New Speech Therapy Method Offers Hope for Autism

For many children with autism, speech therapy provides crucial training to help them develop language skills. A recently published research article describes a new form of speech therapy that offers promising results to children with autism whose speech skills are limited. The article, “Behavioral predictors of improved speech output in minimally verbal children with autism,” published in the October 2018 issue of Autism Research and available online through the Wiley Online Library, describes the AMMT method and suggests which children are most likely to benefit from this form of speech therapy. [To read this article, please click here.]

The researchers, affiliated with Boston University, Harvard Medical School, and Beth Israel Deaconess Medical Center, all located in Boston, Massachusetts, looked for factors that would predict improvement in spoken language for minimally verbal children with autism. Their study included 38 minimally verbal children with autism ranging from ages three years and five months to ten years and eight months.

The children received one of two forms of speech therapy and participated in a minimum of twenty-five sessions that met five days a week for forty-five minutes each time. Most of the children engaged in auditory-motor mapping training (AMMT), “a novel therapy that uses intonation (singing) and rhythmic hand tapping.” The researchers further describe AMMT as “one of a small number of music-based treatments that have recently begun to be used effectively for teaching language and social skills to children with ASD” [autism spectrum disorders]. The other children in the study—the control group— engaged in speech repetition therapy (SRT), which involves no singing or tapping, only saying words aloud.

During these sessions of speech therapy, the children were given thirty familiar two syllable words to say aloud, such as “mommy,” “cookie,” and “bye-bye.” The children in the SRT group simply repeated these words with the speech therapist. However, the children in the AMMT group would sing the words while using two hands to tap on drums at the same time. This method not only combines using auditory and motor skills but also holds the attention of the children during the therapy sessions. The researchers discovered that the children who participated in the AMMT therapy improved their speech production more than those who received SRT therapy.

In addition, the researchers studied which factors were most closely linked to speech improvement, such as age, gender, severity of autism, nonverbal IQ, expressive language skills, and phonetic inventory (the number of speech sounds children can repeat correctly). In some children, the severity of autism influenced the amount of progress made in therapy. However, phonetic inventory was the strongest predictor of how much the children would improve. Researchers were surprised to discover that nonverbal IQ, expressive language, and age did not predict the level of improvement.

In fact, they noted that the older children may have better attention spans during therapy sessions that enabled them to make progress. While the value of speech therapy for older minimally verbal children with autism is sometimes questioned, the researchers note that their observations suggest some older children with autism can benefit from speech therapy.

Although the researchers admit that working with minimally verbal children can be difficult, they also stress the value of effective treatment. Approximately 25% of children with autism are considered minimally verbal. Developing language skills tends to reduce behavioral issues and improve long-term outcomes for these children. As the researchers stress, there is a “great need for these children to acquire even a few words.”

While the researchers affirm the need for further study in the area of speech therapy for minimally verbal children with autism, their study offers hope. First, the AMMT method appears to develop speech skills successfully by combining speech with singing and tapping. Moreover, their results indicate that even older children can develop their speech skills through proper therapy. Certainly, helping children with autism learn to speak is a noble cause, allowing them to communicate their wants and needs, to express their thoughts and feelings, and to interact with others so that they can lead fulfilling lives.

“He has given me a new song to sing, a hymn of praise to our God. Many will see what He has done and be amazed. They will put their trust in the Lord.” Psalm 40:3

The Gift of Waiting

“Let all that I am wait quietly before God, for my hope is in Him.” Psalm 62:5

Although I’m not by nature a patient person, raising a child who does things on his own timetable has made me learn the value of waiting. Last summer, we kept waiting for Alex to get over a bad case of thrush, a yeast infection that made his mouth and throat sore and required multiple doses of antifungal medication and repeated visits to his primary care doctor. One of the side effects of the thrush was that food tasted bad to him, and he lost his normally healthy and varied appetite. I was certain that once the thrush went away, Alex would regain his enjoyment of eating a variety of foods, but his limited appetite continued long after his mouth had healed.

During one of Alex’s appointments last summer, his doctor suggested that we could take him to a speech therapist to work on the food aversion issue. Even though we had the referral paperwork to see a speech therapist conveniently located just five minutes from our home, I didn’t feel a pressing need to make an appointment. Convinced that Alex would just wake up one day and decide to start eating anything and everything again, I felt strongly that we simply needed to wait. After all, the thrush had gone away in time, and we thought the lack of appetite would soon follow. In the meantime, I kept praying that God would give me a sign when the time was right to take Alex to the speech therapist.

About the time we would have taken Alex to the speech therapist, he developed anxiety about going places, worried that the weather was too cold, too windy, too rainy, and/or too snowy. Even places he enjoyed going were off limits because he had a fear of going out into the elements. While we were able to get him to necessary appointments, such as the doctor, he required quite a bit of convincing to get him out the door. Consequently, this was no time for starting something new, and the speech therapy referral sat in a file folder on my desk.

Fortunately, this summer, Alex seems to have conquered his fears of going places, and he has resumed the enjoyment of getting out and about in the community. Unfortunately, his appetite still has not resumed its former enjoyment of foods after nearly a year of being over the bout of thrush. A few weeks ago at an appointment with the nurse practitioner who oversees Alex’s medications, she asked us if his appetite was back to normal, and I had to tell her that his eating habits were still off but that he was managing to maintain his weight. At that point, I suddenly felt the sign I’d asked God to give me and knew that we needed to take him to the speech therapist.

When I spoke to the speech therapist on the phone, I was immediately struck by her warmth and kindness; in talking with her, I felt somehow as if I’d known her for years. She understood my concerns about Alex’s appetite and why we had waited nearly a year to make an appointment with her, due to his ongoing thrush and anxiety about going places. As she sympathetically listened, she also expressed a desire to help Alex, and we agreed to set up an appointment. However, she explained that she’d only recently started working in our local office and admitted that she didn’t know the phone number for me to call. After quickly checking, she relayed the number I needed to call to make an appointment and told me she was looking forward to seeing us. After talking with her, I was convinced we were doing the right thing to take Alex to her, and I now knew why I had waited for months to make the appointment: God had chosen her to work with Alex, and we had to wait until she was available.

A few days later, she called me again with some more questions about Alex, specifically about what kinds of things he likes to eat and what he can eat on his gluten-free and dairy-free diet. As she explained what she planned to do for his evaluation, she asked me to bring some foods that he can eat on his diet so that she could observe how he chews and swallows. Again, I was reassured by her friendly and kind nature, and appreciated her concerns that Alex be comfortable when he came to see her.

On the morning of the appointment, Alex seemed calm and eager to meet her, even getting up earlier than usual. As I filled out paperwork, he was happily reading the Forbes and Bloomberg finance magazines in the waiting room. (Clearly, God was reminding us that Alex belonged there!) When we met the speech therapist, she was just as pleasant in person as she was on the telephone, telling us how happy she was to meet us. Noticing Alex’s Chicago Cubs shirt, she excitedly told him how she’s a big Cubs fan, too; and his favorite player, Anthony Rizzo, is hers, as well. She even told him that her little boy’s middle name is Anthony, which made Alex smile. As they chatted, they also discovered they shared a love of shrimp and country singer Alan Jackson’s music. I think she was amazed by their similar tastes, saying aloud what I was thinking: “It was meant to be!”

As she examined Alex’s mouth and throat and observed him drinking, chewing, and swallowing, she did everything possible to make him feel comfortable and praising him all along the way. We were pleased that he was cooperative and answered her questions, and he responded to her warm personality, smiling throughout the appointment. In addition, we were relieved that she found nothing amiss with his ability to drink, chew, and swallow, and she believes that his food aversion is sensory in nature. She commented that the thrush made food taste bad to him, and he has continued negative associations with food. In addition, she told us that she had been thinking a lot about Alex ever since she and I had talked on the phone the first time and had trouble getting him off her mind. As a result, she had been doing research and trying to figure out the best ways to help him. Again, I felt that God had brought us to her specifically because she was clearly dedicated to helping Alex.

After describing her plan for helping Alex by gradually introducing new textures and flavors of foods, we felt confident that we had brought him to the right person. She asked Alex if he’d like to come see her once a week, and he replied without hesitation, “Yes!” which confirmed our belief that we had found someone who can help him. In addition, her schedule of availability on Mondays and Wednesdays matched ours, once again convincing me God intended specifically for her to work with Alex.

Although waiting to take Alex to the speech therapist may have seemed like procrastination on my part, I know that circumstances and my hesitation were directed by God whose plans are far better than mine. While I was waiting for the right time, God was behind the scenes, moving the right person into place who genuinely wants to help Alex get better. As we look forward to working with her, I truly believe that waiting for the right time and the right person was the right thing to do. Moreover, I believe that she will help Alex regain his appetite because God sent her to us. As Alex often says, “Wait and see!”

“Wait patiently for the Lord. Be brave and courageous. Yes, wait patiently for the Lord.” Psalm 27:14