Aspire CFS Behavioral Health Blog

Speech Therapy & Autism

Speech Therapy & Autism

Communication Deficits Caused by ASD and How Speech Therapy Can Help

Communication is something that changes from person to person and over time. There are subtle cues in our languages, facial expressions to be read and tone of voice to be understood. Since communication is a form of expression, it is something people with Autism usually struggle with. In addition to all of the variables involved in our verbal expressions, people with Autism have difficulty verbalizing thoughts and feelings.

Especially at an early age, a child with Autism will have limited ability and understanding of using language to communicate. People with Autism are typically inexpressive in both their body language and tone of voice. Not realizing the significance of verbalization could lead to the child making noises without distinguishing between words and sounds. This might manifest in humming or repetition of phrases the child hears, a behavior called Echolalia. The child could also use words and complete sentences but using a sing-song voice or mistakenly using emphasis wrongfully in a sentence. One of the things that makes it difficult to improve their communication abilities is their reclusive nature. People with Autism are often introverted and prefer to be alone. They can occupy themselves very well and lose themselves in some sort of project or hobby. This behavior is actually the origin of the label “Autism.” The National Institute on Deafness and other Communication Disorders (NIDCD) notes the Greek root of the word (autos-), meaning “self,” because of the perception that people with Autism were self-absorbed. Although the Greeks did not account for a deficit of expression, part of their assumptions about people with Autism holds up.

The NIDCD does conclude on their website, “Children with ASD are often self-absorbed and seem to exist in a private world in which they have limited ability to successfully communicate and interact with others.” This level of independence can be a strength, but now that we know about the communication barrier, we are able to more effectively help children with Autism wander out of their own headspace and willingly participate in conversation.


Common Communication Problems Linked to ASD

The subtle language cues that cause problems for some people with Autism are typically uses of body language and facial expressions to make a point. A wink or a pat on the back might go unnoticed or send the person the wrong message if they have never received instruction in understanding non-verbal expressions. For someone with Autism, this level of understanding requires a lot of practice and perseverance. That in itself is a challenge. Since conversations are taxing on people with Autism, they often cannot last long. Like a juggler practicing his skill, it takes time and effort before someone can toss a few ideas around in a conversation and keep them in the air for so long.

When a person with Autism works to improve their grasp of language, some of the miscommunications that can manifest later on include taking creative phrases and figures of speech literally. There are so many phrases in languages that come from references or old sayings and understanding them word-for-word can mean deconstructing a metaphor or recognizing hyperboles. Even words and phrases that have been learned can cause difficulties if the child only understands something in one context. For example, a child used to playing games on a computer can have trouble re-associating computers with schoolwork during the school year. Teachers would have to help the student redirect their focus to schoolwork, which can be especially hard if the child starts to settle in to the game.


Severe Problems with Communication and Expressions

Depending on the child, some with Autism are non-verbal and others develop language with enough instruction. Whenever the child does develop language skills, they might learn unevenly. Since it takes so much time to familiarize these children with spoken language, certain things might come quicker than others. For example, if it takes a boy longer to understand something like grammar or tone of voice, he might grow an advanced vocabulary but use it incorrectly in sentences.

Again, no matter where the child is in the learning process, it can be draining on them. Even if they seem fine on the outside, learning language may mean that they struggle anxiously through each word. Silent gaps between turn taking in a conversation can seem tense. If the speaker has Autism, they must think about everything they say carefully to stay focused, and as a listener, they are at the mercy of the other speaker’s pace. Plus, they must make sense of all the sounds and signs they’ve just picked up.

Conversations can be trying, and someone with Autism must pay attention to their temper. Imagine your lips are sealed shut for a week and you need to find ways to communicate. Maybe you could hold it together and find ways to make it work slowly, but if you felt distressed and had to communicate to solve the issue, you’d likely panic. When someone with Autism cannot effectively convey what’s wrong or what they need, they might feel panicked. In a high stress-situation, someone with Autism may shut down communication and show tantrum like behavior. It might seem pointless using words to help during some of the more physical tantrums, but parents, teachers and other guardians must be patient.


Treatment for Communication Deficits

Speech therapy is an effective solution to many of the language difficulties brought on by Autism. The field can address a number of verbalization problems, for people on and off the Autism Spectrum. Ranging from practicing conversation to pronunciation, grammar and phonics, a licensed speech therapist will have the tools to help your child take the right steps. Progress can be gradual, but some cases just require more scaffolding upward toward harder practice, with smaller, achievable goals.

Speech-language pathologists (SLP) can work with your child in whatever capacity they need to improve their ability to communicate. Here are some common ways SLP’s can help patients with Autism, according to the American Speech-Language-Hearing Association (ASHA):

  • Understanding gestures, like pointing, waving and facial expressions
  • Expanding vocabulary and learning how to integrate new words into conversation
  • Learning how to follow directions
  • Read books to improve literacy skills, since Autistic children often develop hyperlexia, which prevents them from understanding the words they read
  • Practice writing letters, words and sentences

Skill acquisition is not the only way for SLP’s to develop a child with Autism’s language skills. They also facilitate practice scenarios so someone with Autism can work on social skills in a pressure-free environment. Here are some of the things your child could work on with a speech-language pathologist:

  • Practice conversations and greetings
  • Practicing manners and getting along with other children
  • Asking and answering questions
  • Beginnings, ends and waiting turns in conversation

With cases affected by more severe speech deficits require even more training with a speech-language pathologist. Some of the ways SLP’s help patients treat more advanced communication issues include:

  • Teaching the child sign language
  • Teaching them to utilize gestures if vocalization is limited
  • Helping them explore technology used for artificial vocalization, like through a laptop or tablet
  • Building writing skills so the child can navigate conversation with a pen and paper


How Speech Therapy Helps

Autism Speaks is an advocate of speech therapy and their website has resources for people looking to seek help from a speech-language pathologist for their child. The specific goals of speech therapy for children with Autism include improving general speaking ability. This means working on pronunciation and speaking tone. Ideally, an SLP will work on non-verbal communication skills and help find alternative ways to communicate. In the long term, the child can go from crawling and walking through speech to being able to run alongside others in conversation. When a child can work with an SLP, they are able to get the right individualized attention for whatever ability level they start at and whatever pacing they need to take steps forward.


Research Backing Speech Therapy

There is conclusive research showing the benefits of speech therapy for children with Autism. Published in a medical journal called the American Academy of Pediatrics (AAP), one study monitors children, ages 2-5, with ASD and a language delay and their experiences beginning speech therapy. The treatment used for the study was scheduled over the span of 24 weeks and the AAP reports that the data would be collected “via behavioral coding of parent-child interactions, standardized parent-report measures, and blinded clinician ratings.” The study aimed to find improvement in subjects’ “frequency of functional utterances” in 5 months. The researchers’ found 91% of parents were able to implement treatment at home regularly by the end of the study.

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