The Learning Sphere - Pediatric Speech Therapy

Speech therapy is almost always recommended for autistic children since many people with autism have difficulty with social communication. Even if a child is very verbal and says a lot of words, they might need to work on communication skills like: 

• responding to questions
• starting or ending conversation
• changing conversation topics
• using gestures like pointing
• understanding other people's body language 

Speech therapy is a big focus in early intervention for autistic children and is usually the starting place for recently diagnosed kids. There is a critical period in the brain for language development and so, it's really important to teach language and communication skills as early as possible, especially if there are any delays in that area. Your child will learn effective ways to communicate which will help them grow into more independent and confident individuals.

It might be obvious when a child struggles with speaking —they are very quiet, say only a few words, or don't speak at all.

Spot speech and language delays like a doctor here.

The goal of speech therapy is to help your child communicate effectively with other people across all environments. This may take the form of using gestures, simple signs, verbal speech, and Augmentative and Alternative Communication (AAC).

Some other common things speech therapists can help with:

• Nonverbal skills, such as signs or gestures
• Forming speech in a clearer way
• Communicating thoughts and feelings clearly
• Understanding and responding to questions
• Discerning facial expressions and their corresponding emotions
• Noticing and understanding body language
• Feeding and swallowing
• Stuttering

Here are a few alternative options to consider:

• Cognitive-behavioral therapy (CBT): CBT helps by identifying and changing unhelpful thoughts and behaviors. It's useful for those dealing with social anxiety or difficulties. CBT addresses cognitive patterns and provides strategies to manage social challenges.
• Group therapy: Group therapy offers a supportive space where individuals can practice social skills. They can feedback from peers and a therapist. It allows interaction with others who understand and learn from each other.
• Play-based interventions: Play therapy or play-based interventions work well for younger children or those who learn through experiences. Play activities target specific social skills like turn-taking and problem-solving in a safe and engaging setting.

The occupational therapy process includes an OT evaluation before care starts. Here are the four steps your family can expect when starting occupational therapy:

1. Complete OT evaluation. An occupational therapist first identifies your child’s strengths and needs through a thorough OT evaluation, also known as an OT assessment or screening. You’ll answer questions about your child’s skills, and your child will most likely demonstrate their skills via hands-on activities with the therapist. Evaluations can last 30 minutes to a few hours.
2. Approve OT plan. The therapist develops a care plan with individualized goals and customized interventions based on your child’s needs. You can also share any specific goals or concerns before approving the OT plan.
3. Start therapy sessions. The therapist works directly with your child and your family, using various strategies and exercises to systematically improve areas of limitations and to build upon a child’s strengths. Some exercises your child might participate in are animal walks, obstacle courses, and therapy swing activities. Your family may learn strategies for supporting your child’s individualized needs at home, such as ways of supporting emotional regulation and sensory processing. The therapist may also recommend tools and techniques to use at home, in the community, or in the classroom to help your child succeed.
4. Monitor your child’s progress. Parents and caregivers can expect ongoing progress monitoring and communication to ensure the child is achieving their short and long-term goals.

Occupational therapy can also be provided virtually via telemedicine. Virtual therapy is a great option for families in rural areas who may not have access to in-person services, or for families who prefer to have therapy in their child’s home.

Virtual OT allows the opportunity for increased caregiver participation and understanding of a child’s strengths, areas of improvement, and generalization of skills in the child’s home environment. Virtual therapy also provides increased opportunities for caregiver and family education to support the child and the family based on each family’s needs.

Even if a provider offers parent training, it may look different from one provider to another. For example, an in-home provider might conduct a parent training session directly following a therapy session with your child to help explain what they’ve been working on with your child. At larger organizations, you might have a support group of families who are dealing with similar issues.

It has become more common! While some families try DIR/Floortime on its own, it can be done in combination with other therapies, such as occupational therapy, speech therapy, and applied behavior analysis (ABA) therapy. Many families enjoy incorporating exercises from DIR/Floortime with other therapies. Many therapists and providers like to include DIR/Floortime’s play and child-led approach into their practices.

DIR/Floortime has some research to support its effectiveness, though this is limited. In a 2019 study, researchers published positive outcomes as a result of DIR/Floortime, including increased joint attention and initiation of activities.

DIR/Floortime is currently considered to be an experimental treatment. As of the 2015 publishing of the National Standards Project on evidence-based treatments, DIR/Floortime was listed under the “unestablished level of evidence” category. While Floortime can benefit some children, more research is needed to establish efficacy. Our expert recommends Affect Autism to learn more about the research behind DIR/Floortime.