Speech is a troubling issue in autism spectrum disorders. Some children develop speech on time according to milestones, and then regress, losing all speech. Some children develop speech on time, but talk so much you’d like to pull your hair out, and some children never develop speech and are completely nonverbal. Every child is different in the “speech” part of the autism spectrum disorder disability. Whether your child is verbal or nonverbal, don’t give up hope. Many children with autism spectrum disorders begin to speak with one on one speech therapy. Others make incredible strides with PECS (Picture Exchange Communication System) and other visual cues.

Always know, however, that your child is “in there.” A very highly publicized story about a boy who was completely nonverbal, who learned to communicate through assisted communication technology, went on to write and communicate brilliantly. He has let us into the mind of a person with nonverbal autism like never before. That man’s name is Tito Mukhopadhyay, and you can read more about it at Autism Today. It’s an exceptionally moving story — and a reminder to never give up hope.

Speech therapy will help both verbal and nonverbal children with autism. Before you begin therapy, you will likely have to complete a speech evaluation from a licensed speech language pathologist. After completing a series of tests with your child, the therapist should be able to tell you if your child would benefit from speech therapy, or if they qualify for speech therapy. Remember, vocabulary isn’t the only part of speech. Children with autism have a severely limited ability to speak in social settings, also known as pragmatic speech. Pragmatics is knowing how to use language appropriately in social settings.

Because children with autism already have social deficits, speech is greater impaired by their limited social skills, which makes for very awkward and odd speech patterns. The ability to converse is severely limited in most cases.

RDI is another type of therapy that is a relative newcomer to the autism scene. RDI is actually a brilliant way to teach children with autism by using nonverbal cues and forcing them to become more and more aware of their surroundings and by referencing facial cues on peers and others around them. RDI was the brainchild of Dr. Steven Gutstein, who initiated the RDI programs and has authored several books on the subject. The program is based on the philosophy that individuals with autism spectrum disorders can participate in authentic emotional relationships if they are exposed to them in a gradual, systematic way. The developers of the program say it is a parent-based clinical treatment for individuals with autism spectrum and other relationship-based disorders. The stated primary goal of the program is to systematically teach the motivation for and skills of “experience sharing” interaction, which proponents of this method claim is at the core of autism spectrum disorders.

For instance, one of the RDI “games” involves holding a tray between the autistic child and the parent or therapist. A glass of water is placed on the tray, and the pair must walk together, but are not allowed to speak to one another. Typical persons can anticipate or sense fluctuations in movements from their partners better than a child with autism, obviously, by reading body language, facial cues and the like. In order to prevent the glass of water from spilling, the child with autism must reference the facial expressions and nonverbal cues from the other person. It’s truly a unique and interesting concept!

Play therapy, or floortime, as some refer to it, is the type of therapy coined by Dr. Stanley Greenspan. The theory behind the concept is to enter the child ‘s world, play with the child on his or her terms, and slowly expand the base of play to include new ideas. Although there have been few studies on the efficacy of play therapy/ floortime, many parents have seen excellent results. For example, if a child is persevering or obsessing with cars and perhaps watching the wheels spin, the play therapy approach would be to get down on the floor with the child and begin by watching the wheels spin with him or her, then eventually d o other things with the car, such as drive it on the floor as a typical child would do. Slowly, over time, the child will learn to expand his or her repertoire of play, and will learn to interact with others. An excellent book on this subject, called “The Child with Special Needs,” by Dr. Stanley I. Greenspan, explains the concept in depth, or you can click on some of the links below.

AutismLink does not recommend one type of therapy over another. We can, however, tell you that what counts is the amount of time that the child spends ENGAGE D with other people. No matter which modality of treatment you choose, you will see your child make progress. There is considerable debate among parents and professionals as to which type of therapy is the “best” or the most effective. Choose what you feel is right for your child. Only you can make that decision. You can also choose more than one type of therapy and use a combination approach.

Staff SHOULD BE trained properly in the treatment modalities such as applied behavior analysis, verbal behavior, play therapy/floortime, RDI (Relationship Development Intervention), etc. Agencies are responsible for educating their professionals. Make sure that the therapist working with your child has been properly trained. To learn more about other modalities of treatment, click on the autism topics menu on the right.

ABA (Applied Behavior Analysis), also sometimes referred to as “discrete trial” is one of the types of therapy that you may choose to use with your child. Based on the philosophies of Dr. Ivaar Lovaas, it is one therapy that has data to back up its efficacy on children with autism. The therapy, which is based quite a bit on the old theories from B.F. Skinner, used immediate and positive consequences to reward positive behavior. This is the theoretical basis und er which ABA is delivered to children with autism.

Discrete trial and ABA are actually two different things. While ABA is the method, discrete trials are the activities that are conducted in an ABA Program. The activities, or “trials” are conducted with the child to elicit a proper response. It’s basically like a puzzle — these trials are used to teach smaller pieces of a larger concept. Once all of the smaller pieces of the puzzle have been taught, the child will then learn the larger concept — or, will have all of the pieces of the puzzle put together.

AutismLink does not recommend one type of therapy over another. We can, however, tell you that what counts is the amount of time that the child spends ENGA GED with other people. No matter which modality of treatment you choose, you will see your child make progress. There is considerable debate among parents and p rofessionals as to which type of therapy is the “best” or the most effective. Choose what you feel is right for your child. Only you can make that dec ision. You can also choose more than one type of therapy and use a combination approach.

In Pennsylvania, wraparound staff SHOULD BE trained properly in the treatment modalities such as applied behavior analysis, verbal behavior, play therapy/f loortime, RDI (Relationship Development Intervention), etc. Wraparound agencies are responsible for educating their professionals. Make sure that the therapist working with your child has been properly trained. To learn more about other modalities of treatment, click on the autism topics menu on the left.