Autistic Spectrum Disorder (ASD)
Autism is a neurodevelopmental disability that presents a range of different symptoms in different people. As there are so many different indications of autism, and the fact that symptoms can be mild or severe it is often referred to as ‘Autism Spectrum Disorder’. In general, a child with autism will have difficulty in three different spheres to varying extents; social interaction, communication (both verbal and non-verbal), imagination, and cognition (individuals with ASD can have a concrete thinking style and be rigid in how they think about things) and thus may react in a seemingly odd way to the world around them.
Communication Difficulties in ASD
Autistic signs, symptoms and behavioural patterns that our Speech and Language Therapists look out for and work on may include;
- Limited speech
- Hard to express basic wants
- Repeating speech (also known as echolalia)
- Not responding in a conversation or not answering questions
- Difficulty following instructions
- Different sounding speech (high pitched, different to the children around them.)
- Reduced eye contact
- Ignoring or avoiding others
- Poor play skills or prefers playing alone
- Not sharing
- Difficulty making friends
- Expressing certain emotions at the wrong time/ difficulty expressing emotions
- Dislike being touched
- Unusual attachment to objects
- Unusual interests
- Unusual fears or no fear of real danger
- Problems sleeping
- Sensitivity or lack of sensitivity to sound, textures, touch, tastes or light
- Specific food tastes/dislikes
Treatment Of Communication in ASD
Treatment for your child with a diagnosis of ASD will vary depending on their age and communication level and overall ability. The following are some general ideas about what treatment will include for different age groups, however all treatment programmes will be individually tailored depending on your child’s individual profile.
Early years/Non-verbal children
The Speech and Language Therapist will work with parents on supporting their communication with their child in the home environment. They will support working on attention and listening skills, non verbal skills, gesture, PECS (Picture Exchange Communication Systems) and early vocabulary development. The PECS programme teaches children to make requests for items using pictures. It is a systematic programme which graduates towards the discrimination of symbols and the development of simple sentences.
At Spectrum Health our Speech and Language Therapists are also Hanen trained. We will use the Hanen ‘More than Words’ programme which is designed for parents of children with ASD. It is an indirect approach working with parents providing them with the tools, strategies and support they need to help their children reach their full communication potential. It teaches parents how to adapt their interaction to scaffold and support their child’s communication skills so everyday routines such as meal time, bath time, shopping, and dressing time become language learning opportunities.
We will use the best evidence based intervention which will be tailored to the specific needs of your child.
School aged children (Verbal)
The Speech and Language Therapist may focus on vocabulary development, sentence structure and may train others how to use visual helpers and schedules in school to support communication in the classroom. The Speech and Language Therapist can provide programmes for school to carry out as well as supporting teachers and assistants when requested. These early years are crucial for further communication development, often children at this stage will have difficulty with peer interactions, having conversations with others and around changes in routine. The SLT will work with you, your child and their educators in promoting further language and social skill development. Visual helpers and visual schedules can be used; this is where pictures are used to build schedules, organise and structure daily activities. They help communicate the daily routine to the child with ASD. They provide children with predictability and consistent cues about what’s happening next, this can help reduce anxiety around changes in routine. This type of intervention can be very useful for children with ASD who may be visual learners and have difficulty with change.
The Hanen “Talkability’ programme is also a very useful programme with this age group, it is a practical programme which supports parents in teaching their child people skills. This supports the child with ASD to tune into the thoughts and feelings of others by observing their gesture, body language, facial expression and tone of voice.
The intervention for the school aged child with ASD will be individually tailored depending on their needs.
For the adolescent with ASD, the Speech and Language Therapist may focus on some traditional forms of speech and language therapy such as listening comprehension, vocabulary development (antonyms and synonyms) and how to structure an essay; again depending on their individual needs. Work with teenagers with ASD will usually focus on social skills development through various individual and group sessions. The aim is to support communication in different situations and environments through breaking social communication into more manageable steps. We often use the Alex Kelly “Talkabout’ programme in these groups, this focuses on body language (eye contact, gesture, posture), conversational skills (starting a conversation, maintain a topic, saying something relevant and ending a conversation) and friendship skills. It allows the teenagers discuss and practice different social scenarios in a safe environment before trying them out in the real world.
We will often work on communication styles and how to differentiate between an aggressive and assertive tone of voice. At this developmental stage we may also work on theory of mind skills, how to tune in to the thoughts of others through examining the situation, their tone of voice, their gesture, eye gaze and facial expression.
We will also liaise with your teenagers school to ensure that the social skills programme in the clinic is reinforced and complimented in the school setting.
The Speech and Language Therapist will work with you, your teenager, their educators or any other relevant people to develop an individually tailored language and communication programme.
We are available to do home visits, this can often be preferred by parents especially if your child has difficulty with unfamiliar people and new situations. It may also be useful for the SLT to see your child in their home, their natural communication environment and where they are most at ease.
All of Spectrum Health’s Paediatric Speech and Language therapists are qualified from University with a B.Sc. or M.sc (Hons) in Speech and Language Therapy and have ample experience working with children who experience communication difficulties associated with ASD.