Nonverbal Autism: Can Speech Therapy Help?

by Team Stamurai

Autism is not a disease. Autism spectrum disorder (ASD) refers to persistent deficits in social interactions, communication, and interpersonal relationships. Autism is a spectrum disorder because the signs and symptoms may affect people to varying degrees.

An early diagnosis of autism can help a child receive the necessary support and therapy. Early interventions can help make up for some of the communication deficits characteristic of ASD. However, there is no cure for autism spectrum disorder (ASD).

While most individuals on the spectrum experience communication challenges and speech delays, around 25% to 30% children with ASD may not speak at all.

What Is Non-Speaking Autism?

Earlier, experts referred to this type of autism as nonverbal autism. These days, authorized sources refer to it as non-speaking autism spectrum disorder. The term “nonverbal” may not be entirely accurate since the person may prefer other means of communication over spoken words.

It is common for children with autism spectrum disorder (ASD) to repeat what they hear. Experts refer to this as ‘echolalia.’ While it is not a trait of nonspeaking autism, it may contribute to speech delays in a child.

Even when a person is “minimally verbal” or “non-verbal”, they may choose to use written words and picture boards to communicate. Research shows that most of them can recognize and understand the words they hear.

Neurotypical children babble in attempts to “copy” the speech of adults. It signals the early development of speech and language in a child. Children who don’t babble by the age of 4-months are at a higher risk of nonspeaking ASD.

However, parents of nonspeaking children with ASD shouldn’t lose all hope. Research shows that a majority of all 4-year olds with ASD have the chance of developing spoken language with correct intervention. Speech therapy for non verbal autism is typically recommended for children with ASD and their parents since they typically do not have any intellectual disability.

What Are the Causes of Nonverbal Autism?

Currently, there is no literature on the causes of nonspeaking Autism Spectrum Disorder (ASD). Even the most renowned neuroscientists, psychologists, and neurologists are yet to discover what causes some people to not use spoken language.

Recently published studies show deficits in the oscillations of theta and gamma waves in the brain of minimally verbal children. It may open doors for new research in the areas concerning the causes of nonspeaking autism in the population.

It can be especially confusing since these people may prefer to use American Sign Language (ASL), picture tools, and communication boards. They are not averse to communicating entirely, but they prefer non-spoken forms of communication.

Some individuals with autism may have childhood apraxia of speech (CAS). It makes it nearly impossible for these children to speak without the intervention of a trained speech-language pathologist (SLP).

Your pediatrician will also check your child for any malformations of the articulators and loss of hearing. This will rule out physiological anomalies that may keep your child from speaking.

However, most children on the spectrum do not have childhood apraxia of speech or articulatory malformations. They simply do not speak!

How is Nonspeaking Autism Spectrum Disorder Diagnosed?

If your child is over a year old and hasn’t said their first words yet then you should speak with a speech-language pathologist (SLP). An SLP should be able to conduct necessary tests and evaluations to determine if your child has autism.

You can compare your child’s speech and language development with a standardized speech checklist to understand if you need to consult an expert.

Most children and adults with autism spectrum disorder have difficulties continuing a conversation with a person, or speaking in a social setup. However, those with nonspeaking autism may not speak at all.

In some cases, children have childhood apraxia of speech, selective mutism or childhood-onset fluency disorders that co-occur with autism and make communication challenging.

To receive a confirmed diagnosis, you may need to talk to your pediatrician. They should be equipped to screen your child for ASD. The pediatrician may request a battery of tests including –

  • A Physical Examination
  • Blood Tests
  • MRI and CT scans
  • Hearing Tests

The reports of these tests may help to rule out other potential causes of a child’s mutism.

Depending on the report of these tests the medical professional may request more tests, such as –

  • A full medical history of the parents and child
  • Older reports and review of the mother’s pregnancy, complete with the list of medicines consumed during the time
  • A complete review of the child’s health, hospitalizations and medical treatments

A developmental-behavioral clinician may use the Autism Diagnostic Observation Schedule (ADOS-2) and the Gilliam Autism Rating Scale (GARS-3) for the assessment of younger children who are experiencing severe speech and language delay.

What Are The Early Signs Of Nonspeaking Autism?

It is not easy to recognize the signs of autism in a young child. Here are a few signs of non-verbal autism that are present in very young children –

  • They do not respond to their name by their first birthday
  • They do not laugh or babble by the time they are 12-months old
  • The child may not point by the time they are 14-months old
  • A child with ASD typically doesn’t pretend play by the time they are 24-months old
  • The child may avoid eye contact and prefer to remain alone
  • A child with ASD may become upset or agitated by minor changes in their daily routine
  • They may rock their body or flap their hands (stimming) for comfort

How Does Speech Therapy Help Children With Nonspeaking Autism?

There is no cure for autism. The existing treatment for autism relies on behavioral interventions, speech therapy and family counseling. These can help a person overcome the more severe symptoms of autism spectrum disorder (ASD) and certain developmental delays.

Here’s how speech therapy can motivate children with nonspeaking autism to talk –

1. Speech Therapy Can Encourage Interactions

Studies show that children on the spectrum respond positively to play-based therapy. Speech therapists incorporate play-based therapy which includes toys that entice the child.

You can create a list of activities with the help of the speech-language pathologist (SLP) that both you and your child enjoy.

Play-therapy with your child will give you more chances to interact with them. If your child doesn’t have any aversion towards socializing, your therapist may recommend groups for your child’s play therapy sessions. They may get to interact with other children with similar diagnoses and you will get the chance to speak to their parents.

2. It Builds Communication Skills

It may sound counterintuitive to a concerned parent. However, research shows that children with nonspeaking autism may prefer other forms of communication.

With the help of an SLP you can determine which methods of communication your child prefers. They may rely on gestures, nodding or pointing.

Try to exaggerate your response to their efforts. For example, if your child points towards the dog. Extend your hand, and say “Dog”. Or, nod and say “yes” out loud when responding to your child’s request.

Always respond to your child’s gestures with spoken words. Point to an object before saying its name or interacting with it in front of your child.

3. It Teaches Alternative and Augmentative Forms Of Communication (AAC)

Children with nonspeaking autism may simply prefer other forms of communication. Your child may already be using the no-tech to low-tech options of Alternative and Augmentative Forms of Communication (AAC) like pointing, gesturing or drawing.

An SLP can teach them how to use other tech-powered options like using an app on an iPad or smartphone.

Some older children with nonspeaking autism benefit from learning the use of speech-generating devices on a computer.

When your child begins attending therapy, you will understand whether they may advance in their speech skills. In most cases, children with autism understand spoken language, but prefer to use other forms of language to communicate.

The target of speech therapy in such cases is to provide them with resources and teach them the skills necessary for communication.

4. Speech Therapy Can Boost the Understanding of Language

Although not very common, some children with nonspeaking ASD may have deficits in the understanding of spoken language.

Attending therapy sessions with an experienced speech therapist or SLP can help them expand their understanding of verbal communication.

Children on the spectrum often struggle with understanding the intention of the speaker. Studies show that speech therapy sessions can enable a child to understand the meaning behind facial expressions and determine the intention of an individual to some extent.

Therefore, speech therapy can boost their communication skills significantly.

What Lies Beyond Speech Therapy?

Since many, if not most individuals with nonspeaking autism spectrum disorder prefer not to use spoken language for communication, speech therapy may not benefit older children.

If your child is speaking a few words after attending speech therapy, that is a sign of improvement. As your SLP will say, speech therapy for autism takes time, especially in the case of someone with nonspeaking autism.

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