Speech-Language Therapy for Autistic Children
Communication difficulties form a part of the diagnostic criteria for autism spectrum disorders. Therefore, some degree of language impairment characterizes all autistic children. For those who cannot enunciate syllables or words clearly, have problems with fluency, or experience difficulty eating and swallowing, a classic speech therapist teaches proper pronunciation, helps strengthen weak mouth and jaw muscles, and works with food textures and temperatures to improve oral skills. However, most children with autism do not need that type of therapy.
Vocabulary makes up only a small portion of speech. Improving eye contact, understanding what words mean, using them appropriately in a sentence, and teaching children to express themselves and carry on a conversation are all important aspects of social communication and language.
While a few autistic children do need help with articulation and other oral issues, speech-language pathologists trained and experienced in autism’s unique processing difficulties and communication deficits mainly focus on language and communication activities.
What is Speech and Language Therapy?
Words carry power. They make things happen. Through speaking and conversation, a child learns that talking can get him what he wants. Speech and language therapy goes beyond articulation and seeks to teach autistic children that communicating is a worthwhile activity. It encourages one-on-one or small group engagement in a home environment, clinical setting, or classroom; and uses applied behavior analysis (ABA) principles sometimes referred to as verbal behavior (VB).
While the details of each individual program depend on where the child falls on the spectrum, his developmental difficulties, and why he is specifically having language problems (as determined by a speech-language pathologist’s evaluation), most intervention plans involve keeping the child engaged through games of interaction and repetition, increased eye contact, and encouragement of expression. Through small, but measurable verbal behaviors, a child learns:
- to imitate through modeling (echoic)
- how to make requests (mand)
- how to label items in his environment (tact)
- better comprehension
- and eventually conversation
By using pictures or picture boards, objects, and books, and by interacting through talking, games, and other activities, a therapist hopes to stimulate or increase vocabulary, grammar skills, problem solving, and sequencing; and thereby improve overall speech and language development.
Speech-Language Therapy Motivates an Autistic Child to Talk
Children learn to speak through imitation and modeling. The same holds true for language development. While autistic children often experience speech delays, initially it is typical for a speech-language pathologist to create situations that will encourage the child to echo exactly what he hears. Verbal behavior techniques do not differ from typical ABA principles. They just zero in on the specialized nature of language and communication problems.
For example, rather than teaching simple verbal imitation where the positive reinforcement does not directly relate to the object’s name, a speech-language therapist will often set up a situation that causes the child to want the object. By first showing the child a ball, and then asking them to say the word “ball” before giving it to them, the child learns to pair language and speech with the actual item – when personal motivation is high.
This shows the child that talking brings benefits and is worth the effort to learn, since he now sees speech as a way to fulfill his needs and desires. With the reinforcement strongly tied to the request, it also strengthens the likelihood that the same verbal behavior will occur in the future, as well as the probability that the child’s interest will be sparked enough to begin naming other objects on his own.
Whether the therapist teaches requests, labeling, expression, grammar, or any other language or communication technique, as in basic ABA principles, speech-language therapy also uses prompts to make learning as errorless as possible. Language is far too complex to allow frustration to override what an autistic child can accomplish through teaching in small steps and using positive reinforcement.
Intensive Therapy Improves Speech and Language Skills
Most medical authorities agree that the earlier a child starts speech and language therapy, the better the chances for a successful outcome. Although school districts in the U.S. must evaluate children with speech and language problems, many therapists are not trained or educated in the complexities of helping autistic children with language development. A school-funded therapist may deny speech services if the child babbles, rather than lisps or stutters, because he doesn’t fit the classic criteria for speech problems. When that happens, parents of autistic children must pay for therapy from an outside source.
In addition, an intensive program works best, because it gives autistic children opportunities to learn throughout the day in a variety of situations. A good speech-language pathologist will teach parents the principles they are using, so the exercises, games, and activities can continue at home. However, a home-based, intensive speech and language program is not as hard as it sounds.
Intensive simply means to provide as many naturally occurring opportunities to talk as possible. Many times, individual speech and language problems continue because a child does not need to speak. If everything he wants is down where he can reach it, or if a sibling always speaks for him, a child has no reason to ask for anything. Without motivation to use words, he won’t.
What Parents Can Do At Home
As with other life skills, parents should begin with observation. The first step is to pay attention to what the child is particularly interested in, and what he spends his time doing throughout the day. That will be different for each child. One child might be particularly fond of trucks, and spend hours lining them up in a row or spinning their wheels. Another might enjoy eating and continuously help himself to a few crackers, or a piece of fresh fruit sitting in a bowl.
Once parents have a handful of possible motivational triggers, they can move what interests the child to where he can no longer reach it. However, objects should always be partly visible to keep the child interested. Instead of using a bowl of fruit to decorate the kitchen counter, a parent can place it on top of the refrigerator in such a way that the child can still see it. Likewise, parents can do the same thing with toys. Instead of keeping a child’s favorite truck sitting on top of his dresser, place it on a higher shelf inside his closet.
There are many ways parents can incorporate speech-language therapy, activities, and games into a child’s day. It just takes thought, and a little time and effort. For typical children, teens, and adults, speech and language comes naturally, but parents of autistic children can train themselves to become more aware of the possibilities. In addition to the games, activities, and exercises learned at speech-language therapy sessions, parents should watch for different times throughout the day when communication takes place through talking. New awareness can bring a crop of ideas that will get an autistic child to speak.
Change does have its consequences though. Autistic children resist anything that is different. But the benefits that come from better communication will help a child in all areas of his life, not just speech.