Communication in everyday life: avoiding misunderstandings

What the guideline named for interaction

The consensus-based recommendation (strong consensus) stated: people with autism have individual skills and needs. Helpful in interaction are in particular (1) the possibility of non-verbal initiation of contact, (2) concrete, direct communication suited to developmental age, (3) structuring the environment and sequences of actions, for example through visual means, predictability and consistency of people, (4) maintaining physical distance, (5) avoiding strong sensory stimuli such as noise, smell, light. A discrepancy between cognitive and social skills should be taken into account. ^{[1, Rec. 3]}

Where misunderstandings can arise

• Figurative meaning: In cognitively gifted people on the spectrum, understanding proverbs, humour or irony can be harder. ^{[2, Ch. A.2.1]} (Suggestion from the editorial team: briefly resolve irony.)
• Non-verbal signals: Non-verbal communication (gestures, facial expression, gaze behaviour) is one of the areas in which autism shows. ^{[2, Ch. A.2.1]} How signals come across to the other person can therefore be interpreted differently by both sides (assessment by the editorial team).
• In both directions: In an experiment with nine groups of eight people, people on the spectrum passed on information among themselves as well as people without autism among themselves; in mixed groups, clearly more was lost, and rapport was lower. ^[4] Misunderstandings are therefore not a matter of “mistakes” by one side. The study had 72 adults (24 each with autism, without autism and mixed), the sample was rather small; the authors stress that replications are needed, the participants knew who was on the spectrum, and the indication of lower rapport in mixed groups was not particularly strong statistically. ^[4]

Suggestions for everyday life

From the principles named, the following suggestions from the editorial team can be derived (not individually backed):

• Say what you mean. Instead of hints: concrete requests, clear details of time and place.
• One thing at a time and, where needed, supplement in writing.
• Allow follow-up questions: “Did you mean it like that?” is better than guessing.
• Do not read differences in pace and eye contact as disinterest.
• Offer breaks and withdrawal when conversations become tiring. ^{[1, Rec. 3]}
• Both sides adapt; the responsibility does not lie only with the person on the spectrum.

For people who speak little or not at all, picture cards or speech-output devices can be used: Augmentative and alternative communication.

What else you should know

• Ask individually. Ask the person what is helpful for them in conversations. The guideline provided for regularly asking about wishes and needs. ^{[1, Rec. 4]}
• Basics: Social communication and interaction in autism.
• Not covered: communication by phone, chat or video conference and particular techniques (for example comic strip conversations).

Sources and literature

1. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 2: Therapie. S3-Leitlinie, AWMF-Reg.-Nr. 028-047, Stand Text 02.05.2021 (Empf. 3, 4). – Guideline (in German); expired on 23 March 2026 (see no. 3)
2. DGKJP, DGPPN et al. S3-Leitlinie Teil 1: Diagnostik. AWMF 028-018, Textstand 23.02.2016 (Kap. A.2.1). – Guideline (in German) (expired; according to the document note under revision)
3. DGKJP. Aktuelle Leitlinien (Einträge 028-018 „Gültig bis 04.04.2021“ und 028-047 „Gültig bis 23.03.2026“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)
4. Crompton CJ, Ropar D, Evans-Williams CV, Flynn EG, Fletcher-Watson S. Autistic peer-to-peer information transfer is highly effective. Autism 2020;24(7):1704–1712. https://doi.org/10.1177/1362361320919286 – Experiment