How Intensive Should Speech Therapy for Autism Be?

Most children with autism need to see a speech therapist to improve their communication skills; that’s just part of the nature of autism.

However, one very common misconception I see is that more time with the speech therapist will result in better communication skills for your child.  Unfortunately, this is not entirely the case for children with autism.  Let me explain…

“My Child Needs More Time with the Speech Therapist!”

This is one of the most common requests that I hear from parents of children with autism and I TOTALLY get where you’re coming from.  A speech therapist helps children talk better.  You want your child to talk better.  It makes sense that increasing the amount of time that your child sees the therapist would help them talk better more quickly, right?

Well, it’s more complicated than that.

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The Trouble with Generalizing:

Children with autism tend to have trouble generalizing skills. Generalizing is what happens when a child takes a skill that he learned in one place and uses it somewhere else.  Our children with autism may be able to learn how to do a skill with one person really well but that doesn’t necessarily mean that the child will be able to do it with anyone else or even in a different location.

For example, if you teach a child with autism to count to 5 using the same 5 yellow cups at the kitchen table and you never practice counting anywhere else, the child will do great at counting to 5 in that exact situation but may not be able to transfer that to counting anything else.

The same goes for communication. If a speech therapist teaches a child with autism to communicate with her in the speech therapy room, it doesn’t necessarily mean that the child will then start communicating with other people and in other settings.

I’ve worked with several children who will learn to say words during our speech sessions but no matter how hard the parents try, they can’t get their child to say those same words at home or at school.

To counteract this, the child must practice the same communication skills with a variety of different people and in a variety of different settings. For that reason, it is vital that the child does not spend every waking moment with the speech therapist. We want the child to communicate in any situation, not just when the speech therapist is present.

How to Get Children with Autism to Generalize Communication Skills:

If the child needs to work on communicating better, then the answer is not necessarily just to add more time with the speech therapist. Instead, the speech therapist must train the other adults that interact with the child on how to do the same types of instruction, prompting, and modeling that she does.

When the speech therapist trains the other adults, the child will make faster progress with his communication skills because he will be getting the same instruction from multiple sources and he’ll be able to practice those skills in the natural environment (at home and in the classroom as opposed to just in the therapy room).

How to Determine What a Child Needs:

I should take time here to clarify that sometimes, more minutes with the speech therapist IS the answer.  I’m not saying that no children with autism should ever have their speech minutes increased.  What I AM saying is that increasing speech minutes is not always the best option.

As speech therapists, our training covers how to know what type of intervention a student needs.  The speech therapist who works directly with your child will be able to tell you what is best for your child.  Also, each child may need a variety of services as opposed to just one kind.  Here are some of the options that the speech therapist may consider for your child:

  • Direct minutes with the speech therapist in a quiet, distraction-free environment, like the speech therapy room
  • Direct minutes with the speech therapist in the classroom
  • More time with an educator or aide who has received special training on techniques that will help the child communicate better
  • Time for the speech therapist to communicate and collaborate with teachers, aides, and parents to train them on strategies that will help the child
  • Time that the speech therapist spends teaching the whole class while monitoring your child’s response and progress in these group lessons

How this Looks in an IEP:

There are many different ways that this might look when it is written into a child’s IEP.  Here are some different ways that speech therapy services may be assigned to help the child make optimal progress:

  • Direct Therapy Minutes: The therapist provides direct therapy to the child, often in an isolated setting like the therapy room. This is often best for introducing a new skill when fewer distractions are necessary.
  • Push-In Therapy Minutes: The therapist provides therapy to the child within the regular education environment. This is often best for generalizing new skills to a more natural environment and modeling teaching strategies for the classroom teacher.
  • Consultation Minutes: These may be called different things but these minutes are written into the IEP as time when the speech therapist will work with the classroom teacher (or parents) to show them the techniques that they can use to help the child learn to communicate in other settings.

As you can see, there are many different ways to serve children with autism and you cannot just add more direct therapy minutes and expect it to help the student. Each student needs an individualized plan including a combination of different services.

Questions to Ask your Speech Therapist:

If you are concerned about the amount of services that your child is receiving or the amount of progress that your child is making, you can speak with your speech therapist directly.  I have prepared a list of questions that you can ask your speech therapist that may help you gain a better understanding of what services are in place for your child.

It is usually helpful to send these questions to your speech therapist ahead of the time that you want to talk about it so they can pull data and relevant notes to help explain what’s happening.  Also, your child’s speech therapist likely has MANY kids on her caseload so it’s helpful if she has time to look over goals and notes so she doesn’t feel like she’s being put on the spot.

  1. How many minutes does my child receive direct minutes with you and where do those minutes take place?
  2. How are other educators and aides assisting my child’s communication development throughout the day?
  3. Do you talk with the teachers and aides so they know how best to assist my child’s communication development?
  4. What can we be doing at home to further assist in my child’s communication development?
  5. If you feel like my child doesn’t make the amount of progress you’d expect, what options do we have for making sure he’s getting everything he needs?

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Carrie Clark, Speech-Language Pathologist

About the Author: Carrie Clark, MA CCC-SLP

Hi, I’m Carrie! I’m a speech-language pathologist from Columbia, Missouri, USA. I’ve worked with children and teenagers of all ages in schools, preschools, and even my own private practice. I love digging through the research on speech and language topics and breaking it down into step-by-step plans for my followers.

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