Autism: From a “Speechie” Perspective

By Karen P. Guerra, M.S., CCC-SLPSpeech-Language Pathologist

ANXIOUS??

CONFUSED??

UNCOMFORTABLE??

HELP IS HERE!!

WHAT IS AUTISM?

Autism is defined by the Autism Society Of America (ASA) as: "Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults with autism typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.

MAIN UMBRELLA TERM IS “PDD”

Autism is one of five disorders that falls under the umbrella of Pervasive Developmental Disorders (PDD), a category of neurological disorders characterized by “severe and pervasive impairment in several areas of development."

SOME CHARACTERISTICS MAY INCLUDE:

May exhibit self injurious behavior when upset i.e. biting selves or banging heads. An overall difficulty interacting with others.

No fear of danger. Over or under sensitivity to pain. May avoid eye contact with you. May prefer to be by him/herself. Has difficulty expressing what they want or

need - may then try to use gestures. May echo words or phrases. May have inappropriate attachments to

objects.

CONTINUED…

May spin his/herself or objects. Prolonged repetitive play. May insist on things/routines always being

the same. May exhibit inappropriate laughing (laughing

when not appropriate to the situation). May display tantrums for no apparent reason. May avoid cuddling.

ASSESSMENT- SPEECH THERAPY

Each evaluation is different based on individual child

Tests may be formal (standardized) or criterion referenced and observational

Assessment determines current skill levels in the following areas: Language Comprehension (and processing) Expressive Language Pragmatics Articulation, Voice, and Fluency

May see the need for further evaluation

SPEECH THERAPY

Therapy is individualized to the needs and levels of each child

Therapy goals will address Language Comprehension Expressive Language and Increasing Use of skills (interaction)

STRATEGIES TO IMPROVE COMMUNICATION

Get AttentionUse interestsUse facial expression

Simple Language Reduce number of words and

complexity Repetition

Emphasis on areas that need increasing Visual Cues

Visual learners

VISUAL STRATEGIES

Signs and Sign Language

Pictures and Symbols

VISUAL STRATEGIES

Schedules There are a variety of schedule

optionsUse a hierarchy to determine for

each childSmall objectRepresentational partPhotosSymbolsWritten

EXAMPLES OF PICTURES AND SYMBOLS

EXAMPLES OF PICTURES AND SYMBOLS

BEHAVIOR AS A MEANS OF COMMUNICATION IN ASD

What does this mean?Push work awayThrow plate on the floorFlap hands and jumpSpin around and aroundPull Mom to the cookie jarStand by the door and look outCover ears

BEHAVIOR AS COMMUNICATION IN ASD

Be aware of these communication attempts

Look for the antecedent to the behavior

Verbalize the words to accompany the behavior

GESTURES

Immature GesturesMay see pulling, leadingReach/grab but not a good point

gestureChild may go to the area near

what he wantsConventional Gestures Interpret gesture with appropriate

language

ECHOLALIA

Immediate or delayedMay serve a variety of functions

Turn takingConfirmation of a choiceAssociation to similar situation

Add language to help child relate to current event or alternative response

WAYS TO INCREASE EXPRESSIVE COMMUNICATION

Provide frequent models, repetitionShape vocalizations or

approximationsExpand on simple utteranceRelate echolalic response to current

situationProvide choices, verbal and visual

INCREASING INTERACTIONS WITH CHILDREN WITH ASD

Children with ASD have a more limited repertoire of communication functions than children with typical development

These children had relative skill in regulating an adult’s behavior to achieve an environmental end

They had higher rate of requesting and protesting than children with typical development

(Wetherby & Prutting, 1984)

INCREASING INTERACTIONS WITH CHILDREN WITH ASDChildren with ASD exhibit less

frequent use and later development of communication for social interactionsDirecting attention to self (show

off)Acknowledging othersCommentingSymbolic play (Wetherby, 1986; Wetherby &

Prutting, 1984)

*Joint Attention!!

CONCLUDING THOUGHTS

Language activities should encourage spontaneous communication

Observe the entire child, consider the options

Consult references for best practices

Build language functions If the child is having fun, you will

have fun

Notes:

Notes:

REFERENCES

Wetherby, A. (1986). Ontogeny of communicative functions in autism. Journal of Autism and Developmental Disorders, 16, 295-316.

Wetherby, A., & Prutting, C. (1984). Profiles of communicative and cognitive-social abilities in autistic children. Journal of Speech and Hearing Research, 27, 364-377.

www.asa.com (definitions and characteristics)