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!
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I often joke that between my two kids we send our speechie on a trip to Bali with her family every year. My eldest had a lot of pronunciation issues and my youngest is hearing impaired, so we have benefited greatly from speech therapy intervention. I wasn’t sure how this related to autism spectrum disorders though, so found your piece very interesting!
I’m glad I’m not the only one who scratched my head when trying to make the connection between speech therapy and autism! btw, I think I’ve sent my speechies all over the world based on what we’ve spent over the years. I really should have done something other than a Bachelor of Arts at uni…
This was most informative Kirsty. I am afraid I was ignorant on many of the issues raised when assisting Gilbert with his oral language. So helpful. Teachers NEED to see your blog…Special Ed teachers and those who are integrating special needs children into their schools. I have a friend/former colleague who works in the field and I will let her know about your blog! Cheers, Denyse
Thanks so much for that D, I really appreciate that. Feel free to share with anyone you think could benefit. I’m actually going to be speaking to new staff at a school in a few weeks time to give them my perspective as a parent. I’d be more than happy to do the same for any school in the Hunter, Central Coast or Sydney area 🙂
My Aspie son could gain so much benefit from seeing a speechie, but he refuses and anyway, we can’t afford it, even having a diagnosis. Our speechie has a social skills program, too, which would be perfect for him, but the costs are prohibitive for us.
I agree, if you don’t have HCWA or NDIS funding, speech therapy costs can be prohibitive. Plus, you really do need your child to want to participate, else it will be a waste of time and money. We’ve recently taken a break from speech therapy with my son because we’re not getting the results we hoped (he goes to high school next year and is overloaded at the moment). I hope your son does get the opportunity to access speech therapy one day, when he is ready x
We havent used a speech therapist as yet. we actually have out first OT appointment on Friday for a few little issues that need evaluating.
Good luck with the OT Karin. There’s a link in this post to one I wrote about our experiences with OT too, so feel free to check that out if you are looking for some info before Friday.
I’m always amazed at the things I learn from you Kirsty. I never realised a speech pathologist could be so helpful for people with an autism diagnosis!
Visiting from #teamIBOT x
They are so helpful for nearly everything Janet! I really should have studied speech therapy at uni instead of a BA!!!!
Great article, as always! Nice to see the connection between speech therapy and autism put so simply and clearly.
Thanks for the feedback Kylie!
My friend thought her son might be autistic (on the spectrum) as he had speech issues and walked on his tip-toes which I gather can be an indicator. He’s been assessed but the tip-toe thing was more of a result of his shins and he had some speech therapy which really helped.
Tip toe walking isn’t a universal sign of autism but it’s not uncommon, due to sensory issues and muscle weakness in the achilles. So pleased to hear your friend’s son has made progress with speech therapy – that’s awesome!
A very informative post, and interesting too. I’ve learned a lot about autism and speech therapy reading your post.
Love your work Kirsty. This is great information for parents of children with autism and also for anyone! It’s sometimes difficult to know which therapies will be most effective until you’ve tried them – and often the results aren’t immediately apparent. Our son has dyslexia and we tried so many different types of therapy for him. Some were effective, but most weren’t. Now that he’s a teen, he’s said, “No more therapy please”, so I have to respect that. It’s great if you can put in the groundwork early. #TeamLovinLife
Thanks Lyndall. I know that Gilbert will more than likely ask the same thing in future years. I can only hope I’ve done enough to help him when that day comes!
We’ve seen a speechie with two of our kids – one who needed a bit of help to learn some letter sounds and blends before starting school, and one who knocked her front teeth out when she was three and needed to learn how to make sounds properly once her adult teeth came in. It’s amazing all the different ways a speech therapist can help!
Wow, I hadn’t really considered how important teeth are to making proper sounds but not having front teeth for that long would have had an affect on your girl. Speechies are gold – I’m in awe of all the different things they can do!
Oh I knew there were one on one sessions but never knew people did group/social skills sessions with speech therapists. That sounds incredibly valuable.
The group sessions have been some of the most useful my kids have taken part in. It’s a great way to teach explicit social skills in a practical and safe setting.
Speech therapists are such a blessing. I know my sister, who has down syndrome used one a lot while growing up. They helped her so much. Glad you have been able to use them in so many places in your life.
I agree Joey, they are definitely a blessing!
This is great! I’ve never been involved in speech therapy but I did coach a speech therapist once in the start-up of her business and I was so intrigued and impressed with the breadth of her services and all the ways speech therapy can assist people with so many different needs.
That would have definitely been an eye opener Leanne!
Like you my eldest was an early talker, very concise, clearly understood and an extensive vocab. Our Speech therapist produced loads of social stories for him to help him relate to other children not just adults whose company he preferred. My youngest now is at the early stages of asd assessment and therapy options (almost 4 and speech only our immediate family can understand)…afraid I’m just not in the right head space, dont have the energy to go through alll this again…hoping I find the strength with the beginning of a new year!
I hope you find the strength too Stephanie. I somehow found it when we were hit with our daughter’s diagnosis but it wasn’t easy. Sometimes the second time around is the hardest because you know what’s ahead and you know how emotionally and physically draining it is. I found it helped me to concentrate on the end result – kids who were better at interacting with the world around them. I wish you all the best and feel free to get in contact if you want to connect x
This is such a great resource, Kirsty. Speechies really are invaluable. We’ve never had to see one, but I know a handful of friends who swear buy them for helping with lisps, stutters and pronunciation.
They are so good at all the things they do – it’s amazing the breadth of knowledge they possess!
There is so much in speech and language development that helps other areas of development as well. It isn’t something we think about but I can definitely understand the connections. What a great post and thank you for sharing your experience and all the benefits of therapy.
Thanks for taking the time to read and leave such a thoughtful comment Julie. It really is amazing the impact that speech and language have on nearly all areas of learning and development.
Speech therapist do an amazing job. So good to read your article on it and thanks for sharing. My daughter has a speech delay and articulation problems. We go to a Language Development School and that’s excellent as well as have therapy. The games and activities are helpful but it can be very slow going with progress at times but she is making progress. She will get there in the end. But some of those sounds are very stubborn.
I hear you on the sounds Julie – it is slow and painful going. Trying to help Matilda re-learn sounds and correct her pronunciation in the early days was not very enjoyable for any of us. But she did get through it and while she has some residual issues with spelling, she is now easily understood by all. Good luck with the road ahead – she will get there in the end x
What a thorough post – thanks for sharing your experiences!
Without speech therapists, I wouldn’t have a clue how to communicate with or help my son communicate with me. Thanks for linking to #spectrumsunday
Speechies are gold – they really are.