Autism and Communication Difficulties

Autism Spectrum Disorder is a very wide-ranging developmental disorder that defies easy description and explanation. It is most broadly defined as a condition where children have some delay in developing the skills that allow them to be social and communicate with others, or can even not noticeably present these skills at all.
Currently, there aren't any medical tests that can diagnose autism. Usually a specially trained physician or psychologists administer autism-specific behavioural evaluations.
Often parents are the first to notice that their child is showing unusual behaviours such as failing to make eye contact, not responding to his or her name or playing with toys in unusual, repetitive ways.
Autism is not only found in children and sometimes the disorder is diagnosed later in life. This again is often in relation to learning, social or emotional difficulties. Like with young children, the diagnosis of adolescents and adults involves observation and sometimes an interview by a trained specialist. A diagnosis in an older person can bring relief to those who have struggled with difficulties with social interaction while not understanding the source of these difficulties. Once diagnosed with the disorder, it can also open access to therapies that can improve function in areas of difficulty and in turn improve the quality of relations and life.
One of the ways that many people have actively sought treatment for their child or adolescent is through a Speech Pathologist.
When a Speech Pathologist is assisting a patient with Autism Spectrum Disorder, it's their job to evaluate how well the child can communicate and socialise in every aspect. This analysis can take place at a clinic, as well as at home and other informal settings. It's not a quick process, as Autism Spectrum Disorder can have such varying degrees of intensity and presentation in a patient. A well-trained and experienced Speech Pathologist can gauge communicative and language skills effectively and will work to have a diagnosis as quickly as they can.
A Speech Pathologist can also pick up on social cues that suggest the presence of Autism Spectrum Disorder but could be misdiagnosed as a variety of other conditions. The prevalence of language and communication-based difficulties in the condition means that a good Speech Pathologist is well-equipped to 'connect the dots' and draw conclusions based on their required professional expertise.
The amount of sessions that one may need will vary, and it is always important to find the right person for treatment.

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Dyspraxia / Apraxia - So Many Terms - What Do They Mean?

DYSPRAXIA OR APRAXIA

SO MANY TERMS - WHAT DO THEY MEAN?

Parents who bring their child to me for Speech Pathology often tell me that they have looked dyspraxia up on the internet, but there are so many different terms that seem to be used it becomes very confusing.

Here are some of the most common terms with their meanings:

Dyspraxia /apraxia

Dyspraxia or apraxia are interchangeable terms which mean that someone is not able to do an action. This is because the brain needs to know how to do an action, plan it, carry it out and make small adjustments, if needed, as the action happens. This is called a motor program or a motor plan. If any disruption happens to this motor planning then the result is a form of dyspraxia (or apraxia).

Developmental dyspraxia / developmental apraxia

The dypraxia is occurring in a child. Children with dyspraxia are born with the condition and it becomes more apparent as a child grows, especially when they have difficulty learning to talk.

Acquired dyspraxia / acquired apraxia

This disorder occurs when there is an interruption to the brain from disease or accident. People who have strokes (CVA) often suffer from dyspraxia. The brain can no longer plan out an action and do it, and this often includes swallowing and speech.

Ideation dyspraxia

Ideation dyspraxia happens when the brain cannot see, or conceptualise, how it is going to start an action or what that action is going to look or feel like. This makes it very difficult for children to learn to do any complex actions like talking, running or climbing.

Ideo-motor dyspraxia

Ideo-motor dyspraxia is when a motor plan cannot be executed (or carried out) properly, even though the person does have the concept of what needs to be done.

Oral dyspraxia / oral apraxia

If a person has dyspraxia that only affects the movements of the face and mouth then this is usually referred to as oral dyspraxia. Oral dyspraxia is often the cause of babies and toddlers drooling and it is hard to make speech sounds. It can also be difficult to blow bubbles, suck through a straw and imitate facial expressions. Babies with oral dyspraxia can find it hard to latch on and establish breastfeeding. When they start to eat food they often resist lumpy food and different textures.

Verbal dyspraxia / verbal apraxia / Childhood apraxia of speech (CAS)

Children with verbal dyspraxia find it hard to learn to talk. Babies use only a few sounds when they babble. They have difficulty learning to make all the sounds they need to talk and putting them together. They will then have trouble trying to put all the sounds in words and joining words into longer words and sentences. When very severe, people with dyspraxia may remain non-verbal and need to use a different communication system such as signing or picture exchange, or a high tech AAC device. Most children, however, can be helped to talk by Speech Pathology.

What to do

Most parents are not able to really identify that their child has a difficulty until they realise that the child is not learning to talk easily. Usually children with dyspraxia are able to show that they have good comprehension (understanding) skills.

If you suspect that your child may have any degree of dyspraxia, please find a local Speech Pathologist who can get to know your child and work out why she or he is having difficulty with talking. If your child has dyspraxia the Speech Pathologist can help you understand the terms and how they relate to your child.

The earlier intervention begins the better, according to all the research. So many later developing language skills depend on a child being able to talk and use communication for many different purposes. But whatever stage your child is at, treatment will make sure that they make gains as quickly as possible.

Speech Pathologists often work together with an Occupational Therapist to make sure your child learns all the skills they need for a happy life.

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Autism Spectrum Disorder (ASD) Diagnosis

As a Speech Pathologist, I often see children who are not learning to talk as well as they should. Sometimes it quickly becomes apparent that these children can be diagnosed to be somewhere on the "autism spectrum". A specific definition could be Autism Spectrum Disorder (ASD).
At some point, as I get to know a child, the idea needs to be raised. Sometimes parents come to therapy and ask, "Do you think my child has autism?" Other parents may have never considered the possibility and find it extremely difficult to begin to talk about this issue.
Parents may have developed their understanding of autism from the media. Very often, movies and books depict people with autism as having ALL the possible autistic symptoms. These symptoms have become a stereotype of autism. This can be very misleading. When parents look at their child, they say, "That doesn't look like my child!"
As a Speech Pathologist I work with many children with autism or who are "on the autism spectrum" somewhere. They are all different. They have different symptoms and learn differently and at different rates. Many clinicians working with children "on the spectrum" find that they can quickly identify that this is the case by seeing a pattern of symptoms, rather than seeing a child exhibiting all of the 'classic' signs of autism.
Usually children arrive at Speech Pathology because they are not talking like their peers. A child may not be talking at all, or may be talking in a limited way. Children with autism often repeat exactly what they have heard, a kind of speech called echolalia. It may be what you have just said to them (like, "hello Olly") or lines repeated verbatim from a movie. Sometimes the children may sound like they are talking in sentences but it may be their own language or the tune of speech without clear words.
From a Speech Pathologist's perspective, there will be differences to normal development in the way a child communicates, not just talking. Eye contact is usually limited, and your child may not automatically turn to you when you try to attract his attention.
When children are learning to talk following the usual pattern, they learn to copy most of the adult purposes for communicating. So they will ask for things, protest and refuse, use polite language, make comments about things they see or hear, and ask and answer questions. They want to communicate because they want to interact with others. If a child is having difficulty getting their message across they can work out a range of strategies to get what they want.
Usually children with autism communicate only for a limited range of purposes and don't tend to seek interaction just for the sake of communicating. They can become very upset when they are unable to have their needs met or when something upsets them. It is not always easy to work out why they are upset. Children with autism can be upset more easily than other children if they have sensory difficulties, also, such as being too sensitive to sound or touch.
They can also be less sensitive to senses such as sound and touch and seek out stimulation, by pushing against people or mirrors, for example, or spinning around or flapping their hands.
Children tend to want to socialise with others, and learn to take turns in conversations and with toys (although this part can take a long time!). Children with autism usually don't seek to play with peers and are happier left to do their own thing. Often they even limit physical contact, such as hugging, with parents and brothers and sisters.
A diagnosis can be a very difficult thing for parents to accept, particularly if their understanding of a disorder is influenced by media. The media has certainly picked up on autism in the last decade or so, and there are almost limitless books and films depicting people with autism.
Please do not be daunted by these portrayals. Children are all individuals with their own personalities and skills. If a child has autism, it is probably better to know than not to know, for a number of reasons. Other people are likely to be more understanding of the difficulties you are facing and treatment can be planned and managed.
Most children with autism can be shown how to communicate with others. They participate in school and lots of other activities in which they show an interest. Some children with autism are exceptionally clever with things that interest them. They learn social skills and how to interact successfully with other people.
If you have concerns, find a Speech Pathologist who works with children with autism, to support you and guide you through the issues, and set your child off on a lifetime of communicating.

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