What Treatments are Available for Speech, Language and Motor Issues for Children with Autism?

The following therapies—also called “allied health services”—address symptoms commonly associated with autism, but are not specific to the disorder.

Speech-Language Therapy

Most autism behavioral intensive therapy programs include speech-language therapy. With a variety of techniques, speech-language therapy addresses a range of challenges often faced by persons with autism. For instance, some individuals on the autism spectrum do not speak, while others love to talk but have difficulty using conversational speech and/or understanding the nuances of language and nonverbal cues when talking with others.

Speech-language therapy is designed to coordinate the mechanics of speech with the meaning and social use of language. Such a program begins with an individual evaluation by a speech-language pathologist to assess an individual’s verbal aptitudes and challenges. From this evaluation, the pathologist sets goals that may include mastering spoken language and/or learning nonverbal communication skills such as signs or gestures. In each case, the goal is to help the person communicate in more useful and functional ways.

The speech language pathologist can provide therapy one-on-one, in a small group or in a classroom setting. Therapists who work with children have additional specialized training.

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7 Ways That An Autism Service Dog Could Benefit Your Child

1. The dog can assist children with autism safely access different environment’s. This could help your child become more independent and also help with transitions, which can be difficult for children with autism.

2. The dog can be a calming influence and give a sense of security to your child.

3. The dog can actually help your child focus on academic and social tasks. The reason that this happens is not known by many trainers of these service dogs, but it is a good side effect.

4. The dog can be tethered to your child to prevent the child from wandering away, which a lot of children with autism are prone to do.

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Social Skills Interventions: Getting to the Core of Autism

Every child on the autism spectrum is unique, with different strengths and needs at different ages. It is the family’s challenge to cobble together an individualized treatment plan based on a wide variety of options, from speech and language therapy to applied behavior analysis, from medication to special diets. One intervention many families consider is social skills training. A lack of intuitive social ability is a hallmark of autism. Social skills training is aimed at addressing the challenges that result, and often plays a central role in treatment plans. But what does “social skills training” mean? What is it intended to achieve? And what research has been done so far to demonstrate whether it works?

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Texas Autism Supplement

Texas regulations (TAC 89.1055) require ARD/IEP committees to consider eleven strategies for students with autism. Schools sometimes use the term “Autism Supplement” to refer to a form that they use at ARD/IEP meetings to address these strategies. This fact sheet can help parents in the development of adequate and appropriate strategies for their child with autism.

While all eleven strategies must be considered, TEA does not require that all be implemented. The ARD/IEP committee determines which strategies should be included in a child’s IEP. If it is decided that services are not needed in one or more area, the IEP must include a statement to that effect and the “basis upon which the determination was made.” “The statement may address the services collectively or individually.” (TX Administrative Code, and the TEA Autism Guidance document)

Schools must consider strategies based on peer reviewed, research-based educational practices to the extent practicable. The U.S. Department of Education says peer-reviewed research “generally refers to research that is reviewed by qualified and independent reviewers to ensure that the quality of the information meets the standards of the field before the research is published. However, there is no single definition of ‘peer-reviewed research because the review process varies depending on the type of information to be reviewed.” They also say “to the extent practicable…generally means that services and supports should be based on peer-reviewed research to the extent that it is possible, given the availability of peer-reviewed research.”

If a school uses a specific form to address the eleven strategies, it is important that this document support and not contradict other parts of the IEP. For example, speech goals/objectives and staff ratios in the IEP should be consistent with what is listed in strategies 7 and 8.

Strategy 1 is extended educational programming (for example: extended day and/or extended school year services that consider the duration of programs/settings based on assessment of behavior, social skills, communication, academics, and self-help skills). TEA notes this should be based on an assessment of the individual student’s needs. The Guidance document says that the “ARD committee should consider a student’s functional communication system, which may require instruction and intervention beyond the normal school schedule. The same may be said for interpersonal and behavioral skills, based on an assessment of individual student need.” The 2007 report on Autism by the American Academy of Pediatrics (AAP) says that an “effective early childhood intervention” includes “provision of intensive intervention, with active engagement of the child at least 25 hours per week, 12 months per year, in systematically planned, developmentally appropriate educational activities designed to address identified objectives.”

Strategy 2 is daily schedules, reflecting minimal unstructured time and active engagement in learning activities (for example: lunch, snack, and recess periods that provide flexibility within routines; adapt to individual skill levels; and assist with schedule changes, such as changes involving substitute teachers and pep rallies). The AAP report says that effective interventions should have “a high degree of structure through elements such as predictable routine, visual activity schedules, and clear boundaries to minimize distractions.”

Strategy 3 is in-home and community-based training or viable alternatives that assist the student with acquisition of social/behavioral skills (for example: strategies that facilitate maintenance and generalization of such skills from home to school, school to home, home to community, and school to community). TEA guidance says that a “student with autism may have difficulty generalizing skills from one environment to another.  In-home/community-based training is an option an ARD committee may choose for a student with autism in order for them to learn or reinforce social skills in a variety of settings.”

Strategy 4 is positive behavior support strategies based on relevant information (for example: (a) antecedent manipulation, replacement behaviors, reinforcement behaviors, reinforcement strategies, and data-based decisions; and (b) a behavior intervention plan developed from a functional behavioral assessment that uses current data related to target behaviors and addresses behavioral programming across home, school, and community-based settings). The TEA guidance document notes that these are examples of potential strategies rather than a requirement to use a specific methodology. The examples are some of the specific strategies/processes that have been shown to be effective for students with autism, but are not all possible strategies. It notes that the ARD has the responsibility of selecting interventions based on the unique needs of each student and there is no one-size-fits-all approach to providing services to students with autism. It is important that this item be coordinated with strategy 9, social skills and strategies. Often “problem behaviors” are a result of deficits in social skills.

Strategy 5 addresses that beginning at any age, but at least by age 16 futures planning for integrated living, work, community, and educational environments must begin that considers skills necessary to function in current and post-secondary environments.

Strategy 6 covers parent/family training and support, provided by qualified personnel with experience in Autism Spectrum Disorders (ASD), that, for example: (a) provides a family with skills necessary for a child to succeed in the home/community setting; (b) includes information regarding resources (for example: parent support groups, workshops, videos, conferences, & materials designed to increase parent knowledge of specific teaching/management techniques related to the child’s curriculum); and (c) facilitates parental carryover of in-home training (for example: strategies for behavior management and developing structured home environments and/or communication training so that parents are active participants in promoting the continuity of interventions across all settings). TEA guidance is limited on resources and access to resources, only adding that schools should provide information regarding available local resources. Even though Texas has many rural areas, and local resources are often limited, there is no guidance on what local means. Some schools and Education Service Centers provide funding for parents to attend workshops and conferences in and outside of their Service Center Region.

It is noted that parent training should be offered that fosters continuity across settings and focuses on generalization of IEP-related skills and include areas such as behavior management, interpersonal skills, communication training and/or structured environments across all settings. It notes that the provision of in-home training should be based on the individual needs of the student. It says that training could be a person working “face-to-face” with parents and/or the student or could be providing a videotape to the family to teach/learn specific skills. It is important that staff, especially paraprofessionals, working with a family have appropriate and on-going training. This item should also be coordinated with strategy 10.

Strategy 7 is providing a suitable staff-to-student ratio appropriate to identified activities and as needed to achieve social/behavioral progress based on the child’s developmental and learning level (acquisition, fluency, maintenance, generalization) that encourages work towards individual independence (as determined by, for example: (a) adaptive behavior evaluation results; (b) behavioral accommodation needs across settings; and transitions within the school day). TEA guidance says ARDs make these decisions on an individual basis considering the setting, a student’s communication abilities, and present level of competence in each area of instruction. It also notes that as a student makes progress, “there should be less adult supervision, more self-monitoring and therefore, a higher staff to student ratio.” While not stated, the implication is that the school is working towards increased individual independence.

Strategy 8 addresses communication interventions, including language forms and functions that enhance effective communication across setting (for example: augmentative, incidental, and naturalistic teaching). TEA guidance says that staff “may wish” to consider these items and “language forms and functions that enhance effective communication across settings. Teachers should also consider a student’s style of learning and the portability of a communication strategy.” Strategy 1 mentions a student’s functional communication system. One source says “Simply said, functional communication is not just about speaking; it’s about making yourself understood, even if it means using an aid like a communication board, or speech generating device. It’s also about being able to do this independently; just saying yes or no in response to a question does not fit the definition of
functional communication.”

Strategy 9 is about social skills supports and strategies based on social skills assessment/curriculum and provided across settings (for example; trained peer facilitators (e.g., circle of friends), video modeling, social stories, and role playing). TEA does not add any additional information to this item. However, it should be noted that social skills assessments and curriculum exist and educators and parents should be aware of them for a variety of students, in addition to those with autism. It is also important that this item is correlated with social skills goals in the IEP. As mentioned, this should be coordinated with strategy 4.

Strategy 10 covers professional educator/staff support (for example: training provided to personnel who work with the student to assure the correct implementation of techniques and strategies described in the IEP). TEA simply notes that schools “are responsible for training teachers and paraprofessionals to effectively implement programs for students with autism. Training may include a foundation of scientifically-based research intervention strategies.” What is not mentioned is the importance of providing this support in a timely manner. Parents should request that the IEP state a timeline for doing this. If this is not done, the parent should request a written statement of why the school is not willing to state a timeline. It is also important that the parent and school monitor that these supports and, sufficient training are provided and the provision is documented.

Strategy 11 is on teaching strategies based on peer-reviewed, research-based practices for students with autism (for example: those associated with discrete-trial training, visual supports, applied behavior analysis, structured learning, augmentative communication, or social skills training). TEA notes that the strategies listed are only some of many instructional options that the ARD committee can consider, but does not list any additional options. They then state that while “it is the responsibility of an ARD committee to make decisions regarding appropriateness of strategies based on the unique needs of an individual student, there is no one-size-fitsall approach to providing services to students with autism.” This statement reflects decisions made in numerous court cases. However, it is important and appropriated for parents to monitor and question whether their child is making reasonable progress under the method being used. If the child is making little or no progress and/or it appears that the school is using a “one-size-fits-all approach” without considering the unique needs of the child, the parents have a basis for challenging the method being used.


Comments that Parents Hear: “We place all children with Autism here.”

The IDEA regulations put an emphasis on students being served at their home campus. Courts, hearing officers, and the Office of Civil Rights (OCR) have allowed schools to place some groups of students with disabilities on one or more campuses with non-disabled students rather than on every campus.

However, the law and regulations put a priority on the concept of students being educated with their peers and in the general education classroom to the extent possible. There also must be a “continuum of alternative placements” within the school.  Also a child with a disability is not to be “removed from education in age-appropriate regular classrooms solely because of needed modifications in the general education curriculum.”

Parents should ask for the rationale for this practice and if exceptions are made and under what circumstances. Chances are the district has made exceptions for specific students. The parent could then discuss at least an exception for part of the day. Placement decisions are to be individualized and should be reviewed periodically. One size fits all models are not individualized. Circumstances/needs could have changed so that the student could be returned to the home campus at least part of the day.

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My Child Has a Lot of Trouble With Social Skills. Should I Be Worried About Autism?

This Q&A is from Understood.org and Sheldon H. Horowitz, Ed.D. 

My son has a lot of trouble with social skills, and I’m beginning to suspect he has autism. What’s the difference between autism and the social challenges associated with learning and attention issues?

Social challenges are one of the hallmarks of autism spectrum disorder (ASD). Children with high-functioning autism or Asperger’s syndrome may share some characteristics with kids who have learning and attention issues. For example, there’s a lot of overlap between nonverbal learning disabilities and Asperger’s syndrome.

Kids with milder forms of ASD may also share some characteristics with kids who have social communication disorder or attention-deficit hyperactivity disorder (ADHD). It’s not uncommon for children with these conditions to repeat a joke in the wrong place and at the wrong time. They may have trouble finding the word they want to say. They may also struggle with the back and forth of conversation that seems to come so naturally to their peers.

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Nonverbal Learning Disabilities

This article from Understood.org will help you understand what Nonverbal Learning Disabilities (NVLD) are, skills affected by NVLD, how NVLD is diagnosed, and how you can help your child.

Many people think of “learning disabilities” as issues with verbal skills such as reading or writing. But what if your child has strong verbal skills and a big vocabulary, but doesn’t understand when somebody is being sarcastic? What if he reads at an advanced level but can’t tell you the most important parts of the story?

These are classic signs of nonverbal learning disabilities (NVLD). NVLD is a brain-based condition that affects skills like abstract thinking and spatial relationships. While NVLD can affect your child’s learning in many ways, it creates an even bigger challenge when it comes to your child’s social life. Read more about the signs of NVLD, possible treatments and ways you can help your child at home.

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Extended School Year (ESY) for Kids with Autism

If your child with autism is like mine, he thrives on routine. Set up a program that works for him, and he’s up with the sun, ready to jump on the school bus, and eager to do what he’s done yesterday and the day before.

Then the school year ends. And for many families, the problems begin.

Children with autism have a tough time adjusting to transitions and change.  But summer is all about vacations to new places, interactions with extended family, different routines, and unexpected events.

What’s even tougher is the reality that children with autism, unlike typical children, have a very hard time just playing with the neighbors, sharing with cousins, or collaborating on the choice of a video game or TV show.  In some cases, asking a child with autism to just relax and take things as they come is asking for major tantrums and negative responses from friends and family.

Fortunately for most families of children with autism, Extended School Year (ESY) offers at least a partial low-cost, at least moderately appropriate answer to the summer dilemma.

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2 Commonly Misunderstood Strategies for Students with Autism

ARD/IEP teams must consider In-Home and Community-Based Training as well as Parent/Family Training and Support for students with Autism. However, many districts do not have a good understanding of these strategies or how to determine appropriate training and support.

The In-Home and Community-Based Training & Parent/Family Training and Support resource manual on the ESC 10 website provides information, procedural guidance and practical considerations for trainers responsible for developing and implementing individualized in-home & community-based services and individualized Parent/Family Support services.

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