While formal speech therapy lessons help children with autism spectrum disorder (ASD) build their communication skills, most of their communication development happens outside speech language pathologists’ offices.
Parents and caregivers are key providers of speech therapy for children with autism, and they can partner with speech language pathologists (SLPs) to embed communication lessons for their children as they grow.
“Children learn to communicate in the context of interactions with their caregivers, with the important people in their lives,” said Elaine Weitzman, executive director of the Hanen Centre, a Toronto-based nonprofit that provides early language intervention resources for parents and providers. “That’s really where we consider the best therapy to take place.”
SLPs can teach parents and caregivers appropriate activities to build their children’s communication skills at home from early childhood through young adulthood.
How to Conduct Speech Therapy Interventions at Home
SLPs tailor speech therapy plans and activities to individual children based on their communication abilities and needs. Those plans incorporate activities at home, school and in the community.
“SLPs then collaborate with the parents to establish child-specific techniques and teach them strategies for these routines,” SLP Adena Dacy said. “Together, they share resources, problem solve and offer feedback as needed.”
Parents can embed interventions in caregiving routines, play routines or community routines throughout the day. As Weitzman explained, these interventions are not designed to add extra work into a family’s routine.
“This is not something that you’re going to have to sit down and make your child do,” she said. “If you sing with your child, if you take your child for a walk to the park, if you give your child a bath, if you sit at the table and have meals with your child, if your child likes playing with blocks,” you can use those activities as learning opportunities for your child throughout the day.
Parents and caregivers can begin by building in 5- to 10-minute learning opportunities that are part of activities children already enjoy and are motivating to a child. Eventually, caregivers can embed interventions in more challenging situations.
“Once that child realizes, ‘I am enjoying this and I’m being listened to and I’m hearing language that’s very much related to what I’m interested in,’ things start to change,” Weitzman said.
Speech Therapy Activities for Children with ASD
Parents and caregivers can use 5- to 10-minute intervals to facilitate communication interventions and slowly build the time their children are learning up to 10 or 20 hours per week.
“Families can build up to that amount of time by systematically adding new routines and activities throughout their day,” said Juliann Woods, an SLP and partner in Autism Navigator.
Speech therapy goals for children with ASD will vary based on a family’s priorities and a child’s functional needs. Goals could include pairing vocalizations with gestures, describing emotions or maintaining conversations (PDF, 86KB) as a child’s communication develops from prelinguistic to emerging and advanced language.
Strategies for communication interventions also vary by age group and communication ability. In general, it works well for parents and caregivers to create opportunities for learning within routines they already conduct. And using specific objects and activities children are interested in can help prompt children to engage with their communication partners.
Speech Therapy for Infants and Toddlers
The earliest interventions for young children with autism focus on increasing engagement and interaction rather than speech.
“For prelinguistic infants and toddlers, interventions often focus on engagement, meaningful play, gestures and parent/caregiver/sibling interaction,” Dacy said.
Interventions can be part of everyday routines in the home, childcare or community, such as dressing, bathing, mealtime or playtime, Dacy said.
“Some of the early intervention strategies really look at play with people,” Woods said. “How do we engage with the people in our lives, show them attention, express our emotions? How do we engage with them and take turns as a foundation for early communication?”
Being animated can help parents and caregivers engage with their children. For non-verbal children, using animal noises and toys can help gain children’s attention, according to AutisMag.
Speech Therapy for Preschoolers
Parents and caregivers of preschoolers with autism can begin to focus on interactions with their peers in places like the playground, daycare or preschool, Dacy said. Using games and role-playing activities, such as playing house, can help reinforce interactions with peers, according to Stages Learning.
Building a picture card library that allows children to match pictures to words can assist children as their vocabulary develops. Parents and caregivers can also imitate play with toys. Singing and acting out action and movement songs can also be helpful.
Augmentative and Alternative Communication (AAC) may help young children with complex communication needs participate in conversations with family members, care providers, peers and teachers. SLPs can help identify whether AAC is appropriate for a child.
Speech Therapy for School-Age Children
School-age children can continue to build on interactions with their peers and improve non-verbal communication skills, including their understanding of body language and facial expressions. Using cartoons and drawings can help children label feelings. Parents and caregivers can address friendships and social skills in and out of school, with skills such as turn-taking, empathy or behavior at mealtime.
SLPs can work with families and teachers to implement classroom strategies that increase students’ access to the curriculum and bridge the gap between their learning styles and abilities and academic demands, Dacy said.
“A goal might be to help the child with reading comprehension or writing activities related to a book they are reading at school or at home,” she said. They might also help families address friendships and social skills in and out of school (e.g., turn-taking, empathy) or behavioral issues at mealtime.
Speech Therapy for Adolescents and Young Adults
Parents and caregivers of adolescents and young adults with ASD should begin to focus on transition planning to prepare them for changes and communication in advanced academic, workplace and community settings.
“Depending on the student, this can mean preparing students for post-secondary educational programs, employment, relationships or independent living,” Dacy said.
To prepare for employment, caregivers can practice workplace skills with their children such as interviewing for jobs and resolving conflicts. They can create opportunities for training in workplace social skills, and they can offer support at work such as workplace modifications and job-coaching.
Parents and caregivers can also help children with autism develop deeper friendships and relationships by creating opportunities for social involvement in their communities.
For college students with ASD, parents and caregivers can help by exploring academic accommodations and social support systems, such as counseling or support groups.
Establishing strategies to support a successful transition from the family home to a group home, semi-independent residence or independent living environment can also be helpful for young adults, Dacy said.
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