Autistic kids sometimes have complex communication needs that require support. Some, especially those who are nonspeaking, need alternative and augmentative communication (AAC) all the time.
Sometimes autistics may only occasionally use AAC, and others only use it until speech comes; for some it is the main source of communication throughout life.
Many Autistics begin to speak at a later stage than their peers, requiring support with the development of speech and language– this is where speech and language pathologists come in! (SLPs, for short)
SLPs are professionals who specialise in methods of communication, the development of language, and ways to assist communication. The first thing a speech and language therapist should do is fully evaluate your child’s current speech and language abilities.
Your child might be automatically referred to speech therapy, or you may need to find one yourself. Unfortunately, especially in rural areas or in regions where autism awareness is behind, there may be little (or indeed no) access to SLP services.
If you do have access, the best speech pathologists are those who fully respect neurodiversity and do not use harmful tactics in their therapeutic approach (for example, approaches that treat neurological differences as if they are bad behavior). Check out my other article for a checklist to see what makes a good or bad therapist!
SLP v/s ABA
Many Autistic people are against ABA. Other articles on the Aspergian will explain to you thoroughly why we don’t endorse ABA as a therapy for autism, and we hope you will read more up on this (a reading list of some articles on ABA can be found at the end of the article). Some ABA therapists or BCBA’s might try and convince you that they can help with your child’s speech and language, but the reality is they are not trained to do so.
The following chart is reproduced with permission from the SLP Neurodiversity Collective compares the educational requirements of SLPs to BCBAs (the people who train and manage ABA therapists). As you can see, SLPs are trained in a wide array of medical issues; however, behavioral analysts are mainly trained in managing behaviors. This chart is typed from a graphic to make it more accessible for those using screen readers.
| SLP Speech-Language Pathologist | BCBA – Board Certified Behavior Analyst |
| Speech-language pathologists (SLPs) have a foundation in preventing, diagnosing, and treating communication disorders and swallowing disorders | Board Certified Behavior Analysts (BCBAs) have a foundation in behavior analysis |
| Required Courses | Required Courses |
| •Voice Disorders •Stuttering •Assessment and intervention of language impairments in preschool and school-age children •Motor speech disorders •Neurogenic communication disorders •Dysphagia |
•Experimental Analysis of Behavior: Special Topics •Learning Principles •Conceptual Issues in Behavior Analysis •Behavioral Assessment •Applied Behavior Analysis •Behavioral Interventions I & II •Research and Practicum in Applied Behavior Analysis •Ethics and Professional Issues in Behavior Analysis •Research Methods in Behavior Analysis •Verbal Behavior |
| 23 semester credit hours from the following: | 6 semester credit hours from the following: |
| •Articulation Disorders •Augmentative Communication •Autism Spectrum Disorder •Audiology •Anatomy & Physiology of Speech & Hearing •Childhood Apraxia of Speech •Dysphagia in Public Schools •Research in Pediatric TBI •Medical SLP •Dementia •Pulmonary Issues •Tracheotomy and Mechanical Ventilation •Pediatric Feeding •Articulation and Mechanical Ventilation •Pediatric Feeding •Articulation and Phonological Disorders •Counseling in Communication Disorders •Bilingual Speech Assessment and Treatment •Speech Science •Language Acquisition •Neurogenic Communication Disorders I & II •Neurological Basis of Language Development •Laryngectomy •Craniofacial Disorders •Advanced Topics in Adult Dysphagia •Pediatric Dysphagia •Birth-to-Three •Preschool Intervention •Therapy Strategies for School-Age Children •Seminar in Aphasiology •Communication and the Aging Brain •Neural Correlates of Human Cognition: Lesion-Deficient Models •Auditory-Verbal Methods •Social Communication in Early Childhood Disorders •Pediatric Traumatic Brain Injury •Current Research in Autism •Language Disorders and Reading Disabilities |
•Human Growth and Development •Psychopathology of Childhood •Psychoactive Drugs •Advanced Social Psychology •Behavioral Medicine •Biological Basic of Behavior •Behavioral-cognitive Therapies •Advanced Cognitive and Affective Psychology |
Apologies for the length of the chart, but it truly demonstrates the differences in approaches as SLP is certainly a complex area. This is why many autistics would endorse the help of a speech therapist for your child; however, we also know for many reasons this may not always be possible.
Therefore, I will leave you with some more free resources that I hope will help your child! Alternative communication should not be avoided in the beginning stages of speaking.
Parents may worry that having access to AAC will cause their children to not feel the need or desire to speak. Remember, finding a communication method that works for your child that is of the utmost important, and verbal speech should not always be a priority.
Makaton
One method to encourage communication is Makaton, which is a simplified version of sign language. This isn’t for everyone, especially those with motor planning difficulties, but for many children, it is fantastic. Here is just one free resource, but there are many available that can be found through a YouTube search.
Makaton will not stop your child’s speech development as you are speaking the words for them to hear while signing.
AAC
Visual Schedules
Language Comprehension
“Wh” Questions
Semantics
Extending and Expanding Language
Grammar
Narrative and Variety Packs
Organizing Thoughts
For older children, text provider Holt, Rinehart, and Wilson has a great link full of printable organizers to help with your child in organising their thoughts and feelings and making plans for school, work, etc.More Help
For more information on ABA try the following articles:
- Autism “Intelligence” Tests Send Mixed Messages to Parents - August 9, 2020
- Free Communication Resources for Autistic Children - February 1, 2020
- How to Spot a Good– or Bad– Therapist for Your Autistic Child - August 31, 2019
7 Responses
While your intent is to share information about communication strategies, accurate portrayals offers the best help to readers. Your comments about PECS being potentially “harmful” because reinforcement can limit communication do not correspond with abundant research. Two publications have shown that children can be taught to use PECS in a manner which encourages “Improvisation” or creative use of pictures- (Marckel, Neef & Ferreri, 2006; and Chaabane, Alber-Morgan & DeBar, 2009 with parents as teachers). A randomized control study involving very young children with ASD (2.5 yrs old) and using 10 or fewer spoken words showed 19 children who learned the PECS protocol averaged over 84 spoken words 6 months later and totaled over 120 words in 3 more months. It is not helpful to perpetuate the natural fear that people have when trying pictures as a communication modality but thankfully there are many unbiased sources available for parents and practitioners. I encourage your readers to visit http://www.pecs.com to find up-to-date information.
Thank you for your response Andy Bondy. So much perpetuation of misinformation presented throughout this blog. So sad.
The pictures aren’t the issue. The operant conditioning is.
Operant conditioning has been debunked as an effective tool for teaching language in animal language research (and for good reason too – it can’t really teach genuine communication beyond requests, since requests are directly associated with obtaining a reward). PECS is behind the curve on that one. One does not need operant conditioning to use pictures as a communication modality.
And yes, rewarding people for saying things associated with feelings IS harmful, since it teaches people to fake certain feelings for the reward and not to express genuine feelings. Especially when the things being rewarded are things like “I love you”. Or other positive sentiments they may not be feeling at the time.
I agree with L above. https://slpndc.org/the-problem-with-pecs/ .
Also providing evidence something works doesn’t mean its ethical. ABA is evidence based, though the science behind it often weak and dubious. None of that justifies the harm it inflicts on children.
I can only imagine, L, what the reaction would be if I tried to compare teaching children to communicate with attempts to teach animals… When people study the motion of objects relative to each other they invariably discover gravity and then describe rules associated with those observations, including factors such as mass, distance, etc. When people study the relationship between behavior and consequences they invariably discover reinforcement and then describe rules associated with those observations, including factors such a timing, patterns, etc. One can chose to not believe in gravity but when one jumps off a building, gravity won’t care- it will influence what happens next. And one can chose to not believe in reinforcement but the laws of behavior won’t care either and still influence what happens next. We can discuss how to improve the application of these laws- including ethical issues- without denying they are part of reality. And of course one needs to use reinforcement to teach children how to “express their emotions”- and the modality has nothing to do with this lesson.
Te reaction to compare teaching kids to teaching animals would be, and is, entirely impassive – enthusiastic, even. In my experience, ABA supporters do that all the time. They have in my animal behavior and cognition program. And twice I heard lectures from a person who champions TAGteach, which is literal clicker training for autistic kids. And let me tell you, the reception for that is WILDLY enthusiastic in these circles. Complete with accusations of denying that humans are animals if you say that this is a bad idea.
And as for the “laws of reinforcement”? There is a world of difference between the natural outcomes of things we do nothing to enact, and literal carrot/stick control methods implemented by us. Neither are those laws entirely neutral – there can be devastating consequences you didn’t intend. And good things that come from within as well as without. Not to mention that the aspects of operant conditioning on’t need to be used more than they are in typical things – ABA, in all its forms, dials this up to 11, and that’s where the problems lie (and the debunking of operant conditioning used in animal language is operant conditioning in this context – not to mention that when they used intrinsic motivation, the only thing where operant conditioning can work on language, they didn’t deny the animals water and make them request their every food scrap, either).
And there is another law which behaviorists ignore because it has nothing to do with operant conditioning – the law of learning information based on what was given. As in, kids hearing a series of words and demands, with none of the adult context, will take the things exactly as they heard them, no matter what YOU understood the directive to be. Science fiction writer Isaac Asimov even addressed this law, in a short story called “Runaround”, which featured a robot who was given orders and had none of the context of a human to know how to follow , and so the robot ended up running around in circles nonstop as a result of a conflict between equally important directives.
And while humans might have a better understanding of particular orders, note that many simple things adults understand (including how and when to know when to follow orders and take a break) can consist of hundreds, even thousands of multiple shades of imperatives and qualifiers, none of which a young child has – and given the sheer number of these, it is prohibitively complex to teach these nuances to children via operant conditioning alone. And language, containing as many words and sentences and shades of meaning as it has, is one of those things – and so you get kids who don’t really understand how to say things or will say things to mean “stop this” or “give me a reward” that have nothing to do with that meaning. And that’s just the tip of the iceberg of consequences experienced when lessons that require nuance are spoon-fed to kids sans context.
I want to share some more resources!
Teaching your child to use an AAC app: https://www.wikihow.com/Teach-a-Nonspeaking-Child-to-Use-an-AAC-App
Identifying abuse in ABA therapy: https://www.wikihow.com/Tell-if-an-Autism-ABA-Therapy-Is-Harmful
To any parent reading this: Good luck. It must be hard right now, trying to get the right support to help your child find their voice. The Autistic community is here for you.