
Parents and carers of children with an ASD often feel unableto communicate and interact with their child and are unsure of how to do so.This guide gives useful information on achieving this.
有自閉癥孩子的父母和照顧者經(jīng)常感覺無法和孩子溝通與互動，并且不知道如何改善這種狀況。這個指導給予了解決此類問題的有效信息。
Communication happens when one person sends a message toanother person either verbally or non-verbally. Interaction happens when twopeople, for example, an adult and a child, respond to one another - a two-waycommunication.
溝通是指一個人向另一個人發(fā)出口頭或非口頭的信息?；邮侵竷蓚€人，比如一個成年人和一個孩子，彼此回應，即雙向溝通。
Most children with an ASD (autistic spectrum disorder) willhave difficulty interacting with others. This is because in order to besuccessful at interaction the child needs to respond to others when they areapproached by them or be able to initiate interactions. Although many childrenwith an ASD are able to do this when they want something, they tend not to useinteraction to show people things or to be sociable.
大多數(shù)自閉的孩子在和他人互動有困難。這是因為為了成功地進行互動，孩子們需要向接近他們的人做出回應，或者能夠開始互動。雖然一些自閉的孩子在想要某些東西的時候，有可能做到這點，但是他們傾向于不與人互動來展示一些東西或者與人交往。
It is important to remember that communication andinteraction do not have to involve the use of language and speech. Manychildren with an ASD are delayed
in their use oflanguage and shy away from using speech. Therefore, other methods ofcommunication need to be established before speech and language will follow.
重要的是記住溝通和互動不一定和語言有關。一些自閉的兒童對語言的掌握比較滯后，所以會羞澀地不發(fā)言。因此，在孩子的語言發(fā)展起來之前，需要建立其他的交流方式。
The way in which the child communicates needs to be observedin order to develop their communicative strengths and needs. For example, ifthe child is not using any sound or speech, rather than communicating with themthrough words, try using gesture. The child with an ASD may use some of thefollowing to communicate with others: crying, taking the adults hand to theobject they desire, looking at the object they desire, reaching, using picturesand echolalia.
為了提高孩子們的溝通能力，我們需要觀察他們的溝通方式。例如，如果孩子不發(fā)出一點聲音或者不說話，我們就不應該通過聲音和他們進行交流，而應該試著用肢體語言。自閉的孩子可能會使用以下方式和他人進行交流：哭，向大人們伸手要他們想要的東西，看著他們想要的東西，伸手拿，使用圖片來說明和仿說。
Echolalia is the repetition of other people's words and is acommon feature of the child with an ASD. Initially when the child usesecholalia it is likely that they are repeating words that they do notunderstand and are doing so with no communicative intent. However, echolalia isa good sign as it shows that the child's communication isdeveloping - in time,the child will begin to use the repeated words and phrases to communicate somethingsignificant. For example, the child may memorise the words that were said tothem when they were asked if they would like a drink, and use them later, in adifferent situation, to ask a question of their own.
仿說是自閉孩子們的一個普遍特點，即模仿他人所說的話。最初當孩子仿說的時候，他們只是在重復他們不懂的詞，而沒有和人溝通的意圖。但是，仿說是一個好兆頭，因為它說明孩子溝通能力正在發(fā)展，孩子會漸漸地開始重復一些詞語和句子，來進行有效的一些溝通。例如，當孩子被問起是否想喝飲料時，他們會記下一些詞，并且日后在不同的情境中使用這些詞來提出自己的問題。
Being successful in communication with the child with an ASD,does not only involve an understanding of how they communicate but alsorequires an understanding of why they communicate. In understanding the purposeof the child's communication you can help the child find more ways and morereasons to communicate.
如果要成功地和自閉癥孩子們溝通，你不僅要了解他們溝通的方式，而且也要理解他們溝通的目的。了解了孩子溝通的目的，你就可以幫助孩子尋找到更多交流的途徑和目的。
There are two main different types of communication:
以下是兩種不同的溝通方式：
Pre-intentional Communication: this is when the child says ordoes things without intending them to affect those around them. This type ofcommunication can be used by the child to calm themselves, focus themselves oras a reaction to an upsetting/fun experience.
前目的性溝通：這個時候，孩子沒有為了影響周圍的人而說話或做事情。孩子用這種溝通方式讓孩子自己冷靜，專注或者向一個好玩的或令人沮喪的事件作出反應。
Intentional Communication: this is when the child says ordoes things with the purpose of sending a message to another person. This typeof communication can be used to protest about what they are being asked to doand to make requests.
目的性溝通：這個時候，孩子會說些話或做些事來向其他人傳達信息。他們用這個溝通方式來抗議他人對自己提出的要求或向別人提出要求。
Intentional communication is easier for the child once theyhave learnt that their actions have an effect on other people - the move frompre-intentional communication to intentional communication is a big step forthe child with an ASD.
當孩子知道自己的行為能對他人造成影響后，目的性溝通會變得更加容易——對他們來說，從前目的性溝通跨越到目的性溝通是一個大的進步。
Sussman (1999) believes that it is helpful to view childrenwith an ASD as being on a continuum in terms of their intentionalcommunication, at one end of the continuum are children who communicate mainlyto get the things they want, 'at the other end are children whocommunicate for many reasons, such as to ask questions, comment on something orto be sociable'.
Sussman（1999）認為應該把孩子的目的性溝通視為連續(xù)的一體，這個連續(xù)的一體的一端是那些只為了得到自己想要的東西而溝通的孩子，另一端是那些為多個目的溝通的孩子，比如提問，對事物做出評論或與人交往。
The four different stages of communication
溝通的四個不同階段
(as defined by The HanenProgramme)
The stage of communication that the child has reached dependson three things:
（由HanenProgramme定義）
孩子們這些交流的階段決定于三方面：
Their ability to interact with another person
How and why they communicate
Their understanding.
他們和他人互動的能力
他們交流的方式和目的
他們的理解力
Stage one - the own agenda stage
第一個階段——自我議程
A child at this stage of communication will appearuninterested in the people around them and will tend to play alone. Theircommunication will be mainly pre-intentional. The majority of children firstdiagnosed with an ASD are at this stage.
處在這個階段的孩子往往對周圍的人不感興趣，傾向于自己玩。他們的溝通主要是前目的性。大多數(shù)孩子們是在這個階段被診斷為患自閉的。
Stage two - the requester stage
第二階段——需求階段
At this stage the child has begun to realisethat their actions have an affect on other people. They are likely tocommunicate to the adult their wants and what they enjoy, by pulling themtowards objects, areas or games.
在這個階段，孩子們開始意識到他們的行為對他人有一定的影響。孩子們可能會通過牽引成年人到某些物件、某些地方或者某些游戲，來向成年人表達他們的需求和喜好。
Stage three - the early communicator stage
第三階段——早期溝通階段
At this stage the child's interactions willbegin to increase in length and become more intentional. The child may alsobegin to echo some of the things that they hear to communicate their needs.Gradually the child will begin to point to things that they want to show theadult and begin to shift their gaze this is a sign that child is beginning toengage in a two-way interaction.
在這個階段，孩子的互動時間有所增長，他們的行為也變得更加有目的性。孩子也或許會通過效仿他們聽到的聲音來表達他們的需求。漸漸地，孩子開始通過方位指向的方式向成年人表明他們的需要，并且開始轉移他們的注視，這是孩子開始參與雙向互動的一個標志。
Stage four - the partner stage
第四階段——伙伴階段
When the child reaches this stage they havebecome a more effective communicator. The child will be using speech to talk andwill be able to carry out a simple conversation. While the child may appearconfident and capable when using communication in familiar environments (eg athome), they may struggle when they enter unfamiliar territory (eg at a newnursery or school). It is in this situation that they may use memorised phrasesand can often appear to be ignoring their communication partner by speakingover them and ignoring the rules of turn taking.
當孩子們到達這個階段，他們已經(jīng)成為更加有效的溝通者。孩子使用語言來交談，也有能力進行簡單的對話。在熟悉的環(huán)境（例如，在家里）與人交流溝通的時候，孩子會表現(xiàn)出自信和一定的社交溝通能力，但是當進入一個陌生的地方（例如在一所新的托兒所或學校）他們可能會經(jīng)歷某些心理掙扎。在這樣的情形下，他們會使用記憶中的習慣用語，也經(jīng)常忽視他們的交流對象，出現(xiàn)搶話，無視話語輪換規(guī)則的現(xiàn)象。
Ways that adults can affect the communication ofa child with ASD
成年人如何影響自閉癥孩子的交流方法
Take on the role of a helper and teacher
充當援助者和導師的角色
When the child is unable to communicate theirneeds it is tempting to help them by constantly doing things for them. Forexample, fetching their shoes and tying their shoelaces. However, by doing thisthe opportunities for the child to show that they can do such things forthemselves are reduced. When the childis at the Own Agenda Stage it is particularly difficult to decipher how much todo for the child. In this instance it is appropriate to ask the child if theyneed help, wait and then ask a second time before adding the help.
當孩子無法表達他們的需求時，人們總是情不自禁地去幫助他們，不斷地為他們做一些事情。舉例來說，為他們拿鞋子，為他們系鞋帶等。然而，這樣的做法對于孩子們來說，意味著他們可以自己完成這類事情的機會被減少了。當孩子處于自我程序階段，要清晰認識到幫助他們到哪種程度是一件特別困難的事情。在這種情況下，比較適宜的方法是詢問孩子是否需要幫助，耐心等待他們的回答然后在提供幫助之前再次詢問一遍。
Instead of letting the child do their own thing,encourage them to do things with others
鼓勵孩子與他人一起共事，而不是讓他們獨自完成
It is tempting to believe that the child ismerely showing their independence when they show no interest in interactingwith the adult. However, it is important that the child does learn to interactand is not just left to their own devices. In this instance the key is topersevere with joining in with whatever activity the child is engaged in,whether this is playing with a piece of string or taking toys in and out of thetoy box. If the child shows anger and aggression when this is tried, stillpersevere. Anger is a type of interaction and is better than no interaction atall. As this interaction is continued with the child they may begin to realizein time that interaction with another person can be fun.
當孩子與成年人互動表現(xiàn)興致索然的時候，人們不禁相信這個孩子只是在表現(xiàn)他的獨立性。然而，讓孩子學會與人互動確實是件十分重要的事情，而不僅僅是讓他們各自玩耍。在這種情況下，解決問題的關鍵是要堅持加入孩子正在從事的活動，無論他們是在玩一條繩子還是把玩具從玩具箱放進去又拿出來。當你在嘗試這種方法的時候，如果孩子表現(xiàn)出憤怒和侵略性，也仍要堅持去參與他們正在做的事情。憤怒也是一種互動，孩子表現(xiàn)憤怒總比毫無反應好得多。與孩子持續(xù)這樣的互動會讓他們適時意識到與另外一個人互動會使一件有意思的事情。
Slow down the pace and give the child a chanceto communicate
放慢節(jié)奏，給孩子一個溝通的機會
Caring for a child with an ASD can be hard workand time consuming. There is often the temptation to rush the child when theyare performing daily tasks such as eating breakfast and getting dressed. Achild with ASD will benefit from an extra few minutes extra time when engagedin these tasks to help them understand what is happening around them and tothink about what they can say during these activities.
照顧自閉癥孩子是一件極其辛苦且十分耗時的事情。當孩子正在完成日常任務——諸如吃早飯和穿衣服這樣的事情的時候，成年人時常會冒出一種催促他們快點做好的想法。當自閉癥孩子在從事這樣的日常事務的時候，他們可以從額外的幾分鐘里獲得好處。因為額外多出來的時間有助于他們明白正他們身邊正在發(fā)生什么，也有助于他們思考在做這些事情的時候可以說些什么。
When playing with the child take on the role ofa partner rather than a leader
在與孩子玩耍的時候擔當搭檔而不是領導者的角色
As the child becomes more capable atcommunicating, they need less direction - if they are given too many questionsand suggestions it can become difficult for them to initiate their ownconversations. It is important to follow the child's lead and respond to whatthey do.
隨著孩子與人溝通交流能力的增強，他們不需要太多的指導——如果人們向他們提出太多的問題和建議，將使他們展開他們自己的對話變得十分困難。跟隨孩子的引導，并適時對他們所作的事情做出回應十分重要。
Present the child with feedback
給孩子提供一些反饋
It is important to reward the child when theyattempt to understand and communicate. By doing this you can increase the likelihoodthat they will try and do it again. By using simple descriptive praise thatcomment on what the child has achieved, the child can make a connection betweentheir own actions and your specific words.
當孩子嘗試理解并交流的時候，給予他們一定的獎勵是十分重要的。這樣做可以增加他們再次嘗試溝通的可能性。在對孩子所取得的進步發(fā)表評論的時候，使用一些簡單的描述性的贊揚話語，可以使孩子對他們的行為和你的特定用語產(chǎn)生關聯(lián)。
Giving the child with ASD a reason tocommunicate
為自閉癥孩子創(chuàng)造一個溝通的理由
If the child with ASD has no difficulty gettingwhat they want, they will have no reason to communicate and interact.Therefore, on many occasions the adult will need to engineer a situation inorder to create a communicative opportunity for the child and encourageinteraction.
如果患自閉癥的孩子獲取他們所需的事物時沒有遇見任何困難，他們則沒有任何理由去與他人溝通和互動。因此，在許多場合下，成年人需要營造一個情景，為自閉癥孩子創(chuàng)造一個溝通的機會，并鼓勵他們與他人互動。
Encouraging requests
激發(fā)孩子提出要求
This can be achieved by placing the child'sfavorite toy/food/video in a place where the child can see it but is unable toreach it, for example, a high shelf. Alternatively, place the child's favoriteobject in a container, which the child finds difficult to open such as an oldice-cream tub or an old jam jar. This will encourage the child to ask for helpand result in an interaction between adult and child.
要實現(xiàn)這樣的目的，可以將孩子最喜歡的玩具、食物或者錄像帶放置到一個他們看得見卻無法拿到的地方，例如放到一個很高的架子上。要不然，把孩子最喜歡的東西放進一個對于孩子來講不容易打開的容器里，例如一個舊的冰淇淋桶或者一個舊的果醬罐。這樣的方式可以激發(fā)孩子向他人尋求幫助，并促使他們與成年人產(chǎn)生互動。
Give the child a toy that is difficult tooperate
給孩子一個難以操作的玩具
Wind up toys and games that need to be squeezedto make them work will be difficult for the child to operate alone but willalso interest the child. Once the childhas been given the toy/game, allow them some time to establish how to use it.When the child becomes frustrated at their inability to work the toy/game, theadult can step in and help them. Examples of this type of toy includeJack-in-the-boxes, spinning tops and music boxes.
需要上發(fā)條的玩具和需要擠壓才能玩的游戲對于孩子來說很難獨自操作但同時又讓他們感興趣。把玩具或者游戲器具給了孩子之后，給他們留一些時間來發(fā)現(xiàn)如何玩耍這些玩具。當孩子因為沒有能力玩耍某個玩具或游戲器具而受挫的時候，成年人可以及時介入進來幫助和引導他們，這種類型的玩具包括玩偶匠、陀螺以及音樂盒。
Give thechild a toy that is 'high interest'
讓孩子玩極具趣味的玩具。
Balloons andbubbles are high interest toys and can be easily adapted to involve two people.Simple games such as blowing up a balloon and then letting it go so that itflies up in the air may appeal to the child. Blowing up the balloon part wayand waiting for a response from the child before blowing it up to its fullcapacity is also a clever way to enhance interaction between adult andchild. A similar thing can be achievedwith bubbles - blow a few bubbles towards the child, once their attention hasbeen captured, close the container and wait for a response from them before youblow any more.
氣球和泡泡就是所謂的極具趣味的玩具，很適合進行雙人游戲。吹起一個氣球，然后任其飛上天空，類似這樣簡單的游戲會引起孩子的興趣。把氣球吹到一半，等孩子有所反應再把氣吹滿，這同樣也是一種增進孩子與大人之間的互動的好辦法。吹泡泡也能達到類似的效果——向著孩子吹一些泡泡，等他們的注意力被吸引過來了就關上瓶蓋，直到他們有所反應才再開始吹泡泡。
Give thingsto the child gradually
循序漸進地給孩子東西
If the childis given everything that they wants they will have no reason to ask the adultfor anything else. By staggering how much food/how many toys are given to thechild they are provided with opportunities to interact by expressing theirwants and needs. For example, if the child wants a biscuit, break it into smallpieces, initially give them one piece and then gradually given them more oncethey have communicated a request for it.
當孩子的需要被完全滿足了之后，他們會很自然地不再向大人提出別的要求。減緩向孩子提供玩具或食物的過程也給孩子提供了表達自己需求的溝通機會。舉個例子，如果孩子想要一塊餅干，你可以把餅干掰成小塊，最開始只給他們一塊，等他們提出要求之后再給逐漸增加餅干的數(shù)量。
Let thechild decide when to end an activity
讓孩子來決定什么時候結束一項活動
Once thechild is engaged in an activity with the adult, carry on with that activityuntil the child indicates that they have had enough. Look out for facialgrimaces or the child pushing away the activity. This way, the child is forcedto communicate that they are ready to finish the activity. If the child doesnot use language to indicate they have finished, accompany their form ofcommunication with words such as had enough and stop to encourage their languagedevelopment.
大人在和孩子共同參與一項活動時，不斷地進行那項活動直到孩子暗示他們覺得玩夠了。留心孩子顯露出厭惡的表情或是對活動有所排斥的表現(xiàn)。這往往能迫使他們提出自己已經(jīng)準備好結束這項活動。如果孩子不用語言來暗示自己已經(jīng)不想?yún)⑴c了，配合他們的交流方式，輔以類似“夠了”這樣的詞語來鼓勵孩子進一步進行語言交流。
Increasinginteraction by following the child's lead
讓孩子做主導以促進互動
Followingthe child's lead rather than directing them will enable them to learn tocommunicate while they do things with another person, hence increasing theirinteraction. The child that leads is more likely to pay attention to theactivity, more likely to focus on the same thing as the adult and will learnhow to make choices for themselves.
讓孩子做主導而不是引導他們——這能使孩子學會在與他人合作時進行溝通，從而促進他們與他人的互動。孩子自己做主導時會更注意正在進行的活動，像成人一樣專注于同一件事，并學會如何自己做決定。
讓孩子做主導時，大人最好與孩子面對面，這樣大人就能觀察孩子對什么感興趣。這也有助于孩子進行目光接觸——通常這對自閉癥患兒來說并非易事。和孩子保持在一種平等的位置也能保證他們能觀察到在交流中不同的表情變化。自閉癥患兒常常不能抓住談話中的非言語表達/交際行為；因此，在可能的情境下讓他們注意到這一點十分重要。這種訓練的目標是最后使孩子習慣大人處在同等的位置跟他們一起玩，并開始期待大人的出現(xiàn)，在大人不在時會自發(fā)地邀請大人一起游戲。
Imitatingthe child's actions and words will help the child become involved in two-wayinteractions. If the child bangs the spoon on the table, and the adult does thesame, it is likely that the child will pay attention to the adult. This ideacan also be used with sounds that the child makes or with the child's sensorybehaviors, for example, hand flapping and spinning. Once the child has established that theadult is imitating her actions, they may begin to imitate back. This createsthe opportunity for the adult to add something new to the exchange for thechild to duplicate.
模仿孩子的行為與語言能幫助孩子參與進雙向的互動中。如果孩子用勺子敲打桌面，大人做出同樣的舉動，就會使孩子注意到大人。同樣的，大人也可以模仿孩子發(fā)出的聲音或是做出的感官行為，比如拍手和旋轉。當孩子發(fā)現(xiàn)大人在模仿自己的動作時，他們也會倒過來模仿大人的動作。這就為大人在互動中加入供孩子模仿的新內(nèi)容創(chuàng)造了機會。
When thechild with an ASD is disinterested in playing with any of the toys presented,or prefers to line toys up rather then play with them, there are stillcommunication and interaction opportunities available. For example, if thechild is lining up their cars in a row, the adult can join in the activity byhanding the child the cars one by one. This way, the adult plays a part in thegame and the child has to include them in what they are doing. If the child isonly interested in throwing the toys on the floor, the adult could use a basketto collect them before giving them back to them, thus establishing a pattern ofinteraction and communication with the child.
當自閉癥患兒對手中的所有玩具都不感興趣，或是想要排列玩具而不是玩玩具時，大人們也能找到一些進行交流與互動的機會。舉個例子，如果孩子把小汽車擺成一排，大人就可以加入進來給孩子一架一架地遞小汽車。這樣，大人就能參與進游戲中，孩子也不得不讓大人和他們一起做事情。如果孩子只想把玩具亂丟在地上，大人可以用籃子把玩具收集起來再還給孩子，從而建立起與孩子的互動與交流。
Ways thatadults can help a child with ASD understand what is said to them
幫助自閉癥患兒了解別人在說什么的方法
A child withan ASD will find processing information a difficult thing to do. This is because they may find it difficultto understand the world around them. Even when the child with an ASD doesunderstand a situation, they may not understand the words that go with thatsituation. Sometimes it is easy to assume that the child understands what isbeing said to them because they appear to follow instructions. However, thelikelihood is that the child will know what to do when instructions are givenin certain contexts because they have done it numerous times previously.
處理信息對于自閉癥患兒不是件容易的事。這是因為他們在理解周遭的世界時就會感到很困難。即便一個自閉癥患兒了解一種具體的情境，他們也可能不理解這種情境下出現(xiàn)的語言。有時候我們會以為孩子理解了別人在說什么，因為他們似乎能夠服從指導。然而孩子在一定語境中能夠根據(jù)指示知道該做什么，往往是因為他們之前已經(jīng)重復了許多次同樣的舉動。
There areseveral ways in which to enhance a child's comprehension of what people aresaying to them.
以下幾種方法可以用來提高孩子的理解能力，明白別人在對他們說什么。
Say less andsay it slowly
少點說，慢點說
The adultcan limit the amount of words they use to communicate with the child but stillcommunicate the relevant information. Use key words that are specific to thecontext of the situation, repeat and stress them and use gesture, such aspointing, to accompany them. Sussman (1999) uses the following rhyme as areminder of how an adult make it easier for a child with an ASD to understandthem:
在和孩子交流時，大人可以控制詞語的數(shù)量，但依然談論相關的內(nèi)容。利用特定語境下的關鍵詞，進行重復與強調(diào)，并輔以類似指示等手勢。薩斯曼（1999）用了下面這句話來提醒大人如何使自己的語言更簡單，便于自閉癥患兒理解。
'Say lessand stress, go slow and show!'
“少點說，多強調(diào)；慢點說，做演示”
Ifthe child has only recently begun to use speech as a means of communication,the adult should use single words to communicate with them. For example,labellingfavourite toys and food.When using this method of communicationit is important to label things when they are immediately given to the child.If the child's attention has shifted onto the something else, the word willlose its meaning.
如果孩子是在最近才開始把說話當做一種交流方式，那么大人就應該用一個一個的詞來和孩子交流。例如，把孩子喜歡的玩具和食物貼上表明該東西的標簽。把東西給孩子時，應即時貼上標簽，這是很重要的。如果孩子的注意力轉移到別的東西上，這個標簽就會失去預期的作用。
Pausing in between spoken words and phrases canalso help the child with an ASD to understand what is said to them. The adultshould use pauses to give the child time to process what has been said to themand to give them an opportunity to think of a response.
單詞和短語之間的停頓也可以幫助患有自閉癥的孩子理解剛剛對他們說的是什么。大人應該利用停頓來給孩子時間以消化剛剛對他們說的是什么，并且給他們一個思考如何應答的機會。
講話的同時使用手勢也能幫助孩子去理解剛剛對他們說的是什么。例如，當給孩子喝水時，大人可以做一個喝水的姿勢，假裝一只手拿著杯子并送到嘴邊喝一口水。同樣，吃飯的時候也可以這樣。另外也可以使用夸張的面部表情，用點頭和搖頭表示“是”和“否”，用揮手來表示“你好”和“再見”。而當跟孩子談論到人的時候，例如“外婆要留在家”，給孩子一張談論對象（外婆）的照片是很有幫助的。
對本文的特別申明: 由于我們的醫(yī)學專業(yè)知識和翻譯水平有限，譯文可能會有瑕疵，歡迎大家提出寶貴的意見和建議，以便幫助豆苗計劃翻譯小組更好地開展工作。
豆苗計劃翻譯小組
翻譯：yu翼 MONOの caicai ゼ~SUNNY~ザ 馬里亞納の陽光
復核：Rexx TAOF.R*
