Language delays and disorders are common in autistic children, but speech and language pathologists (SLPs) are often taught very little, if anything, about autism. The lack of knowledge and experience in treating language delays and disorders in children with autism can make the process difficult for both the SLP and the autistic child.
Insights on Language Impairments in Autism
A failure to develop language is one of the earliest signs of autism, per the journal article “Speech and Language Impairments in Autism: Insights from Behavior and Neuroimaging” (Mody & Belliveau, 2013). While deficits in meeting language development milestones in autistic children is common, speech and language impairments differ between autistics, which can make intervention and prognosis a challenge.
A neurotypical child uses language for social and conversational interactions, but “The child with ASD typically uses words to regulate his or her environment. Some autistic children may have apraxia or oral-motor impairment impacting their ability to communicate. However, it is the “absence of communicative intent” due to social deficits that often disguises itself as an expressive language impairment. It is easy to conceive that a reduced social drive to talk may manifest as delayed or impaired language development.”
As an SLP, some of the challenges that you may encounter in treating language disorders and delays in autistic children may be connected to your SLP/client relationship itself. A compilation of studies, “Autistic Peer-to-Peer Information Transfer is Highly Effective” (Compton et al., 2020), finds that autistic individuals prefer interacting with other autistics. A sense of close association is reported in autistic-to-autistic interactions.
Rachel Dorsey, autistic speech-language pathologist and owner of Dorsey SLP, LLC, writes about The Dilemma of Social Skills Therapy Part 1: The Young Child:
“It is incredibly painful to hear that your well-intentioned, compassionate, and dedicated therapy plans targeting pragmatic language are likely hurting the very population you serve. It is uncomfortable to hear criticism from the minority you possibly got into this career to help. However, autistic voices on this matter urgently needs to be listened to and appreciated. And this is not just criticism for criticism’s sake—there is an actual solution. Current social skills curriculums are not working—but there are meaningful ways forward to truly help autistic kids navigate, socially. Not just autistic kids, but all kids. In fact, that’s the key.
Your autistic client, child, or loved one is not broken – they are living in a world that makes it difficult to truly thrive as an autistic person.”
Rachel explains her philosophy to empower autistic people through her four professional goals:
- Building communication, whether that be through spoken language, AAC, or body language.
- Identifying emotional and sensory regulation strategies as they pertain to overall regulation needed for effective communication.
- Building self-advocacy skills, respecting boundaries, and presuming competence.
- Identifying accommodations and supports to be put in place in a variety of settings.
Communication Is Key (Not Language)
We believe that using RDI® as the foundation for the treatment of autistic language delays and disorders in your practice encourages growth and forward motion and in the child.
In the RDIconnect podcast episode, “RDI and Non-Verbal Children,” a discussion between Kat Lee and Dr. Rachelle Sheely illustrates how our model approaches communication first, and how other treatments miss that important factor.
Here are some of the highlights from Dr. Rachelle Sheely:
We (RDI®) always start with communication, and (we) worry about the language later. What we have found is that the children who don’t have language to begin with, when we begin to work with them on facial expression and tone of voice, and where their bodies are, they begin to get really good at interacting with other children the same age. They come to us with no language…and with communication, it begins to build, just as it does in typical development.
Typical Language-Building Programs Do Not Work
For parents who have been told that they need to immerse themselves in programs that teach language…sometimes for 40 hours a week (with children sitting at desks). They (may) get to the point where the child can say, “Give me a cookie, please,” but the child cannot sustain a conversation, and they (i.e., parent, SLP) realize that they have missed something (e.g., communication).
We believe in working with the child in everyday environments, and everyday activities, with patience, reduced distraction, positive reinforcement, and with a focus on non-verbal communication (e.g., gesturing) rather than language.
Learn more at our blog post: “How to Improve Communication with Autism (Improving Communication for Your Autistic Speech Clients)”
We want to reach every child’s fullest potential, and we have high expectations. We never know where the child is going to end up, but do not judge the child’s potential. Do not predict it based on whether the child (does or does not) have language.
RDI® Speech Therapy Goals
Communication is vital, but communication is more than words. Reciprocal communication is essential for the autistic person’s expression of basic wants and needs.
We believe that the SLPs role is vital to diagnose, assess, and plan autism treatments. The goal is not to treat the autism but to enable the child to communicate functionally and spontaneously, and to include nonverbal language.
It is crucial that the SLP coordinate with other autism professionals and teachers to provide education and direction to the parents to equip them as the key speech therapy leader(s), as they are the most important guide in their children’s lives.
Communication starts with relationship. Without relationship and communication, a child on the autism spectrum does not readily develop in the six areas of dynamic intelligence that make independence possible. At RDI® our focus is not on language, but it is on emotional referencing, social coordination, declarative language, flexible thinking, relationship information processing, and foresight and hindsight.
Dynamic intelligence helps individuals, including autistic children, connect with the complicated and ever-changing world that we live in.
Learn more at our blog post “Six Areas of Dynamic Intelligence.”
Are you interested in joining other professionals from all over the world, and the parents they work with, who come together to help each other navigate autism at all stages of life?
We are currently accepting applications to become a Certified RDI® Consultant! Find out more about RDI® certification in your area and sign up for more info.