Effective Speech Therapy For Autism - Management Options

Speech therapy is an intervention which aims at enhancing a child's speech skills and abilities to understand and express language, including nonverbal language.

Quite simply put, Speech therapy is an intervention service, for speech and language disorders.

In children who have difficulties communicating their wants and needs, either verbally, or nonverbally, speech therapy not only works on training the mouth to create sounds that form words and sentences, in order to address articulation, fluency, and voice volume regulation, but also, understanding and expressing language in order to address the use of language through written, pictorial, body, and sign forms. It also encourages the use of language through alternative communication systems.

If your child does not meet the age appropriate milestones of speech, language, and communication, despite normal audiology testings, you may be advised to visit a speech therapist

This brings us to charting out age appropriate milestones for speech and language development.

Age	Hearing and Understanding	Speaking
0–3 Months	Startles to loud sounds Quietens or smiles when spoken to Seems to recognize your voice and quietens if crying Increases or decreases sucking behaviour in response to sound	Makes pleasure sounds (cooing, gooing) Cries differently for different needs Smiles when sees you
4–6 Months	Moves eyes in direction of sounds Responds to changes in tone of your voice Notices toys that make sounds Pays attention to music	Babbling sounds more speech-like with many different sounds, including p, b and m Chuckles and laughs Vocalizes excitement and displeasure Makes gurgling sounds when left alone and when playing with you.
7 Months–1 Year	Enjoys games like peek-a-boo and pat-a-cake Turns and looks in direction of sounds Listens when spoken to Recognizes words for common items like "cup", "shoe", "book", or "juice" Begins to respond to requests (e.g. "Come here" or "Want more?")	Babbling has both long and short utterances such as "tata upup bibibibi" Uses speech or non-crying sounds to get and keep attention Uses gestures to communicate (waving, holding arms to be picked up) Imitates different speech sounds Has one or two words (hi, dog, dada, mama) around 1st birthday,
1-2 years	Points to a few body parts when asked. Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?"). Listens to simple stories, songs, and rhymes. Points to pictures in a book when named.	Says more words every month. Uses some one- or two- word questions ("Where kitty?" "Go bye-bye?" "What's that?"). Puts two words together ("more cookie," "no juice," "mommy book"). Uses many different consonant sounds at the beginning of words.
2-3 Years	Understands differences in meaning ("go-stop," "in-on," "big-little," "up-down"). Follows two requests ("Get the book and put it on the table"). Listens to simple stories, songs, and rhymes.	Has a word for almost everything. Uses two- or three- words to talk about and ask for things. Uses k, g, f, t, d, and n sounds. Speech is understood by familiar listeners most of the time. Often asks for or directs attention to objects by naming them. Asks why? May stutter on words or sounds.
3-4 Years	Hears you when you call from another room. Able to hear television or radio at the same loudness level as other family members. Understands words for some colors, like red, blue, and green. Understands words for some shapes, like circle and square. Understands words for family, like brother, grandmother, and aunt.	Talks about activities at school or at friends' homes. Talks about what happened during the day. Uses about 4 sentences at a time. People outside of the family usually understand child's speech. Answers simple "who?", "what?", and "where?" questions. Asks when and how questions. Says rhyming words, like hat-cat. Uses pronouns, like I, you, me, we, and they. Uses some plural words, like toys, birds, and buses. Uses a lot of sentences that have 4 or more words. Usually talks easily without repeating syllables or words.
4-5 Years	Understands words for order, like first, next, and last. Understands words for time, like yesterday, today, and tomorrow. Follows longer directions, like "Put your pajamas on, brush your teeth, and then pick out a book." Follows classroom directions, like "Draw a circle on your paper around something you eat." Hears and understands most of what is said at home and in school.	Says all speech sounds in words. May make mistakes on sounds that are harder to say, like l, s, r, v, z, ch, sh, th. Responds to "What did you say?" Talks without repeating sounds or words most of the time. Names letters and numbers. Uses sentences that have more than 1 action word, likejump, play, and get. May make some mistakes, like "Zach got 2 video games, but I got one." Tells a short story. Keeps a conversation going. Talks in different ways depending on the listener and place. May use short sentences with younger children or talk louder outside than inside.

The ultimate objective of speech therapy is to improve the communication skills of your child on the Autism spectrum, which is associated with symptoms that do impair his/her language and communication skills. To understand how Speech Therapy for Autism works, it is important to know that language is used to communicate our feelings, thoughts and needs with other people. Language can be either communicated verbally or non-verbally.

Speech is essentially, the physical production which make use of the oral muscles and the coordination between them to express the ideas, thoughts and feelings. Speech therapy focuses on developing the language as well as speech aspects, and therefore, would work towards uplifting these areas by means of exercises and activities, so as to enhancing the overall communicative ability, which in turn boosts your child’s cognitive capacity on a whole.

Speech therapy can directly benefit your child in the ability to understand and express their thoughts, ideas and feelings, through intelligible speech, along with an increased ability to solve problems, in an independent environment, which makes them school-ready. Speech therapy also can help with improved swallowing.

Speech therapy has a great effect on pre-literacy skills, vocal quality, fluency of speech, and the development of practical social skills. This could help your child achieve a better quality of life, build a greater self-esteem, and thus, increased independence.

Speech and language are two individual, but related components of communication. Speech therapy also helps with communication, which would help your child convey the ideas in his/her mind, either verbally or nonverbally.

Speech therapy includes various techniques, exercises, activities and aids, which work towards improving coordination of speech muscles through strengthening and coordination exercises, sound repetition and imitation.

Speech therapy techniques might include:

Electronic "talkers"
Signing or typing
Picture exchange communication systems that start out using pictures instead of words to help your child learn to communicate. This can be done by the means of aids such as picture boards with words.
Using sounds to which a person is over- or under-sensitive to expand and compress speech sounds
Improving articulation of speech by massaging or exercising lips or facial muscles
Having individuals sing songs composed to match the rhythm, stress, and flow of sentences

Some of these techniques are supported more by research than others. Be sure to discuss them thoroughly with your speech-language pathologist and your child's pediatrician.

Benefits have also been seen by a treatment philosophy called Social Thinking. It teaches children about the relationship between how we think and behave, and how others respond to us. Your speech language pathologist also might bring out some blow toys and whistles and have "blow the cotton ball" relay races to strengthen muscles used in speech and eating. There are what may seem like more fun strategies to help children tolerate different sensations in their mouths, such as, Using crazy straws, a toothbrush that makes music, and blowing bubbles.

Your Speech Therapist may suggest the therapies to be conducted at least 2-3 times per week. Our database can be used to find a speech language pathologist based on city, state, and country. They normally work in close association with the occupational therapist and pediatrician.

Speech therapy can be started as soon as a child starts exhibiting the communication and language symptoms of autism.

Speech Therapy for Autism is performed by a qualified the Speech Language Pathologist who collaborates with other professionals to modify and make efficient, the flow of messages and exchange of information from one person to another.

As a parent, the best thing you can do is work in close association with the speech therapist, as well as occupational therapist to find ways to continue doing some vocal, communication, or mouth exercises at home.

Moreover, it is important to be aware of the benefits of speech therapy and keep the therapist updated of the noticeable gains.

You can find below, strategies of teaching communication skills to children with Autism with the help of a visual table.

Pre-linguistic Skills (the skills required for language development)	Receptive Skills (understanding/comprehension)	Expressive Skills: (conveying needs/wants)
Always hold the object or picture card at your eye level while showing it to the child, so that the child looks at the object or picture and then looks into your eyes while you say the name of the item. Always raise your hand at the child's eye level while asking for any object or picture from the child. Always gain the child's attention and eye contact towards you and then speak to the child.	To teach comprehension/ understanding of simple unidirectional (one-step) commands. Give the child simple one step commands like give me the bottle/ keep the bottle in the kitchen/ open the door, etc and encourage the child to follow it. Provide proper reinforcement/ reward after the child follows 1 command correctly. To hold the object at your level and tell its name to the child, repeat it 2-3 times then take the next picture, say the name 2 - 3 times. Keep both the objects in front of the child and ask him/her to pick up or point at 1 object from them. Give a reward on completing the activity successfully.	To encourage production of vocal play sounds. Teach the child to imitate vocal play sounds like animal sounds and vehicle sounds. - How does a dog bark? /Bow Bow/ - What does a cat say? Meow - What does a cow say? Mooo..., etc. - How does the horn of car sound? /pip pip/ - How does horn of train sound? /kuuu.../, etc. To teach use of objects to the child using pictures or real objects. In what do you drink water? Glass With what do you brush your teeth? Toothbrush With what do you have bath? Soap, etc.

Pre-linguistic Skills (the skills required for language development)

Receptive Skills (understanding/comprehension)

Expressive Skills:
(conveying needs/wants)

Always hold the object or picture card at your eye level while showing it to the child, so that the child looks at the object or picture and then looks into your eyes while you say the name of the item.

Always raise your hand at the child's eye level while asking for any object or picture from the child.

Always gain the child's attention and eye contact towards you and then speak to the child.

To teach comprehension/ understanding of simple unidirectional (one-step) commands.

Give the child simple one step commands like give me the bottle/ keep the bottle in the kitchen/ open the door, etc and encourage the child to follow it. Provide proper reinforcement/ reward after the child follows 1 command correctly.
To hold the object at your level and tell its name to the child, repeat it 2-3 times then take the next picture, say the name 2 - 3 times. Keep both the objects in front of the child and ask him/her to pick up or point at 1 object from them. Give a reward on completing the activity successfully.

To encourage production of vocal play sounds.

Teach the child to imitate vocal play sounds like animal sounds and vehicle sounds.

- How does a dog bark? /Bow Bow/

- What does a cat say? Meow

- What does a cow say? Mooo..., etc.

- How does the horn of car sound? /pip pip/

- How does horn of train sound? /kuuu.../, etc.

To teach use of objects to the child using pictures or real objects.

In what do you drink water? Glass

With what do you brush your teeth? Toothbrush

With what do you have bath? Soap, etc.

Nonverbal communication of your child:

Voice accompanied by body languages makes it easier for the children on the autism spectrum to understand. Gestures and eye contact can build the foundation for language development. The usage of gestures should be done in a way so that the child can easily imitate them.

For example, nodding of head, point out a particular items, etc.

Response time of your child:

Allow your child to speak, by giving ample response time. It's a human tendency to feel the need to fill in for your child when s/he doesn't respond spontaneously. However, it is essential to always give your child lots of opportunities to respond, even if the child isn't speaking. When you ask a question see that it is answered by the child verbally or nonverbally.

Commenting about what your child does:

Sometimes to engage with your child, you may direct the activities towards that of your child's interest. While communicating with your child, make it a point to associate vocabulary with his/her area of interest such as narrating what the child is doing, naming the things used by him/her for playing so that he/she doesn't get restless.

Talking to your child about what engages him/her will help him/her to learn vocabulary easier, and help alleviate his/her communication problems with autism. Engaging in a range of activities that are of your child's interest such as: building blocks, floor activities, coloring/painting with constant stimulation from you as a parent can contribute largely to your child's development.

Social interaction/play with your child:

One of the most convenient ways for your child to learn communication is through interactive play and social interaction. This helps in teaching communication skills to children with autism as it provides opportunities for your child to develop communication initiation and is tempted to interact. Some of the activities that you can do with your child is to perform pretend play such as: doctor set/kitchen set pretend play, flipping through a book with your child, playing at the park, engaging your child with peers at the park.

Use of visual supports:

Training the child with visual support can foster speech and language development. Some examples include visual time tables, pictorial representations of animals, numbers, fruits, vegetables. Using picture boards for sorting and matching can assist in developing receptive and expressive language skills.

Reward your child:

Provide a reinforcement to your child when a certain target has been achieved. (Eg: your child has earned 5 stars for the day, reward them with an item of their liking). This will encourage the developing milestones to occur more often and consistently.

These are some of the stimulation techniques that can be used in teaching communication skills in your child with Autism. As parents, you may employ any technique or a combination of techniques to assist your child's language development.

Speech Therapy

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