Early Autism Intervention – The London Speech and Feeding Practice

Explore 12 questions to determine whether your child may be Autistic

ByLondon Speech and Feeding October 7, 2022February 10, 2023

A young boy is in the foreground and has turned his head away from the woman sitting next to him. — May your child be autistic?

As professionals, when diagnosing young children with an Autistic Spectrum Condition, it is vital we work as a multi-disciplinary team, so you will likely see many professionals. This may include Educational Psychologist, Dietician, General Practitioner, Occupational Therapist, Paediatrician, Special Educational Needs Coordinator, Speech and Language Therapist and Social worker. Once the evidence is collated, then a diagnosis may be made.

You may be wondering what are some of the early signs of social communication difficulties? Whilst no autistic child is the same and we know Autism is very much a very wide spectrum of abilities and needs there are some autistic spectrum characteristics we do typically see in the early years of childhood. You may wish to think about these areas or presentations to help you prepare for the Speech and Language Therapy appointment.

Twelve questions

Does your child respond to their name?
Are they fixated with watching their hands?
Do they have sensory processing difficulties such as bright lights, food textures, or loud noises?
Are they meeting their milestones or are they delayed?
Do they flap their arms or legs when excited?
Have you noticed any rocking back and forth?
Do they blink excessively or display any facial tics?
Do they play with a particular sort of toy e.g. spinning toys?
Have you noticed that they lack interest in toys?
Have they regressed in their language? Perhaps you’ve noticed they are not using words that they have previously learnt.
Do they use gestures to communicate their needs? How do they communicate their wants and needs?
Do they appear to be in their own world?

You are not alone

These questions are by no means exhaustive and there are many more factors to consider. But it is important to trust your instincts as you are the expert on your child and know your child the best. Regardless of whether you see all of the above points or none, do not hesitate to have an assessment if you are concerned as, even if it turns out to be nothing to worry about, there is always at least one or two great pieces of advice I can offer you on the way and you will leave feeling hopeful and empowered. It’s always best to seek early intervention with communication difficulties. This allows strategies and support to be put in place. Never feel alone, always speak out.

Find communication support here from me, Sonja, (Specialist Speech and Language Therapist)

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

Support your autistic child’s communication by learning the stages of Gestalt Language Processing

ByLondon Speech and Feeding September 28, 2022January 3, 2024

If your child is using echolalia and/or has a diagnosis of autism, then your child’s way of processing language is most likely different to the classic way children typically learn language. We call this process Natural Language Acquisition or Gestalt Language Processing.

Speech Therpaist in London — Step by Step guide to Gestalt Learning

Let’s explore the following stages of Gestalt Processing:

Stage 1: communicative use of whole language gestalts

(e.g., “let’s get out of here”)

Children and young people in this stage use echolalia. They need to hear more gestalts or scripts. So, your job is to model, model, model and to use functional language that your child can repeat back.

Stage 2: mitigated into chunks and re-combining these chunks

(e.g., “let’s get” + “some more”) and (e.g., “let’s get” + “out of here”)

This is when you take parts of gestalts or phrases and then combine it with other parts.

Stage 3: further mitigation (single words recombining words, formulating two-word phrases)

(e.g., “get…more”)

They are going beyond their gestalts. Furthermore, they may begin to label different objects.

Stage 4: formulating first sentences

(e.g., “let’s get more toys”)

You may see more grammatical errors during this phase as they are creating unique sentences. Please don’t worry about this, it means they are playing and experimenting with language. As communication partners, you could model the correct form of the sentence.

Stages 5 & 6: formulating more complex sentences

(e.g., “how long do you want to play inside for?”)

You can see that language learning is a process, that is trialled and tested, used in different contexts for children to be able to learn and use language appropriately.

My next blog will give you activities ideas and how you might use them specifically with a Gestalt Language Processor.

Remember early intervention is vital. So, if you have any concerns, please seek the advice of a Speech and Language Therapist.

Contact me, Specialist Speech and Language Therapist Sonja here.

Autism Therapy · Top tips

Joint Attention For Children With Autism

ByLondon Speech and Feeding August 19, 2021February 10, 2023

Why is joint engagement important for communication development?

It has been well-documented that the development of joint attention is impaired in children who have social communication difficulties or autism. It is, in fact, this impairment which distinguishes children with ASD from children who have other developmental delays.

A lack of joint attention in very young children is an early sign of autism as it is a signal that there is a disruption in the motivation to connect socially with others. Since this is a crucial element, I thought I would outline what we mean by Joint Attention as supported by the research undertaken at Hanen.org.

In typically developing children, the ability to shift attention between a person and an object for the purposes of connecting socially or for requesting develops around the same time. However, for children with ASD, these components emerge one at a time and in a linear fashion. Children with ASD usually start with requesting something and later they may learn to share attention for social sharing. (see pattern below as a general guide).

As with typical development, there is variation in the order that these skills emerge but the following patterns of development is commonly seen:

Reaching, taking adult’s arm/hand or pointing to ask for something — but without looking at the adult
Gradually alternating looking between person and object of desire
Then learning to follow the point of another — which is responding to joint attention initiated by another
Directing attention to share interests — without looking at the adult: pointing to a truck on the road/ helicopter circling above
Then directing attention to share interest by alternating gaze shift between person and object — here the child is now initiating joint attention.

What is important to note is that in order to fulfil the criteria for true joint attention, the purpose of directing the attention of another person must be social in nature. In other words, it must not be exclusively to obtain a desirable object or event/action. True Joint Attention is seen verbally or non-verbally; we want to share a thought with another person and direct them to something we are interested or excited or spooked by.

For example: we can see an amazing firework display in the distance and we want to quickly direct our friend’s attention to this. In order to do this we might be tugging their sleeve/arm whilst pointing to the display in the distance, and perhaps we might add “wow look over there!” We are doing so simply to share an interest without obtaining anything, we are just being social with each other. So True Joint Attention is not just looking at what we want to have, then look at the person who can get this for us and then point to the item. We can say that this is the precursor to true joint attention, which is purely social in nature.

Because true joint attention is an essential precursor to typical language development, the absence of joint attention in children with ASD contributes to difficulties with language learning. Beuker, K., Rommelse, N., Donders, R. & Buitelaar, J. (2013).

The Hanen programme for Parent Child Interaction teaches parents of children with Social Communication Difficulties step by step how to enable their children to learn to pay attention to an object and the parent at the same time.

We learn how to enable a child to:

engage take turns
shift eye gaze between toy and adult
copy adult’s actions, gestures and then words
play with toys in different, new ways
interact and for longer periods of time
have fun whilst playing

If you would like to know more about the Hanen programme please get in touch. I look forward to exploring the topic with you and help guide you forward if this is something your child is struggling with.