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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)