How to develop language in children having autism

Table of content:
1. 2. 3. 4. 5. 6. 7. a. b. c. d. e. 8. a. b. 9. a. b. c.
interests Definition of autism History of autism What is autism spectrum? Early Signs of Autism Possible Early Autism Signs Characteristics of children with Autism Types of Autism Autistic Disorder Aspergers Disorder Pervasive Developmental Disorder Retts Disorder Childhood disintegrative Disorder Causes of autism Family Factors Neurotransmitters Autism Symptoms Social Interaction Verbal and Nonverbal Communication Repetitive behaviors or narrow, obsessive Diagnostic criteria of autistic disorders What is language? Language Development in Autistic Children

10. 11. 12.

13. 14.
Autism?

Language Development in Autistic Children: What Causes Speech and Language Problems in What Are the Communication Problems of Autism? How Are the Speech and Language Problems of What Are the Goals? Causes and Milestones Causes of delays in speech Speech milestones Speech and Language Therapy for Children with Sign Language & Autism / Special Needs What to do to improve your childs speech and References

Understanding Normal Development

15. 16.
Autism Treated?

17. 18. 19. 20. 21.

Autism

22. 23.
language

24.

How to develop language in children having autism Definition of autism:

Autism

is a complex developmental disorder distinguished by difficulties with

social interaction, verbal and nonverbal communication, and behavioral problems, including repetitive behaviors and narrow focus of interest

History of autism:

Leo Kanner introduced the label early infantile autism in 1943. Leo Kanner first identified autism in 1943 when he described 11 selfabsorbed children who had "autistic disturbances of affect contact." At first, autism was thought to be an attachment disorder resulting from poor parenting. This has been proved to be a myth. While the cause remains a mystery, most specialists now view autism as a brain disorder that makes it difficult for the person to process and respond to the world. Autism has been observed in several members of the same families. Therefore, many scientists believe that, at least in some individuals, autism may be genetic. Scientists have identified some genes as playing a possible role in the development of autism.

What is autism spectrum?

This is about the classic autistic disorder; some writers use the word autism when referring to the range of disorders on the autism spectrum or to the various pervasive developmental disorders.

Early Signs of Autism:

Autism varies widely in its severity and symptoms. Because of this, early signs may go unrecognized, especially in mildly affected children or when it is masked by more debilitating handicaps.

Possible Early Autism Signs:

Doctors rely on a core group of early signs to alert them to the possibility of a diagnosis of autism. These early signs of autism can include:

Impaired ability to initiate or sustain a conversation with others Impaired ability to make friends with peers Inflexible adherence to specific routines or rituals Absence or impairment of imaginative and social play Stereotyped, repetitive, or unusual use of language Restricted patterns of interest that are abnormal in intensity or focus Preoccupation with certain objects or subjects.

Characteristics of children with Autism:

1. "Marked impairment in the use of multiple nonverbal behaviors such as eye-toeye gaze, facial expression, body postures, and gestures to regulate social interaction." (DSM-IV Diagnostic criteria for Autistic Disorder. 1994.)

2. "Failure to develop peer relationships appropriate to developmental level."

(DSM-IV Diagnostic criteria for Autistic Disorder. 1994.)

3. "A lack of spontaneous seeking to share enjoyment, interests, or achievements

with other people (e.g., by a lack of showing, bringing or pointing out objects of interest)." (DSM-IV Diagnostic criteria for Autistic Disorder. 1994.)

4. "Lack of social or emotional reciprocity." (DSM-IV Diagnostic criteria for Autistic

Disorder. 1994.)

5. "Delay in or total lack of, the development of spoken language (not

accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime)." (DSM-IV Diagnostic criteria for Autistic Disorder. 1994)

6. "In individuals with adequate speech, marked impairment in the ability to initiate
or sustain a conversation with others." (DSM-IV Diagnostic criteria for Autistic Disorder. 1994.)

7. "Stereotyped and repetitive use of language or idiosyncratic language." (DSMIV Diagnostic criteria for Autistic Disorder. 1994.)

8. "Lack of varied, spontaneous make-believe play or social imitative play

appropriate to developmental level." (DSM-IV Diagnostic criteria for Autistic Disorder. 1994.)

9. "Encompassing preoccupation with one or more stereotyped and restricted

patterns of interest that is abnormal either in intensity or focus." (DSM-IV Diagnostic criteria for Autistic Disorder. 1994.)

10. "Apparently inflexible adherence to specific, nonfunctional routines or rituals."

(DSM-IV Diagnostic criteria for Autistic Disorder. 1994.)

11. "Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or
twisting, or complex whole-body movements)." (DSM-IV Diagnostic criteria for Autistic Disorder. 1994.)

12. "Persistent preoccupation with parts of objects." (DSM-IV Diagnostic criteria

for Autistic Disorder. 1994.)

Types of Autism:
Data from several studies that used the current criteria for diagnosing autism and autism spectrum disorders (ASD), such as Asperger syndrome and pervasive developmental disabilities (PDD-NOS), found occurrence rates for autism spectrum disorders between 2 and 6 per 1,000 individuals. Therefore, it can be summarized that between 1 in 500 (2/1,000) to 1 in 166 children (6/1,000) have an ASD. Actually, the umbrella heading is Pervasive Developmental Disorder (PDD). Autism is one of the PDDs. All have commonalities in communication and social deficits. Differ in terms of severity

1. Autistic Disorder:
Impairment in social interaction, communication, and imaginative play. Apparent before age 3. Also includes stereotyped behaviors, interests and activities.

2. Aspergers Disorder:
Impairment in social interactions, and presence of restricted interests and activities. No clinically significant general delay in language Average to above average intelligence.

3. Pervasive Developmental Disorder Not otherwise Specified (PDDNOS):

Often referred to as atypical autism Used when a child does not meet the criteria for a specific diagnosis. But there is severe and pervasive impairment in specified behaviors.

4. Retts Disorder:
Progressive disorder which, to date, has only occurred in girls. Period of normal development and then the loss of previously acquired skills.

Also loss of purposeful use of hands, which is replaced by repetitive hand movements. Beginning at age of 1-4 years.

5. Childhood disintegrative Disorder:

Normal development for at least the first 2 years. Then significant loss of previously acquired skills.

Causes of autism:
Scientists aren't certain of the cause of autism, but it's likely that both genetics and environment play a role.

1. Family Factors:
Recent studies strongly suggest that some people have a genetic predisposition to autism. In families with one autistic child, the risk of having a second child with the disorder is approximately 5 percent, or one in 20. This is greater than the risk for the general population. Researchers are looking for clues about which genes contribute to increased susceptibility. In some cases, parents and other relatives of an autistic child show mild impairments in social and communicative skills or engage in repetitive behaviors. Evidence also suggests that some emotional disorders, such as manic depression, occur more frequently than average in the families of people with autism. The theory that parental practices are responsible for autism has now been disproved.

2. Neurotransmitters:
Some studies suggest that people with autism have abnormal levels of serotonin or other neurotransmitters in the brain. These abnormalities suggest that autism could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how neurons communicate with each other. While these findings are intriguing, they are preliminary and require further study.

Autism Symptoms:
There are three distinctive symptoms of autism:

Difficulties with social interaction Problems with verbal and nonverbal communication Repetitive behaviors or narrow, obsessive interests.

1. Social Interaction:
The hallmark symptom of autism is impaired social interaction. Parents are usually the first to notice possibly symptoms in their child. As early as infancy, a

baby with autism symptoms may be unresponsive to people or focus intently on one item to the exclusion of others for long periods of time. A child with autism may appear to develop normally and then withdraw and become indifferent to social engagement.

2. Verbal and Nonverbal Communication:

The second most common symptom of autism is problems with verbal and nonverbal communication. Children with autism may fail to respond to their name and often avoid eye contact with other people. They have difficulty interpreting what others are thinking or feeling because they can't understand social cues, such as tone of voice or facial expressions, and don't watch other people's faces for clues about appropriate behavior. They lack empathy.

3. Repetitive behaviors or narrow, obsessive interests:

These behaviors include:

Impaired ability to make friends with peers Impaired ability to initiate or sustain a conversation with others Absence or impairment of imaginative and social play Stereotyped, repetitive, or unusual use of language Restricted patterns of interest that are abnormal in intensity or focus Preoccupation with certain objects or subjects Inflexible adherence to specific routines or rituals.

Diagnostic criteria of autistic disorder:

There is no medical test for diagnosing autism. Diagnosis is made after careful observation and screening by parents, caregivers, and physicians. Early diagnosis is beneficial in treating the symptoms of autism. Some early warning signs are:

avoiding eye contact avoiding physical contact such as hugs inability to play make-believe not pointing out interesting objects not responding to conversation directed at him/her practicing excessively repetitive behaviors repeating words or phrases loosing skills and/or language after learning them

Once parents feel there is a problem or their pediatrician has identified

developmental problems during well-baby check-ups, they can seek out a developmental pediatrician for further diagnosis. There are several screening tests used. They are:

Childhood Autism Rating Scale (CARS)-a test based on a 15 point scale where specific behaviors are observed by the physician. Checklist for Autism in Toddlers (CHAT)-a test to detect autism in 18-month olds that utilizes questionnaires filled out by both the parents and the pediatrician.

Autism Screening Questionnaire-a 40-item questionnaire for diagnosing children four and older. Screening Test for Autism in Two-Year Olds-a direct observation of three skill areas including play, motor imitation, and joint attention. Some children have a few of the symptoms of autism, but not enough to be

diagnosed with the "classical" form of the condition. Children who have autistic behavior but no problems with language may be diagnosed with Asperger syndrome by using the Autism Spectrum Screening Questionnaire, the Australian Scale for Asperger's Syndrome, or the Childhood Asperger Syndrome Test. Children who have no initial symptoms but who begin to show autistic behavior as they get older might be diagnosed with "childhood disintegrative disorder" (CDD), another autistic spectrum disorder. It is also important to rule out other problems that seem similar to autism.

What is language?
Language is define as, A system of conventional, spoken or written symbols by means of which human beings, as members of a social group and participants in its culture, communicate Language is the code whereby ideas about the world are represented through a conventional system of arbitrary signals for communication

Language Development in Autistic Children:

Language development in autistic children varies, depending upon the intellectual and social development of the individual. Problems associated with language development in autistic children include difficulty with word and sentence meaning, intonation, and rhythm. These difficulties interfere with an individual's ability to interpret and interact with the world. Some scientists tie the communication problems to a "theory of mind" or impaired ability to think about thoughts or imagine another individual's state of mind. Along with this is an impaired ability to symbolize, both when trying to communicate and in play.

Language Development in Autistic Children: Understanding Normal Development:

The most intensive period of speech and language development is during the first three years of life, a period when the brain is developing and maturing. These skills appear to develop best in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others. At the root of this development is the desire to communicate or interact with the world. The beginning signs of communication occur in the first few days of life when an infant learns that a cry will bring food, comfort, and companionship. Newborns also begin to recognize important sounds such as the sound of their

mother's voice. They begin to sort out the speech sounds (phonemes) or building blocks that compose the words of their language. Research has shown that by 6 months of age, most children recognize the basic sounds of their native language. As the speech mechanism (jaw, lips, tongue, and throat) and voice mature, an infant is able to make controlled sound. This begins in the first few months of life with "cooing," a quiet, pleasant, repetitive vocalization. Usually by 6 months of age an infant babbles or produces repetitive syllables such as "ba, ba, ba" or "da, da, da." Babbling soon turns into a type of nonsense speech called jargon that often has the tone and cadence of human speech but does not contain real words. By the end of their first year, most children have mastered the ability to say a few simple words. Children are most likely unaware of the meaning of their first words, but soon learn the power of those words as others respond to them. By 18 months of age most children can say 8 to 10 words and, by age 2, are putting words together in crude sentences such as "more milk." During this period children rapidly learn that words symbolize or represent objects, actions, and thoughts. At this age they also engage in representational or pretend play. At ages 3, 4, and 5 a child's vocabulary rapidly increases, and he or she begins to master the rules of language. These include the rules of:

Phonology (speech sounds) Morphology (word formation) Syntax (sentence formation) Semantics (word and sentence meaning) Prosody (intonation and rhythm of speech) Pragmatics (effective use of language).

What Causes Speech and Language Problems in Autism?

Although the cause of speech and language problems in autism is unknown, many experts believe that the difficulties are caused by a variety of conditions that occur either before, during, or after birth affecting brain development. This interferes with an individual's ability to interpret and interact with the world. Some scientists tie the communication problems to a "theory of mind" or impaired ability to think about thoughts or imagine another individual's state of mind. Along with this is an impaired ability to symbolize, both when trying to communicate and in play.

What Are the Communication Problems of Autism?

The communication problems of autism vary, depending upon the intellectual and social development of the individual. Some may be unable to speak, whereas others may have rich vocabularies and are able to talk about topics of interest in great depth. Despite this variation, the majority of autistic individuals have little or no problem with pronunciation. Most have difficulty effectively using language. Many also have problems with word and sentence meaning, intonation, and rhythm. Those who can speak often say things that have no content or information. For example, an autistic individual may repeatedly count from one to five. Others use echolalia, a repetition of something previously heard. One form, immediate echolalia, may occur when the individual repeats the question, "Do you want something to drink?" instead of replying with a "yes" or "no." In another form called delayed echolalia, an individual may say, "Do you want something to drink?" whenever he or she is asking for a drink. Others may use stock phrases such as, "My name is Tom," to start a conversation, even when speaking with friends or family. Still others may repeat learned scripts such as those heard during television commercials. Some individuals with higher intelligence may be able to speak in depth about topics they

are interested in such as dinosaurs or railroads but are unable to engage in an interactive conversation on those topics. Most autistic individuals do not make eye contact and have poor attention duration. They are often unable to use gestures either as a primary means of communication, as in sign language, or to assist verbal communication, such as pointing to an object they want. Some autistic individuals speak in a high-pitched voice or use robot-like speech. They are often unresponsive to the speech of others and may not respond to their own names. As a result, some are mistakenly thought to have a hearing problem. The correct use of pronouns is also a problem for autistic individuals. For example, if asked, "Are you wearing a red shirt today?" the individual may respond with, "You are wearing a red shirt today," instead of "Yes, I am wearing a red shirt today." For many, speech and language develop, to some degree, but not to a normal ability level. This development is usually uneven. For example, vocabulary development in areas of interest may be accelerated. Many have good memories for information just heard or seen. Some may be able to read words well before the age of five but may not be able to demonstrate understanding of what is read. Others have musical talents or advanced ability to count and perform mathematical calculations. Approximately 10 percent show "savant" skills or detailed abilities in specific areas such as calendar calculation, musical ability, or math.

How Are the Speech and Language Problems of Autism Treated?

If autism or some other developmental disability is suspected, the child's physician will usually refer the child to a variety of specialists, including a speechlanguage pathologist, who performs a comprehensive evaluation of his or her ability to communicate and designs and administers treatment. No one treatment method has been found to successfully improve communication in all individuals who have autism. The best treatment begins early, during the preschool years, is individually tailored, targets both behavior and communication, and involves parents or primary caregivers.

What Are the Goals?

The goal of therapy should be to improve useful communication. For some, verbal communication is a realistic goal. For others, the goal may be gestured communication. Still others may have the goal of communicating by means of a symbol system such as picture boards. Treatment should include periodic in-depth evaluations provided by an individual with special training in the evaluation and treatment of speech and language disorders, such as a speech-language pathologist. Occupational and physical therapists may also work with the individual to reduce unwanted behaviors that may interfere with the development of communication skills.

Some individuals respond well to highly structured behavior modification programs; others respond better to in-home therapy that uses real situations as the basis for training. Other approaches such as music therapy and sensory integration therapy, which strives to improve the child's ability to respond to information from the senses, appear to have helped some autistic children, although research on the efficacy of these approaches is largely lacking. Medications may improve an individual's attention span or reduce unwanted behaviors such as hand-flapping, but long-term use of these kinds of medications is often difficult or undesirable because of their side effects. No medications have been found to specifically help communication in autistic individuals. Mineral and vitamin supplements, special diets, and psychotherapy have also been used, but research has not documented their effectiveness.

Causes and Milestones:

Some children take longer to develop their speech to a level where everything they say can be understood. These speech or language delays can occur for a variety of reasons.

Causes of delays in speech:

According to Elizabeth M. Prather, PhD, Finding the exact cause or causes of your child's speech problem can be difficult. Each child's speech is influenced by many factors, including the ability to hear, the physical development of the mouth and throat, and the abilities the child inherits. Some of the most common causes of delay she discusses are: 1. Hearing Loss: Children learn to speak by hearing others speak. So when repeat ear infections or other hearing problems occur children can not hear speech correctly so cannot learn to speak correctly. For example, "cat", "hat, "sat" may all sound the same to a hearing impaired child. From 12 months to 4 years of age language development is at its peak, so repeated ear infections during this time may affect speech and language.

2. Language Delay: Children may have difficulty learning the meaning of words and how to use words in sentences. Learning delays affect language acquisition. 3. Genetic Inheritance: It is common but not inevitable that late speech development runs in families. One or both parents or any number of relatives may have had speech problems when they were young. However, children with slow speech development do not always have parents who had the same problem. 4. Bad Speech Habits: When children are beginning to speak they say many words incorrectly. If a child repeats an incorrect pattern long enough they learn it as a habit. For example, a child may say bor if instead of for if. If uncorrected the bad speech will become habit. While these are the most common, they are by no means the only causes for speech or language delays. A physician can help you determine if a delay is due to physical or other causes.

Speech milestones:
Usually, there is concern about a child's speech and language skills if there is no speech by the age of 1 year, if speech is not clear, or if speech or language is different from that of other children of the same age. Though a physician or speech therapist should be the final source for determining if a child has a speech delay, the following milestones may help you do an initial evaluation.

3 MONTHS: A baby should become startled at loud noises, soothed by calm, gentle voices, cry, gurgle, and grunt. 6 MONTHS: Baby watches your face when you talk, tries to "talk" to you, coos and squeals for attention. 1 YEAR: The child understands some common words when used with gestures, like "bye, bye", and tries to say words like- "ba ba", "ma, ma." 18 MONTHS: One-year-old children should be able to understand a variety of words and should be using a few single words. The child should be babbling, understanding simple questions/statements such as "where is your nose? And "give me". 2 YEARS: By age two, words should be combined into two and three-word phrases and sentences, such as "more milk", "all gone", "my turn". The child also understands "where is mommy/daddy?" and simple directions such as, "get your coat". Two year olds understand more words than they can speak. A two-year-old understands approximately 300 words. 3 YEARS: A three-year-old can follow simple directions such as, time to take a bath, "tell him your name. She can also put an object in, under, or on top of a table when asked. She can also answer simple questions about objects such as which one is bigger? By age three a child understands approximately 900 words and speaks 200 words clearly. 4 YEARS: A four-year-old can follow two-step directions such as "close the book and give it to me". She also knows her first and last name, can answer reasoning questions such as, "What do we do when we're cold?", and can tell a short story such as, "two kids played ball." Sentences are usually 4 to 5 words long. By four a child is giving directions such as "put my shoes on" and asking many questions. A four-year-old understands 1500-2000 words and can use the following pronouns: he, she, you, me, I, and mine.

5 YEARS: A child this age can follow 3 related directions such as "get your crayons, make a picture and give it to the baby". Most letters are pronounced accurately except perhaps for L, R, S, K, TH, CH, SH, TH. A five-year-old can describe objects and events and can tell you the meaning of words. A five-year-old typically understands 2500-2800 words, speaks in 5-8 word sentences, uses 15002000 words and tells long stories accurately. 6 YEARS: By this age a child understands 13,000 words, understands opposites, classifies according to form, color and use, and uses all pronouns correctly.

7 YEARS: A child this age can now understand 20,000-26,000 words, understands time intervals and seasons of the year, and is aware of mistakes in other peoples speech.

Speech and Language Therapy for Children with Autism: What is it?
The goal of speech therapy is to improve all aspects of communication. This includes: comprehension, expression, sound production, and social use of language . Speech therapy may include sign language and the use of picture symbols . At its best, a specific speech program is tailored to the specific weaknesses and the environment of the individual child. Unfortunately, it can be difficult to create a child-specific, evolving, long-term speech therapy plan.

The National Research Council describes four aspects of beneficial speech therapy.
1. Speech therapy should begin early in a child's life and be frequent. 2. Therapy should be rooted in practical experience in the child's life. 3. Therapy should encourage spontaneous communication. 4. Any communication skills learned during speech therapy should be generalizable to multiple situations. Thus, any speech therapy program should include practice in many different places with many different people. In order for speech therapy to be most successful, caregivers should practice speech exercises during normal daily routines in the home, school, and community. Speech therapists can give specific examples of how best to incorporate speech therapy throughout a child's day.

What's it like?
Speech therapy sessions will vary greatly depending upon the child. If the child is younger than three years old, then the speech therapist will most likely come into the home for a one-hour session. If the child is older than three, then therapy sessions will occur at school or in the therapists office. If the child is school age, expect that speech therapy will include one-on-one time with the child, classroom-based activities, and consultations between the speech and teachers and parents. The sessions should be designed to engage the child in communication. The therapist will engage the child using games and toys chosen specifically for the child. Several different speech techniques and approaches can be used in a single session or throughout many sessions (see does it works?). Speech and language therapy may include tools and strategies

called augmentative and alternative communication (AAC). These tools can be very helpful for children with little or no verbal communication skills. For example, a picture exchange communication system(or PECS; http://www.pecs.org.uk/)

allows the child to communicate using pictures. Go to our PECS Fact Sheet for more information.

What is the theory behind it?

Children with autism not only may have trouble communicating socially, but may also have problems behaving. These behavioral problems are believed to be at least partially caused by the frustration associated with the inability to communicate. Speech therapy is intended to improve social communication skills, and teach the ability to use those communication skills as an alternative to unacceptable behavior.

Does it work?
Many scientific studies demonstrate that speech therapy is able to improve the communication of children with autism. Parents reported improvements in social play, confidence, and behavior at home and at school with speech therapy. The most successful approaches to speech therapy include components of early identification, family involvement, and individualized treatment. There are many different approaches to speech therapy and most of them are effective. The table below lists some of the different approaches. In most cases a speech therapist will use a combination of approaches in a program.

Type of Speech Therapy

Definition

Does the Research Support It?

Augmentative and alternative communication (AAC)

broad term for forms of communication that suppleme ntor enhance speech, including electronic devices, picture boards, and sign language

Yes

Discrete trial training Facilitated communication

therapy that focuses on behavior and actions

Yes

communication technique that involves a facilitator who places his hand over the patient's hand, arm or wrist, which is placed on a board or keyboard with letters, words or pictures use of positive reinforcement to motivate the child to communicate

No

Functional communication training (FCT)

Yes

Generalized imitation

child is encouraged to mimic the therapists mouth motions before attempting to make the sound

Yes

Mand training

use of prompts and reinforcements of independent requests for items (referred to as mands) therapy techniques that focus on following the child's lead and capitalize on the child's desire to respond use of children who are trained to interact with the autistic child throughout the day a type of AAC that uses picture symbols to communicate(see P ECS Fact Sheet)

Yes

Motivational techniques

Yes

Peer mentors/circle of friends

Yes

Picture exchange communication system (PECS)

Yes

Relationship

trademarked treatment program that centers on the belief that

Yes

development intervention (RDI)

individuals with autism can participate in authentic emotional relationships if they are exposed to them in a gradual, systematic way language of hand shapes, movements, and facial expressions (especially useful for ages 0 to 3) actual stories that can be used or adapted to teach social skills Yes

Sign language/total communication

Story scripts/social stories

Yes

Sign Language & Autism / Special Needs:

Sign language is most often thought of in the context of the deaf community. But, as this website demonstrates, it can also be taught to pre-verbal babies, with numerous benefits for parent and child. Research also shows that sign language is often beneficial for children with special needs which effect their speech and/or social development, such as autism, apraxia or downs syndrome. Teaching a child sign language usually has great academic benefits, especially for children with special needs. Some children have an impairment that affects his ability to make auditory and visual connections. Sign language helps trigger that area of the brain linked to speech and language development, thus helping to expand the childs vocabulary and enhancing speech development. When a childs speech development is enhanced, so are his social and emotional skills. Children with special needs can be very frustrated when communication becomes difficult. This frustration may manifest itself in the form of depression or tantrums and aggression. Sign language can help remove communication barriers and eliminate much of the frustration associated with the

same. By expanding his vocabulary, and eliminating communication barriers, the child will have more independence and greater self esteem and behave in a more socially accepted manner.

What to do to improve your childs speech and language

1) Set realistic expectations. Speech milestones are not reached overnight and
especially not when the child has a disability such as autism. Patience and understanding are key when helping a child with autism learn speech.

2) Sing or whisper words when speaking, because autistic people can often
understand the words better this way.

3) Teach nouns first since autistic people are known to be visual thinkers and it is
often easier for them to learn words they can associate with a picture in their minds. Starting out this way is ideal when they are learning and becoming comfortable with the basic concepts of speech and language.

4) Use fixations to keep them focused and incorporate learning. It is not uncommon
for autistic children to become fixated on certain things. Use this as an advantage when possible. For example, if an autistic child likes cars and you are trying to teach him a sentence, use a car as the sentences subject to keep him interested.

5) Help the child pronounce consonant sounds, because difficulty with this is
known to occur among autistic children. For example, the child might confuse words like "mop" and "hop." In that case, it is especially important to take time to stress consonants to the child by enunciating those sounds.

6) Avoid long sentences and verbal instruction. Keep language simple and direct
while the child is learning the concept of verbal speech.

7) Use flashcards and pictures often. If the child can develop a clear picture in her
mind to associate with the words she is learning, it will help her to remember them.

8) Respond to the child appropriately. Sometimes it can be difficult for an autistic

child to remember words. They may confuse words such as "spoon" and "fork." If your child asks you to hand he a fork and you suspect he may actually mean that he wants a spoon, hand him a fork. If he becomes frustrated, ask him if he wants a spoon and show him the correct object.

9) Be honest when you do not understand what your child says. Don't pretend that
you understand by saying "OK" or "Yes, that's right." Encourage, but dont force, your child to try to tell you again. When you do understand what your child says letting her know will encourage good language use.

10) Model good speech. When your child makes errors repeat what she attempted
to say correctly. Children learn correct speech by listening to you talk and read correctly.

11)

Read to your child. Children acquire vocabulary and speech sound

production gradually. Capitalizing on a childs desire to repeatedly read the same book increases familiarity with language. The more she hears the words and sentences the more likely she is to retain and use the language.

12) Consult a professional if you have any concerns about your childs speech or
language. Your physician should be able to refer you to a speech therapist or speech pathologist if further evaluation is necessary. If there is a problem, early attention is important. If there is no problem, you will be relieved of worry. No child is too young to be helped and language is an important life tool, so if you are in doubt has your childs language and speech evaluated.

References:
1. 2. 3. 4. Caronna EB, Milunsky JM, Tager-Flusberg H. Autism spectrum American Psychiatric Association. Diagnostic and Statistical Manual Levy SE, Mandell DS, Schultz RT. Autism. Lancet. 2009. Johnson CP, Myers SM, Council on Children with Disabilities.

disorders: clinical and research frontiers. Arch Dis Child. 2008 of Mental Disorders. 4th, text revision (DSM-IV-TR) ed. 2000.

Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007 5. 6. 7. 8. 9. Abrahams BS, Geschwind DH. Advances in autism genetics: on the Arndt TL, Stodgell CJ, Rodier PM. The teratology of autism. Int J Dev Rutter M. Incidence of autism spectrum disorders: changes over time Gerber JS, Offit PA (2009). "Vaccines and autism: a tale of shifting CDC Data "Autism Spectrum Disorders - Data & Statistics". Center threshold of a new neurobiology. Nat Rev Genet. 2008. Neurosci. 2005. and their meaning. Acta Paediatr. 2005 hypotheses". Clin Infect Dis 48 for Disease Control and Prevention. May 13, 2010. http://www.cdc.gov/ncbddd/autism/data.html CDC Data. Retrieved December 25, 2010.