Speech and language has become a huge part of my life over the last couple of years, my son is now three and a half and is non-verbal, he has started to speak three times but each time has regressed and we are currently back to no speech again. My son has Autism and has complex speech and language delay, we currently use Picture Exchange Communication (PECs) as our main form of communication. My youngest son (one) is now starting to speak and all the skills I have learnt over the last couple of years are helpful for him too. I plan to write many posts about speech and language but let’s start with some of the basics of speech and language and communication in autism.
Most children learn to speak naturally without parents doing anything other than interacting and playing with their child. However this is not the case for all children and some need more help than others. It was clear at about 16 months that my son had a speech delay and we got a referral to see a speech and language therapist at about 18 months.
SLT – Speech and Language Therapy: The provision of treatment and care for individuals with difficulties relating to speech, language and communication.
SALT – Speech and Language Therapist: A specialist that provides assessment and treatment for individuals with difficulties and delays in speech, language and communication. They also work with individuals who have difficulty eating, drinking and swallowing.
Some children with autism really struggle with speech and language and most children with autism struggle with communication. I think of my son as being fluent in pictures and verbal speech is a second language for him. Speaking is so natural to me that I find it hard to stop and break down the steps – first you need to understand someone is communicating with you, then that you are expected to communicate back, you need to listen to what is being said, understand and process it, take in any gestures or tone being used and understand it, decide how you plan to respond, find the right words to respond then get the words out verbally. There is so much involved and if you struggle with any part of this process or if it simply takes you a longer time than most people you are going to really struggle.
Hanhen sets out the four stages of communication . The first stage is focused on the child’s own agenda, the second they begin to make requests, the third is early communication with more interaction and understanding, the fourth stage is partnering with others and developing simple conversation. I found it very interesting and helpful to look at each stage in more depth to really understand where my son was at. Children with communication difficulties will go through the same stages of development but at a slower pace.
Top ten tips for speech and language:
1 Keep it simple and speak clearly
2 Attention – make sure you have it
3 Reason to communicate – be exciting
4 Labelling – name what they are engaged with
5 Waiting and turn taking – give them a chance to communicate
6 Repeat over and over, don’t rephrase
7 Comment and talk about what is going on
8 Expand – when they use one word you use two
9 Questions – don’t ask too many
10 Understanding – are you on their level
I intend to do another post going into more detail on these very soon.
Try and cut out distractions and background noise like TV and music when you are communicating with your child so they can focus on your speech. If you can try to give your child half an hour a day one on one time when you are talking to them, maybe at bedtime when you are sharing stories.
Children with autism can struggle with many aspects of speech and language, try to keep the following in mind:
- At first teach practical words like more, up, again and avoid social words like thank you as these concepts can be very difficult to grasp
- Avoid closed questions, offer restricted choices and provide opportunities for your child to communicate
- Reduce your language and repeat key words like ‘finished’ and ‘more’, generalise keywords and use them across the day
- Say things in order so your child knows what is coming first e.g. ‘shoes on we are going out’ rather than ‘we are going out put your shoes on’
- Give brief clear instructions one at a time
- Say what you want them to continue doing –‘good listening’, ‘great sitting’
- Don’t assume they understand what you have said
- Make sounds fun –‘wheeee’, ‘uh-oh’, use nursery rhymes and songs
- Say what you mean – kids with autism are literal thinkers, avoid sarcasm
- Your facial expression / tone may not be picked up
- Don’t ask children to repeat words especially in front of people
- Don’t tell a child when they make a mistake – simply say yes and say the word correctly back.
- Don’t force eye contact
For a child with complex speech and language delays you may want to consider Makaton or picture exchange communication (PECs).
Some useful websites for speech and language: