Autism Spectrum Disorder Speech Language Pathology Perspective

A few words about Autism Spectrum Disorder (ASD) Autism is a neurodevelopmental disorder characterized by social impairments, cognitive impairments, communication difficulties, and repetitive behaviors. It generally appears before the age of 3 years old. It can range from very mild to very severe and occur in all ethnic, socioeconomic and age groups. Males are four times more likely to have autism than females. Autism impacts the normal development of the brain in the areas of social interaction, communication skills, and cognitive function. Individuals with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities Regressive type of autism: Some children with autism appear with typical behaviors and language before the age of 1 or 2 years and then suddenly “regress” and lose the language and social skills they had previously gained.

SIGNS OF AUTISM No back-and-forth sharing of sounds, smiles, or other facial expressions by nine months or thereafter No babbling by 12 months; No words by 18 months or speaking in an apparent abnormal tone of voice or odd rhythm or pitch that would be expected for a typical child No Gesturing (pointing, waving bye-bye) by 12 months Any noticeably significant loss of speech or babbling or social skills at any age Looks through people; limited awareness of others; typically not responsive to other people’s facial expressions and feelings; Minimal to no eye contact (e.g. does not look at the adult who is feeding him/her) Lack of pretend play; little or no imagination Does not adjust gaze to look at objects that others are looking at Does not show typical interest in peers; lack of play with or near peers purposely

SIGNS OF AUTISM Minimal to no pointing at an object for purpose of gaining joint attention with another; lack of initiation of an activity or social play Unusual and/or repetitive hand and finger mannerisms or body movements Unusual reactions, overly reactive or lack of reaction, to sensory stimuli; heightened or low senses of sight, hearing, touch, smell, or taste (e.g., may refuse to wear "itchy" clothes and become distressed if they are forced to wear the clothing item; may find normal noises painful and hold hands over ears; unusually high tolerance to or low response to pain; seeking out sensory input such as rubbing surfaces, mouthing or licking objects, crashing into objects/floor) Become very distressed when routines are changed Producing words/sentences without apparent communicative intent; may repeat words or phrases over and over without communicative intent (e.g., repeats words or memorized passages such as commercials or favorite cartoons/TV shows)

Signs of Autism

Treatment for Autism At this time, there is no cure for Autism Spectrum Disorders (ASD). An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with ASD. Most programs build on the interests of the child in a highly structured schedule of constructive activities. Focus needs to be on joint attention and communicative intent - Joint attention: sharing interest in the same object, action, or event with another person. It includes eye contact/gaze, pointing to, naming or talking about, or playing with the same objects or events. - Communicative intent: communicating about the interesting objects, actions, or events. It includes asking questions, making comments, requesting turns, rejecting objects or turns, and commanding others. Joint attention and communicative intent both begin to develop during the first days of life.

What can you do? Select interesting toys and activities that seem to motivate the child the most to want to attend. By following the child’s lead in what he chooses to interact with, one can discover what he/she enjoys most. Share the toy/object by taking turns with it Very briefly withhold the toy and then give it back; while it is “your turn” with it, use appropriate language to comment about the item/actions performed with it and then encourage the child to indicate he/she wants another turn (e.g., “Look, the baby is hungry. I am giving him food to eat. Do you want baby now?”)

More of what you can do Respond to requests for objects/actions/attention Indicating the desire for another turn, verbally or non-verbally, is a type of communicative intent; as soon as the child indicates desire for an object (i.e., by reaching for it, eye gaze on that object, vocalizing or verbalizing, producing words, etc.), respond by giving the object back to him/her for his/her turn with it Provide models of appropriate language. Use language yourself that the child can use: - to request (e.g., point to brush and say “I want brush” or “Give me the brush”) - for joint attention (e.g., “Look, I wash baby doll. Baby all clean now.”; “Cow eating. Cow says ‘moo’.”). Sing familiar simple songs child enjoys by singing with child; Many children, especially those on the autistic spectrum, respond positively to music and singing