Hello everyone! Sorry for not posting in a while. I sustained an ankle injury that took up the majority of my time. I wrote this research paper a while back, and feel that this is a needed topic to be discussed. I provide my own insight and analysis to research regarding speech therapy. Enjoy!
How Can Speech-Language Pathologists Better Assist High School Students On The Autism Spectrum With Communication?
“There needs to be a lot more emphasis on what a child can do instead of what they cannot do” (Dr. Temple Grandin). It’s a well-known fact that one out of every fifty-nine children has an Autism Spectrum Disorder. One significant treatment that is provided to these children is speech therapy, which is facilitated by a speech-language pathologist (SLP). Despite ongoing therapy, many students on the spectrum in their high school years still have deficits in speech and communication. This begs the question: during this difficult time for students on the spectrum, what can speech-language pathologists in high school settings do to help? Speech-language pathologists in a high school setting can better assist students on the Autism spectrum with communication by understanding the certain speech deficits associated with Autism as well as knowing their specific roles in order to provide the best services possible.
In a high school setting, speech-language pathologists can better assist their students with Autism by understanding students’ own specific and unique speech/communication deficits. All of the types of speech and communication deficits that are worked on in speech therapy fall into one of three categories. Two authors from “Autism At A Glance,” an Autism column dedicated to helping high school staff, mentioned that “deficits appear in three main areas: comprehension, expressive communication, and interacting with others” (Butler and Dykstra). Speech-language pathologists have to (in most situations) figure out which category a specific deficit or issue falls into in order to provide proper treatment. Similarly, two faculty members from Southern Connecticut State University noted:
People with ASD may have major problems with both speech and nonverbal communication. They may also find it hard to be social. Common speech deficits include not talking at all, uttering grunts, humming, and inexpressive tones of speech. Additionally, common communication deficits include trouble with conversational skills (eye contact and gestures), difficulty understanding words out of context, memorization, little understanding of words or symbols, and lack of creative language (Bhandari).
Speech-language pathologists in high school have the duty to focus on what deficits are present in each individual student on the spectrum. It’s not only inconvenient for a student, but never productive to work on fixing deficits that don’t exist. For instance, it wouldn’t make sense for a student who needs help with social skills to only work on the pronunciation of words. Because of this, it’s important to note that every single student is unique and therefore needs unique interventions. One distinguished professional notes to parents that “the type of intervention your child receives is going to be highly individual, depending on his needs and abilities. You are an important member of the team and will also play a role in the intervention with the pathologist. It’s important to remember that the goals and specific intervention strategies will be re-evaluated regularly, so expect changes in technique and approach as time goes on” (Vann). As speech-language pathologists in schools are able to provide a variety of interventions, they should know that each student that they have is different and therefore may need different interventions. It’s crucial for high school speech-language pathologists to understand deficits of each unique individual on the Autism spectrum. Knowing this, SLPs should also be aware of their roles as a team member for a student’s treatment plan.
High school speech-language pathologists can better assist their students with Autism by knowing their clear-cut roles as a member of a student’s treatment team. There are many roles for SLPs that are widely known throughout the profession but there are still some equally important duties that are sometimes overlooked by SLPs. There are many roles that SLPs who treat high school students have, which include helping the team understand functional communication, documenting how and why the student communicates, documenting communication skills needed in living and vocational tasks, and using professional references (Cascella and McNamara). Speech-language-pathologists need to educate the student’s professional treatment team on the basics of functional communication. SLPs also need to document the processes of communication for the respective student. Furthermore, education is a lifelong journey. It’s important for SLPs to not only continue their education, but also to use professional resources available to them as it may be very helpful in assisting their high school students. These professional resources can majorly impact the decision on how speech-language pathologists apply services to high schoolers with Autism. There are many different types of services that can be offered. Beverly Vicker, a speech-language pathologist of Indiana University, Bloomington wrote about some of these:
“Some speech-language pathologists may wonder what role they should have when providing for a student with Autism. Individuals with Autism are very unique and vary across a long spectrum, so one answer isn’t possible. The main thing that SLPs need to figure out when working with a student on the spectrum is which model of services to provide. The main types of services are direct, consultation, and collaboration. Finding out which model to use is key to customizing a program which meets a student’s needs” (Vicker).
As a SLP, narrowing down which service to use when assisting a high school student on the Autism spectrum is pivotal for providing the best interventions possible. As an overview, the direct service model can either be “pull-out” or “push-in” services. “Pull-out” services are when a student is taken to a private location for individual services while the “push-in” model is when the SLP provides services either in a classroom or another class setting, such as PE or recess time. Consultation services are usually with other school staff members who work with the student. This consultation is done without the presence of the student. Collaboration services are similar to consultation services, but they have more teamwork involved. Team teaching is an absolute example of this. Another case of this is when a private SLP and a school SLP come up with a joint treatment plan. As you can see, there are many roles of SLPs, looking mainly into the present time; what speech-language pathologists do can help their students currently. Another important role for SLPs is to prepare their high school aged students for the ‘real world.’ Autism researcher and advocate Anne Roux indicated that “four in ten with Autism are disconnected from employment and continued education after leaving high school. Whether this is a failure of special education, transition planning, or the service system is unknown. What remains is a vast expanse of unexplored opportunities to create and deliver supports and services, and to measure their effects on quality of life for young adults with Autism” (Roux). High school students are either planning for or are actively participating in the transition process into the ‘real world.’ So when the question of whether or not SLPs should care about services for transition-age youth with Autism, the answer should most definitely be a ‘yes.’ This fact establishes how the lack of transition services is affecting high school students with Autism. With this in mind, SLPs not only have the role of assisting their students now, but also preparing them for the future. With so many important and varied roles for SLPs, some might be asking themselves: what are some tools and strategies that I can use to best assist my students?
Speech-language pathologists in a high school setting can better assist their students with Autism by diversifying their methods of treatment. Many SLPs stick to a set of treatments that they’re used to. However, there are many more options for speech-language pathologists to try! The same two authors from “Autism At A Glance” also mentioned in the same article that “there are numerous approaches you can use to support and encourage comprehension, expressive communication, and/or interaction in the high school environment. Some of these key strategies and examples include: visual supports, additional processing time, opportunities for communication, modeling, and peer supports and social connections” (Butler and Dykstra). Visual supports are objects, pictures, or written flashcards that act as a way to communicate. These are so important for treating students of all ages in speech therapy. Many of these students on the spectrum also need a little bit longer to fully comprehend information given to them. Try building in extra time. This extra time allows high schoolers with Autism to soak up all of the information being thrown at them without skipping crucial parts. During speech exercises, try to incorporate opportunities to communicate even more than already present such as communicating a choice or subject of particular interest. Additionally, now more than ever, online media is a great way to model socially-appropriate communication and social skills. One popular method is showing clips of Sheldon Cooper (a character with Autism) from “The Big Bang Theory.” SLPs can show clips of socially appropriate modeling of common scenarios and then discuss them. “The Big Bang Theory” clips can also be shown and then SLPs and students can discuss whether the scenario was socially appropriate or not. This tactic is especially helpful since many high schoolers can relate to Sheldon Cooper and his way of interacting with others. Lastly, try finding other peers that are willing to befriend and support these students through the use of clubs, lunch groups, and peer programs. Social connection is the best way to support communication. There are additional tools that have been researched and have worked well in speech therapy. These include using social stories, comic strip conversations, and role-playing (Teens With ASD: Social Skills). Social stories are made-up stories that include a variety of social situations that can come up during an event. Social stories and comics also are both extremely useful resources for material to use during speech therapy sessions, which also happens to be a visual support. Role-playing is another great tool to implement, with situations including greeting someone, jumping into a conversation, asking someone for help, etc. High school is an environment full of nonverbal communication, so SLPs that work with this population need to teach nonverbal cues in depth. Especially during high school, therapy approach should focus on non-verbal peer interactions due to how much teenagers are able to communicate without saying a word. High schoolers on the Autism spectrum need to also be taught etiquette towards the opposite gender, how to respond to unpredictable social interactions, and conflict resolution (Is Speech Therapy Only For Autism?). It’s essential to teach the skills above mainly for safety reasons. Many individuals with Autism have trouble with boundaries. High school students on the spectrum need to be taught physical boundaries in order to prevent avoidable incidents from happening. Also, conflict resolution should be taught. Conflicts arise often in high school and students must be taught how to respectfully and safely resolve problems with both peers and adults. Similarly, responding to unpredictable social interactions (especially with strangers) is essential. When these situations come up, students on the Autism spectrum might act out their negative feelings. In Uniquely Human: A Different Way Of Seeing Autism, Dr. Barry Prizant mentioned that “children with Autism have a variety of responses to fear and anxiety such as fleeing, panicking, deer in headlights, closing eyes and ears, and dropping to the floor” (Fields-Meyer and Prizant). These are just a few responses to fear and anxiety, which are feelings that arise during unpredictable situations. Socially-appropriate responses should be taught instead of the responses listed above. These appropriate responses will better integrate a student with Autism into social environments. This next piece of advice is the most important thing that a SLP can do:
“One of the most valuable things an SLP can do is to observe the child in a variety of environments and focus on the best moments: the ones when the child is attentive and engaged in joyful interaction, at the ‘top of her game.’ If time is spent evaluating the characteristics of those moments -- noting that the child was in a swing with her body supported, and that her father was at eye level using lots of facial expression and affect, for example -- we will have found strategies which will allow us to immediately increase and then expand upon those moments throughout the child’s day. Not all speech therapists know to do this, but if parents find someone who does, the work is going to be so much more meaningful and will have better results” (Sadler).
Many therapies seem to only point out the negatives that are happening in life. It’s pivotal to point out when things go well, determine why, and then build upon that to create greater success.
Speech-language pathologists that work with high schoolers with Autism can better assist them with socially appropriate communication by understanding the deficits associated with Autism in general, as well as each student’s specific and unique deficits. In a high school setting, SLPs can better assist their students with Autism by knowing their clear-cut roles as a member of a student’s treatment team, using a variety of treatments, and working to prepare their students for life after high school. SLPs must also work to determine when their high school students are most successful and then build those factors into other situations in order to maximize progress. All of this will greatly help SLPs to provide the best possible treatment to their high school students on the Autism spectrum.
Works Cited Page
Baio J, Wiggins L, Christensen DL, et al. “Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years.” Center for Disease Control and Prevention. April 27, 2018. <www.cdc.gov>
Bhandari, S. “Benefits Of Speech Therapy For Autism.” Webmd. May 30, 2016. Web. December 19, 2017. <www.webmd.com>
Butler, C and Dykstra, J. “Autism At A Glance: Supporting Functional Communication In High School.” The Center Of Secondary Education For Students With Autism Spectrum Disorders. February 2014. Web. December 15, 2017. <www.csesa.fpg.unc.edu>
Cascella, P and McNamara, K. “Practical Communication Services For High School Students With Severe Disabilities.” American Speech-Language-Hearing Association. May 1, 2004. Web. December 15, 2017. <www.leader.pubs.asha.org>
Fields-Meyer, T and Prizant, B. Uniquely Human. Simon & Schuster, La Jolla, CA. July 19, 2016.
Roux, A. “Role Of The Speech-Language Pathologist In Improving Outcomes Of Young Adults With Autism.” A.F. Drexel Autism Institute. January 6, 2016. Web. December 15, 2017. <www.drexel.edu>
Sadler, J. “What A Great Speech-Language Pathologist Can Do For Your Child With Autism.” Thinking Autism Guide. July 7, 2010. Web. December 22, 2017. <www.thinkingautismguide.com>
Vicker, B. “The Role Of The School Speech Language Pathologist And Students With An Autism Spectrum Disorder.” Indiana Resource Center For Autism. 2008. Web. December 14, 2017. <www.iidc.indiana.edu>
Vann, M. “Speech-Language Therapy For Autistic Children.” Everyday Health. January 12, 2010. Web. December 22, 2017. <www.everydayhealth.com>
Unknown. “Is Speech Therapy Only For Autism?” Autism Magazine. February 8, 2016. Web. December 15, 2017. <www.dealwithautism.com>
Unknown. “Teens With ASD: Social Skills.” Talk About Curing Autism (TACA). November 22, 2015. Web. December 19, 2017. <www.tacanow.org>