Speech Therapy for Children with Autism

By Eric WunderlichUncategorized

By Amy Inman, BCBA

Introduction

When you have a child that struggles to effectively communicate their wants and needs, it can be incredibly frustrating for the child and heartbreaking for you as their parent. You want your child to tell you all about their day, how they are feeling, and what they are thinking about. It can cause feelings of hopelessness and uncertainty about where to turn for help. Some children may develop their own way of communicating. They may create their own words or sounds for specific items or use gestures to demonstrate what they want. Sometimes a child may pull or lead others to items that they cannot access on their own. If these communication efforts fail, a child may resort to crying and tantrums to get their needs met. Does this sound like your child?

This article is written for parents and caregivers of children diagnosed with autism spectrum disorder who also have a moderate to severe speech and language delay. The hope of this article is to provide information on what having an autism diagnosis means in terms of communication deficits and how speech therapy can help overcome those delays to create a functional communication system for your child.

Autism and Communication

You may be asking yourself how autism and communication are related. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a guidebook used by healthcare professionals to diagnose mental disorders. According to the DSM-5, deficits in social communication and social interactions are part of the diagnostic criteria for autism spectrum disorder. Thus, every child with an autism diagnosis has some form of delay in the following 3 domains:

  1. Social-emotional Reciprocity. This refers to engaging in back-and-forth communication that takes place during conversations; sharing interests with others; and initiating and/or responding to social interactions.
  2. Non-verbal Communicative Behavior. This includes using eye contact, body language, gestures or facial expressions during social interactions. 
  3. Create and Maintain Relationships. This relates to adapting behavior to current social contexts; engaging in various types of play with others; and having a general interest in peers and social engagements. 

These deficits can vary from mild delays to severe impairments. Given the significant need for speech and language in everyday interactions, it is important for children with ASD to have access to an effective method of communication. This is where Speech Therapy, provided by a trained Speech-Language Pathologist, can help.

The Benefits of Speech Therapy

Speech therapy can be extremely beneficial in building the foundational skills needed to increase speech, language, and overall communication. Your child may have a delay in one or more areas of communication. The terms Speech, Language, and Communication are not the same but are often used simultaneously.

–Speech is the physical motor ability to produce single sounds as well as patterns of sounds to create meaningful words. It also involves correct production and articulation of spoken language to be able to engage in communication with others. 

–Language is the use and understanding of spoken or written words as well as social gestures. It is how important messages are sent or received between individuals.

–Communication is a much broader term. Not only does it refer to the exchange of information using either spoken, written, or gesture cues, but it also encompasses different types of communication; personal and mass. Personal communication consists of talking and listening along with social gestures and/or facial expressions. Mass communication is the use of larger communication outlets to reach a larger audience.

Speech, language, and communication differ in terms of usage, scope, and importance. However, they are closely intertwined, and each plays a prominent role in our daily lives and social interactions.

Speech-Language Pathologists (SLPs) are medical professionals that are intensively trained to identify and treat communication delays. Prior to starting services, an SLP will conduct a speech and language assessment to identify the primary underlying deficits and create a comprehensive plan to treat the identified concerns. 

Speech therapy can target many different types of speech, language, and communication delays. 

Some types of goals the SLP may treat include: 

  • Increasing the frequency of sounds or words emitted by the child 
  • Pairing multiple sounds together to create meaningful words or phrases 
  • Correcting pronunciation of sounds or words to increase intelligibility
  • Increasing the mean length of utterance of words to produce phrases and sentences
  • Expanding language associated with echolalia

SLPs also have a well-rounded skill set to meet those goals. They may use some of the following techniques to help them achieve the desired outcome for your child. 

Examples include: 

  • Targeting sounds or words based on your child’s motivation (Ex: present the word “ball” while your child is playing with the ball)
  • Physically placing your child’s lips, mouth, or jaw in the correct position when prompting words or sounds. Check out this video for an example: What is PROMPT Therapy? (Official Video) – YouTube
  • Presenting a sound with a specific gesture to emphasize the target sound and to use it as a visual prompt to teach the sound. (Ex: Saying the “n” sound while touching the side of the nose.)

Sometimes spoken language is not the best method of communication for your child with their current skill level. An SLP may suggest adding an additional type of communication to be used while spoken language is still developing. There are multiple types of systems a child may use to indicate their wants and needs. An SLP could identify and recommend any of the following communication methods. 

  • Augmentative and Alternative Communication (AAC) device or a Speech-Generating Device (SGD) is an electronic device used to assist with or replace vocal communication. It has a voice output system that transmits messages or symbols into understandable language for the listener.
  • American Sign Language (ASL) is the use of gestures and facial expressions.
  • Picture Exchange Communication System (PECS) involves giving pictures, symbols, or sentence strips to the listener. 

Research shows that using an alternative form of communication in addition to speech therapy can increase overall vocal communication. Thus, the addition of the alternative form of communication can be used temporarily while speech and language skills are still developing.

This list is not exhaustive, so make sure you talk with your child’s SLP about the concerns you have with your child’s speech and language delays. 

Parent Involvement 

This part is key. It is important for parents and SLPs to build a partnership and work together to create the best outcome for the child. This can be done by having open and honest communication. SLPs will use the speech therapy sessions to work with the child and to teach the parent how to implement the various techniques that are most successful. Parents should feel confident in the strategies that are being used so they can continue to target the goals outside of the sessions. 

Helpful Hints

  1. Practice, practice, practice. Some children require hundreds of trials per day to learn a new form of communication. Use any opportunity you can to have your child use the techniques provided by the SLP. 
  2. Do not compare your child’s communication progress with other children. Each child will progress at their own rate as each child is on a different area of the spectrum. Some children may take longer and need more opportunities to practice than others.

How to Obtain Speech Therapy

Talk to your family doctor or child’s pediatrician if you believe your child has a speech and language delay. The doctor should be able to make a referral to the appropriate service provider for an evaluation and assessment.

Research and References

Centers for Disease Control and Prevention. 2021. Diagnostic Criteria | Autism Spectrum Disorder (ASD) | NCBDDD | CDC. [online] Available at: <https://www.cdc.gov/ncbddd/autism/hcp-dsm.html> [Accessed 30 September 2021].

The Prompt Institute. 2021. [online] Available at: <https://promptinstitute.com/> [Accessed 30 September 2021].