Speech, 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 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.

Speech and Language Tips

Speech and language has become a huge part of my life over the last couple of years. My eldest son is five and non-verbal. He has started to speak three times but each time has regressed.  My son is autistic with a complex speech and language delay.

We use the Picture Exchange Communication System (PECS) as our main form of communication. Speech and language therapy has been extremely important for us. In this post I want to share all the helpful skills I have learnt over the last couple of years. 

Communicating

Some autistic children really struggle with speech and language but most will have difficulty with communication in some way.  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 longer than most people you are going to have difficulty communicating.

Hanhen four stages of communication

Hanhen sets out the four stages of communication 

1. child’s own agenda
2. begin to make requests
3. early communication with more interaction and understanding
4. 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 often at a slower pace.

Top 10 speech and language tips:

1. Keep it simple and speak clearly
2. Attention – make sure you have
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

A few more tips

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 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). Visual aids are also very important.

I would really recommend Attention Autism and some fun attention builders for children struggling with attention and communication.

Some useful websites for speech and language:

Talking Point

I Can children’s communication charity

Hanhen Centre  

Foundation Years, what to expect when

The Literacy Trust

The Autism Page Online School

You may also be interested in my online course ‘ Communicating with your non-speaking child‘.