Some children diagnosed with Autism Spectrum Disorder (ASD) tend to have difficulties producing sounds. This makes the process of learning language much longer than is typically expected. With those children, the typical strategies used to get speech production going don't work and we need to try other strategies.
Typically we either look at teaching some simple signs taken from American Sign Language (ASL) or use an Augmentative and Alternative Communication (AAC) device. The verdict is still out as to which method is better (or if either one of them is helpful at all). But what you should keep in mind is that these techniques are halfway steps and that the ultimate goal is to have your child communicate with you vocally.
Once we do have a consistent system of basic communication in place (ASL or AAC or some hybrid of both), we need to look to see how we will use this to assist in the production of various sounds. I'm going to review a strategy that we've found to be helpful
Stimulus-Stimulus Pairing (SSP)
SSP is a process where we pair sounds with things that are highly preferred by your child. Put simply, we will be making sounds while delivering (or doing) some of the most awesome things that your child has ever seen, heard, or experienced. It helps if the sound that is delivered is related to the activity itself, but it doesn't necessarily have to.
Here's an example of a program that we implemented with an 4-year-old child with ASD who was not vocalizing. Let's call him Andrew. He loved bubbles (but then again, who doesn't?) so we used that as our starting point:
You might ask when did we did do this? During our breaks from some of the more intensive ABA work. We also had Andrew's parents join in the fun and work with us on this as well. The sound /b/ was not the only phoneme we worked on - we also worked on /m/ (and paired it with milk, which he loved)
At no point did we ever require that Andrew do anything besides orient his head towards us. Sometimes he got a little squiggly and we needed to move our face to match his, or, at least speak the sounds softly into his ear.
Some people might refer to this as another example of reinforcement, but it really isn't. When we use the word "reinforcement" we are suggesting that some sort of an exchange or transaction has occurred - the child performed some sort of motion and he earned the reinforcer (it doesn't even need to be an intense action).
What we are doing when we implement a SSP procedure is basically pairing the sound which is neutral (Andrew really didn't have any strong positive or negative feelings about the sound) with something that is highly preferred. The association, over time helps the neutral stimulus (the sound) become positively associated.
Where did the idea of SSP come from anyways? Well, SSP is based on a behavioral model of development of how babies learn. Early on, babies learn that producing and listening to speech sounds as well as producing sounds is awesome because they are usually paired with other amazing experiences. Let's look at an example of what the infant is probably thinking (FULL DISCLOSURE - This is all hypothetical - I am not a psychic):
In these situations, the baby is made to feel great while sounds are produced by the adults around her/him. Infants with ASD sometimes have difficulties making these connections and we need to work even harder on developing them as strongly as possible. Think of SSP as a way to continue this work.
Oh, and back to Andrew - within about a week and a half we got him to consistently say buh-buh throughout the day!!!
When implementing this strategy, it's a good idea to consult with your child's child's speech pathologist. You want to support what they are doing in therapy, by working on those sounds that they're working on. Then, start to think about what objects or activities might fall into that "highly preferred" category. For example, with Andrew, we could have also bounced him on the bed and repeated the word "bounce" over and over again. But, Andrew wasn't really didn't like bouncing on furniture, so we didn't go that way.
There are a lot of ways to teach kids to vocalize, and SSP is just one of them. Let me know if this works for you or if there are other ways that you prefer!
This blog is curated by Dr. Livanis, our Supervising Behavior Analyst and Chief Psychologist