How Speech Therapy Benefits Autistic Children

Healthcare providers may refer people diagnosed with autism spectrum disorder (ASD) to speech therapy. In some cases, this can help autistic children with limited or compromised speech and their families gain vital communication skills.

Even very verbal autistic people are likely to benefit from speech therapy. That's because, while they can form words and sentences, they are likely to misuse and misunderstand language on a regular basis.

This article explains how speech therapy can help autistic people and offers some tips on how to find a qualified speech therapist.

What Is Speech Therapy?

Speech therapy involves the treatment of speech and communication disorders, which means it's a very wide-ranging field.

Speech therapy can help children with stutters or lisps to pronounce words correctly, but it can also help children with developmental disorders to understand and use spoken language in a social context.

A certified speech-language pathologist (SLP) is a communication expert who holds a master's degree. Also known as a speech therapist, an SLP may work in a private setting, a clinic, a school, or an institution and may be a part of an educational team.

Speech therapists use a wide range of tools and interventions, ranging from toys and play-like therapy to formal tests and speech curricula.

What a Speech Therapist Does for Autistic People

Autism is a social communication disorder. Some people with autism are nonverbal or have limited oral language skills. Others develop a strong vocabulary quickly, usually related to a special interest, but have difficulty with nonverbal communication. 

Speech therapists can play a major role in helping an autistic child learn to communicate and engage with other people.

The first step in speech therapy is an assessment to determine your child's needs and develop a treatment plan. Depending on the setting, your child's therapist may work 1:1 or in groups.

It's important to note that while speech therapy may be viewed as a "must" for autistic children, it can also benefit autistic adults.

Children often focus on the basics of communication, while adults may focus on more subtle forms of communication for different types of social interactions.

Where Are Services Provided?

SLPs provide services in the following settings: 

• Autism clinics that provide other therapies, such as sensory occupational therapy
• At your home
  
• In residential care facilities and institutions
• In a private office setting
• Schools and early-intervention settings

Speech therapists may work as part of your child's educational team or in conjunction with other therapies and providers.

How Speech Therapy Addresses Autistic Challenges

Speech therapists address communication and feeding challenges in people with autism in several ways.

Non-Verbal Communication Skills

This may include teaching gestural communication or training with PECS (picture exchange communication system), electronic talking devices, and other non-verbal communication tools.

Alternative and Augmentative Communication

The SLP can also teach how to use augmentative and alternative communication (AAC) devices. This technology helps people with autism expand communication, increase social interactions, and promote independence. 

Body Language

How can you tell if another person is joking or serious? When is it okay to join a conversation and when is the conversation private? Speech therapists can teach children how to recognize subtle cues and signals.

Asking and Answering Questions

Autistic children may not develop the ability to ask and answer questions without the help of a therapist.

The therapist can teach your child how to recognize a question and determine appropriate answers to provide. They can also help your child formulate, ask, and understand the answers to their own questions.

Speech Pragmatics

It's all well and good to know how to say, "good morning." But it's just as important to know when, how, and to whom you should say it. Speech pragmatics training can also help your child understand the meaning of idioms (sometimes hard for autistic people) and use idioms themselves.

Prosody

The term "prosody" relates to the melodic sound of a voice as it goes up and down in conversation.

Autistic people may have flat prosody, which causes other people to believe they have no emotions. Speech therapists can help autistic kids to build their vocal skills.

Grammar

Some autistic children have a tough time using correct grammar even when it's modeled at home or at school.

They may refer to themselves in the third person ("Johnny wants juice") or use incorrect tense. Speech therapists often work with autistic children to help them correct grammar mistakes.

Conversation Skills

Knowing how to make statements is not the same thing as carrying on conversations. Speech therapists may work on back-and-forth exchange, sometimes known as "joint attention."

Concept Skills

A person's ability to state abstract concepts doesn't always reflect their ability to understand them. Autistic people often have a tough time with ideas like "few," "justice," and "liberty." Speech therapists may work on building concept skills.

Social Skills

Along with play therapists, occupational therapists, and people in specific areas of expertise such as recreational therapy, drama therapy, and art therapy, speech therapists often help autistic people to build social communication skills.

Such skills include the ability to ask and answer questions, stand at an appropriate distance from a conversational partner, assess the "mood" of a room (or a person), and more.

Feeding Challenges

Some SLPs are specifically trained to address feeding and swallowing challenges in people with autism.

A speech therapist can evaluate the particular issue a person is dealing with and provide treatment plans for improving feeding-related challenges.

Does Insurance Cover Speech Therapy?

Speech-language therapy is well-established in the treatment of autism. As such, it is typically covered by medical insurance, provided your child has an established autism diagnosis.

Speech therapy services are also often provided for free through the school system or early intervention programs.

Some speech therapists in private practice or autism clinics may be in-network with your health insurance. If that is the case, the visit will require either a copay or co-insurance payment.

Some SLPs do not take insurance directly. In that case, you may need to pay at the time of service and then submit it to your insurance company for reimbursement. This is sometimes referred to as a superbill.

How to Find a Qualified Speech Therapist

To find a qualified speech therapist for autism services, start by checking your insurance directory.

You can also ask your child's healthcare provider or school social worker for recommendations.

Any therapist must be a good personal match for your child's needs. For that reason, you should meet, interview, and observe the therapist as they work with your child.

Some therapists are terrific with verbal children but less effective with non-verbal children, and vice versa.

What Questions Should I Ask?

When interviewing a provider about speech therapy for an autistic person, it can help to ask the right questions. When calling to set up a first appointment, consider asking the following:

• Do they take your insurance, and, if not, how is billing handled?
• Do you need a referral?
• Is there a waiting list for services and, if so, how long can you expect to wait? 
• What does the initial assessment entail, and how long will it take?
• What services are provided in the practice?
  

Prior to the assessment, jot down any other questions or concerns you have. Things you may want to ask include:

• Can you observe your child’s sessions?
• How are goals determined, and can you provide input?
• How is progress measured, and what progress should you expect?
• How long are therapy sessions, and how many sessions a week?
• What are some of the typical milestones for speech and language?
  
• What does a typical program look like?
• Who will be working directly with the client, and how much experience do they have?
  

Summary

Speech therapy for autism helps improve verbal and nonverbal communication skills. A speech therapist or SLP can help autistic people grasp abstract concepts and pragmatics (like idioms) and develop social and conversational skills. Some SLPs also treat food-related issues, like picky eating, which is common with autism.

Insurance commonly covers speech therapy with an autism diagnosis. Along with a copay, you may first need to meet a deductible and be limited to in-network providers. Some therapists and centers do not accept insurance but provide a superbill you can submit for reimbursement from some plans.

Speech therapy is also often offered free through the school system or early intervention programs. To find a speech therapist for autism, ask your child's healthcare provider, school social worker, or parents in your community.