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Early Intervention Speech Therapy

Treating Children Diagnosed with Autism: A Follow-up

Published October 16, 2009 9:48 AM by Stephanie Bruno

On September 29th 2009 we published a post entitled: Autism and Early Intervention Speech Goals. The post discussed a local case of a speech therapist working with 3-5 years olds who prefers and recommends only using sign language with children diagnosed with autism. When the IEP goals were written for this child transitioning from birth-3 to the 3-5 program, none of the goals addressed verbally stimulating the child or using picture communication. I wanted to revisit this post because there was such an overwhelming response from therapists regarding the issue at hand.

In addition, it raised the question of how we as therapists should be treating children who fall within this category. I think this is a very vital issue within our field and I would like to highlight some of the helpful and interesting suggestions that colleagues offered in their comments after reading the post.

Many of you were outraged at the thought of ONLY using sign language with a non-verbal toddler. One therapist described the practice as "limiting" and another went on to say, "I too found it hard to believe that anyone in this day and age would focus solely on sign language. Certainly sign should be a component of a total communication approach, but I almost always use all three communication systems..."

Overall, the majority of comments supported the practice and promotion of multi-modality communication when working with very young children who are non-verbal. One therapist shared her views by saying, "I believe it is negligent to concentrate on signs without verbalizations, especially since the child is already beginning to talk. Signs should be a means toward an end, not the end itself.  Studies have shown that signs paired with verbalizations will help increase verbalizations".

Another therapist expressed her outrage this way, "I couldn't believe what I was reading!  I worked with the autistic population for ten years in a collaborative therapy model approach and ALWAYS used a combination of all three modes to achieve optimum results".

Finally, two other therapists mentioned a fourth option called "Enhanced Natural Gestures" taught by Dr. Stephen Calculator and recommended it as an additional way to promote effective communication. As one therapist stated, "these gestures don't require anyone to really "learn" sign language.  The gestures are fairly recognizable to the average guy...." which essentially is the point of successful communication.

Reading through the comments and suggestions, I was thrilled to see so many therapists weigh in on this issue and share their expertise. Thank you!!

2 comments

I want to weigh in on this issue of which approach to use with children diagnosed with autism. Like many others, I was very surprised that a therapist would choose to use only sign language. I have found in my 30 years in the field that multi modality is a choice that gives the child the best opportunity to succeed. Most importantly though is using professional judgement and not loosing focus on "individual" when making therapy decisions. There is a reason that family service plans(IFSP) and education plans (IEP) are preceeded with the word individual. Let's continue to practice with professionalism and respect.

Jo Ann, early intervention - speech/language pathologist November 12, 2009 3:44 PM
Albuquerque NM

Wow....I didn't read the first part of this article but I, too, am amazed by this archaic approach. This poor SLP must be exhausted from teaching not only the toddler, but all of his/her communication partners, sign language as well, because then how else are they all going to understand him/her?

Lisa Durstin October 26, 2009 6:00 AM

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