Autism communication

Autism has no single known cause. Research suggests that autism develops from a combination of genetic and nongenetic or environmental influences (Autismspeaks). Despite significant advances in genetic and biomedical research on ASD, there is currently no known biological marker for either autism or ASD^[2]. Research continues to investigate how to support families in making the earliest possible diagnosis^[3] as there is mounting evidence to demonstrate that therapy prior to 3 years old has an even greater impact than therapy after the age of 4^[4].

Autism is called a ‘spectrum’ disorder because of the huge range of strengths and challenges children, teenagers and adults with ASD possess. Generally speaking indicators for ASD may be evident in children from the age of 6 to 9 months old.

In the identification of ASD speech pathologist are often one of the first professions consulted. Often the first recognised difficulties are largely communication based often appearing as late talking, limited play skills and reduced social engagement (e.g. not responding to their name, limited smiling)^[5].

Longitudinal research has demonstrated that failure to acquire gestural joint attention (e.g. using eye contact to share interest about an object with another person) may form a core deficit in ASD^[2]. Learning to share interests and interactions with others is a key skill to developing language skills and difficulty establishing joint attention may be a critical milestone that impairs language development^[2].

There is an increasing level of evidence supporting the effectiveness of early intervention for children with ASD^[2]. Supporting families in early detection of ASD allows them to maximise therapy outcomes for their child^[7].

Wetherby (2004) and Sacery et al. (2015)^[5] outline some of the key indicators for children who have ASD. Children with ASD are found to show many of the following indicators:

• Lack of appropriate gaze
• Lack of sharing enjoyment or interest
• Lack of response to name
• Lack of coordination of gaze
• Lack of facial expression (e.g. smiles)
• Lack of gestures (e.g. showing, pointing, reaching)
• Repetitive movements with objects
• Repetitive movements of body, arms, hands or finger
• Late talking

If your child is having difficulties in one or more of these areas we recommend talking to a TalkShop speech pathologist for more information.

The strengths and weaknesses of a person with ASD develop and change as they grow up. A wide range of verbal language abilities are reported in individuals with ASD however a core characteristic of ASD is a difficulty with social communication and interaction^[8]. This often referred to as social communication or pragmatics. Typically, children and adults with ASD could have difficulty with one or many of the skills below:

• Difficulty staying on topic
• Understanding gesture, facial expression and social cues (e.g. when someone is bored)
• Taking turns in a conversation by either talking too much or not enough
• Establishing appropriate eye contact
• Initiating a conversation
• Asking questions

Long-term impacts of social communication difficulties can lead to poorer social relationships^[8]. Seeking evidence based therapy can reduce the level of isolation and long term impacts of social communication barriers for children, teenagers and adults with ASD^[8].

Speech pathologists are communication specialists. This means as a profession we have the expertise required to screen, assess, and support individuals with ASD and their families^[9].

Assessment

At TalkShop each child begins their therapy journey with an individualised assessment that allows us to develop a personalised therapy plan. During your child’s assessment we will complete a range of norm-referenced standardised assessments (meaning your child’s skills will be measured against their age matched peers), communication or behavioural checklists and informal assessment.

According to our peak body Speech Pathology Australia assessment of an individual with ASD must account for their strengths and difficulties. Speech pathology assessment must consider the impact of ASD on a child or adults ability to participate in their everyday activities and life. Assessment should also consider personal and environmental factors that would impact on an individual’s functioning^[10]. Applying these principles to our practice we aim to develop an understanding of your child’s overall abilities, not only the test scores on a page. By working with your family and other health professionals we aim to support you in setting and achieving your child’s goals.

Therapy

We offer a range of therapy options for children with ASD. We provide therapy at our centre and have strong working relationships with our local schools Arranounbai and the ASPECT Vern Barnett school. This allows us to provide one-to-one therapy to your child at their school.

We are Registered NDIS providers and provide services for adults and children of all ages. Following assessment and if available specific NDIS plan goals we will select intervention approaches appropriate for your child. Some of the evidenced based^[11] approaches to supporting your child are listed below:

• Language training
• Modelling
• Natural teaching strategies
• Parent training – we are registered Hanen “More than words” providers
• Augmentative and Alternative Communication Devices (AAC)
• Picture Exchange Communication System (PECS)
• Self managing
• Scripting
• Social Communication Intervention Program
• Story based intervention