The goal of speech therapy is to improve all aspects of communication. This includes: comprehension, expression, sound production, and social use of language (1). Speech therapy may include sign language and the use of picture symbols (2). At its best, a specific speech therapy program is tailored to the specific weaknesses and the environment of the individual child (1, 3). Unfortunately, it can be difficult to create a child-specific, evolving, long-term speech therapy plan (1 , 4).
The National Research Council describes four aspects of beneficial speech therapy.
Thus, any speech therapy program should include practice in many different places with many different people (2). In order for speech therapy to be most successful, caregivers should practice speech exercises during normal daily routines in the home, school, and community (1 , 6). Speech therapists can give specific examples of how best to incorporate speech therapy throughout a child's day (7).
Speech therapy sessions will vary greatly depending upon the child. If the child is younger than three years old, then the speech therapist will most likely come into the home for a one-hour session. If the child is older than three, then therapy sessions will occur at school or in the therapist's office. If the child is school age, expect that speech therapy will include one-on-one time with the child, classroom-based activities, and consultations between the speech therapist and teachers and parents (2).
The sessions should be designed to engage the child in communication. The therapist will engage the child using games and toys chosen specifically for the child. Several different speech therapy techniques and approaches can be used in a single session or throughout many sessions (see Does it work?).
In addition to trouble with communication, children with autism may also have problems behaving. These behavioral problems are believed to be at least partially caused by the frustration associated with the inability to communicate. Speech therapy is intended to improve social communication skills, and teach the ability to use those communication skills as an alternative to unacceptable behavior (1).
Many scientific studies demonstrate that speech therapy is able to improve the communication skills of children with autism (1). The most successful approaches to speech therapy include components of early identification, family involvement, and individualized treatment (7).
There are many different approaches to speech therapy and most of them are effective. The table below lists some of the different approaches. In most cases a speech therapist will use a combination of approaches in a program.
| Type of Speech Therapy | Definition | Does the Research Support It? |
|
Augmentative and alternative communication (AAC)
|
broad term for forms of communication that supplement or enhance speech, including electronic devices, picture boards, and sign language |
Yes (8) |
|
|
therapy that focuses on behavior and actions |
Yes (1) |
| Facilitated communication |
communication technique that involves a facilitator who places his hand over the patient's hand, arm or wrist, which is placed on a board or keyboard with letters, words or pictures
|
No (1, 4) |
|
Functional communication training (FCT)
|
use of positive reinforcement to motivate the child to communicate | Yes (9) |
|
|
child is encouraged to mimic the therapists mouth motions before attempting to make the sound |
Yes (9 ) |
|
|
use of prompts and reinforcements of independent requests for items (referred to as mands) |
Yes (10) |
|
|
therapy techniques that focus on following the child's lead and capitalize on the child's desire to respond | Yes (6) |
|
Peer mentors/circle of friends
|
use of children who are trained to interact with the autistic child throughout the day | Yes (7) |
|
Picture exchange communication system (PECS)
|
method of using picture symbols to communicate (see PECS Fact Sheet) | Yes (8) |
|
Relationship development intervention (RDI)
|
trademarked treatment program that centers on the belief that individuals with autism can participate in authentic emotional relationships if they are exposed to them in a gradual, systematic way | Yes (7) |
|
Sign language/total communication
|
language of hand shapes, movements, and facial expressions (especially useful for ages 0-3) | Yes (1) |
|
|
actual stories that can be used or adapted to teach social skills | Yes (1, 7) |
There are no reports of speech therapy being harmful.
The cost of speech therapy is covered by the government through the Individuals with Disabilities Education Act (IDEA). The amount of speech therapy provided in this setting may be suboptimal and thus should be supplemented with private therapy. Private speech therapy can be expensive (approximately $100/hour or more)
Speech therapy requires parental investment of time. In order to be most effective, parents may need to be fully integrated into the therapy program and should seek out opportunities to practice communication throughout the daily routine. With time, this should become a new way of life.
Autism is a condition covered under the Individuals with Disabilities Education Act (IDEA). Services covered by IDEA include early identification and assessment and speech language pathology (speech therapy). This law protects the rights of patients with autism and provides guidelines to assist in their education. It covers children from birth to age 21. Pediatricians can provide contact information for the state early intervention program for children 0 to 3 years old. School districts will coordinate special services for children 3-21 years old.
Parents of nonverbal children should consider incorporating PECS: http://www.pecs.com/WhatsPECS.htm (see PECS Fact Sheet).
Signing Times is one of many companies selling systems that help to teach children sign language.
American Speech-Language-Hearing Association. (2006). Principles for speech-language pathologists in diagnosis, assessment, and treatment of autism spectrum disorders across the life span: Technical report.
Social and Communication Development in Autism Spectrum Disorders: Early Identification, Diagnosis, and Intervention by T. Charman and W. Stone. 2006. The Guilford Press, pp. 115-266.
Enhancing early language in children with autism spectrum disorders by R. Paul and D. Sutherland. In Handbook of Autism and Pervasive Developmental Disorders, Third Edition Volume Two. 2005. John Wiley & Sons, pp. 977-1002.
Or subscribe to feed using a feed reader.
