what direction does speech therapy take after your ASD child is considered verbal?

[kathteach]

I'm sorry if this is confusing.

DS, who knew twenty words at 2 1/2, is now verbal and will be in a preschool collaborative classroom (15 NT kids, 5 special ed kids with two teachers and two aides) this fall at 4+ years old. He previously attended a classroom that was inclusive as far as speech, behavior, OT, and academics, but he graduated from that program. At his last IEP no speech services were given, and when I asked why I was told he had graduated from his speech program and was age-appropriate in his speech. When I said I had concerns about his articulation and that he didn't use what/why/where/who/when questions, it was agreed that a speech evaluation would be done in fall.

I am concerned that they will tell me his speech is fine to access his academic environment and I won't know what to say. I'm considering paying out-of-pocket to get a private speech evaluation, but I don't even know what to look for as far as the things he needs to improve. I guess what I'm saying is I don't know the official terms to take back to the district and say, see look he is lacking in this. There is the articulation, and the W questions like I said, but...there's more. Low vocabulary. He has that halting speech that seems to be characteristic of autism. He also sometimes speaks in this strange tone that sounds like it's "normal" speech with inflections in the right places but it's all hoarse and is a direct imitation of me or tv speech. His rate of speech is slow, and I've read this is common to autism as well, but I can't find any information online about it or even how to remediate it.

I feel like I'm failing my son because I know with therapy he could improve even more, but I don't know how to explain to the district what it is he needs because I don't even understand. And I know the district will take the stance that he is doing great and has the speech skills necessary for preschool and that will be the end of it.

What does speech therapy look like for kids with autism after they have learned to be verbal? What sorts of things do ASD children need therapeutically (sp) as far as speech? Should I get a private evaluation before the IEP or wait and see what the district evaluation finds?

[Lollybrat]

Pragmatics, which is the social use of language.

DS is 6 and in 1st grade. Although he does have some articulation issues, most of the speech goals on his IEP are related to pragmatics. Once my son became verbal (around age 3), his speech took off. Most of it was echolalia and scripted speech, but he had a large vocabulary and enough speech scripts to fool most people into thinking he had spontaneous language. Even on most langauage test he was able to score reasonably well on expressive speech, because the tests were not geared towards the types of language problems he has. For example, my son is unable to hold a real conversation and does not ask questions to seek new information (he only asks for permission).

I requested the school SLP do a language test that includes a pragmatic profile. I requested the CELFP-2 (Clinical Evaluation of Language Fundamentals Preschool -2nd edition), but there may be others. As we had expected, DS scored below average in receptive language, average in expressive language, and very low in pragmatics. With these scores he qualified for continued speech services to work on pragmatic skills.

Speech/Language goals on his IEP include:

Greeting teachers and classmates/saying farwell
Taking conversational turns & remaining on topic
Not iterrupting others/how to get someone's attention in conversation
Identifying other people's emotions and what to say in repsonse
Asking questions to gain new information
Answering questions appropriately
Following directions involving sequence, position, quality, and/or size
Appropriate ways to ask for help

I hope that helps!

[Rose-Roget]

Any good SLP would recognize the complexities of ASD and keep him on through young childhood. W-questions are huge. Understanding, remembering, and following complex directions - often with time or directional concepts. Vocabulary expansion. Social skills and non-verbal language are huge, too - start teaching him the "social rules" now. Also, an SLP can be very helpful in problem solving some of the more difficult moments throughout the home and school day.

[samandhenrysmom]

Definitely pragmatics as well as sublties of both receptive and expressive language used in a functional way. I have worked with many kids on the AS who used tons of words/sentences but did not use language functionally. I am a speech path and I specialize in ASD/

[MotheringRubyJo]

My daughter has SPD only, but still gets speech under pragmatics as well.

A

[khaoskat]

Not ASD, but intial diagnosis of speech apraxia.

I can tell you that my child was non-verbal at 2 1/2. We are now very verbal, and age level or well above in all but articulation. His articulation is on the level of a 3 yo at 5 1/2 years of age.

He will still receive services, as Articulation Disorder, if far enough behind to met your state guidelines.

What our ST has transitioned from teaching him to talk, to now working on articulation and letter production sounds both in isolation and in conjunction with other sounds. After that I have no clue, as we have been at this point for at least a year now.

[kme]

What you are seeking is therapy for pragmatic language/communication and not necessarily speech.

My son has SPD, ADHD and a language disorder and also was non-verbal as a toddler. He was discharged from speech through the school at around age 4. We have since been paying out of pocket to a private speech therapist who specializes in ASD and language disorders. They work on things such as retelling a story, making up different endings for stories, inferencing, problem solving (what are 3 things you could do if...), and right now they are focusing on what types of questions it is appropriate to ask strangers vs. friends because my son has a huge problem with asking tons of questions, some of which are inappropriate. He has very little "filter" and is impulsive.

I have found the school to be much more focused on articulation problems and vocabulary acquisition and basically clueless on pragmatics.

Good luck.

[jillmamma]

My son is 7.5 and just started second grade. His Speech therapist at school is focusing on the pragmatics things like the other posters have mentioned. Stuff like, ask your friend about their spring break, not what color their shirt is, acknowledge that you heard someone even if you don't want to keep talking about that subject, greet people, etc. They consider that sort of thing to be necessary for his success in school socially as well as academically.

[kathteach]

Thank you, thank you, thank you all so much. You all have explained to me how I can talk to the IEP team and explain what he needs. I really appreciate all the time you mamas took to explain this to me.