Cluttered communication in a deafened adult with autistic features

This is a case study of a 36-year-old man who was assessed by a psychiatric service for deaf people in London, England. Among the presenting symptoms of the client were poor eye contact, inconsistently hurried, poorly organized gross movement, apparent deficits in ability to establish rapport, grandiose content in the context of excellent writing skills, and, most relevant to this discussion, unintelligible speech marked by several types of disfluency. The client appeared to have little or no insight into his speech impairment. Formal and informal assessment procedures were used by the speech and language pathologist and clinical psychologist to distinguish the effects of childhood-onset deafness from those of autism, psychosis, depression, and/or a hitherto undiagnosed genetic or neurological disorder. Investigation included hematological and neurological tests.