Community Psychiatric Centers
Monroeville, Greensburg, Monessen, and Wilkinsburg Pittsburgh

February 14, 2012

Autism: When is it good to talk to yourself?

Written by Dr. Carosso

Is it good to talk to yourself?

Sure it is. In fact, this is how we, as humans, problem-solve and work through our difficulties. We learn, beginning at a young age, how to ‘talk things through’ in our head, which helps us to process our feelings, experiment with potential problem-solving strategies, and rehearse resolutions.

Go on, let it out

How often have we heard young children ‘talking out loud’ in their play, or when working through some difficulty? In fact, as adults we not uncommonly do the same thing, but are more discreet about it (you know what I mean; talking out loud while driving home from work and hoping other drivers don’t think you’re strange). However, it’s not until about seven year old that children begin thinking more in words, quietly in their head, as opposed to out-loud and in pictures, the former of which tends to be more efficient and effective.

What’s this got to do with autism?

As we know, children with autism struggle with expressive language. Children who struggle with talking to others also struggle with talking to themselves. In fact, a recent study out of Durham University (Development and Psychopathology, January 26, 2012) found that 2/3 of children with autism experience significant difficulty with self-talk, even if they had some level of expressive language capacity.

Lets talk this out

So, what do we do about this skill deficit? Well, for starters we take every opportunity, in the presence of children with autism, to ‘talk out’ our thoughts as we plan our day and problem-solve, and we give children the words to problem-solve on their own. We do so as simply as possible, using as few words as possible depending on the age and language skill-level of the child.

Younger the better

To help young children and those with more severely compromised language, we use visual cues and schedules with actual pictures of the child or item. However, it’s important to transition, over time, to symbols, then symbols with written words, then only written words with speech, we then rely solely on speech; all of which builds the foundation toward inner speech.

20 Questions

This process is no game, but you’ll present it that way. We build foundations of self-talk by asking questions, during games and activities, which promote planning and ‘thinking things through’. Such as: “what can you do with that puzzle piece?” “What will you need next to finish the puzzle” “Where can you find that piece?” “What will happen after you’re done? Sometimes the questions can be posed to direclty promote self-talk, “I wonder what will happen next if you do that…?”

Turning action into words

The approach I find to be invaluable is ‘parallel talk’ that involves playing alongside a child and talking through what he or she is playing (putting actions into words, which is exactly what we want the child doing to plan and problem-solve). This is also helpful to enhance play skills.

Summing it all up

It is vital that children are able to utilize ‘self-talk’ to plan and problem-solve; it’s a skill that all children need to master but is usually quite deficient in children with autism. These strategies can help to increase your child’s ability to ‘talk to themselves’ and thereby more effectively plan and problem-solve.


Please comment, or Email me with any comments or questions at or Your feedback and individual experiences are welcomed and will be invaluable to share with others. Thanks again and God bless.

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