Speech Therapy and Autism
Post in collaboration with Box Hill Speech Pathology Clinic
When Gilbert was first diagnosed with autism, speech therapy (also known as speech pathology), was suggested as a necessary therapy for him.
I’ve shared before how I was first confused when occupational therapy was suggested as a potential therapy for my son’s autism. I must confess I was equally at a loss when it came to making the connection between autism and speech therapy too.
My son was verbal (perhaps too verbal), he was an early reader and had no difficulties in being understood. Why then, the need for speech therapy?
As it turns out, there are many reasons why speech therapy is a recommended part of autism early intervention. Even for kids who are verbal and appear to be able to communicate without difficulty, speech therapy is a valuable tool in assisting them to make connections and better interact with the world around them.
Speech Issues and Autism
Autism is, in essence, a social communication disorder. Speech, language development and social communication are all areas most affected by a diagnosis of autism.
For instance, someone with autism may be non-verbal and may not be able to communicate with speech at all. Someone else may communicate in unexpected ways (through grunts or shrieks) or might prefer to sing or hum as they speak.
Others might use made up words (like my daughter once did) or copy what everyone else around them says (called echolalia, something that characterised my son’s early speech). Some on the spectrum speak in a monotone voice or talk in a robotic way, while others are over-enthusiastic and loud.
There are also comprehension issues when it comes to language. Where people have learned speech through echolalia, there is often a lack of comprehension of the meaning of the words and phrases being repeated as they were learned without real understanding. This can also lead to difficulties in understanding the meaning of words outside the context where they were learned (the inability to generalise learning across more than one setting).
These speech issues can compound the social communication problems experienced by those on the spectrum, who often struggle with understanding the unwritten rules of social interaction. These rules are not often spelt out, which leads to confusion around how to hold conversations, how to maintain eye contact, how to identify and act on non-verbal cues, what gestures are appropriate to use and where to stand when conversing with others.
Speech Therapy and Autism
Speech therapy can help improve speech, language and communication outcomes for those on the spectrum and their families. Speech therapists can assist by teaching skills to improve:
- the pronounciation and articulation of words
- verbal and non-verbal communication skills
- the ability to recognise and comprehend verbal and non-verbal communication and cues from others
- skills to initiate communication without prompting from others
- recognising the appropriate time and place to communicate something
- the development of conversational and social skills (one-on-one and in social skills groups)
- communication in ways to develop relationships
- the enjoyment of communicating, playing and interacting with peers
- emotional and behavioural self-regulation.
In our own case, we’ve sought assistance from speech therapists to improve the way our kids communicate and to improve our own communication with them too. Over the years we’ve concentrated on developing social skills, improving phonic recognition, bolstering letter and sound knowledge and working on building emotional regulation skills.
How Speech Therapy Has Helped My Kids
Speech therapy includes many areas of specialty. As mentioned above, nearly 10 years on, we’ve seen several “speechies” for a variety of different issues, just in our family alone.
Our son has undertaken speech therapy to develop his social skills, both in a one-on-one setting with a speech therapist and also as part of a social skills group, with 6 other children.
These sessions focused on teaching him the basics of social skills – taking turns, listening, making connected comments, showing interest in the other person, using polite words and manners and not interrupting. Tools used in these sessions include comic strip conversations, following the Superflex social thinking curriculum and modelling behaviour by filming participants displaying expected and unexpected behaviours and encouraging them to work together in a movie making group.
Over the years, speech therapists have also done a lot of work to get him to understand that everyone thinks differently and has different thoughts and feelings in their heads. This is related to theory of mind, which is the ability to understand what others may be thinking or feeling. Most people on the spectrum lack this understanding which can impact negatively on social interaction and speech therapists can help build up this awareness through role play and games.
Gilbert has also worked with speech therapists on his ability to recognise and regulate his own emotions. We have used a few different visual scales over the years to recognise when he is feeling agitated, stressed, angry or frustrated and have worked on strategies to manage these feelings with him. Our speechies have also helped us put together social stories to help him anticipate new situations and give him direction on how to deal with them.
Early on we also worked on auditory processing skills as Gilbert struggled to take in information aurally (he, like most on the spectrum, is a visual learner). I remember having to practice aural memorisation tasks with him to help develop his auditory processing and comprehension skills when he was younger.
At this time, we also worked hard to help him make statements, rather than continue to ask questions all the time. This was due to his echolalia and his practice of repeating what we said to him, which were often questions to check what he understood or what he could see. We had to learn how to initiate proper conversations with him and it took many years, and a lot of work, to address his speech issues.
Our eldest daughter was diagnosed with glue ear and moderate hearing loss in 2009. After surgery to insert grommets and restore her hearing, she attended intensive speech therapy to help address her pronounciation and sound recognition issues. Sessions focused on introducing her to blended sounds through playing games and undertaking role playing activities. She later received help for literacy too as she struggled with phonetics and early reading as a result of her early hearing loss.
When she eventually received an autism diagnosis, our efforts moved to building her social skills, addressing theory of mind and helping her with her auditory processing difficulties (which were more pronounced than her brother’s). We’ve also used social stories, visual regulation scales and social skills groups to help her better relate to her peers over the years too.
Speech therapy is a wide field and I’m continually amazed at the help and support I receive from my children’s speech therapists, even after all these years!
Speech Therapy Isn’t Just for Kids
However, speech therapy is not just for kids. Speech therapists assist adults in many ways too. They can help improve the social and emotional outcomes of adults with a range of conditions, including stuttering, voice disorders, swallowing problems, language difficulties, acquired communication disorders (such as strokes) and cognitive issues.
I was surprised to find speech therapists in the stroke ward I landed in (following my brain meltdown in 2014). They are an integral part of post-stroke recovery, helping patients learn to make sounds and talk properly again. They are crucial in the recovery process for a wide range of surgeries, neurological conditions and acquired injuries.
Speech therapy also helped my father, after his laryngectomy (removal of his voicebox) at the end of 2014. With the help of a team of speech therapists, he learned to use alternative means of communication, to swallow and eat again, later talk via a voice prosthesis and clean and take care of his stoma and HME (heat & moisture exchanger).
I had no idea how wide ranging the field of speech pathology was before I experienced it for myself.
Care to share your own speech therapy experience?
Disclaimer: I received monetary compensation from Box Hill Speech Pathology Clinic for this post. However, all experiences, memories and opinions shared in this post are 100% my own. I honestly don’t know where I’d be without the help I’ve received over the years from our team of speechies!