As a parent you have a tool, an expertise that puts you in position to supplement your child’s therapy at home. This expertise is unmatched by even the most qualified therapist: you know your child. Your intimate knowledge puts you in a unique position to help your child thrive…
Home is where the heart is, or lately it seems like home is where everything is. Our changing world forced home to become the epicentre of our world. Since we’re working, schooling and shopping from home, many parents with kids on the spectrum are also delving into therapy and treatment executed from home.
Parents are putting on an increasing rota of hats, therapist being one of the more challenging. But many experts believe a parent’s insider knowledge is a piece of the therapy puzzle that can lead to more complete development in areas of difficulty. Afterall, who knows a child’s areas of struggle better than a parent? Embracing a strength or interest based intervention program is also best suited to someone with first hand knowledge of the child’s specific strengths and special interests.
When it comes to speech therapy, an expert’s advice is invaluable. Speech-language pathologists identify, prevent, treat, and manage a variety of speech and language deficits and/or developmental challenges. While an expert’s input is often the most appropriate starting place, many parents wonder about continuing or supplementing speech therapy at home for their child on the spectrum.
Getting started may feel intimidating, but with guidance from a speech-language pathologist and some speech therapy materials, most parents will be able to facilitate development of better speech and language skills for their child on the spectrum.
Speech therapy: the basics
According to the Journal of Speech Pathology and Therapy: “Speech Pathology & Therapy is a clinical practice to diagnose and treat speech disorders related to oral motor, swallowing, cognitive-linguistic, speech, and language. A speech pathologist or speech-language pathologist is a professional who treats these disorders.”
So while parents may not be in a (professional) position to identify, treat, and help children overcome speech and language disorders, at home supplementing of therapy may be beneficial to your child to develop better speech and language skills.
Autism and its influence on speech and language
The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013) highlights communication deficits as one of the core diagnostic criteria of autism spectrum conditions. Included in communication deficits are impairments specific to language, speech, and social communication.
When defining language characteristics of children with autism spectrum disorders (Mody & Belliveau, 2013) it seems like most have some sort of receptive and/or expressive language impairment or challenge. This is why a delay in first words spoken is often one of the symptoms alerting parents to seeking medical advice or a possible autism diagnosis. Research (Mitchell et al., 2006) confirms delays in language development are clear early on in children on the spectrum.
For some parents, a delay in speech ultimately leads to their child’s autism diagnosis. For others, their child on the spectrum may develop language in a similar way when compared to neurotypical peers. Asperger syndrome, which is no longer a diagnostic term, but still frequently used, may present in this way.
Research (Saalasti et al., 2001) found normal development of linguistic skills in children with asperger syndrome, while comprehension of language presented challenges. This emphasizes the importance of consulting with a speech-language pathologist to determine the specific aspects of speech and language which needs to be addressed for your child.
Specific speech challenges for those on the spectrum
Parents with autistic children often consult speech therapists when their child’s speech is delayed. A delay in “first words spoken” is not the only speech and language challenge faced by kids on the spectrum, other difficulties or challenges may include:
Apraxia
Childhood apraxia of speech is a condition which impairs a child’s ability to make sounds in the correct way. The child’s brain struggles with the complex motor coordination required to speak. Autism and apraxia of speech commonly co-occur; a study found 64% of the participants initially diagnosed with autism also had apraxia (Tierney et al., 2015). The condition may cause great difficulty when learning to speak. The child may struggle to coordinate his or her jaw, lips and tongue to make a sound, or to make the sound clearly and correctly
Dysfluency
Children on the spectrum may stutter or struggle with other issues hampering fluency. When autism and stuttering co-occur it presents significant communication challenges (Brundage et al., 2013)
Echolalia
Autistic children often repeat noises, phrases, and words they have heard. Such repetitions are usually meaningless and/or unsolicited
Problems with articulation
Individuals on the spectrum often have problems with articulation (the formation of clear speech sounds)
Uneven speech development
Even though children with autism may develop language, it may be concentrated development in an area of special interest and development in other areas may be lacking
Other
Speech therapists and researchers agree that speech and language difficulties and challenges vary greatly between individuals on the spectrum. A speech-language pathologist will help to identify the specific challenges for your child, this may look very different depending where the child finds him or herself on the spectrum. High-functioning autistic children may need help addressing problems with comprehension and context of speech and language, while a nonvocal child may (initially) need help imitating speech sounds for preferred objects
Trust your parental instincts
Once your child has been evaluated by a speech-language pathologist, you can start working on an at-home plan to further speech and language goals. At home, you as a parent know best which time of day your child is most likely to feel productive and cooperative. You know which room aids concentration and you know which aspect of his/her special interests can be incorporated to further speech and language development.
Many speech-language pathologists are also using autistic children’s special interests as a gateway to work on speech and language skills. A child who only wants to talk about trains may not want to participate if a therapy session’s theme is farm animals or vegetables. Instead parents may want to concentrate on the words their children need for functional communication and try to use a special interest to make such words more accessible.
Advice from a speech-language pathologist
The best place to get therapy ideas is of course from an experienced speech-language pathologist. Kathleen Keller, a speech-language pathologist (certified by The American Speech-Language-Hearing Association) with many years’ experience, including work with individuals on the spectrum, had the following advice for parents to develop speech and language at home:
“Typically, little ‘extra’ is needed to target communication skills at home. Most of what we say is communicated with 200 basic words, which makes it easy to practice important speech and language skills within the context of our daily routines and chores. Involve your learner and practice understanding and using words and concepts that repeat across activities. For example, cereal goes ‘in’ a bowl, dirty clothes go ‘in’ the washing machine, and we get ‘in’ bed each night. Try choosing a word, concept, or speech sound of the day and make a game of practicing it as many times as possible throughout your daily routines.”
This is great advice and easy to incorporate at home. After using words and concepts during daily routines and chores, such learning can be reinforced by also incorporating the child’s special interests. In the above example, “in” is the word the child may be getting familiar with—by using it when talking to the child about their special interest, learning may feel effortless. For example you may refer to sitting “in” a train, or ask your child whether he/she would like to put toy figures “in” a train, if trains are one of his/her special interests.
Of course you would not want to encourage uneven language development by only facilitating learning in narrow areas of interest. That is why Kathleen’s advice of practicing speech in the context of daily chores and routines is important.
These are simple strategies that can be used as an entryway to helping your child develop speech and language skills at home. You can take this process to the next level by incorporating learning materials, activities, worksheets and other therapy resources. Speech therapists can be consulted if you need resource recommendations for your child’s specific challenges. There are also many free materials and therapy ideas online, some recommended and endorsed by speech-language pathologists.
Speech therapy materials
Browsing through countless pages of free materials on the internet may feel overwhelming. The best place to start is, once again, your knowledge of your child. Tailoring a learning environment to compliment her son’s interests was one of the topics discussed by LaTonya Davis in her presentation for the Autism Parenting Summit (September, 2021).
LaTonya—an autism mom, educator and lawyer who designs content with school districts, companies and organizations on topics including autism, academics and antiracism— shared her experience of homeschooling her child on the spectrum during the pandemic.
She zoned in on her son’s interest in cooking, movies and his aspirations to be a pilot or astronaut—by embedding these interests in academic areas she kept their learning fun and interesting. She continued by emphasizing how such areas of interest could be utilized to promote learning of listening, speaking, and functional skills.
She shared a great example: using visual recipes to bake cookies created an opportunity for learning and fun, while accommodating her son’s interest in cooking. LaTonya believes: “All kids can learn when you tap into their interests and motivations, make learning joyful, praise effort, and receive their feedback.”
So, in keeping with our example of a child on the spectrum who loves trains, how can parents use knowledge of this special interest to stimulate speech development? While looking for speech therapy materials online, I found a blog on http://www.playingwithwords365.com with an entry detailing Using Train Sets to Stimulate Language Skills written by Katie, a speech-language pathologist.
In addition to finding therapy materials in line with your child’s special interest, parents may also want to consider a strength-based approach when looking for ways to promote speech development. Kids on the spectrum are often visual learners and many have razor sharp detail orientated focus. Consider these aspects when putting together materials for at home therapy activities.
A comic strip, for example, could be a useful material to illustrate a speech or language concept to a visual learner. Especially if the comic strip has interesting graphics aligning with the child’s special interests.
Free online resources
Finding appropriate teaching materials online depends on your child’s specific needs. Teachers, parents and speech therapists often share ideas online, some cater specifically to children on the spectrum while others provide materials for specific areas of concern like articulation, grammar, and literacy.
Speech and Language Kids rounded up some free speech therapy materials based on web traffic (https://www.speechandlanguagekids.com/11-free-speech-therapy-materials/). Parents can incorporate these materials if appropriate for their child—a speech-language pathologist could help decide which are best to address your child’s specific needs.
Speech on a spectrum
The therapy needs of kids on the spectrum vary greatly, many factors including their current speech and language ability will determine the kind of program most appropriate to encourage better communication. Most autistic children also have sensory processing difficulties, a condition like auditory processing disorder could influence the way speech and language is developed and acquired. Your child’s uniqueness, their medical history and preferences need to be considered when embarking on any type of therapy.
Working with your child in areas of learning like literacy, grammar or articulation may not be of much worth until your speech-language pathologist addresses issues like sensory processing difficulties or conditions like childhood apraxia of speech discussed above.
Furthermore, the spectrum nature of autism means there is no set plan to help children improve speech and language skills. Children on the spectrum who are nonvocal will need specific early intervention programs, their therapy needs will differ from those of a child with typical language development struggling with the subtleties of social communication.
Helping your child thrive
The benefits of speech therapy for children with autism are plentiful—the power of expression rates highly among these. Parents often share sadness at how much their kids struggle with frustration, because they lack the means to express themselves.
Most children experience feelings of being small in a big world, with too little control over their lives. Their way of exercising control over their environment is often by expressing needs, wants, feelings and frustrations. Helping your child to gain speech and language skills will help with feeling more in control, with having a “say”.
When starting speech therapy parents need to recognize their power in helping their child with one of life’s most valuable skills. Parents with their unmatched knowledge of their child’s strengths, interests and uniqueness are in a premium position to encourage and empower better speech and communication.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Brundage, S. B., Whelan, C. J., & Burgess, C. M. (2013). Brief report: treating stuttering in an adult with autism spectrum disorder. Journal of autism and developmental disorders, 43(2), 483–489. https://doi.org/10.1007/s10803-012-1596-7.
Mody, M., & Belliveau, J. W. (2013). Speech and Language Impairments in Autism: Insights from Behavior and Neuroimaging. North American journal of medicine & science, 5(3), 157–161.
Mitchell, S., Brian, J., Zwaigenbaum, L., Roberts, W., Szatmari, P., Smith, I., & Bryson, S. (2006). Early language and communication development of infants later diagnosed with
autism spectrum disorder. Journal of developmental and behavioral pediatrics : JDBP, 27(2 Suppl), S69–S78. https://doi.org/10.1097/00004703-200604002-00004
Saalasti, S., Lepistö, T., Toppila, E., Kujala, T., Laakso, M., Nieminen-von Wendt, T., von Wendt, L., & Jansson-Verkasalo, E. (2008). Language abilities of children with Asperger syndrome. Journal of autism and developmental disorders, 38(8), 1574–1580. https://doi.org/10.1007/s10803-008-0540-3.
Tierney, C., Mayes, S., Lohs, S. R., Black, A., Gisin, E., & Veglia, M. (2015). How valid is the checklist for autism spectrum disorder when a child has apraxia of speech?Journal of Developmental and Behavioral Pediatrics, 36(8), 569-574. https://doi.org/10.1097/DBP.0000000000000189.
