Delayed language development was one of our first clues that Alex had autism. While he would say some words and short phrases, his vocabulary and conversational skills were quite limited. In addition, he had trouble articulating some sounds, so his speech wasn’t always clear. Once he received a diagnosis of autism, the school district provided speech therapy as part of his I.E.P., or individualized education program. Considering how much language impacted his development and social skills, the amount of speech therapy offered to him was—as is often typical in special education—much less than he really needed. Alex only received two twenty-minute sessions of indirect speech therapy and one twenty-minute session of direct speech therapy per week. Indirect speech therapy can be basically any language-related activity, and even the direct sessions do not have to be one-on-one with the therapist. Consequently, we supplemented the school speech therapy with private speech therapy.
The school speech and language therapists are overworked with caseloads much too heavy to individualize for the varied children with whom they work. My impression was that the two who worked with Alex didn’t have much experience with autism, either. The first speech therapist assigned to Alex gave me no feedback, despite my repeated requests and offers to supplement her lessons at home. We happened to see her at the library one day, where I specifically asked what I could do to help Alex’s speech. She told me, “Just try to get him to talk because I can’t get a word out of him!” Since Alex was cooperative and would say what he could, her lack of success with him didn’t give me much confidence in her ability or her efforts to work with him. He was given a different speech therapist the following school year, and she would not update me on his progress, either. She simply told me that Alex wasn’t happy about having to share his speech sessions with another boy, nor were we since we felt he needed individual attention during that brief weekly session. I asked to observe her to see what kinds of lessons she was doing with Alex and was disappointed to discover that all she did was follow him around during free time in preschool class and write down what he said. She didn’t try to engage him at any time; she just recorded data. If this was typical of the therapy sessions, no wonder they weren’t eager to report what they were doing with Alex. Moreover, his lack of progress in speech was not surprising, and we knew we needed to hire someone to work with him who would put forth more effort to encourage him to talk.
Knowing that Alex needed intensive language therapy, we found a local private speech therapist who recommended two individual speech therapy sessions of thirty minutes each per week. Even though she and our pediatrician submitted letters explaining Alex’s need for speech therapy, our insurance company denied coverage, and we had to pay for private speech therapy ourselves. Had Alex been an elderly stroke victim, they would have paid for speech therapy, but they refused to cover a four-year-old child because they routinely denied paying for any therapies related to autism. Thankfully, we could afford to pay for speech therapy ourselves, but not all parents have this option. Alex’s private speech therapist actively involved him in various activities to improve his vocabulary, conversational skills, and his articulation to help make his words clearer. She provided feedback after every session so that we had a good indication of what she was doing to help him. In addition, she had me make flashcards for him with certain sounds that he needed to improve. I would write the words on one side and put pictures from magazines and catalogs to illustrate the words on the other side. Alex and I would go over these flashcards every day to improve his speech; this gave me specific skills to work on with him, which was beneficial. In addition, she used a speech and language game-based computer program with him called Earobics, and we purchased a home version, as well, to supplement what he was doing with her. (At that time Earobics was marketed to parents and speech therapists as a way to improve auditory skills and receptive language so that children could better understand what they heard. Now they promote the program to schools as a phonics reading program.) By working cooperatively with his speech therapist, we were able to improve Alex’s language skills, which lessened his frustration of not being able to communicate effectively. Speech is still a weakness for Alex, but he continues to make progress as he strives to interact with others.
“Let your conversation be gracious as well as sensible, for then you will have the right answer for everyone.” Colossians 4:6