“How long until they’re like other kids their age?”
Each week I speak with 10 or so parents, most of who have newly diagnosed autistic children.
These are questions that many parents ask. It’s so difficult to ask these questions and it’s equally difficult to answer them. I am always honest when I answer. I tell them that I believe that each child can make change and learn new skills but that there is no cure for autism. It’s not for me to say how ‘normal’ they will become. I try to stress to these parents that their child has so much potential and with the right mix of learning opportunities they will grow into incredible little humans.
Taking the expectation of being ‘normal’ off the table is a relief for some parents. Others aren’t ready to hear my message. They’re still grieving the loss of the child they thought they’d have. One of the most difficult things for people to handle is uncertainty. Humans are hardwired to have a plan or at least a destination. We dream of the future. When your child is diagnosed with a special need your journey takes a turn. There is a wonderful poem that conveys this message so beautifully. It’s called ‘Welcome to Holland’ and it was written by Emily Perl Kingsley in 1987.
(I need to say that no one poem or piece of writing will perfectly sum up the experience of the entire special needs parenting population. This poem should be taken for what it is, one woman’s perspective, at one point in her life. Some people will identify with it and others will not.)
What Should Parents Do?
There are a number of evidence based treatments for autism. Research the options that are available in your area and decide which aligns with your beliefs and goals. Applied Behaviour Analysis (ABA) has the most research backing it’s effectiveness for autistic children. There is also Speech Therapy that can be essential for autistic kids as well as Occupational Therapy. There is a lot of overlap between the disciplines. Sometimes your child’s needs can be addressed by the ABA team alone, but sometimes the expertise of a specialist is required. Any therapy team you work with should be open to collaboration with other disciplines that provide evidence based therapy.
Alternative Cures For Autism
As with any issue that affects a group of people, there will always be bad actors who try to dupe vulnerable people. I always caution my clients against spending resources on non evidence based interventions. Resources can be money, time and energy. Very few people have unlimited resources. When you devote resources to one treatment, automatically you’re taking resources away from the others. You want to ensure that you’re putting your resources where you’ll get the most benefit. Some examples of non evidence based interventions are: biomedical interventions (chelation therapy, autism diets, supplements) or other treatments like swimming with dolphins or hyperbaric oxygen chambers. While these treatments may have many glowing reviews look for peer-reviewed, double blind controlled studies to use as your base of information when determining if something is evidence based.
Each child develops at their own pace. However, there are general guidelines, called milestones, that are used in monitoring if your child is progressing. When a child doesn’t meet their milestones, it can be a red flag for autism. Red flags don’t necessarily mean your child will be diagnosed, but they are considered when determining if further assessment is needed.
Red flags for autism are divided into 3 categories. These categories align with the 3 diagnostic domains for autism: language, social skills and repetitive and stereotypic behaviours.
8 Red Flags for Autism
No words by 18 months or no two-word combinations by 24 months
Most children will have 10 words by the time they’re 18 months old. These words might not be complete but will be easy to understand and consistent. By 24 months many children are using two-word combinations. These combinations are often a name + item to make a request (e.g.: “Julia Milk”, “Daddy bed” etc.)
No pointing or use of gestures
Pointing is a very important skill. It allows a child to share their thoughts and interests in a non-verbal way. Most children point with their whole hand at first (reaching) but will eventually begin to extend their index finger to point. Likewise, gestures allow us to understand a child’s meaning without spoken language.
Inconsistent responding to name
By about a year old, your child should be consistently looking when you call their name. Responding to their name demonstrates that the child is able to divide their attention from what they’re doing when they hear a specific auditory cue.
Loss of previously mastered language skills
One of the biggest red flags for autism is a regression in language skills. Regression is when a child has mastered a skill but is then unable to demonstrate the same skill. Many parents of children with autism describe their child’s language development as typical until around 2 years of age, when the child lost the words, comprehension, pointing and gestures they were using.
Inconsistent eye contact
Many children with autism do not make eye contact naturally. In fact, adults with autism have said that eye contact can be painful or anxiety provoking. This goes beyond shyness.
Lack of joint attention
One of the red flags for autism is the inability to show joint attention. Joint attention happens when a child and their communication partner use gaze and gestures to divide their attention between a person and an interesting object or event.
Stereotypic or Repetitive Behaviours
Unusual or repetitive behaviours with their hands or other body parts
One of the red flags for autism is moving hands and the body in general in unusual ways. Some children will wave their fingers near their eyes, flap their hands, rock their body or walk on their toes.
Preoccupation or unusual interests
Another red flag for autism is intense preoccupation with non-toy items. Some children become very attached to random objects (a spoon, a block, a piece of clothing) and will become upset if it is removed.
What to do if you notice red flags for autism in your child
While none of these red flags for autism are enough to get a diagnosis on their own, it is important to notice them. When a child’s displaying a combination or stops making gains make an appointment with your paediatrician for advice and potential referrals.
Often autistic children have language delays. Receptive language is the ability to understand information provided by other people, either verbally or in writing. Expressive language is the ability to put our own thoughts into words, both spoken and written. Speech therapy can help your child learn these valuable skills.
Autistic children might have a language delay, meaning their communication skills are not developing as expected. This delay can affect the receptive or expressive language and, in some situations, both. When the child does not follow a typical developmental pattern, all areas of their learning and development are impacted.
Language delays add to the complexity of ASD
Language delays add to the complexity of an autism diagnosis, having a negative impact on socialization and academic performance.
When a child has poor language abilities, she might find it hard to interact with peers. Children rely on verbal cues to play and take part in games, not to mention they need to understand language to follow instructions. The struggle is complex. The child cannot use expressive language to convey her thoughts. In addition, she might have a hard time understanding explanations or directions.
Receptive language disorder
When receptive language is delayed, the ability to understand words and associated concepts suffers. During the initial assessment, the therapist will determine the level of comprehension and establish an intervention plan.
Receptive language disorder is common in autistic children, affecting their ability to understand spoken language. The child might not follow directions, answer questions, or identify various objects. she might not understand gestures and their reading comprehension might suffer.
How does therapy help?
The speech-language pathologist can help the autistic child improve her receptive language. After identifying areas of need, the S-LP will use strategies to increase the level of comprehension. During therapy the S-LP will work on expanding comprehension, identifying pictures, following instructions and more. Progress will result in a higher level of independence and participation in activities of daily living.
Expressive language disorder
Many autistic children have difficulties in expressing their thoughts using words. Very often the expressive language is more affected than the receptive. Thus, the speech-language pathologist will concentrate on helping the child with the production of sounds and words. Visual support might facilitate the learning process.
Initially, the therapist will assess the child’s ability to use spoken language. She will also assess the child’s non-verbal communication. Based on the identified weaknesses, she will develop an intervention plan.
Autistic children who suffer from an expressive language disorder might have difficulties communicating their wants and needs. For instance, they might not say when they are hungry or if they need to use the toilet. Common struggles include using appropriate gestures and facial expression, correct choice of words and asking questions.
How does therapy help?
The S-LP will work to improve expressive language. During therapy, she will use strategies to teach the child to communicate her wants and needs. As therapy progresses the child will learn to express more complex thoughts and ideas.
The therapist might also use an augmentative and alternative communication system (AAC) to increase the expression of thoughts and feelings. Some examples are PECS, high-tech systems (LAMP etc) or even sign language. For more information about AAC read this blog post.
Mixed receptive and expressive language disorder
It can happen that both the expressive and receptive language abilities are impacted. In this situation, the speech-language pathologist will have to work on both areas, helping the child progress towards greater ease of communication. The earlier one starts intervention, the better the outcome is likely to be.
The most important thing to remember is that language impairments become visible as early as the first two years of life, when one can still take advantage of the brain’s neuroplasticity. Parents should be active in the intervention process, as they need how to communicate with their child and meet her on her level.
Patience is key in working to develop language abilities in autistic children. In the beginning, prompting and offering instructions in multiple steps might be highly beneficial. Also, one should provide the child with adequate time to respond. Visual supports can be useful in helping the child overcome any existing challenges and even to establish long-term communication.
For parents knowing how to choose a Speech-Language Pathologist can be tricky. The diagnosis of autism often involves language delays, causing parents to wonder what steps they should take in terms of intervention. Naturally, every parent wants the best for his/her child, including in therapy.
A Speech-Language Pathologist can help your child learn to communicate more effectively. But how can you be certain you have chosen the right S-LP? What are the things you should look for and what are the right questions to ask?
Things to consider in choosing a Speech-Language Pathologist
This might sound like a given but you need to choose a therapist that has experience in working with children. This kind of specialist will know how to approach the child so he/she feels comfortable. Therapy should look like play, especially for young children.
Experience is essential. A knowledgeable Speech-Language Pathologist should interact with the child through play, opting for subtle strategies to improve communication. He/she should involve the parents in the intervention. A transdisciplinary approach always guarantees the best results, and he/she should include parents at all times.
A good therapist knows that parents play a major role in the therapeutic progress the child will make. The S-LP should teach parents strategies to use at home, taking parental input and comfort level into account.
From a pragmatic perspective, you can get referrals or research for Speech-Language Pathologists online, looking at your province’s College of Speech-Language Pathologists. You can also ask your child’s paediatrician or the school counsellor for a recommendation. Other parents are also a good resource. Once you have found a therapist, be sure to inquire about certification and additional education on autism intervention.
Questions to ask when choosing a Speech-Language Pathologist :
When choosing a Speech-Language Pathologist it is normal to ask questions. It might be a good idea to start by asking about the experience that they have.
Don’t be afraid to ask about the methods used and the reasoning for choosing these. The S-LP should also be able to provide evidence supporting her/his recommendations and point you toward resources where you can learn more.
These are some questions you might ask:
Who will work with my child?
Often, the Speech-Language Pathologist is part of a transdisciplinary team, which includes a speech therapy assistant, a behavioural therapist, occupational therapist, educator and so on.
What are the primary objectives of intervention?
You will work on these together but as a general rule the principal aim is to improve communication and social interaction. In some children, feeding and swallowing issues might also be addressed.
How many years of experience do you have with autistic children?
This is not necessarily relevant, but it can help you get an idea about how knowledgeable the SLP is in this field. Follow up with some discussion about previous cases and outcomes.
What is your treatment philosophy?
You are putting your trust in a new person, so it is important to know this. A good therapist will work with the family. He/she will always take the child’s needs into account.
Do you use AAC (Augmentative and Alternative Communication)?
This is important, as it is beneficial for many autistic children at the beginning of therapy and even later on.
How do you gain the trust of a child?
Some children require time to trust a new person. A good therapist will respect the child and his/her uncertainty, putting his/her emotional well-being in first place. Therapy should be offered through a lens of caring and empathy.
Practical questions are important as well:
What does the initial assessment entail?
Can I use my insurance to pay for therapy?
Are your services available right now? Or do I have to join a waiting list?
How many hours of therapy are recommended per week? And how long is a therapy session?
Are parents allowed to observe therapy sessions?
How is the intervention plan established? Are we allowed to offer suggestions?
How is the progress the child has made assessed?
Do not hesitate to ask as many questions as possible, as this process will help you choose a Speech-Language Pathologist for your child. It never hurts to follow your instinct, as parents often have a gut feeling telling them they found the right person for the job.
Communication represents one of the core challenges for autistic children. Speech Therapy in autism treatment is essential. They may have difficulties engaging in a conversation. Not picking up on social cues, they might find it hard to interact with their peers.
A speech-language pathologist can help autistic children improve their communication and social skills. Addressing key areas, the therapy team will help the child overcome daily challenges and learn how to function within a social context.
What are some of the challenges caused by autism?
It depends on the severity of the condition – autism is a spectrum. Some children may not understand non-verbal communication easily, while others will have trouble with spoken language. They may need help learning to read or write or engage in conversations with others.
In severe forms of autism, the speech/language impairment will be more obvious. These children might not speak at all, or they might resort to challenging behaviours to express themselves. They may not seek interaction with others or prove unable to maintain eye contact.
Speech/language delays are among the first noticed by parents. Many go to their paediatrician or family doctor stating their concern that the child has lost some or all of the previously gained words.
Others are worried that their child constantly repeats certain words or phrases, either heard on the spot or weeks before. This is called echolalia. It can also serve the purpose of communication. The therapist will help the child resort less to repetition and rely more on novel speech.
How can Speech-Language Pathology help?
The first thing a Speech-Language Pathologist (S-LP) does is assess communication, articulation and social skills. The S-LP will notice any red flags, and work out an intervention plan to improve the areas. The primary goal is to help the child become more communicative within the home, school and social environments.
When we say communicative, it is important to remember that might not always refer to verbal language. There are children who will use other communication methods to interact with other people, and they will need help to master these. Some examples of other methods of communcation are: sign language, picture exchange, typing/writing or high-tech speech output devices.
During S-LP sessions, autistic children might work alone or in groups. The therapist will facilitate interaction, teaching the child to use appropriate communication behaviours. The child will learn to maintain eye contact, take turns and communicate according to the context and other’s cues. They will also work to develop reading and writing skills where possible.
A non-verbal child can communicate
You might not know this, but 90% of communication is non-verbal. If an autistic child presents severe language impairment, he/she might still communicate. Through speech-language pathology, he/she can learn alternative means of communication.
The S-LP can teach him/her to understand and use gestures correctly. Communication systems can be helpful, including those based on pictures or visual supports. Some children find it easy to communicate with the help of electronic devices. The goal is to find the best method for each child, taking his/her abilities and challenges into consideration.
What about verbal children?
Once again, the intervention depends on the language and communication difficulties the child is experiencing. All children must learn the appropriate use of language and how to have a conversations with their peers and those around them.
At more advanced levels, Speech-Language Pathology might help the child understand the complexity of language. For instance, that a word can have more than one meaning or how certain expressions are used figuratively.
Social communication, one of the primary goals of S-LP
Human beings are social creatures by nature, and autistic children do not represent an exception. With the help of S-LP, they can learn how to interact with their peers and overcome the communication their challenges.
The Speech-Language Pathologist will work with the child to adapt his/her language to the correct context. They will explore non-verbal cues in a social setting and practice with other children.
It takes time, but some children can learn to recognize verbal and non-verbal cues, improving their communication abilities. This will help them feel less frustrated. When these skills improve, the challenging behaviours often become less frequent. This will have a positive effect on the academic outcome.
S-LP, helping with early diagnosis of autism
When parents have concerns about their child’s development, speech and language delays are present at the top of the list. The Speech-Language Pathologist can help with the early diagnosis of autism, recognizing the red flags associated with communication and social skills problems. The earlier the diagnosis of autism is made, the more successful the specialized intervention can be.
S-LP and the Ontario Autism Program
Your child can access S-LP services using their OAP funding (legacy funding, childhood budgets and one-time interim funding). Here is a list of eligible services and supports that can be purchased with the funding.
The province of Ontario provides funding to families of children diagnosed with Autism Spectrum Disorder. Recently, the Ontario Autism Program (OAP) has changed many times. To learn more, read Ontario Autism Program: a short history.
Who can get the OAP funding?
To access the funding your child must:
have a diagnosis of autism (given by a qualified professional)
Meanwhile, the current program is changing from a childhood budget model to a needs-based therapy model. Don’t worry, you do not have to register again for the OAP if you have registered before. The new program will hopefully begin in March 2021. So far, the province has not released any details of how the new program will work or who will determine each child’s therapy needs.
As the program continues to change, autistic kids fall into 4 categories:
Behaviour Plan Budget (Legacy funding)
Interim One-Time Funding.
Side by Side Therapy can help guide you through the uncertainty that comes with changes in funding. Also, we work with you to make the most of your child’s funding.
What can be purchased with Ontario Autism Program funding?
OAP funding can purchase: ABA services, Speech Therapy, Occupational Therapy and respite services. Side by Side Therapy offers all of these services. OAP funds can be used to purchase materials and equipment that will benefit your child’s learning. In addition, families are able to purchase a desktop computer, a laptop computer, a tablet/iPad or a smartphone to help their child.
Parents are often the first ones to notice that their child isn’t developing, especially in terms of communication. The lack of infant babble, the absence of eye contact and reduced interest in interaction are just a few of the features that cause one to question a potential diagnosis of autism. It is possible and often practical to begin speech therapy in Toronto before a formal diagnosis is given.
Autistic children might also present a limited range of facial expressions, being unable to comprehend language or show a regression (loss of words). The sooner Speech Therapy in Toronto is started, the better the outcomes are going to be. In this article, you will find a number of therapeutic strategies which might be of help.
Speech Therapy in Toronto Strategies:
#1 Using non-verbal communication
Interestingly, non-verbal communication accounts for 90% of all communication. Our body language, the gestures we make, along with eye contact, help us interact with other people and communicate our needs.
A good strategy is teaching the child, through imitation, gestures that can be used daily. You can begin with gestures that are easy to imitate such as: clapping the hands, waving, stomping feet or raising arms in the air.
#2 Oral Motor Exercises
For children who exhibit few or no facial expressions, this strategy might be quite useful. Performed regularly, it can strengthen the oral muscles, especially the ones around the mouth and jaw.
The exercises can be practiced with a mirror, so your child is able to see what their face looks like when they make the specific movements. You can get some ideas of exercises from this Youtube Channel: Speech Therapy Practice. They have a series of different videos depicting different exercises you can try with your child.
#3 Animal noises
A fun beginning step to teach vocal speech might be to try and have the child make animal noises, especially if the child is motivated by animals. Capitalizing on this motivation might be helpful in engaging your child in doing the difficult work of learning to make the sounds.
Various toys or books can be used to introduce the child to animal sounds. As his/her interest becomes visible, you can move to more complex games – perhaps you can create a toy barn or an animal train, having fun in the process. Be patient and have fun.
#4 Singing songs
Very few children dislike music. Singing can help the child to learn new vocabulary, rhythm and even new topics or ideas.
In choosing songs, it is important to take into account not only the current communication abilities of your child, but also their cognitive level. Nursery rhymes are a great place to start for younger children but older children can be introduced to all kinds of music.
#5 Technology as basis for communication
We are lucky to live in an age where technology is advanced, creating opportunities for us to help autistic children communicate. Augmentative and alternative communication represents an option for children with limited or no functional speech, allowing them to communicate desires, needs, preferences, dislikes and comment.
There are devices that contain recorded messages, which the child can use with the push of a button. As progress is made, these messages can become more complex. A low tech alternative is a picture exchange communication system. You can read more about Alternative and Augmentative Communication in this blog I wrote at the end of April.
#6 Learning how to sequence and tell a story
This is a strategy which is generally used in children with more advanced receptive language, allowing them to continue to develop their language. You would present them with images of the parts of a story, and ask them to put them in order.
For example, you might provide a picture of an empty glass with a carton of milk beside it, another picture with a full glass of milk and a third picture with half the glass of milk drank by a child in the picture.
In opting for this activity, you would choose to begin by presenting the stories or situations that your child has experienced. This makes it more concrete and is easier for the child. In time, he/she can do this activity alone, or even draw his/her own pictures to tell a story. Many children enjoy ‘authoring’ their own stories.
#7 Pretend play
Pretend play is a difficult skill for an autistic child to achieve but, with perseverance, it will help improve many aspects of the child’s development. On the plus side, it helps with social interaction, reinforcing communication again and again.
The strategy would be to choose some of the child’s favorite activities, expanding on their existing sounds, words or sentences. Once you’ve identified what your child is doing naturally, you want to encourage the next step.
For example, if your child is building towers with blocks, you might begin labeling the colours of the blocks or dividing the blocks into colour groups to make red buildings and blue buildings. You could also create a road (by laying the blocks side by side instead of on top of each other) to expand their play.
With expanded play comes the opportunity for you to model expanded language use. The more you speak to the child, the more likely it will be for new words to appear in his/her vocabulary.
This by no means, should suggest, that these children understand less, but rather, they just have difficulty expressing what they understand. Speaking is one of the most effective ways of communicating and it allows us to successfully interact and navigate our way through life. However, for many ASDchildren, they do not have this option and sadly, therefore, have a greater challenge to having their needs and wants understood.
How can Speech Therapy help?
If you are a parent of an ASDchild that is non-verbal or struggles with communicating, this can be very stressful and overwhelming. It is important to know that there is help. To date, numerous tools and programs have been developed to aid in these communication and language development barriers. These are known as Alternative and Augmentative Communication (AAC) systems.
AACis an alternative method of communicating, outside of traditional speech, that has been developed to assist children with communication and language developmental issues. These systems can be added to your child’s existing speech therapy programs, however, they can also introduce new and alternative ways of dealing with communication issues.
AAC is a way to provide your ASD child with the ability to relay their thoughts and needs through alternative ways that include the use of pictures, gestures, sign language, visual aids or speech-output devices such as an iPad or Tablet.
These AAC systems give your child access to their right to communicate and helps to ensure that their needs are being heard, taken into account and addressed. Every person deserves the right to share in the decisions surrounding their care and well being.
Sounds liberating, (not only for your child but for you, the parents and caregivers), doesn’t it? Taking the guesswork out of what your child is trying to communicate helps to reduce stress, for everyone, and opens up the opportunity to build stronger relationships between your child and the rest of their social and support network.
Here is a breakdown of the types of AAC – Unaided andAided & Low and High Tech
Unaided systems – These systems don’t require the use of any equipment. Gestures, facial expressions, body language and sign language are some examples of unaided systems used to communicate.
Aided systems – These systems use tools or materials and can be either low-tech or high-tech. Some examples of low-tech are symbol boards, choice cards, communication books, alphabet boards or cards. High-tech examples include speech-generating devices (SGD) or communication devices and AAC apps on mobile devices.
Below I will further elaborate on four of the aided systems that I feel may be helpful with your ASD child’s path to achieving successful communication.
Picture Exchange Communication Systems (PECS) – This program is a tool to aid in communication with non-verbal ASD children. PECS is a program where pictures of desired objects are exchanged (such as clothes or food) as a way of communicating. These pictures can be photographs, digitally created images or hand-drawn pictures.
When a child wants something, they would hand a picture of the desired item to their communication partner (the parent, peer or care-giver) in exchange for the desired object. PECS begins with a basic request which will be extended to include sentences and eventually comments as well.
As with most things that are of value and worthwhile, this program can take a long time (months) to become independent. It also requires special training and materials and is able to be supervised by anyone who has taken the PECS training (usually speech therapists or BCBAs).
While some children will be able to pair a vocalization with the exchange, PECS itself does not teach the use of vocal language. Creating a ‘verbal’ child is not the goal but rather creating a ‘communicative’ child is the end goal.
Speech Generating Devices (SGDs) or Voice Output Devices – These are hand-held electronic devices that when a child presses a button or flips a switch, the device will play pre-recorded words or phrases. These SGDs allow non-verbal people to communicate electronically. Therefore, in its most basic form, if a child would like a banana, they would press a picture of a banana and the device would then say “banana”, “banana please”, “I want banana” or I would like a banana, please” (or some other variation) in a pre-recorded human voice.
Three examples of apps that can be paired with designated devices or used on tablets or iPads to become SGDs are:
TouchChat HD with WordPower – Although this is one of the most costly communication apps on the market, this program offers a range of options that far outweigh the competition. Utilizing Its voice recording capabilities allows you to touch individualized set-up cells and the program will then conveniently speak.
LINGGO – This is a mobile app used on an iPad or tablet that’s currently in beta testing. It was created by a team led by a behaviour analyst in Toronto. The app lists words that are most used and relevant to the child’s daily needs, preferences and social activities. Linggo learns the language patterns of its users through machine learning. Linggo also aims to enhance literacy by transitioning the learner from using picture based communication to written words and phrases.
Linggo also encourages vocal speech in the learner with the optional time delay feature to allow time for the learner to vocalize before the app. One of the most exciting parts of Linggo is that it gathers data on the learner’s independent vs prompted communications which will help the speech therapy team fine tune the teaching program to achieve maximum learning and communication.
LAMP Words for Life – This is an AAC app that is available for the iPad. It is based on the motor planning theory of language acquisition. It utilizes pre-designed vocabulary pages that do not require much individualization or adjusting. This allows the user to transition between pages without having to re-learn the positions of previously acquired words. There is evidence to suggest that children can become more proficient AAC users using motor planning because there is less searching for icons and specific phrases or sentences become almost rote.
Now that you know about some of the AAC systems, implementation may be another challenge. Finding professional help can be useful and will play a very important role in your child’s communication development. It is important to work closely with a Speech Therapy team to ensure that you are using the correct AAC systems.
Some AAC programs can be quite costly, you want to be sure they are worthwhile and effective for your child’s specific needs. A Speech Therapy teamwill often include a Speech-Language Pathologist, a communication disorder assistant or speech therapy assistant. The Speech Therapy team will take into consideration which AAC is appropriate and valuable for your child and will be able to address the many questions you will have. Furthermore, they will create and implement a program that will work with your child at their current stage of communication development and capabilities.
Some advantages of AAC as described by users include:
Improved ability to communicate
Stronger friendships and relationships
Increased ability for social interactions
Increased involvement in decision-making and autonomy regarding their lives
A feeling of being respected
Access to employment and volunteer opportunities
An improvement in physical and mental health.
AAC systems have proven to be tools that can open up doors for your ASD child by empowering them to communicate their needs and wishes. Through the set-up of a well-designed communication program with the help of a Speech Therapyteam, including the use of AAC tools and consistent practice, your child will find that a whole new world of opportunities can become available.
If you would like help developing your child’s communication skills using AAC or otherwise, please contact us to set up a no-charge consultation today.
Equality and equity are words that are often understood as being synonymous as they both have the implication of fairness, however, the two meanings are actually very different. Equality means to have the same opportunities as everyone else. Equity speaks to ensuring that everyone has the opportunities they need to be successful.
There have been many political movements that have espoused equal rights: women’s groups, minority groups, autism advocacy groups and other disability rights groups.
With equality, it is assumed that everyone has the same starting point and should be treated in exactly the same way. While with equity, the belief is that not all people start at the same point and for that reason, each person should receive (based on their distinct abilities) what they need to be successful. In understanding the difference between the two, we can conclude that fairness does not mean equality.
Modifications and Accommodations for Autism
While the idea behind equality is to treat everyone “fairly” and “equally”, it has sadly missed the mark when looking at fairness around Autism Spectrum Disorder (ASD). Assuming that everyone is equal and is starting from the same place (which we know is not true, especially in autism) can actually create unintentional barriers. For instance, modifications are necessary for those with autism to be successful in their daily routines.
Making practical changes allows the starting point to truly become one of fairness. Simply put, modifications and adjustments are how we can promote fairness and ensure that all people are provided with the tools they need to achieve success.
An example of these modifications put into action is an autism framework is that of a child who has sensory concerns or challenging behaviour and has trouble sitting in a circle on the floor with the rest of the class. Pressuring the child to join on the floor may create resistance or even a meltdown which affects not only the autistic child but the class as a whole. A small concession that a teacher may make is to allow the child to sit on a chair in the circle to help with engagement and integration.
Yes, this may seem to some degree “unfair” to the other children or “special treatment”, however with this minor adjustment being made to accommodate a child that has additional needs, the teacher has effectively created a more positive and successful learning environment not only for the autistic child but for the entire class as well.
We cannot and must not expect every child to fit into one box and hope that success will be the same across the board. We have to realize that accommodations and flexibility provided by parents, professionals and autism caregivers are not only kind but are actually essential to achieving true equity.
As these adjustments are necessary, we need to position them as being so. Instead of the modification being looked at as unfair, it rather should be seen as levelling the playing field to ensure fairness. If we don’t make a big deal about these accommodations than others (classmates, siblings etc.) won’t either. We need to keep in mind that it’s not only those with autism that are different, but we are also all different in our own way and therefore have different capabilities and needs.
In focussing too much on equality and fairness, we end up overlooking the wonderfulness of difference. Instead, we need to look at each person individually to ensure equity and flexibility are at the forefront. Then and only then we can indeed provide fairness in its truest form.
To further exemplify, here in Ontario, Canada all of the changes that are being proposed and made regarding the Ontario Autism Program’s funding is a prime example of the misunderstanding surrounding equality and equity. The province seems to be under the impression that allocating the same amount of funds for children who fall within provincially designated categories (age, etc). will provide equality across the board. However, where the mistake lies is that autism does not affect each person in the same ways.
Therefore, funding and resources should not be allocated based on provincially set rigid categories such as age, and should instead be provided and distributed based on individual need. As autism falls on a spectrum from mild to severe, one child who is nonverbal may require, for example, far more Applied Behaviour Analysis (ABA) Therapy or Speech Therapy, than a verbal autistic child. This example is just one of many reasons why “equality” in this case will just not work.
Below is a helpful example of a lesson that can be played with your children to help explain this confusing topic:
The One Size Fits All Band-Aid Lesson – Ask the children to share their most serious injury: some may say a broken arm, a dislocated shoulder or a cut on the forehead. Once the injuries have been acknowledged, explain to them that your solution to heal them is to provide them each with a band-aid.
This solution will most likely raise some confusion to the children, as how is a band-aid supposed to fix a broken arm or a dislocated shoulder? This unhelpful solution shows that there is not one solution to all situations and that each situation needs to be addressed in it’s own way. Even though using the same solution (the band-aid) may in theory seem fair, how can this “equal” method of treating three different injuries be acceptable? All that is accomplished is that only a small number of people actually get the help they need while the rest of the group suffers.
Once again, it is important to remember that there is a difference between equality and equity. Fairness can only truly be gained with compromises and modifications which ensure that all people are indeed given the tools they need to be successful. Would you not agree to a person with bad eyesight getting glasses or a non-english speaker having a translator at the hospital? It is a similar situation when making adjustments for autistic children and others with exceptionalities.
We know that not all people are born the same, and in keeping this in mind, we need to continue to work towards levelling the playing field to ensure actual fairness is received.
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Speech therapy is carried out by a Speech-Language Pathologist (SLP). It addresses a number of speech and communication issues in both children and adults.
Speech therapists address 5 main areas:
Pragmatics (social skills)
Feeding and swallowing
Why choose Side by Side?
Our SLPs will conduct a thorough assessment of your child’s speech and language abilities and will determine if they would benefit from intervention. If intervention is recommended, they will set goals and will discuss with you the best therapy schedule for your child.
Some common problems that an SLP can address are:
ASD (Autism Spectrum Disorder)
Augmentative Communication Devices
Auditory Processing DisordeR
Fluency Therapy for stuttering
PECS – Picture Exchange Communication System
PROMPT – Prompts for Restructuring Oral Muscular Phonetic Targets (for motor speech disorders)
Social Skills Training
Speech Sound Disorders
Our SLPs work as part of our transdisciplinary team, when necessary, to address all of your child’s needs in a comprehensive way. We will ensure that your child’s speech goals align with the rest of their treatment goals.
Our Speech-Language Pathologists are registered with the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) and members of either Speech-Language & Audiology Canada (SAC) or the Ontario Speech-Language Association (OLSA).