According to Autism Speaks, the term “autism” or “autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication.  In order to be diagnosed with autism, a child must have each of the following two conditions present in early developmental life:

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Since social communication impairments are a defined feature of the autism diagnosis, speech therapy is a common recommendation for children with autism.  Speech therapy for autism will target improving the child’s social communication and interaction skills and helping them become more independent and confident in their environment.  The following speech therapy goals that should be considered for all clients with autism spectrum disorders.

The first goal with any child who has autism is to make sure that he or she can communicate functionally, and spontaneously. This means that the child needs to be able to communicate his basic wants and needs to those around him without needing to be prompted through it (the adult shouldn’t have to say “what do you want?” or “use your words”).

If the child already has that down, awesome! You can move on. If not, stop here! Do not pass go, do not collect $200! This step is a MUST!

Each child with autism will need this area of speech therapy to look slightly different. Some children will need alternative means to communicate because they won’t be able to speak. Others will speak just fine but will help learning the right words to use in the right situation. A speech-language pathologist will be able to customize therapy to meet the needs of each individual child with autism.

If a child’s speech is not adequate for functional speech (meaning that the child isn’t talking or isn’t able to communicate all of his/her wants and needs), it can be helpful to introduce various forms of augmentative-alternative communication (AAC) until you find a method that works for the child. Remember, each child is different so different methods will work differently for each child. Here are a few options to try:

Children with autism often have difficulty with using language spontaneously. They may speak when told to or in response to specific questions but won’t speak up when they need something or when they are upset.

For these children, it’s important to work on fading the amount of prompts that you are giving so that the child does more and more independently each time. For example, at first you may have to tell the child exactly what to say in each situation. Then, you can fade back to a prompt like “use your words”. Then, you can fade back to a visual cue like a picture that says “use your words” or shows someone talking. There are many ways to fade cues so that is just an example.

Another alternative for helping children who are having trouble using language spontaneously is to use a PECS system like mentioned before. This structured program has been very successful with increasing spontaneous communication in children with autism.

It also may be helpful to start with teaching the child basic requests (as those will be the most motivating for him) and then move on to other types of communication such as commenting, greeting, asking, etc. once requesting has been established.

Echolalia is the term for when a child repeats what we say back to us instead of coming up with his/her own sentences. This is common in children with autism who are learning to speak. Sometimes, we hear parents say “he didn’t speak at all and then one day he started speaking in full sentences”. This is because these children are learning sentences as one unit. Later, they will learn how to break those sentences down into single words and then rearrange them to create their own sentences.

For more resources on helping children with echolalia, click here

Need some more help with learning how to improve functional communication in children with autism? Check out our functional communication course bundle here. It includes video training courses along with printable therapy materials and activities.

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The next thing that all children with autism will need to some degree is social instruction. Children with autism often have a problem with understanding socially acceptable behavior. They don’t always know how to act or behave in various social situations. Since school is basically just one big social situation, that can make learning environments especially hard for them.

Again, the specific therapy techniques and strategies for this area will vary depending on the child and their individual needs.  But the key is for this social instruction and support to continue throughout the day.  Children with autism often have difficulty transferring skills learned in one setting to a different setting.  For that reason, they need to work on social interactions in more places than just during speech therapy sessions.  Educators and caregivers should carry-over social instruction in other settings as well.

It is important to teach children what behavior is socially acceptable in various environments. This includes what the child should do and say in social situations as well as how he should listen and attend. For young children, you will choose goals for basic skills like listening to a teacher, answering questions, and following directions. For older children, you will choose goals like group conversations and being a good friend.  Again, the social skills chosen will depend on the needs of the child.

Here are several strategies that have been proven effective methods of social instruction for children with autism:

Since children with autism often have a difficult time with peer interactions, these skills must also be directly taught. All children with autism struggle with this to some extent as part of the nature of autism. However, you will target significantly different skills depending on the age and developmental level of the child you are working with.

Here are some goals for children who are just beginning their peer interaction training:

These activities are better for older children who are struggling with peer interactions:

One of the most common requests I hear from parents of children with autism is “My child needs more time with the speech-language pathologist”. I completely understand why they want this! The speech therapist is the person who is helping their child communicate better so more time with that person should equal better communication, right?

Unfortunately, that’s not exactly how it works.

Children with autism tend to have trouble generalizing skills. For example, if you teach a child with autism to count to 5 using the same 5 yellow cups at the kitchen table and you never practice counting anywhere else, the child will do great at counting to 5 in that exact situation but may not be able to transfer that to counting anything else.

The same goes for communication. If a speech-language pathologist teaches a child with autism to communicate with her in the speech therapy room, it doesn’t necessarily mean that the child will then start communicating with other people and in other settings.

Instead, the child must practice the same communication skills with a variety of different people and in a variety of different settings. For that reason, it is vital that the child does not spend every waking moment with the speech therapist. We want the child to communicate in any situation, not just when the speech therapist is present.

If the child needs to work on communicating better, then the answer is not necessarily just to add more time with the speech-language pathologist. Instead, the speech therapist must train the other adults that interact with the child on how to do the same types of instruction, prompting, and modeling that she does.

When the speech therapist trains the other adults, the child will make faster progress with his communication skills because he will be getting the same instruction from multiple sources and he’ll be able to practice those skills in the natural environment (at home and in the classroom as opposed to just in the therapy room).

Speech therapy services for children with autism can look very different depending on a lot of factors. Each speech therapist will need to determine which services will be best for each child. Here are some different ways that speech therapy services may be assigned to help the child make optimal progress:

As you can see, there are many different ways to serve children with autism and adding more direct therapy minutes isn’t always the best solution. Each student needs an individualized plan including a combination of different services.

Finally, we look at other communication skills that may be impacting the child with autism. Once the child begins to make progress on these larger items, we can begin to address some of the smaller issues that may also be impacting the child’s communication.   Here are a few areas that may need to be addressed:

Source: http://www.asha.org/Practice-Portal/Clinical-Topics/Autism/

Check out our additional resources for working with autistic children here:

Access all of our autism courses and resources inside The Hub

How to Help Children with Delayed Echolalia and Scripting

Check out the freebies that we have inside our Free Therapy Material Library!

Autism Therapy Cheat Sheet

AAC and Autism Handout

Initiating Interactions Social Story

Hi, I’m Carrie! I’m a speech-language pathologist from Columbia, Missouri, USA. I’ve worked with children and teenagers of all ages in schools, preschools, and even my own private practice. I love digging through the research on speech and language topics and breaking it down into step-by-step plans for my followers.

Fun Fact: My family’s favorite vacation spot when I was a kid was Myrtle Beach, South Carolina.  My favorite restaurant there is Sea Captain’s House.  They used to have a shrimp in phyllo dish that was my favorite, but sadly they stopped serving it!  We still love going though and it’s been fun to bring my kids there now, too!

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