What are the two main characteristics of Autism Spectrum Disorder according to DSM-5?

According to DSM-5, ASD is characterized by two main dimensions: 1) Deficits in communication and social interactions, including socio-emotional reciprocity, non-verbal communication, and social relationships, and 2) Restricted and repetitive behaviors, including stereotypies, rituals, restricted interests, and sensory peculiarities.

What are the main non-verbal communication challenges in autism?

The main non-verbal communication challenges include atypical eye contact (avoidance or fixation), difficulty with joint attention in sharing attention on an object or event, pointing that is often absent or delayed (especially proto-declarative pointing), and sometimes atypical facial expressions.

What tools are commonly used for autism and communication support?

Common tools for autism and communication support include pictograms, visual supports, social scenarios, and AAC (Augmentative and Alternative Communication) systems. These tools help facilitate communication and understanding for individuals with autism.

What areas should be covered in a comprehensive guide for speech therapists working with autism?

A comprehensive guide should cover understanding ASD, communication disorders, language profiles, assessment techniques, speech therapy intervention strategies, recommended approaches, downloadable tools, and frequently asked questions to provide thorough support for speech therapists.

Autism and Communication: A Complete Guide for Speech Therapists

Q: Why is autism referred to as a spectrum disorder?

It is referred to as a spectrum because the manifestations are very variable, ranging from individuals without oral language to individuals with elaborate language but subtle pragmatic difficulties. The level of support needed also varies considerably from person to person.

Q: What role does a speech therapist play in supporting individuals with autism?

The speech therapist plays a central role in supporting individuals with ASD, whether the child develops oral language or uses alternative communication. They help address communication disorders that are at the heart of ASD and provide appropriate interventions.

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Autism and Communication: Complete Guide for Speech Therapists

The Autism Spectrum Disorder (ASD) is characterized by difficulties in social communication and restricted and repetitive behaviors. Communication disorders are at the heart of ASD, and the speech therapist plays a central role in supporting whether the child develops oral language or uses alternative communication.

💬 Tools for Autism and Communication

Pictograms, visual supports, social scenarios, AAC

Access the tools →

Understanding ASD

ASD is a neurodevelopmental disorder characterized by two main dimensions according to the DSM-5:

Deficits in communication and social interactions: socio-emotional reciprocity, non-verbal communication, social relationships
Restricted and repetitive behaviors: stereotypies, rituals, restricted interests, sensory peculiarities

It is referred to as a spectrum because the manifestations are very variable: from individuals without oral language to individuals with elaborate language but subtle pragmatic difficulties. The level of support needed also varies considerably.

Communication Disorders in ASD

Non-verbal Communication

Eye contact: often atypical (avoidance or fixation)
Joint attention: difficulty sharing attention on an object/event
Pointing: often absent or delayed, especially proto-declarative pointing
Facial expressions: sometimes reduced or atypical
Communicative gestures: less varied and less frequent

Verbal Communication

Echolalia: repetition of words/phrases (immediate or delayed)
Atypical prosody: monotone or exaggerated intonation
Literal language: difficulty with figurative language, humor, implicit meanings
Pragmatic difficulties: turn-taking, context adaptation, coherence of speech
Pronoun reversal: "you" for "I" (developmental phase)

Communication Intentions

Communication often more instrumental (requesting) than social (sharing)
Difficulties with the communicative functions of commenting and sharing
Sometimes limited interest in reciprocal conversation

Language Profiles in ASD

Profile	Characteristics
Absence of oral language	About 25-30% of individuals with ASD. Need for AAC.
Delayed language	Later acquisition, may catch up or not.
Atypical language	Echolalia, jargon, particular prosody.
Preserved formal language	Correct vocabulary and syntax but pragmatic difficulties.

Speech Therapy Assessment

Areas to Assess

Pre-linguistic communication: joint attention, pointing, imitation, turn-taking
Comprehension: words, phrases, instructions, non-literal language
Expression: vocabulary, syntax, storytelling
Pragmatics: communicative functions, adaptation, conversation
Play: functional and symbolic play

Specific Tools

ADOS-2: diagnostic assessment (doctor/psychologist)
ECSP: early social communication assessment
Vineland: adaptive behavior including communication
CCC-2: pragmatic questionnaire

Speech Therapy Intervention

💡 HAS Recommendations (2012)

Early and intensive interventions
Developmental and/or behavioral approaches
Individualization according to the child's profile
Parental involvement and generalization
Implementation of AAC if necessary, without delay

Recommended Approaches

Developmental approaches: follow the natural development of communication, based on play and natural interactions. Examples: DIR/Floortime, ESDM (Early Start Denver Model).

Behavioral approaches: based on ABA (Applied Behavior Analysis), structured, with reinforcement. Examples: discrete trial teaching, incidental teaching.

Naturalistic approaches: combine developmental and behavioral in natural contexts. Examples: PRT (Pivotal Response Treatment), ESDM.

Recommended Strategies

Visual Supports

Visual schedule: predictability, reducing anxiety
Visual sequences: breaking down tasks
Social scenarios: preparing for social situations
Pictograms: communication and understanding

Alternative and Augmentative Communication (AAC)

PECS (Picture Exchange Communication System)
Makaton: signs + pictograms + speech
AAC tablets and applications

Social Skills Training

Social skills groups
Role-playing and simulations
Explicit teaching of implicit social rules
Working on theory of mind

Our Downloadable ASD Tools

📅 Visual Schedule

Structure the day to reduce anxiety and facilitate transitions.

Download

📋 Visual Routines Sequences

Break down daily routines into visual steps.

Download

📖 Social Scenarios

Illustrated stories to prepare for social situations.

Download

💬 Communication Pictograms

Pictogram bank for AAC.

Download

Frequently Asked Questions

📌 Does AAC prevent the development of oral language?

No, quite the opposite! Research shows that AAC promotes the development of oral language. It does not replace speech but supports it. Children who have a means of communication are more motivated to interact, which stimulates overall communication development. HAS recommends not delaying the implementation of AAC.

📌 Is echolalia a problem to eliminate?

Echolalia is not always a behavior to eliminate. It can have a communicative function (requesting, protesting, maintaining interaction) and be a step towards more flexible language. The current approach is to understand the function of echolalia and help the child develop more flexible forms while respecting this way of communicating.

📌 How long does speech therapy last for ASD?

Care is generally long, often several years. Intensity and frequency vary according to needs and progress. Goals evolve with age: basic communication in young children, pragmatics and social skills later. Some individuals with ASD benefit from occasional support into adulthood.