Speech and language therapy

The ability to use language well is what drives social interaction. It is an important skill to have but unfortunately, is something which many autistic people struggle with.

If you stop to consider: we use speech and language every day and on a constant basis. This also includes non-verbal aspects such as gesture/facial gesture, eye contact and body language.

As babies and young children we start off with minimal speech but this expands and becomes more sophisticated over time. Once we reach adulthood we have a rich and varied vocabulary at our disposal.

The process of acquiring speech and language usually starts with a few basic sounds as a baby through to several words at the ages of 3 or 4. We develop the ability to string words together in sentences from the age of 5 onwards.

Construction of language

What do we mean by language? Language is the communication of thoughts, opinions, ideas and feelings by means of speech. This involves uttered sounds, written symbols and gestures.

Language itself is comprised of four sections which are:

• Semantics: the meaning of language.
• Syntax: refers to the use of grammar and the way it is ordered.
• Phonology: refers to speech sounds
• Pragmatics: using language in order to communicate with others.

These sections are useful when determining what the problem is regarding speech and language in an autistic person.

Someone with an autistic spectrum disorder has a delay in acquiring these skills which means that they find it difficult to communicate with speech and/or language.

Children normally learn this during their developmental stages and acquire the ability to do so as a result of interaction with their parents and others. They actively look to make contact with other people which then improve their language skills.

But the autistic child often avoids social interaction or does not engage in conversation which limits their ability to do so. This leads to a great deal of frustration for that child who struggles to make themselves understood.

Another aspect is that an autistic child does not see any reason to communicate or interact with other people so will avoid doing so. But by doing this he/she is denying him/her self the chance to acquire these skills.

Examples of speech and language problems in autistic children

If an autistic child is unwilling or unable to acquire these skills or avoids situations where they have the opportunity to learn then this will impact upon their development.

This limitation means that they do not expand their vocabulary which leaves them lagging behind their peers in terms of development.

Unless they participate in conversations or scenarios where they have the chance to observe, learn and acquire the necessary language skills then they will be isolated as a result. This means learning about the various forms of communication such as pointing, tone of voice and writing; reasons for using language such as expressing a need or a request; and the time and place to do so, e.g. at home.

Common problems include:

• Parroting (echolalia): this means repeating what has been said but not understanding why or what has been said.
• Idiosyncratic speech/language: this is where the child uses a word or expression to refer to something which is unrelated or irrelevant.
• Literal speech/language: this refers to the habit of taking everything seriously and literally, e.g. don’t put all your eggs in one basket.

They will also have difficulty with the change in tone and pitch within speech, the use of slang and popular sayings and when something is said in a humorous fashion.

Methods for learning speech and language

A speech and language session in run by a trained therapist who will use a variety of techniques, e.g. picture cards, toys and gesture to improve these skills. This means teaching the child to listen, pay attention to what is being said and responding appropriately.

The child also needs to understand the context in which language is used and the mood of the speaker at that time. Plus he/she needs to understand about emotions and their role in a conversation. Emotions are a major part of speech which is used to convey meaning so it is important to understand the type of emotion being expressed and why. For example, if the person speaking is upset and is expressing this via speech then the listener needs to interpret this and deliver a correct response such as showing sympathy with that person.

If your child has poor language abilities or is unable to speak then the therapist will use pictures, written cards and sign language as means of communication.

Where to find a speech and language therapist?

Your GP will be able to recommend someone or you can obtain details of a speech and language therapist (SALT) from the Royal College of Speech and Language Therapy.

This is for people looking for an NHS therapist. If you are thinking of going private then contact the Association of Speech and Language Therapists in Independent Practice. They will provide you with details of therapists in your area.

Another option is to see if you can access a therapist via your local education authority. If your child has been classed as a Statement of Special Educational Needs then you may be able to access this therapy as a part of that statement.

Details about any of this can be found on our links page.