What to Know About Speech Therapy for Autism

by Casey Ames February 01, 2021

What to Know About Speech Therapy for Autism Blog Image

Speech-language therapy was developed to support children and adults with language and communication difficulties. Speech-language pathologists -- therapists trained in this field -- evaluate and treat any manner of disorders having to do with speech, cognitive functioning, language, and feeding and swallowing.

Conventionally, this kind of support may only be associated with the treatment of lisps or stutters, but it can also be employed when treating adults and children with autism. Speech therapy can be harnessed to help them with their verbal, nonverbal, and social communication skills. It enhances their ability to apply and understand language in social settings.

What is Autism Spectrum Disorder?

Autistic Spectrum Disorder, commonly referred to as autism, is a developmental disorder that shows up before the age of three. It’s categorized as a neurological disorder that can cause impaired communicative skills, social interaction skills, and cognitive skills, as well as limited or compromised speech (when a person can’t be understood when they talk or they’re nonverbal). It’s generally detected before 18 months and sometimes as early as 10 to 12 months.

Signs of autism can include:

  • Repetitive activities (hand flapping, rocking of the body, jumping, etc.)
  • Fixations on objects or activities
  • Extreme discomfort to changes in routine
  • Sensitivity to light, touch, and sound
  • Speech development delays

If you notice any of these signs in your child, it’s important to discuss them with your doctor, as early intervention is extremely important for people on the autism spectrum.

Speech Therapy for Autism

Speech therapy is one of the many kinds of therapies used to support people who are on the autistic spectrum. Even if they’re high-functioning, anyone on the spectrum can benefit from speech-language therapy. No case of autism is exactly like any other case; thus, it follows that every autistic person will have different language developmental needs that a speech-language pathologist has to meet.

Speech Therapy for autism

When it comes to language and communication, some children with autism may not be able to utter a single word, while others will love to talk, but it comes out in a single, unwavering tone of voice. Autistic people may also have difficulty interpreting body language, facial expressions, other nonverbal cues, and social rules.

Other people with autism may:

  • Only speak in grunts, cries, humming, or babbling.
  • Make up their own words.
  • Speak using echolalia, which is repeating back what is said to them.
  • Experience trouble with conversation skills, like holding eye contact.
  • Have difficulty understanding the meaning of words outside the original context in which they were taught.

For these reasons, any speech-language therapies for autistic people will include learning communication development on many levels: practical application, social context, physical movements, other ways to communicate language, and abstract conceptualization.

What Should I Expect from my Speech-Language Pathologist?

When it comes to language development, it’s incredibly important to start as early as possible. This is why speech-language pathologists are called in to conduct an assessment as soon as a child is diagnosed on the autistic spectrum.

With this base level understanding of the child’s communication strengths and challenges, they can create a program with individual goals, or refer the parents to different specialists. A different specialist may be necessary, since pathologists can have different experiences. For example, one pathologist may be great with non-verbal kids, but recommend a colleague for verbal kids who want to improve their social skills, and vice versa.

In general, a speech-language pathologist’s program will target the following categories:

Spontaneous Communication

One of the first things a pathologist will do after assessment- or even during assessment- will be to establish functional, spontaneous communication.

This is when the child is able to communicate his basic needs and wants without needing to be prompted. Depending on the child’s needs and abilities, they may approach this in a few different ways.



For example, if a child is nonverbal or has difficulty speaking, they’ll employ Alternative Augmentative Communication (AAC)as a way to communicate. AAC involves using tools like a device that talks for them, signing or typing, or using a Picture Exchange System (PECS), which involves the kids using imagery with words to communicate and learn how to communicate.


Applying Skills in Diverse Social Settings

It’s not enough for your child to practice skills in your pathologist’s office. They’ll need instruction in various settings throughout the day to better understand socially acceptable behavior. Therapists do this by directly instructing kids on socially acceptable behavior with visual supports, books, and demonstrative videos.

For young kids, they’d focus on teaching them how to listen to a teacher, answer questions, and following directions. It would focus more on creating relationships with their peers for older kids, like having group conversations and learning how to be a good friend.

Peer Interactions

Creating relationships is an essential skill for functioning in society. When it comes time to teach kids how to create relationships with their peers, therapists will focus on teaching younger children play skills, when to respond to their names, and how to employ joint attention. Older children will learn conversational skills and how to take different perspectives.

Training and Support for Other Adults

As mentioned previously, for adequate teaching of necessary speech and language skills, these practices have to extend out of the therapist’s office. One of the reasons is that autistic people often struggle with generalizing concepts, meaning they can’t readily apply skills they learned in session to similar activities outside of a therapy session.

Other adults in the child’s life will have to step in and continue modeling good behaviors in various circumstances so the child can learn effectively.

Different Kinds of Therapy

Therapists teach in the following ways:

  • Direct Therapy Minutes: the pathologist works directly with the child in an isolated room, which is best for learning new skills.
  • Push-in Therapy Minutes: when therapy occurs within the regular education environment. This is best for generalizing skills to a more natural environment and modeling strategies to the teacher.
  • Consultation Minutes: 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.

Continued Growth Towards Better Communication Skills

In addition to making progress on these larger items, a speech-language pathologist can begin to address some of the smaller issues that may also be impacting the child’s communication like:

  • Speech sound errors, difficulty with figurative language, strengthening muscles in the mouth, jaw, neck, etc.
  • Asking & answering questions: A therapist can teach your child to recognize questions and identify the appropriate answers.
  • Speech pragmatics: Some kids will struggle with knowing what to say in certain situations, how to say it, and when to say it (e.g., saying “good morning”). Pathologists can also teach autistic kids to understand the meanings of idioms and even use them themselves.
  • Prosody: This is when a person speaks in a melodic voice that goes up and down in conversation. Autistic people, however, have flat prosody, which makes many people believe that they have no emotions.
  • Grammar: Speech-Language Pathologists can help teach kids the correct usage of grammar. Autistic kids can have difficulty with this, even if it’s modeled for them by other adults.
  • Conversation skills: Knowing how to make statements is not the same thing as carrying on conversations.
  • Conceptualization skills: For some autistic people, understanding abstract concepts like “liberty” or “few” can be difficult.
  • Other social skills include standing at an appropriate distance from a partner they’re talking to, assessing the “mood” of a room, and other body language cues.
  • Feeding challenges: Therapists can help retrain a body to eat and swallow more effectively. They can evaluate the particular issue a person is dealing with and provide treatment plans for improving these challenges.

How to Choose a Speech-Language Pathologist

Before you decide to work with a speech therapist, it’s important to analyze whether they can meet your child’s needs. It’s recommended that you meet and interview the therapist and then observe them during a session with your child. These practices should be possible whether you choose traditional in-person therapy or an online platform.

You should also ask them for references to other parents whose children have similar challenges as yours, so you can get an idea of their skills and experiences that academic merit won’t communicate.

Speaking of academic merit, a speech therapist is required to hold a master’s degree in their field. Additionally, if you see the letters “CCC-SLP” after their name, it stands for Certificate of Clinical Competence, earned through the American Language Hearing Institute. It indicates that this therapist achieved excellence in academic and professional standards.

When interviewing your potential speech-language pathologists, some important questions to ask are:

  • Who should I expect to be directly interacting with my child?
  • How many years have you been working with people with autism?
  • Where will we be going to attend therapy sessions? If online, what space is ideal for the video sessions?
  • What type of insurance do you accept? Will my insurance cover your services?
  • How are goals determined? Can clients and parents provide input?
  • How do you measure progress?
  • What are some of the typical milestones for speech and language?
  • What can we do to practice at home?
  • What progress should we expect?

Will Speech-language Therapy be covered by my insurance?

Given that speech-language therapy is a medically established practice, your insurance should cover it, though they may require your doctor deem it medically necessary. It could also be offered free of charge by your child’s school as part of their Individualized Education Program (IEP). Some kids can also receive speech therapy through a state’s early intervention program depending on how old the child is, how they’re developing, and their income levels.


Speech-Language therapy is an essential part of an autistic person’s medical support plan, similar to using a fitness app to track diet and weight loss: if progress is going to be marked, training has to be done. If performed correctly, an intensive and individualized program can improve their ability to interact socially and enhance their overall ability to live their lives and form relationships.


This is a guest post from Better Speech, a website that offers convenient and affordable online speech therapy for both children and adults. Better Speech is passionate about helping all people communicate at their best. With a team of over fifty certified therapists, Better Speech matches each client with the professional whose expertise and schedule aligns with their needs.

Casey Ames
Casey Ames

Casey Ames founded Harkla in 2015 on the pursuit to create products and information that can help those with special needs live happy and healthy lives. This passion has lead Casey to help design some of the best products for those with special needs, as well as create The Harkla Blog to try and provide free information to families and caretakers.

When Casey isn't working, you can find him backpacking through the Pacific Northwest, reading, or playing soccer.

To learn more about Casey, the whole Harkla team, and how they work to change the lives of those with special needs, check out Harkla's About Us Page.

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