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来源：http://www./living-with-autism/communicating-and-interacting/communication-and-interaction.aspx Communication and Interaction 沟通和互动 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. 有自闭症孩子的父母和照顾者经常感觉无法和孩子沟通与互动，并且不知道如何改善这种状况。这个指导给予了解决此类问题的有效信息。
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. 沟通是指一个人向另一个人发出口头或非口头的信息。互动是指两个人，比如一个成年人和一个孩子，彼此回应，即双向沟通。
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. 大多数自闭的孩子在和他人互动有困难。这是因为为了成功地进行互动，孩子们需要向接近他们的人做出回应，或者能够开始互动。虽然一些自闭的孩子在想要某些东西的时候，有可能做到这点，但是他们倾向于不与人互动来展示一些东西或者与人交往。
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. 重要的是记住沟通和互动不一定和语言有关。一些自闭的儿童对语言的掌握比较滞后，所以会羞涩地不发言。因此，在孩子的语言发展起来之前，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. 为了提高孩子们的沟通能力，我们需要观察他们的沟通方式。例如，如果孩子不发出一点声音或者不说话，我们就不应该通过声音和他们进行交流，而应该试着用肢体语言。自闭的孩子可能会使用以下方式和他人进行交流：哭，向大人们伸手要他们想要的东西，看着他们想要的东西，伸手拿，使用图片来说明和仿说。
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. 仿说是自闭孩子们的一个普遍特点，即模仿他人所说的话。最初当孩子仿说的时候，他们只是在重复他们不懂的词，而没有和人沟通的意图。但是，仿说是一个好兆头，因为它说明孩子沟通能力正在发展，孩子会渐渐地开始重复一些词语和句子，来进行有效的一些沟通。例如，当孩子被问起是否想喝饮料时，他们会记下一些词，并且日后在不同的情境中使用这些词来提出自己的问题。
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. 如果要成功地和自闭症孩子们沟通，你不仅要了解他们沟通的方式，而且也要理解他们沟通的目的。了解了孩子沟通的目的，你就可以帮助孩子寻找到更多交流的途径和目的。
There are two main different types of communication: 以下是两种不同的沟通方式：
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. 前目的性沟通：这个时候，孩子没有为了影响周围的人而说话或做事情。孩子用这种沟通方式让孩子自己冷静，专注或者向一个好玩的或令人沮丧的事件作出反应。
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. 目的性沟通：这个时候，孩子会说些话或做些事来向其他人传达信息。他们用这个沟通方式来抗议他人对自己提出的要求或向别人提出要求。
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. 当孩子知道自己的行为能对他人造成影响后，目的性沟通会变得更加容易——对他们来说，从前目的性沟通跨越到目的性沟通是一个大的进步。
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）认为应该把孩子的目的性沟通视为连续的一体，这个连续的一体的一端是那些只为了得到自己想要的东西而沟通的孩子，另一端是那些为多个目的沟通的孩子，比如提问，对事物做出评论或与人交往。 The four different stages of communication 沟通的四个不同阶段 (as defined by The HanenProgramme) The stage of communication that the child has reached dependson three things: （由HanenProgramme定义） 孩子们这些交流的阶段决定于三方面： Their ability to interact with another person How and why they communicate Their understanding. 他们和他人互动的能力 他们交流的方式和目的 他们的理解力 Stage one - the own agenda stage 第一个阶段——自我议程
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. 处在这个阶段的孩子往往对周围的人不感兴趣，倾向于自己玩。他们的沟通主要是前目的性。大多数孩子们是在这个阶段被诊断为患自闭的。
Stage two - the requester stage 第二阶段——需求阶段 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. 在这个阶段，孩子们开始意识到他们的行为对他人有一定的影响。孩子们可能会通过牵引成年人到某些物件、某些地方或者某些游戏，来向成年人表达他们的需求和喜好。
Stage three - the early communicator stage 第三阶段——早期沟通阶段 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. 在这个阶段，孩子的互动时间有所增长，他们的行为也变得更加有目的性。孩子也或许会通过效仿他们听到的声音来表达他们的需求。渐渐地，孩子开始通过方位指向的方式向成年人表明他们的需要，并且开始转移他们的注视，这是孩子开始参与双向互动的一个标志。
Stage four - the partner stage 第四阶段——伙伴阶段 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. 当孩子们到达这个阶段，他们已经成为更加有效的沟通者。孩子使用语言来交谈，也有能力进行简单的对话。在熟悉的环境（例如，在家里）与人交流沟通的时候，孩子会表现出自信和一定的社交沟通能力，但是当进入一个陌生的地方（例如在一所新的托儿所或学校）他们可能会经历某些心理挣扎。在这样的情形下，他们会使用记忆中的习惯用语，也经常忽视他们的交流对象，出现抢话，无视话语轮换规则的现象。
Ways that adults can affect the communication ofa child with ASD 成年人如何影响自闭症孩子的交流方法
Take on the role of a helper and teacher 充当援助者和导师的角色 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. 当孩子无法表达他们的需求时，人们总是情不自禁地去帮助他们，不断地为他们做一些事情。举例来说，为他们拿鞋子，为他们系鞋带等。然而，这样的做法对于孩子们来说，意味着他们可以自己完成这类事情的机会被减少了。当孩子处于自我程序阶段，要清晰认识到帮助他们到哪种程度是一件特别困难的事情。在这种情况下，比较适宜的方法是询问孩子是否需要帮助，耐心等待他们的回答然后在提供帮助之前再次询问一遍。
Instead of letting the child do their own thing,encourage them to do things with others 鼓励孩子与他人一起共事，而不是让他们独自完成 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. 当孩子与成年人互动表现兴致索然的时候，人们不禁相信这个孩子只是在表现他的独立性。然而，让孩子学会与人互动确实是件十分重要的事情，而不仅仅是让他们各自玩耍。在这种情况下，解决问题的关键是要坚持加入孩子正在从事的活动，无论他们是在玩一条绳子还是把玩具从玩具箱放进去又拿出来。当你在尝试这种方法的时候，如果孩子表现出愤怒和侵略性，也仍要坚持去参与他们正在做的事情。愤怒也是一种互动，孩子表现愤怒总比毫无反应好得多。与孩子持续这样的互动会让他们适时意识到与另外一个人互动会使一件有意思的事情。
Slow down the pace and give the child a chanceto communicate 放慢节奏，给孩子一个沟通的机会 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. 照顾自闭症孩子是一件极其辛苦且十分耗时的事情。当孩子正在完成日常任务——诸如吃早饭和穿衣服这样的事情的时候，成年人时常会冒出一种催促他们快点做好的想法。当自闭症孩子在从事这样的日常事务的时候，他们可以从额外的几分钟里获得好处。因为额外多出来的时间有助于他们明白正他们身边正在发生什么，也有助于他们思考在做这些事情的时候可以说些什么。
When playing with the child take on the role ofa partner rather than a leader 在与孩子玩耍的时候担当搭档而不是领导者的角色 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. 随着孩子与人沟通交流能力的增强，他们不需要太多的指导——如果人们向他们提出太多的问题和建议，将使他们展开他们自己的对话变得十分困难。跟随孩子的引导，并适时对他们所作的事情做出回应十分重要。
Present the child with feedback 给孩子提供一些反馈 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. 当孩子尝试理解并交流的时候，给予他们一定的奖励是十分重要的。这样做可以增加他们再次尝试沟通的可能性。在对孩子所取得的进步发表评论的时候，使用一些简单的描述性的赞扬话语，可以使孩子对他们的行为和你的特定用语产生关联。
Giving the child with ASD a reason tocommunicate 为自闭症孩子创造一个沟通的理由 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. 如果患自闭症的孩子获取他们所需的事物时没有遇见任何困难，他们则没有任何理由去与他人沟通和互动。因此，在许多场合下，成年人需要营造一个情景，为自闭症孩子创造一个沟通的机会，并鼓励他们与他人互动。
Encouraging requests 激发孩子提出要求 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. 要实现这样的目的，可以将孩子最喜欢的玩具、食物或者录像带放置到一个他们看得见却无法拿到的地方，例如放到一个很高的架子上。要不然，把孩子最喜欢的东西放进一个对于孩子来讲不容易打开的容器里，例如一个旧的冰淇淋桶或者一个旧的果酱罐。这样的方式可以激发孩子向他人寻求帮助，并促使他们与成年人产生互动。
Give the child a toy that is difficult tooperate 给孩子一个难以操作的玩具 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. 需要上发条的玩具和需要挤压才能玩的游戏对于孩子来说很难独自操作但同时又让他们感兴趣。把玩具或者游戏器具给了孩子之后，给他们留一些时间来发现如何玩耍这些玩具。当孩子因为没有能力玩耍某个玩具或游戏器具而受挫的时候，成年人可以及时介入进来帮助和引导他们，这种类型的玩具包括玩偶匠、陀螺以及音乐盒。
Give thechild a toy that is 'high interest' 让孩子玩极具趣味的玩具。 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. 气球和泡泡就是所谓的极具趣味的玩具，很适合进行双人游戏。吹起一个气球，然后任其飞上天空，类似这样简单的游戏会引起孩子的兴趣。把气球吹到一半，等孩子有所反应再把气吹满，这同样也是一种增进孩子与大人之间的互动的好办法。吹泡泡也能达到类似的效果——向着孩子吹一些泡泡，等他们的注意力被吸引过来了就关上瓶盖，直到他们有所反应才再开始吹泡泡。
Give thingsto the child gradually 循序渐进地给孩子东西
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. 当孩子的需要被完全满足了之后，他们会很自然地不再向大人提出别的要求。减缓向孩子提供玩具或食物的过程也给孩子提供了表达自己需求的沟通机会。举个例子，如果孩子想要一块饼干，你可以把饼干掰成小块，最开始只给他们一块，等他们提出要求之后再给逐渐增加饼干的数量。
Let thechild decide when to end an activity 让孩子来决定什么时候结束一项活动 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. 大人在和孩子共同参与一项活动时，不断地进行那项活动直到孩子暗示他们觉得玩够了。留心孩子显露出厌恶的表情或是对活动有所排斥的表现。这往往能迫使他们提出自己已经准备好结束这项活动。如果孩子不用语言来暗示自己已经不想参与了，配合他们的交流方式，辅以类似“够了”这样的词语来鼓励孩子进一步进行语言交流。
Increasinginteraction by following the child's lead 让孩子做主导以促进互动 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. 让孩子做主导而不是引导他们——这能使孩子学会在与他人合作时进行沟通，从而促进他们与他人的互动。孩子自己做主导时会更注意正在进行的活动，像成人一样专注于同一件事，并学会如何自己做决定。 让孩子做主导时，大人最好与孩子面对面，这样大人就能观察孩子对什么感兴趣。这也有助于孩子进行目光接触——通常这对自闭症患儿来说并非易事。和孩子保持在一种平等的位置也能保证他们能观察到在交流中不同的表情变化。自闭症患儿常常不能抓住谈话中的非言语表达/交际行为；因此，在可能的情境下让他们注意到这一点十分重要。这种训练的目标是最后使孩子习惯大人处在同等的位置跟他们一起玩，并开始期待大人的出现，在大人不在时会自发地邀请大人一起游戏。
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. 模仿孩子的行为与语言能帮助孩子参与进双向的互动中。如果孩子用勺子敲打桌面，大人做出同样的举动，就会使孩子注意到大人。同样的，大人也可以模仿孩子发出的声音或是做出的感官行为，比如拍手和旋转。当孩子发现大人在模仿自己的动作时，他们也会倒过来模仿大人的动作。这就为大人在互动中加入供孩子模仿的新内容创造了机会。
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. 当自闭症患儿对手中的所有玩具都不感兴趣，或是想要排列玩具而不是玩玩具时，大人们也能找到一些进行交流与互动的机会。举个例子，如果孩子把小汽车摆成一排，大人就可以加入进来给孩子一架一架地递小汽车。这样，大人就能参与进游戏中，孩子也不得不让大人和他们一起做事情。如果孩子只想把玩具乱丢在地上，大人可以用篮子把玩具收集起来再还给孩子，从而建立起与孩子的互动与交流。
Ways thatadults can help a child with ASD understand what is said to them 帮助自闭症患儿了解别人在说什么的方法 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. 处理信息对于自闭症患儿不是件容易的事。这是因为他们在理解周遭的世界时就会感到很困难。即便一个自闭症患儿了解一种具体的情境，他们也可能不理解这种情境下出现的语言。有时候我们会以为孩子理解了别人在说什么，因为他们似乎能够服从指导。然而孩子在一定语境中能够根据指示知道该做什么，往往是因为他们之前已经重复了许多次同样的举动。
There areseveral ways in which to enhance a child's comprehension of what people aresaying to them. 以下几种方法可以用来提高孩子的理解能力，明白别人在对他们说什么。
Say less andsay it slowly 少点说，慢点说 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: 在和孩子交流时，大人可以控制词语的数量，但依然谈论相关的内容。利用特定语境下的关键词，进行重复与强调，并辅以类似指示等手势。萨斯曼（1999）用了下面这句话来提醒大人如何使自己的语言更简单，便于自闭症患儿理解。
'Say lessand stress, go slow and show!' “少点说，多强调；慢点说，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开始把说话当做一种交流方式，那么大人就应该用一个一个的词来和孩子交流。例如，把孩子喜欢的玩具和食物贴上表明该东西的标签。把东西给孩子时，应即时贴上标签，这是很重要的。如果孩子的注意力转移到别的东西上，这个标签就会失去预期的作用。
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. 单词和短语之间的停顿也可以帮助患有自闭症的孩子理解刚刚对他们说的是什么。大人应该利用停顿来给孩子时间以消化刚刚对他们说的是什么，并且给他们一个思考如何应答的机会。
讲话的同时使用手势也能帮助孩子去理解刚刚对他们说的是什么。例如，当给孩子喝水时，大人可以做一个喝水的姿势，假装一只手拿着杯子并送到嘴边喝一口水。同样，吃饭的时候也可以这样。另外也可以使用夸张的面部表情，用点头和摇头表示“是”和“否”，用挥手来表示“你好”和“再见”。而当跟孩子谈论到人的时候，例如“外婆要留在家”，给孩子一张谈论对象（外婆）的照片是很有帮助的。
对本文的特别申明: 由于我们的医学专业知识和翻译水平有限，译文可能会有瑕疵，欢迎大家提出宝贵的意见和建议，以便帮助豆苗计划翻译小组更好地开展工作。 豆苗计划翻译小组 翻译：yu翼 MONOの caicai ゼ~SUNNY~ザ 马里亚纳の阳光 复核：Rexx TAOF.R* |
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