Question:

«Hello, my name is Inmaculada, my 4-year-old son has Autism Spectrum Disorder and still does not speak, he communicates very little with us. What can we do to help him improve? Thank you.»

Answer:

Hi Inmaculada, thanks for asking. As we all know, communication and language are one of the main affected areas by Autism Spectrum Disorder. In the first place, it would be necessary to carry out an evaluation to obtain an objective and realistic assessment of the communicative characteristics of the child. The most basic need that can be found is to have a communication tool.

A small child, a person who has not been previously intervened and does not handle any tools, or someone who has confused the tools they have and is not capable of making functional use of them, will present this first need that will be the basis on which to build more complex skills.

Children will always try to develop oral language as a vehicle of communication. As a general rule, functional communication will always be prioritized over formal communication. It is essential that the child understands the importance of the communicative act and therefore it will be reinforced and attended to at all times. Bearing in mind that you, the family, are the most stable element of the child and with whom he spends most of his time, it is essential that you have strategies that promote communication and social relationships.

We can highlight the following strategies:

  • Always face to face.
  • Adjust to the level of the child, that is, if their understanding is reduced to one word or to simple commands, the language with which we should address them should also be simple, with sentences of 1 or 2 words at most.
  • Use high-impact words, that is, those that have the most meaning, coinciding with their interests. For example, if the child is playing with the ball, we can say the word «ball» instead of longer phrases like «that’s great, how the ball jumps».
  • Be consistent with the language used. That is, always use the same word for objects or actions. For example, every time the child plays with the bubbles, we say the word «bubbles», avoiding using other words such as «bubbles» so as not to create confusion.
  • Use short and informative sentences that reflect what is happening at a given moment.
  • Model language whenever the child communicates nonverbally. That is, if the child gives us a bag of chips to open it, we can say «help» or «open», giving voice to their communication.
  • Avoid speaking quickly, quickly, or asking many questions.
  • Avoid anticipating the child’s communication or emissions. Be patient and wait as long as it takes.
  • Create communications opportunities throughout everyday life situations. Create game routines that allow the child to initiate communication and make it as spontaneous and natural as possible.
  • Avoid commands and the use of conditional sentences, replacing them with declarative sentences. For example: “we are going to open the door”, “we are going to eat”.
  • Avoid forcing repetition. Communication should be as natural and spontaneous as possible. Giving commands such as “say I want a car” inhibits functional communication, and even if the child repeats it, it would not have a communicative function.

To promote the most basic function of communication, the first in which we put the focus of attention, that of request and rejection, it is recommended:

  1. Put in sight, but out of reach, containers with food or objects of interest. Transparent shelves and cans are two very useful elements in this case.
  2. Play interactive games and use children’s songs. These little routines usually contain simple, repetitive language that includes an element of anticipation before the climax. Careful use of time pauses, and rhythm in this type of game help create opportunities to develop communication in playful situations.
  3. Finally, it should be noted that the key to stimulation is to always follow the interest and motivation of the child and create situations and opportunities for communication in all of the child’s vital contexts and especially in situations of their daily life, bearing in mind that any time can be conducive to learning.

We hope this has been helpful, and remember that these are general parameters. Ideally, a speech therapist should attend to your child’s case and help you.

speech therapy child's therapy Autism spectrum disorder