About Autism Spectrum Disorder (ASD)
What is Autism Spectrum Disorder?
Autism Spectrum Disorder (ASD) is a developmental disability which affects a person’s ability to relate with others and make sense of the world. This is usually seen in how individuals with ASD have difficulties with social situations, communicating with others, and may have some different interests or behaviours — for example, being fixated with a particular topic of interest, or finding it challenging to accept slight changes in their surroundings. Some individuals with ASD may also have intellectual or sensory difficulties as well.
Currently, there is no one known cause for ASD. What we know is that there are genetic links for ASD, and other influencing risk factors. As its name suggests, ASD has varying degrees of severity, from individuals who are able to hold a conversation but face some challenges in social settings, to those who may require assistance learning to communicate with others.
How does Autism Spectrum Disorder affect communication?
Communication is the exchange of thoughts, ideas and feelings with one another. There are spoken and unspoken ways of communication, such as using our words to tell someone about our day, or looking at someone and cocking up an eyebrow to convey some surprise in a conversation.
In individuals with ASD, the foundations for communication develop differently.
The foundational skills of communication — joint attention (being able to focus and direct attention on the same thing with someone else), social referencing (observing another person’s response to a situation before deciding what to do next), and eye contact are affected. When this happens, an individual with ASD finds it difficult to notice and pay attention to the same thing as others, and observe their reactions or interactions to it. They miss out on opportunities to communicate with others, and hence may not be able to easily make sense of what others are saying, or are unable to decode the meaning behind others’ body language and nonverbal behaviour.
What are some communication difficulties in Individuals with Autism Spectrum Disorder?
Communication difficulties in individuals with ASD present differently across the lifespan. Each individual with ASD may present with varying kinds of communication difficulties according to their own unique makeup, so it is important to do an assessment with a professional to determine the type of communication difficulties the individual may need help with. Below are some examples (but not exhaustive) of some of the issues which may affect communication for individuals with ASD, from toddler to adulthood.
For toddlers, some communication difficulties individuals with ASD may face are:
- Not using gestures
- Using a person as a tool, for example, using someone’s hand to open a jar
- Poor eye contact
- Showing no interest in others, including their family
- Not using words, using few sounds
- Not following simple instructions like ‘Sit down’
For preschoolers, some communication difficulties individuals with ASD may face are:
- Ignoring others around them
- Not being able to play in a make-believe manner, for example, pretending to eat invisible food off a spoon
- Having difficulty socialising with other children, playing together
- Being unable or uninterested to retell past events
- Having difficulties with language use, such as using ‘I’ for ‘you’ and vice versa, for example, saying ‘You eat ice cream’ when he/she is the one eating the ice cream
- Not responding to others in conversations or only responding superficially, such as stopping the conversation after answering a question and not continuing the topic
In older children, teenagers and adults, some communication difficulties individuals with ASD may face are:
- Impaired social skills, such as starting awkward conversation topics, saying things that may offend others, standing too close to someone else while speaking with them
- Avoiding eye contact
- Inability in forming and maintaining relationships with others
One of the hallmarks of ASD is weak communication skills. A speech therapist is able to help and support caregivers in developing skills to help their loved ones with ASD.
Speech Therapy and Autism
How does speech therapy help individuals with autism spectrum disorder?
For ASD, a team of professionals across different specialities are normally involved in assessing and managing the condition. This normally includes doctors, occupational therapists, speech therapists, just to name a few, and other relevant specialities if required, such as a physiotherapist. Speech therapists play an important role in helping an individual with ASD maximise their communication abilities and reach their full potential. To understand more about speech therapy, you can look through our article on Speech Therapy here.
Speech therapy for individuals with ASD uses different approaches for treatment. The speech therapist will first conduct a comprehensive assessment, before designing an appropriate personalised treatment programme for the individual.
Speech Therapy for Younger Children with Autism
For younger children with ASD, treatment may focus on improving speech and language skills, which starts from the prerequisite skills of communication, such as joint attention and eye contact as mentioned above. Just as how a child must first learn to stand before learning to walk, speech therapy will focus on these prerequisite skills to build up foundations for communication. Parents and caregivers are often highly involved, and therapy may use play and interactions as a medium to help the child with ASD.
Speech Therapy for Older Individuals with Autism
Speech therapy for older individuals with ASD may involve teaching basic speech and language skills, such as using single words and phrases to tell others what they want, responding to simple questions, or making comments.
As they advance, therapy may focus on understanding how language can be used for social purposes, such as to hold a conversation with someone else, or to recognise unspoken social and conversational rules. This could include staying on topic in conversations, being able to read and understand body language, and learning how to take turns to speak.
Some may also focus on perspective-taking, which is to understand how others may think or feel when certain events happen. This then helps the individual with ASD to learn ways to adjust and respond appropriately to maintain communication and build relationships with others.
Some individuals with ASD may take a long while before they talk, or may never talk at all. For such individuals, the goal would then be to learn alternative forms of communication, such as using gestures or pictures to talk with others. These forms of communication can range from picture boards to electronic devices or applications in tablets which can generate speech through the use of buttons, which normally have a picture or symbol representing different kinds of words. The individual learns to recognise them and then uses them to communicate with others.
When is the best time to start speech therapy for autism?
Starting young would help the individual with ASD to reach their fullest potential, and also provide the necessary support for caregivers to best help their child from an early age. Present research suggests that treatment starting before 3 years old is most effective. However, it is never too late to start and support the individual with ASD, whatever age he or she is at.
Speech Therapy Options for Autism
There are several options available locally for individuals with ASD. Do note that some of them require a referral from another professional, such as a doctor.
For young children, you may go to KK Women’s and Children’s Hospital or National University Hospital to seek a consultation. For Singapore residents, you can obtain a polyclinic referral to seek a consultation with the relevant departments. During the consultation, the doctor will assess and refer your child to the appropriate services necessary, speech therapy included.
For individuals under 18 years of age, speech therapy services are often available in Social Service Agencies (SSAs). There are therapy hubs by some of these SSAs, where various therapy options are available. You can seek further evaluation from a speech therapist at these centres.
Otherwise, if the child has been seen in the public hospital setting, if need be, they will be referred on to Early Intervention Programme for Infants and Children (EIPIC) centres or Development Support Plus (DS-Plus), where appropriate developmental services tailored for the child’s needs will be given. Speech therapy is often an option in these services as well, whether it is face-to-face with the therapist one to one, or as part of a group with other children.
Older children may be referred to special schools, where speech therapy services may be available or integrated as part of the classroom curriculum as well.
Private clinics often provide speech therapy for individuals with autism. You can look up a few clinics on the internet, and approach them to ask about speech therapy services.
Home Speech Therapy
Home-based speech therapy is a convenient option as well, such as with Homage. A certified speech therapist will visit you at your home. Besides convenience, the comfort and familiarity of the home setting can also be beneficial for your loved one’s progress.
Homage provides a range of services for individuals with different conditions, including speech therapy services for autism. You can contact our Care Advisors at 6100 0055 to learn more about our range of services and find out how Homage Care Professionals can help.
If you are caring for a loved one with autism, you may also find it helpful to check out our guide on resources available for those with autism, as well as a list of schools suitable for children with autism in Singapore.
Disclaimer: The information is provided for general informational and educational purposes only, and is not a substitute for professional health advice. To seek further medical advice for your medical condition, do consult your doctor or go to the nearest health institution to get assistance.
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