Speech Therapy for Autistic Children: Supporting Communication in Every Form

Speech and language therapy is one of the most common supports for autistic children. But the goal is not simply to get a child talking. Good therapy helps a child communicate, to make requests, share ideas, refuse things, ask for help and connect with others, in whatever way works best for them.

What does a speech and language therapist do?

A speech and language therapist (SLT), also called a speech-language pathologist, assesses how a child understands and uses language, including speech, gestures, facial expression and play. For autistic children, therapy often focuses on:

• Understanding words, instructions and everyday routines
• Expressing needs, choices and feelings
• Shared attention, such as looking at and enjoying the same thing as another person
• Back-and-forth interaction, turn-taking and play
• Social communication, such as starting conversations and understanding others’ points of view
• Feeding and swallowing, in some cases

Goals should fit the individual child

There is no single programme that suits every autistic child. A good therapist sets goals with you, based on what matters most in your child’s daily life. For one child, that might be asking for a drink without becoming distressed. For another, it might be joining a game at school. Goals should build on your child’s strengths and interests, and they should be reviewed regularly.

Play-based approaches

Young children learn best through play. Many effective approaches, sometimes called naturalistic developmental behavioural interventions, use everyday play and routines to build communication. Therapists may:

• Follow the child’s lead and join in with what interests them
• Set up situations that create a reason to communicate, such as placing a favourite toy in sight but out of reach
• Model simple words and gestures that match what the child is doing
• Pause expectantly to give the child a chance to respond

Parents are often coached to use these strategies at home. This matters, because children spend far more time with family than in therapy sessions.

Gestures, signs and echolalia

Gestures and signs are valuable stepping stones and can reduce frustration quickly. Many autistic children also use echolalia, repeating words or phrases they have heard. This is often a real attempt to communicate. For example, a child who says “Do you want a biscuit?” may mean “I want a biscuit.” Therapists help families understand and build on this, rather than trying to stop it.

AAC: augmentative and alternative communication

AAC means any way of communicating that adds to or replaces speech. It includes:

• Low-tech options: picture cards, communication boards, choice cards and picture exchange systems such as PECS
• High-tech options: tablets with communication apps and dedicated speech-generating devices that speak a word aloud when a picture is touched

Many parents worry that AAC will stop their child from learning to talk. Research shows the opposite. AAC does not hold back speech, and for many children it supports spoken language. Most importantly, it gives a child a voice right now. Children learn AAC best when the adults around them use it too, by touching the symbols as they talk.

Signs of good therapy

Everyday ideas for home

• Get down to your child’s level and join their play.
• Use short phrases, one or two words longer than your child uses.
• Offer choices: “banana or apple?” with the items in view.
• Wait. Count to ten in your head to give your child time to respond.
• Celebrate every attempt to communicate, in any form.

How FXMed can help

Communication is easier when a child is comfortable and well rested. We help families address the tummy troubles, sleep problems and nutrient gaps that can get in the way. Our Autism Support program works alongside your child’s paediatrician, therapists and school. It does not aim to cure or change autism. It focuses on the physical health issues, such as digestion, nutrition and sleep, that can make everyday life harder.

This article is for general education and does not replace advice from your own doctor or care team. If you are worried about your child’s development or health, please speak to a qualified professional.