Speech and language disorder diagnosis in addition to ASD

[Athena]

My child has an additional diagnosis of a speech and language disorder, in addition to the social communication difficulties caused by her ASD.

 

Just wondered if anyone else has experience of this and what it means in practice. Is it common to have two forms of Speech and language problems,those caused by the ASD pus another?

[call me jaded]

DS has oromotor dyspraxia which is why he doesn't have expressive (spoken) language.

[coolblue]

Strictly speaking 'autism' is a set of symptoms. It's a description of behaviours that are the outcome of a developmental impairment, not the cause of it. We don't know, of course, what the underlying cause(s) are. There could be different ones in different people.

 

Any expressive and/or receptive speech problem in and of itself could produce autistic characteristics - ie a significant impairment in social interaction and communication and repetitive or restricted behaviours. Speech is a complex thing, so it's quite possible for a child to have several different speech problems. If they had problems with social interaction and communication as a result they could qualify for a diagnosis of ASD. This doesn't mean they have two different developmental disorders - ASD plus a speech and language disorder. I'd bet good money that what's underlying it all is an auditory processing disorder.

 

 

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[Jannih]

My child has an additional diagnosis of a speech and language disorder, in addition to the social communication difficulties caused by her ASD.

 

Just wondered if anyone else has experience of this and what it means in practice. Is it common to have two forms of Speech and language problems,those caused by the ASD pus another?

[/quote

 

Pragmatic - semantic language disorder appears to be a co morbid condiotion with ASD. http://www.mugsy.org/bishop.htm

 

Frm my own experience. I feel that I too have an expressive language disorder. Though I'm don't think it falls into the pragmatic semantic category. I tend to have problems in describing something or explaining a procedure to someone. It feels that my words and sentences are disjointed and don't flow. People often look at me and think "what the f***K is she on about !" I am ok with the odd sentence here and there. I can also express myself better on the computer as I am doing so now.

[Sally44]

My son also has both diagnosis ie. ASD and a moderate/severe speech disorder.

How I see it is that all children on the spectrum must have some speech and language difficulties because it is part of the diagnosis. However the greater the speech and language difficulty the greater the problems with social interaction and with academic learning as (as coolblue says) there is usually an auditory processing problem as well.

 

This can cause an overspill into other diagnosis such as dyslexia due to problems with phonics, or sound/sight integration or processing. Or overspill between muscle control or muscle memory spilling over into dyspraxia and language problems associated such as sequencing (for spelling and writing), articulation.

 

What it means is that you have a much better case for Speech and Language Therapy to continue throughout the school years and for specific programmes for social interaction skills.

 

I have also found that as my son struggles with language he finds it very hard to multi-task, which can give the impression of low ability when that is not the case at all. For example he is perfectly capable of holding a two way conversation about quite complicated subjects such as DNA etc. However in a small group of people he would be concentrating so hard on trying to put a sentence together to get across what he wanted to say that he would be effectively deaf to everyone and everything else in his immediate environment and so misses huge amounts of 'whole class learning'.

 

Coping strategies for difficulties with processing language tend to spill over into sensory ones such as appearing deaf, or producing noise output to stop input.

 

So in total it means a greater need of SALT for language and social communication, probably specialist teaching (which maybe the teacher and SALT planning the lesson together), OT programme for sensory integration and auditory integration therapy, small group work or 1:1 for learning, with whole class mainstream being a complete no no.

[Sally44]

I also have an auditory processing disorder. I don't think my son is the same as me, but there are some similarities.

 

This what I experience:-

 

I often zone out and appear deaf to the extent that my husband has to keep repeating my name or touch me to get my attention. I am usually concentrating on something and somehow I just turn off any other sensory input. It is automatic and I don't control it.

I cannot speak on the phone if the kids are in the house or the TV is on because I just cannot hear what the person on the phone is saying.

I have no idea of sound direction. I have to cover one ear and turn sound slowly to get the sound source. I cannot tell you how long it takes me to find the cordless phone when it is ringing! Usually I don't find it. I have to use the mobile to repeatedly call the other phone until I manage to home in on its location.

In a room of people such as a meeting, or pub I cannot hold a conversation because I cannot hear what someone is saying to me. My ears home into different conversations and sounds and it just becomes a mish mash of words and noise.

Even in the GPs surgery I cannot hear my name being called if the TV is on in the waiting room.

I also have some sensory issues too.

But I am not autistic. Yet it helps me to understand my son because I know that he may not be receiving sensory input as everyone else and I know what that feels like and how frustrating it can be.

I have also made a point of explaining to my son (as incidents occur) that it was because he felt, heard, saw, understood DIFFERENTLY. Otherwise he assumes that everyone experiences what he does and cannot understand how they cope and he can't or how they come to a different conclusion to him.

 

So language problems - and any suspected auditory processing difficulties - should be taken seriously.

[Athena]

Jannih and Sally, thank you both for your very helpful replies. DD's problems are very similar to yours Jannih, she has terrible trouble describing what has happened or a procedure. She would be unable to tell someone how to make a cup of tea, although she is bright enough to know!!

 

Due to severe dyslexia, she cannot read and write (yet!).

 

I sometimes feel that all DD's difficulties are wrongly attributed to her ASD diagnosis, and I have found that I have to push really hard for co-existing (I hate the term co-morbid, sounds like someone has died!) conditions to be recognised and treated in their own right.

 

Fighting to get specialist dyslexia teaching for her at the moment, together with Sensory Integration Therapy. I sometimes despair, as she has so many problems!

[Sally44]

Jannih and Sally, thank you both for your very helpful replies. DD's problems are very similar to yours Jannih, she has terrible trouble describing what has happened or a procedure. She would be unable to tell someone how to make a cup of tea, although she is bright enough to know!!

 

Due to severe dyslexia, she cannot read and write (yet!).

 

I sometimes feel that all DD's difficulties are wrongly attributed to her ASD diagnosis, and I have found that I have to push really hard for co-existing (I hate the term co-morbid, sounds like someone has died!) conditions to be recognised and treated in their own right.

 

Fighting to get specialist dyslexia teaching for her at the moment, together with Sensory Integration Therapy. I sometimes despair, as she has so many problems!

 

That is exactly what it is like with my son. And he too struggles to find the words and 'give' information. The SALT put together a picture framework that he works through eg. pictures to prompt him 'who' 'what' 'where' 'when' 'how' etc. My son also has problems with sequencing and has poor auditory memory. Try to use visual memory if that is better.

 

Out of interest can your daughter make the correct word shapes with her mouth in silence. If you ask her to not make the sound with the word, but just mouth 'carpet' or 'staircase' etc silently. Can she do it? Can she count in her head, again without actually saying the words. My son cannot do this. To me this means that he will find phonics very difficult because you have to be able to hold an 'auditory' picture of the word in your head to apply phonics to it. He cannot do that. He can sound out some simply phonetic words, but he has to actually 'say' them. And when given instructions he has to keep actually repeating them to hold that auditory memory. I would be interested if your daughter has similar difficulties. Because this indicates to me that that will be a major difficulty causing the dyslexia and will mean whole class learning will be virtually impossible because my son won't be able to listen to all the auditory output from the teacher. He will not be able to read or write 'silently' and will need to say what he is doing (which will be distracting to others). And he will miss huge chunks of class learning because he will be trying to focus on the immediate task of writing a sentence or remembering the first part of an instruction.

Have you tried Widgit communicate in print? My son has learnt to read/write 25 words in 5 weeks using the symbols with the words underneath and has learnt them as 'whole' words and has not applied phonics at all. This is compared to his current IEP which is to be fluent in 16 high frequency words (that is after 5 years in school!). That is such a huge difference in learning and proves my belief that he is academically much more capable and that they just have a very low expectation of his academic ability and are using the wrong approach.

There is also the morpheme approach used by Maple Hayes school. Google their school and see the short video clip at the beginning. This system works for children with dyslexia who are not making progress with phonics.

[Athena]

Oh Sally, that is amazing! You are describing my daughter exactly!