What is autism scripting?

Autism spectrum disorder is a developmental disorder that can be present in both children and adults, that typically emerges by the age of three ^[1]. Autism can impair communication abilities, functioning, and behavior, which can cause difficulties in social, academic, and professional situations. Many autistic people use scripting as a way to manage and compensate for these difficulties.

What is scripting?

Scripting is a commonly seen symptom of autism, that can be either intentional or unintentional. Autistic people often struggle with spontaneous initiation of verbal exchanges and scripting can help to make this easier ^[2].

Scripts can be taught or learned, and ready for use in a variety of circumstances, reducing the need to understand social contexts and acceptable or ‘normal’ responses or behaviors. For instance, someone who lives with autism can be taught certain scripts for finishing conversations or initiating an interaction with a peer ^[2].

There are various types of scripting that can help with social situations, learning, and self-soothing. These scripts involve using learned words, phrases, or written dialogues to be repeated in various situations ^[3][4].

How does scripting help people with autism?

Scripting can help people with autism in several ways, such as:

Helping to initiate play or conversation

Many autistic people struggle to initiate conversations with others. Studies have found that children with autism spectrum disorders are able to start conversations and play with their peers by using prior written scripts, creating an increase in social interactions ^[5][6].

These studies have also found that scripting can decrease disruptive behaviors and help children to require fewer conversational prompts from their teachers, thus allowing them to explore more general and unscripted language, prompting an increase in spontaneous interactions ^[6][7].

Reducing anxiety in social situations

Social anxiety can be very prevalent amongst autistic people, due to impaired social functioning. Scripting can help to reduce this anxiety, by providing set words and phrases to use in various situations ^[8].

By utilizing a set response to a specific question, this reduces the need to understand context, emotion, or facial expressions to formulate an appropriate response. This can also help to improve the ability to understand these aspects of social interaction, through repeated exposure ^[5].

Helping to make friends

Scripting can help autistic people integrate in social groups, by masking some of their symptoms and helping them to feel that they fit in. Scripts, whether written about basic social interactions or copied from movies and TV, can make it easier to join in conversations and make friends, which is typically very challenging for people with autism ^[3].

Self-stimulation

Self-stimulation, or ‘stimming’, is a technique used by many autistic people as a way to self-soothe or relax and may be done in various ways ^[8]. Repeating words or phrases is a commonly seen stimming technique, usually using quotes from movies or TV that are repeated several times, often with the same accent and intonation as the original performance ^[4].

Improve job and interview skills

Many people use scripting to help camouflage autistic characteristics in job interviews or while at work, utilizing set responses to predicted questions. This can reduce anxiety around stigma and preconceptions, thus contributing to an improvement in performance ^[3].

Are there downsides to autism scripting?

While there are many benefits to scripting, extended or regular use of this technique can have several negative consequences, such as:

Loss of identity

Some people who use movie or TV scripts within their day-to-day language report that they begin to emulate the character they are quoting, taking on many of their characteristics and even sometimes their appearance, changing their clothes or hair to match ^[4].

This can result in a loss of self-identity and a reinforcement of the need to pretend and perform consistently, rather than being comfortable as themselves, which can prevent improvements in social interaction and contribute to feelings of low self-esteem ^[3][9].

Preventing diagnosis

Scripting may camouflage many characteristics and symptoms of autism, which can make it more difficult to notice and thus, delays referral and diagnosis, or may lead to misdiagnosis, preventing the person from receiving appropriate support ^[3].

Research suggests that females are more likely to internalize and camouflage their symptoms, which is considered one of the reasons that males are more often diagnosed with autism than females ^[9].

Exhaustion

Feeling the need to constantly perform as another character or hide personal characteristics can lead to exhaustion, stress, and autistic burnout, which may have many consequences on physical and mental health, including reducing social interactions and potentially withdrawing from all social occasions to avoid experiencing this exhaustion ^[3][8].

Being unprepared

While it may be useful to have scripted phrases to utilize in social interactions, it could also be limiting and lead to feeling unprepared if a situation arises that has not been scripted and prepared for, thus potentially increasing stress and anxiety ^[3][8].

Worsening mental health

Scripting can contribute to worsening mental health, such as low self-esteem, depression, and anxiety, due to a constant pressure to perform, feeling that a false persona is required to be liked by others, or fear about planning for upcoming social events and interactions ^[3].

Examples of autism scripting

Autism scripting can be taught or learnt and may be utilized in different ways, such as:

Improving communication

Studies have shown that, for adults and children, scripting can help to improve communication in various situations, such as in the classroom, at work, or within social interactions. Scripts can be used to learn how to begin or end a conversation, learn appropriate responses to questions, learn how to interact during a task or activity, and learn how to make requests for items or meeting needs ^[5][7].

Repetition or echolalia

Repeating words or phrases is also known as echolalia and is a commonly seen way of scripting, often used as a self-soothing technique. This can include phrases from movies and television or from real people, which are then repeated, often in the exact same intonation ^[10].

For example, if someone asks a question, the autistic person may then respond by repeating the question or last word, also as a question, rather than giving an answer. This may be an immediate response or may be delayed and said many hours or days later, often repeated several times.

Film or movie scripts

It is common for autistic people to repeat quotes from movies and television, or even to try and become the character they are quoting, taking on their persona and mannerisms to help them cope with interactions ^[4].

Camouflaging

Similarly, scripting may be used as a way to camouflage characteristics of autism, helping the person to fit in amongst others, which can reduce feelings of being stigmatized and allow for improvements in social and professional interactions ^[3].

Out of context

While some scripts are used as a response to specific questions, it is also common for autistic people to say learned words or phrases out of context, which can appear odd to others, particularly if a specific question is asked and an unrelated response is given ^[10].

How to manage scripting in autistic individuals

People with autism may need support in managing their symptoms and reducing their need for scripting. There are various ways in which to provide support, such as:

• Fading: Many teachers who use scripting to improve communication will incorporate fading into this education, to gradually reduce the need for prewritten phrases, prompting the integration of spontaneous communication ^[2][5].
• Rewarding: Using a rewards system can also help to reduce the use of scripting, if rewards are given when spontaneous or general language is used, or at times when scripting is not used, thereby reinforcing this behavior ^[7].
• Speech and language therapy: Trained speech therapists can assist with teaching and developing speech for those who struggle to understand or use language in context ^[11].
• Social skills groups: It can be useful to learn communication skills amongst others who share similar challenges, as this can reduce feelings of shame or loneliness, while improving social skills ^[11].
• Psychotherapy and CBT: Cognitive behavioral therapy and other types of therapy can help to reduce negative feelings, such as depression, anxiety, and low self-esteem, that may be associated with social impairments and the use of scripting ^[11].

In summary, scripting can be a way for individuals with autism to learn conversational skills, but if used in excess, it can become problematic. Ideally, scripting interventions should be faded over time, so that individuals who live with autism can learn spontaneous conversation skills.