speech and language

[thomastank]

Hello! My son, HFA, 5 yrs has an appointment at school to see a speech and language therapist coming up. Although his speech is generally good, there are some things that he cannot seem to grasp ie he has never told me he is hot /cold, has tummy ache/headache. Would these come under S&L? Does non verbal communication come under S&L? He also gets he/she/him/her muddled. What other non obvious things would come under Speech and Language? I don't want to miss out on any help if he needs it just because he can hold a conversation if you know what I mean? Hope I'm making sense.

 

Thanks for your help. TT x

[Tally]

Although his speech is generally good, there are some things that he cannot seem to grasp ie he has never told me he is hot /cold, has tummy ache/headache.

Does he tell you these things if you ask him?

Many people with autism have sensory processing issues and may not actually know if they are hot or cold or in pain. If this is the case, then it obviously isn't a speecha nd language issue, but might be an issue the therapist can flag up.

[thomastank]

Does he tell you these things if you ask him?

Many people with autism have sensory processing issues and may not actually know if they are hot or cold or in pain. If this is the case, then it obviously isn't a speecha nd language issue, but might be an issue the therapist can flag up.

 

 

To be honest, if I say "have you got a tummy ache?" I think I am putting words into his head so wouldn't necessarily trust the answer.

 

He did run through stinging nettles the other day and have a rash up his legs, he didn't say anything until I pointed it out and said what must have happened. On the other hand I think he can feel some pain. When he broke his leg when he was 1, (long story) he started crawling round the hospital and the nurses wouldn't believe that he'd done anything until we insisted he had an xray. Of course we didn't know about his autism then but it makes me think that he has a very high pain threshold. Sorry, just thinking out loud and am kinda off the speech and language topic I started but I'm just trying to piece all these things together and work out who needs to help him in various areas (or what I can do!)

 

thanks for "listening".

 

 

[Sally44]

Sensory issues are common. My son varies between a very high and a very low pain threshold. So sensory issues are the remit of an Occupational Therapist.

Communicating information ie. learning how to tell someone you have hurt yourself would come under 'social lanuage' and is something that a SALT can cover.

Understanding your 'emotional' state and the emotions in others is usually the remit of the Educational Psychologist.

 

You have highlighted problems with pro-nouns which is part of the SALT remit. Mention that to them. My son also had difficulties with I, me, you, he, him, his, she, her, they, us, we etc etc. But he has learnt them. It is the fact that they are interchangeable that they find so difficult eg. mum could be called you, her, she, or could be part of 'we' or 'they' or 'us' etc. This suggests a 'speech disorder' not a 'speech delay'.

 

You can google autism and speech and language difficulties to get a better idea of what difficulties there can be.

For example 'receptive' and 'expressive' speech differences. Eg. a child might talk, even to an advanced level, but only have a very basic grasp of what is being said to them.

Problems with 'inference' ie. getting information from 'verbal' information.

Predicting outcomes from information given verbally.

Delayed processing of auditory information can mean difficulties processing whole class learning because they cannot process all the 'spoken language' in real time.

Communicating information in narrative form.

Social use of language.

 

There is a long list of possible areas of difficulty. And it needs alot of indepth assessments to identify them. If you notice any difficulties write them down and mention them to the SALT as you notice them.

 

For example on one assessment my son was told a short story about how a burglar broke into a house and stole a watch and how a piece of white material was left on the broken window. My son could not explain 'why' the burglar had broken into the back of the house ie. less chance of being seen. As the father in the house was wearing a white shirt my son said 'he is the burglar' - but why would the father break into his own house and steal his own watch?? So problems with 'comprehending' and 'inference' etc are very common. And when you consider these difficulties you can see how they would need support in class to have things 'explained' to them. Otherwise they will get the wrong end of the stick quite often. These are all skills that can be worked on by a SALT

There can be problems understanding or recognising differences in voice tone or facial expressions. For example, if I said to my son "We are going swimming today, go upstairs and get dressed." He would go upstairs. Then I would need to keep reminding him to get dressed. If he still did not come down stairs dressed and I shouted to him "Don't you want to go swimming?" - he would not understand that as a question. He would also hear the 'Don't you' as 'You don't go swimming' and would get upset because he would think I was telling him he was not going swimming. When I am actually asking him a question in a way for him to understand that he needs to get dressed quickly if he wants to go swimming. He has the same problem with words like 'don't' or 'can't'. So I have to try to avoid saying things like 'don't you want to XXX?', or 'Can't you find the DVD?' because he hears it wrong.

There might also be problems with working memory or short term memory, again this is the remit of the SALT.

[Sally44]

My son is also diagnosed with Semantic Pragmatic Speech Disorder. Google that as many children have these types of language difficulties.

 

My son also uses echolalia and delayed echolalia ie. he uses learnt phrases from other people, TV and films and uses them in his speech.

[thomastank]

 

 

 

Sally, thank you so much, just what I was after! I've got to dash, but just wanted to say thanks x

[Sally44]

I hope it is helpful.

What I found worked in my situation was requesting a SALT that had experience of ASDs and speech disorders. Not all SALTs have this experience.

I also specifically asked them questions and put down my suspicions and all requests in writing.

In my case I found the SALT department seemed to have a 'set programme' they worked through which was not really relevant to my son. They also did not pick up on the social use of language at all until I wrote to them and reminded them that the social use of language and social interaction and part of the problems you need to get a diagnosis in the first place and I specifically asked them to assess in this area.

I don't want you to go in guns blazing. But just be aware that you may need to push them to assess for certain things. But remember that 'every' child's need should be identified and should be met in school.

My persistence in insisting on the amount of speech therapy input being specified in his statement has had remarkable results over this last academic year. This is especially true in the area of social interaction.

I have just posted about my son joining a football after school club. Without the work the SALT has put into the social use of language group and her work on other social skills that have been worked on weekly by her in the therapy session and practised daily in school, I am sure my son would not be where he is now. Previously, during breaktimes he would walk up and down the fence line repeating DVD/TV dialogue to himself. I did have to fight with all involved who told me my son should 'be allowed to be autistic' during his free time. I totally disagreed and said that he wanted to join in and play because that is what he told me. He just did not know how to do it. Now he does he has built relationships with the other children. That success breeds more success because his confidence has increased and he is not afraid to approach other children and other children involve him in their play because he can respond to it.

But you need an experienced SALT who has worked with autistic children.

Another thing I found very helpful was I found a group of Play Therapists that worked with play skills for autistic children. Karen A has posted about the play approach, which sounds a bit similar to what we did. But basically it was a group of children who each had an adult play therapist with them and they played with the child on their terms and gradually extended their play skills and then gradually introduced group play etc. My son responded brilliantly to this and I believe it motivated him to be interested in interacting with other people.

Unfortunately these very areas ie. speech therapy, more specifically the social use of language, social interaction and play skills and usually absent in therapy form for many children on the spectrum, which I personally feel is a great loss of opportunity.

[Sally44]

It is also worth looking at other associated skills that impact on language ie. executive functions.

For example my son has little understanding of time and the passage of time. This impacts greatly on his understanding and use of language within any concepts of timeframes. So words like yesterday, tomorrow, next week, in a few minutes, now, when, next etc had to be specifically taught to him and some of those concepts remain very weak. So most language has to be about 'here and now'.

Problems with organisation, sequencing and planning can also affect the organisation, sequencing and planning of language. So the child may not be able to access the words they need to put into a sentence to convey the message they want to tell you.

And it is important to know that these difficulties are not due to lower 'intelligence' but are a direct result of a speech disorder or problems with auditory processing or short term memory or memory retrieval.

Again alot of work can be done on this by trying to organise the 'storage' of words eg. networking where all new concepts/words are linked into other words associated with them. The private SALT I used said that my sons verbal memory storage was like a libarary that had been destroyed by a tornado. That was why he could not access information he knew because his mind did not know where to access it or could not find it. My son knows alot of things and often those 'memories' are retrieved accidently and he can give you some information he has stored on that particular topic. But this memories are sometimes 'tripped' rather than retrieved himself. Does that make sense?

So work on storing information, on working memory, on extending memory by playing memory games.

My son also has dyslexia, which often accompanys speech disorders and other related difficulties.

I could go on and on. But it has taken alot of work, consistent pressure from me on everyone involved, a Statement, a Tribunal which included having to get private reports and take a expert SALT to tribunal as witness. Hopefully you don't need to do all that. But just to let you know that it can be done.

Good luck.