Impact of Autism on Speech
Impact of Autism on Speech-Language Development
The reporting of the effect of autism Spectrum Disorders (ASD) on the ability of speech varies significantly based on the choice of the instrument of assessment, age of the child and the particular communicative ability measured. According to Volden et al (2011), despite the recognition that individuals with ASD experience communicative impairment, accurate, age-appropriate instruments for the assessment of language skills are not available. Volden et al, further established that children start to acquire language skills before the age of three, yet the norms for evaluation of semantic and syntax development apply to children at the ages of at least three years old. However, other studies (Yoder, 2006) show that useful speech begins after three years of age and this might explain the lack of proper instruments to measure speech ability for children below the age of three years old.
Volden et al (2011) applied Preschool Language Scale (PLS-4) for measuring the semantic and syntactic language skills in pree-school going children with ASD. According to the PLS-4 measurements, language ability is positively correlated to cognitive development and therefore, PLS-4 is an ideal instrument for examining the syntax and semantic development in pre-school children suffering from Autism Spectrum Disorders. Higher scores on PLS-4 were linked to a lower severity of the symptoms of ASD. However, the effectiveness of PSL-4 in the assessment of syntax and semantic abilities may be limited since the scale does not measure pragmatic language skills. According to Volden & Philips (2010), the measurement of pragmatic communication in children with ASD is critical because individuals who are found to show syntax and semantic abilities often have problems in using language in social context. For example, individuals who have autism’s communication behaviors has been described as ‘’out of place, irrelevant, inappropriate and metaphorical’’ (Volden & Philips, 2010, p. 204).
The inability to keep focus on a subject by choosing and connecting pieces of information appropriately further shows the impairment of pragmatic speech in individuals with ASD. Besides, people suffering from ASD have trouble in using figurative language. For instance, they usually miss the underlying meaning of statements and often give literal responses to such statements (Volden & Philips, 2010). Volden et al (2011) made comparisons between PSL-4 scores and Vineland-II scores to determine the link between syntax and semantic ability, and daily communicative ability. The researchers established that children with better PSL-4 scores had higher levels of daily communication.
The impact of autism on vocal quality and phonological productions was investigated in Schoen, Paul & Chawarska
(2011). The researchers compared the quality of speech and non-speech sounds made by very small children (aged 18 to 36 months) with autism and their typically developing peers. Both the study group and the control group produced the same speech-like sounds, but significantly varied based on the production of non-speech sounds. The speech sounds that were studied included consonants and syllables while the non-speech sounds included laughter, growls, yells and squealing. According to Schoen, Paul & Chawarska (2011), the lack of basic speech skills is not the cause of language delays in children with autism because their phonological ability is comparable to that of typically developing peers. The authors further claimed that the overproduction of non-speech sounds in toddlers with ASD is an implication that they have problems in aligning themselves to the language model which they are exposed to, and accounts for their delayed development in speech.
Enhancing language developments in children with Autism Parent responsiveness may predict the acquisition of language skills in children with ASD. Haebig et al (2013), argue that follow-in commenting (describing the attention and focus of the child without controlling him or her) may enhance outcomes of language in children with verbal difficulties. The same findings had been reported earlier in Yoder (2006) which showed that attention following accompanied by a diverse object play predicts growth of lexical density in non-verbal children. Haebig et al (2013) also examined the impact of parent’s comments about their own actions on the language development of the child. The results also showed that while children with ASD may be attentive to parents commenting on their (parents’) own behavior, the children are unable to acquire any benefit linguistically from such kind of behavior. Another finding also made by Haebig et al (2013) was that, parent follow-in directives give the child the ability of engaging with others and contributing to language development in children with ASD.
In the same way, Ingersoll et al (2012) noted that interventions targeted at children with autism should include components aimed at improving parental responsiveness to the behavior of the child to enhance his or her social skills. However, Ingersoll et al (2012), acknowledged that responsive interaction is inferior to milieu teaching (prompting) in promoting expressive skills in children with ASD. Besides, Ingersoll et al (2012) showed that the combination of milieu teaching with responsive interaction could be more effective instead of using a single intervention in enhancing the total language targets in children with autism.
Besides parental responsiveness, the potential use of music training to enhance verbal production in children with autism has been studied. Lim (2010) used three study groups in comparing the impacts of speech training, music training and no training on speech development in children with ASD aged three to five years. Lim (2010) established that children who underwent music training and speech training enhanced their verbal skills significantly irrespective of their level of functioning. However, the minimally verbal children who underwent music training showed the highest improvement in verbal skills. The researcher explained that music lessons might enhance speech production since the process of analyzing musical stimuli is the same in perceptual pattern to the process of producing speech. Car & Felce (2006) conducted an investigation on the role of perceptual skills in speech development using the Picture Exchange Communication System (PECS) (phase I-III) for children aged three to seven years old. After 15 hours of training for five weeks, the study group demonstrated significant improvement in their ability to start conversations with their teachers. Besides, the study group also improved their abilities in initiating communicative interactions that elicit meaningful responses from adults.
The possibility of enhancing communicative ability of children with ASD using environmental intervention as opposed to developmental approaches has also been investigated. According to Meadan et al (2006), children with autism have problems in communicating in social settings, because their non-verbal and speech behavior is incongruent with the expectations of their typically developing peers. Meadan et al (2006) proposed and tested the application of environmental approach to help children with ASD to enhance their expressive skills and overcome communication breakdowns. The researchers further tested the use of such repairs as modifications and repetitions for fixing communication breakdowns in two children with low expressive abilities. The results of the study showed that the two participants repaired at least 70% of their communication breakdowns. However, there were variations in the effectiveness of repair strategies across participants and communicative settings.
Communication repair has been taught elsewhere (Sigafoos et al, 2004) using voice output communication aid for supplementing pre-linguistic behavior like guiding and reaching, which the researchers argued are necessary for the effective repair of communication breakdowns. According to Sigafoos et al (2004), overreliance on pre-linguistic skills in children with autism is one of the main causes of communication breakdown and therefore, interventions should be focused on scaffolding activities that assist the children in successfully changing from pre-linguistic to linguistic communication. However, these results may not apply to all children with autism because of their disparities in environmental and personal factors. Besides, the study samples for Meadan et al (2006) and Sigafoos et al (2004) were too small to capture the differences in environmental and personal factors that might influence the result of the intervention.
There are several trends that have emerged from the reviewed literature. One is that most studies on the impact of ASD on speech skills and the treatment of autism in children focus on subjects aged at least three years. As a result of this, the effect of autism on the development of speech among infants and minors in early childhood is understudied, which accounts for the lack of sufficient, appropriate tools and procedures for assessment of speech abilities in children aged below three years old. Another trend is that for most children with ASD, the main factor contributing to their communicative limitations is the slow development of pragmatic communication skills. This is an implication that interventions should focus more on this area. Communication repair, responsive interaction and milieu teaching may contribute to the development of pragmatic communication because they encourage the child to start and maintain interactive experiences in natural settings. Finally, only the non verbal or minimally verbal children with ASD appear to benefit from most of the available interventions, which highlights the need for adjusting interventions to the severity of the symptoms of autism.
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Carr, D. & Felce, J. (2007). The effects of PECS teaching to phase III on the communicative interactions between children with autism and their teachers. Journal of Autism and Developmental Disorders 37, 724-737.
Haebig, E., McDuffie, A. & Weismer, S. E. (2013). The contribution of two categories of parent verbal responsiveness to later language for toddlers and preschoolers on the autism spectrum. American Journal of Speech-Language Pathology 22, 57-70.
Ingersoll, B., Meyer, K., Bonter, N. & Jelinek, S. (2012). A comparison of developmental social-pragmatic and naturalistic behavioral interventions on language use and social engagement in children with autism. Journal of Speech, Language, and Hearing Research 55, 1301-1313.
Lim, H. A. (2010). Effect of developmental speech and language training through music on speech production in children with autism spectrum disorders. Journal of Music Therapy 47(1), 2-26.
Meadan, H., Halle, J. W., Watkins, R. V. & Chadsey J. G. (2006). American Journal of Speech-Language Pathology 15, 57-71.
Schoen, E., Paul R. & Chawarska, K. (2011). Phonology and vocal behavior in toddlers with autism spectrum disorders. Autism Research 4(3), 177-188.
Sigafoos, J., Drasgow, E., Halle, J. W., O’Reilly, M., Seely-York, S., Edrisinha, C., & Andrews, A. (2004). Teaching VOCA use as a communicative repair strategy. Journal of Autism and Developmental Disorders 34(4), 411-422.