When it comes to describing how autism affects language, interview subject Rachael Lampi is an expert. As a speech pathologist in hospital and clinic settings and in the public schools, she has worked to improve the communication skills of dozens of autistic children. She also has her own home therapy business, called The Candid Therapist. Rachael sat down with LoveToKnow Autism to discuss some of the language challenges that affect kids on the autism spectrum.
How Autism Affects Language: Interview with Rachael Lampi
LoveToKnow (LTK): What made you decide to become a speech pathologist? What do you like about the job?
Rachael Lampi (RL): I was in school studying business and law with the intent to become a business lawyer. I realized that business wasn't as interesting to me as I thought it might have been, so before I took any law classes, I had mentioned to my father that I wasn't too keen on what I was studying. In all his wisdom he said, "Your personality is similar to that of my speech therapists, why don't you try a class in that field?" I did, and that is where I stayed.
I enjoy many aspects of my job, but the two things that give me most joy is seeing the children succeed when they didn't think they could and hearing updates on previous clients. There is a lot of joy in hearing that your work made a positive difference in a family's life.
What Is Speech Therapy?
LTK: Many people don't realize that there's more to speech therapy than just the proper articulation of speech sounds. What else does it include?
RL: Wow. This is a big question. Speech therapy involves evaluating and treating children and adults who present with communication difficulties in the areas of language and/or speech difficulties from a variety of illnesses and disorders. This is a general listing of language areas evaluated by a speech and language pathologist:
- Receptive language, which is a person's ability to understand the words that are being said and to complete a variety of activities, including following directions and learning from instructions
- Expressive language, which is a person's ability to use words together to express their wants, needs, and ideas
- Pragmatic language, which is a person's ability to use language appropriately within a social context
- Speech, which refers to a person's ability to make individual sounds within words
- Phonology, which refers to the rules of how sounds go together to form words
- Oral motor skills, which include the range and strength of motion of the tongue within the oral cavity for speech and feeding purposes
- Voice, which refers to the tone a person uses to communicate
When we consider all of this, a speech language pathologist is truly able to evaluate and treat all aspects regarding communication.
Language and Autism
LTK: What are some early language-related signs that a child may be on the autism spectrum?
RL: This is a difficult question to answer as language and speech-related skills alone do not indicate that a child is on the spectrum. It should be understood that a speech language pathologist doesn't diagnosis autism. They are able to treat children with language delays related to autism. Each child is so individual is it impossible to say that each of these signs will be indicative that another child with the same signs will be diagnosed with autism. However with this in mind, these may be some of the most common language-related signs:
- Slow speech development
- Lack of interest in others and their language
- Speaking very early on and/or levels of speech that seem advanced for the child's age
- Communication through signs or behaviors
- Slow or monotone speech
- Having speech but being unable to use is appropriately to communicate basic needs and wants
An even earlier sign for children around 6 months of age is the lack of a social smile.
LTK: What are some of the communication challenges faced by kids on the autism spectrum?
RL: Here again this varies from one child to another depending on where they fall on the autism spectrum. For those children with more severe autism, their communication means may be non-verbal, and they may use behavior to communicate. For those on the higher end of the spectrum, a challenge may be in the area of social communication and appropriate use of language. One skill that seems to affect most children on the spectrum is the ability to perspective take.
LTK: How does perspective-taking play a role in these challenges? What else might contribute to communication difficulties in autistic kids?
RL: First I want to start off with a story about a child with higher functioning autism with a lack in perspective taking skills. This 7-year-old client came into therapy one day chewing a large piece of blue bubble gum. She looks at me and asks, "Guess what I'm chewing?" (chew chew) I respond , "Ah…. gum." She looks at me bewildered and says, "Yeah! How'd ya know?" Of course, I laughed because it simply was funny. But in all honesty, she wasn't able to understand how I knew she was chewing gum. She wasn't able to use perspective taking skills to think from my point of view that I could see her chewing gum.
To practice on a skill such as this, you can teach your child to learn from his or her environment by watching what others are doing and encouraging your child to think about what others are thinking. A simple way to work on this skill is to play this game: Lay three or four pictures or items in a line, and have your child guess which picture or item you are thinking about. Tell them to watch where your eyes are, and then you look at the picture or item that you are thinking about. Play the game where you also guess what the child is thinking about by reversing roles.
How Parents Can Help
LTK: What can parents do to help their autistic kids learn to communicate more effectively?
RL: All parents are the experts of their own children. You know and understand your child the best. When helping your child communicate, one of the best things a parent can do is understand the level that their child is at and work at that level and increase the expectations during times that you know your child can handle the stress of higher expectations. If your child is involved in outside therapies or with therapies within the school setting, it is important to share your expertise of your child with the therapist. Then, with the therapist's help and collaboration, you can incorporate communication strategies into everyday living situations. These strategies will vary heavily based on your child's needs.
One strategy that works, not only for children diagnosed on the spectrum but for all children, is to WAIT. Often times we are moving our children through the day without giving them ample time to respond to us. By waiting a few extra seconds, we may be surprised at how children respond to our requests and questions. A good rule of thumb while using the strategy of 'waiting' for children to respond is to count to 10 in your head, allowing the child to have time to talk.
LTK: How can parents and caregivers encourage appropriate social language skills?
RL: To encourage social skills, a parent may want to teach in the moment. For example, when guests arrive and your child is greeted with a "hello," this is a good opportunity to work on social language. Your child may want to just walk away or say "hello" but not look. This would be a good opportunity to calmly tell your child, "It is polite to look at the person saying hello to you" or "When we have guests arrive, it is important that you look at them when you say hello instead of walking off."
Getting Help with Speech and Language
LTK: If a parent suspects her child is on the spectrum, how should she go about getting help with speech therapy?
RL: If a parent suspects that her child has autism, it is important to get help as soon as possible. Research is suggesting that the earlier the intervention, the better the outcomes for children diagnosed with autism.
If you are looking for speech therapy, the first step would be to get a referral from your family physician, pediatrician, or developmental specialist who may have diagnosed the autism. Then look for a provider of speech therapy. You may want to check with your insurance to see who is listed as in-network providers as a first step to finding a provider.
Research Is the First Step
LoveToKnow Autism would like to thank Rachael Lampi for discussing how autism affects language. Interviews and articles can be very helpful for parents in learning how to handle language issues with kids on the spectrum, and research is the first step toward helping your child or other family member.
