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Recent research compared the intensity of therapy for Autistic children of different severities. These 87 children were split into 4 groups - “15 hrs per week of discrete trial teaching (DTT), 25 hrs per week of DTT, 15 hrs per week of a naturalistic developmental behavioural intervention (NDBI), or 25 hrs per week of NDBI.” This was done over 12 months.

https://onlinelibrary.wiley.com/doi/10.1002/aur.2416

What’s DTT?

Therapy that involves structured tasks and trials. Children on the spectrum learn well with structures and routines. Think ABA therapy and traditional early intervention.

What’s NDBI?

This is more naturalistic training. Think TEACH or DIR Floortime, therapy that isn’t done at the table with structured learning.

“The researchers found that more hours per week of therapy, in this case, 25 vs. 15 hours per week,...

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Autism Levels and Severity

https://www.autismspeaks.org/autism-diagnosis-criteria-dsm-5

Sleep disturbances

https://www.sciencedirect.com/science/article/abs/pii/S0891422221001736?via%3Dihub

69% of preschoolers with an autism diagnosis showed signs of sleep issues (compared to 20–40% of typically developing peers)

Gastrointestinal Symptoms

https://link.springer.com/article/10.1007/s10803-020-04786-9 

Three times more likely to have GI symptoms compared to typically developing peers

Get a Free Framework for Teaching Speech Sound Disorders Here → https://www.agentsofspeech.com/speech

Speech Therapy Waiting Lists are LONG

If people are having difficulty understanding your child, then of course you’d see a speech therapist. But the waiting list is long, in most major cities the wait is years on end. Speech is different from language. Speech will get better over time and is relatively less urgent than treating language. That’s why speech cases have a lower priority especially if your child is speaking in phrases and sentences already.

Following Kids Who Didn’t Get Therapy

This study from Hong Kong followed children who were on the waiting list for 2.5 years.

https://pubs.asha.org/doi/10.1044/2022_JSLHR-21-00444

They found that most children resolved their speech errors by 6.5 years old.

Also, children who passed an intelligibility screener were about 23% more likely to normalize and did so faster.

...

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Speech therapy costs are going up!

Finding a good fit

Make it worthwhile for all of you

Start teaching your child at home. Download my FREE home therapy checklist→ https://www.agentsofspeech.com/checklist

The following are my personal opinions and experiences. School-based speech therapy is still needed. My gripe is with the system and how it’s implemented at schools.

Everyone hates it

Documentation and Bureaucracy Over Therapy

How Should School-age Speech Therapy Be Like?

Get a Free Framework for Teaching Speech Sound Disorders Here → https://www.agentsofspeech.com/speech

Speech Disorder? What’s that?

It can happen to people of all ages. We’ll focus on ones that affect children. Speech sounds are the sounds we make to communicate. Whilst the words and sentences carry the message. Speech is the sound we give it. That’s why we understand spoken language. We can also read language and that doesn’t require us to use speech sounds.

A disorder is a condition that disrupts a person’s daily life. Communication is a pretty big part of our lives. So when someone cannot communicate because of speech impairment. That would be a disorder. When children are developing, there are typical errors that the child would have. No one is born with perfect speech. Where there is a distinction between developmentally acceptable errors and a speech disorder… For that, please see a qualified speech therapist for a thorough...

Get a Free Framework for Teaching Speech Sound Disorders Here → https://www.agentsofspeech.com/speech

Functional Speech and Communication

Establish a way for children to communicate with you. It may be sign language or AAC. The most important is that your child has a way to tell you what he wants/needs.

If your child is verbal, then write out the most functional words your child would use. And practice it over and over again. Apraxic children can get good at saying certain words when there’s enough repetition.

Teach Flexibility and Sequencing

This is to increase your child’s base speech abilities. For younger children below word level, we teach syllable sequencing. Which means repeating a syllable 3-7 times. It might be the same syllable or a variation, this totally depends on your speech therapist’s assessment results.

For older children Rapid Syllable Transition Treatment (ReST) Program is a viable option. We also use non-words that follows your language...

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 AAC as a Substitute for Speaking

Children and adults use AAC to communicate because they cannot physically do so. For individuals who have a neurological and structural deficit, AAC becomes their default way of communicating.

AAC can be gesturing (sign language), writing, drawing, alphabet boards, pictures, iPad or tablet apps, or even computer-generated voices.

AAC as a Bridge to Speaking

Sometimes, therapists would suggest a child use AACs even if the child is capable of speaking. This might be because of a low communication intention. Using an AAC might reduce the friction of communication. Then it’ll be easier to teach pre-linguistic skills. Often bridging to use speech is possible because speaking is faster than using AAC. It becomes a routine or framework that the child understands. And that becomes a good foundation to teach other skills.

Why...

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Finding out the reason

Why is your child screaming? There are usually 4 reasons why.

1. Wanting something from you
2. Desire to escape
3. Attention seeking
4. Sensory related

Which one is it? Find out why and you’ll know exactly NOT to do. You should not give in and let them get what they want. 

Can you find a replacement behaviour for these reasons? Usually, speaking and communicating can be the best replacement you can teach. Whereas for sensory seeking, you should find a different outlet for the child to get what s/he needs. An idea would be singing instead of screaming.

Rewarding the opposite behaviour

The importance of rewarding the absence of behaviour is often overlooked. That means when a child isn’t doing something, you should actually praise and reward that. One thing we did with a child who screamed randomly was that we gave him a piece of...

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How to calculate speech clarity?

Speech clarity also known as speech intelligibility is a percentage.  A speech therapist calculates this after assessment. Children should reach 90-100% speech intelligibility by 5 years of a ge. It’s within normal limits for younger children (2-3 year olds) to have lower speech intelligibility.

What factors affect speech intelligibility?

A child’s language ability affects speech intelligibility. Because understanding speech sounds needs a level of linguistic ability. If your child becomes makes more mistakes as s/he tries to say more syllables, that is also developmentally acceptable. That is related to linguistic ability as well. 

General coordination of speech, what we call coarticulation is also a factor. This relates to the child’s motoric ability. Yes, it’s permissible if the child does have problems...