Speech Therapy Guide for Parents of Children with Autism
Daily tasks as simple as making breakfast can become teachable moments for parents of children diagnosed with autism spectrum disorder (ASD).
“Mom could just do it on autopilot. She could embed some opportunities for the child to make a choice between the cereals that are there and identify which one the child wants. She could label the silverware or set the table and help out and do a chore,” said Juliann Woods, a speech-language pathologist and partner in Autism Navigator. “You don’t even think of that as intervention, but the child is learning valuable communication and social interaction skills.”
Although children with autism vary in their communication abilities, parent and caregiver involvement in speech therapy is key for children on the autism spectrum to progress in their communication skills.
How Speech Therapy Helps Children with Autism
Autism spectrum disorder is usually diagnosed in early childhood as communication skills are developing. The condition makes it difficult for children to communicate to varying degrees. Some children may not be able to speak at all or may have limited speaking abilities while others may be able to talk about specific subjects in great detail.
“Children with ASD may have difficulty developing language skills and understanding what others say to them,” according to the National Institute on Deafness and Other Communication Disorders. “They also often have difficulty communicating nonverbally, such as through hand gestures, eye contact, and facial expressions.”
Speech therapy can help children with autism refine their spoken language, improve non-verbal skills, or learn to use other communication methods. SLPs can train parents in different approaches to improving their child’s communication that are tailored to the child’s abilities, communication contexts, and family needs. There is a range of evidence-based treatment approaches for children with ASD, including:
- Augmentative and Alternative Communication (AAC)
- Activity schedules/visual supports
- Computer-based instruction
- Video-based instruction
- Behavioral interventions
- Cognitive behavioral therapy
- Play-based interventions
- Social communication/social skills interventions
- Literacy interventions
- Relationship-based interventions
- Parent-implemented interventions and coaching
- Routines-based interventions
Speech Therapy Benefits for Children with Autism
Speech therapy interventions can have a range of benefits for children with autism. Working with a speech-language pathologist (SLP) can help determine if a child has a social communication disorder and identify whether Augmentative and Alternative Communication (AAC) is appropriate for them.
Speech therapy can also help children:
- Match pictures with meanings
- Strengthen mouth and jaw muscles
- Make speech clearer and improve articulation
- Regulate tone of voice
- Learn to use AAC, such as writing or sign language
- Increase understanding of body language and facial expressions
- Enhance skills in different social situations, including at home, at school, and in the community
- Adapt to feeding challenges
- Improve independence and self-advocacy
Parents’ Role in Speech Therapy for Autism
Parents have a stronger relationship with their children than SLPs and more opportunities to interact with them, so they play a critical role in children’s communication development.
“[Parents] can do it just as well as we can,” said Elaine Weitzman, executive director of the Hanen Centre, a Toronto-based nonprofit that provides early language intervention resources for parents and providers. “In fact, they can do it better.”
Adult understanding and empowerment are essential to children’s therapy, according to 92% of therapists who participated in a study on speech therapy for preschoolers with developmental and speech and language disorders published in the International Journal of Language & Communication Disorders.
Parent-led interventions often have positive outcomes for the child and other family members, which can ultimately reduce stress on the family of a child with ASD, according to Adena Dacy, a speech-language pathologist and the American Speech-Language-Hearing Association’s associate director for clinical issues in speech-language pathology. Involvement by parents helps them develop stronger bonds with their children; they understand their child better and learn to encourage communication in ways they didn’t notice before.
“Parents need to implement specific, individualized strategies to support their child’s communication and learning,” Dacy said in an email. Such strategies can include following the child’s lead, giving their child a reason to communicate and then waiting for a response, engaging in parallel talk or play, using visual supports or AAC, or providing choices.
“If you stop talking and wait and observe the child, give the child a chance to communicate in any way — doesn’t matter what — then you can follow his lead. And that is motivating,” Weitzman said. “And any language the child hears in response to what he’s communicated is language that he’s more likely to learn from.”
Though some parents are apprehensive about providing speech therapy interventions, SLPs can work with caregivers to build the skills they need to assist their children.
“Families then become more knowledgeable, engaged, independent, confident, and competent in their abilities to communicate with their child, to enhance their child’s learning, and to accomplish everyday activities,” Dacy said.
Challenges for Parents of Children with Autism in Speech Therapy Interventions
Parents and caregivers are a child’s first and long-term communication partners, so a child’s communication abilities affect them, too. But parents can encounter challenges as they are learning how to communicate with their child. These can include:
- Difficulty catching a child’s attention and engaging them in activities
- Anxiety about their ability to facilitate speech therapy interventions at home
- Unclear expectations about their role and the SLP’s role in speech therapy
- Resources on at-home speech therapy interventions without professional support
- Limited collaboration between their child’s care providers or conflicting treatment recommendations from different providers
- Difficulty accessing therapy due to location, transportation barriers, schedule conflicts, or waitlists for services
- Grief and stress about their child’s diagnosis
- A sense of being overwhelmed by their child’s needs
Building Confidence and Competency to Assist Children with Autism in Communication
When parents learn to implement speech therapy interventions on their own, interventions become more relevant and higher quality for the child, Dacy said. Parents and caregivers should start with activities that are part of their child’s routine already and slowly embed learning opportunities in more challenging scenarios.
“Gaining confidence as a caregiver in embedding intervention — it goes a long way toward motivating caregivers to try things that might be a little trickier, that might be a little more high-stakes,” Woods said.
Parents and caregivers can turn to these tips as they’re learning to implement speech therapy interventions for children with autism:
Don’t underestimate your qualifications
You are your child’s first teacher and communication partner, and you know your child best, including their strengths and needs. You spend more time with your child than anyone else does, and your child trusts you.
Communicate your speech therapy goals with your child’s SLP
Lay out goals for you, your child, and your family.
Participate in your child’s formal speech therapy lessons
Observe the SLP’s strategies for interacting with your child, and practice them before you leave. Completing the same speech therapy activities as your child will help you learn how to replicate or modify them at home. Ask your child’s SLP for specific cues you can use to help your child.
Use familiar daily routines as learning opportunities
Children learn best in natural contexts, and they tend to communicate more in familiar, everyday situations. “Embedded learning is not more learning; it’s not more work to do,” Woods said. “It’s learning in the moment that is important and produces independence and engagement and meaningful outcomes for kids.”
“Your child learns best when they’re happy, when they’re motivated, and when they’re enjoying the interaction,” Weitzman said.
Reflect on what’s working and what’s not
Don’t be afraid to ask questions, offer suggestions, or solicit feedback. Ask for help with a particular routine. Solve problems and plan your sessions with an SLP or other professionals.
Strategize for breaks
Devise plans for vacations, school changes, or other gaps in formal therapy sessions to continue working with the child.
Learn as much as possible
“The more information that families have and the ability to work collaboratively with partners helps build their confidence, their self-esteem, and self-efficacy,” Woods said. “Also, they gain skills that help them feel more confident working with their child as a member of the team.”
Celebrate small successes
Praising even the smallest interactions can encourage children with autism to develop their communication skills.