Welcome to the speech and language page about autism. 

Here you will find information about:

• What is autism?

  What is autism?

  Autism is a lifelong developmental disability that affects people in the following areas:

  • Communicating and interacting with other people.
  • Flexibility in thinking and behaviour.

  Autistic people (people who have autism), including children and young people, may also:

  • Find it hard to understand how other people think or feel – and people who are not autistic may find it hard to understand how autistic people think or feel.
  • Repeatedly do, say or think the same actions or words.
  • Find certain sensations, such as loud noises, the feel of particular textures, or bright lights, overwhelming, stressful or uncomfortable.
  • Become anxious or upset about unfamiliar situations.
  • Take longer to understand information.

  Autism is a neurodevelopmental condition – this means it is a difference in the way a person’s brain works and develops.

  This is a diagram of the different areas in which autistic children and young people may show differences to children and young people who are not autistic:

  

  Autism is different for everyone

  • All autistic children and young people are different.
  • Autism is a spectrum condition. This means that different autistic people demonstrate the characteristics of autism in different ways and to different degrees.

  Positives of autism

  • As well as facing challenges, autistic children and young people demonstrate a number of strengths. For example, autistic people are often able to think about the world in a different way, and some autistic people become experts in subjects or hobbies for which they have a passionate interest.
  • Like all children and young people, autistic children and young people will also have their own talents, gifts, passions, people who are important to them, and things in which they find happiness, fulfilment and wellbeing.

  Causes of autism

  • The cause of autism is not known.
  • Autism is not caused by:
    • Vaccines, such as the MMR (measles, mumps and rubella) vaccine.
    • Parenting.
    • Emotional deprivation.
    • Diet.
    • An infection that can be spread between people.
  • Some evidence indicates that autism is caused by a variety of factors that affect the development of the brain, including some genetic factors (genes or combinations of genes that run in families).

  Atypical autism

  Some autistic traits that can often go unnoticed and not typically associated with the ‘male’ autistic stereotype:

  • Females demonstrate a strong ability of ‘masking’, which might appear as laughing along with others even though they didn’t understand the joke or mimicking body language and conversation styles in a bid to fit in.
  • Social deficits which are described as ‘shyness’ when the child avoids social interaction and has difficulty understanding the social cues
  • Special interests in areas deemed ‘acceptable’, despite being more intensified then their peers, and more likely to go unnoticed.
  • Tendency to appear as ‘passive’ and go along with their peers due to difficulties fitting in
  • May hold in anxiety through the day that’s released when they get home, often as a ‘meltdown’ or exhaustion
  • Difficulty understanding and labelling their emotions
  • Aversion and distress at sudden changes in routine
  • Avoids larger social gatherings, busy environments or reports feeling unwell when visiting places which are more visually and audibly stimulating.

• Did you know?

  Did you know?

  • One in 100 people is on the autism spectrum.
  • There are around 700, 000 autistic people in the UK (ref. National Autistic Society)
  • Famous autistic people include climate activist Greta Thunberg, TV presenter Chris Packham and the actors Anthony Hopkins, Dan Ackroyd and Daryl Hannah.

  • Sometimes there can be quite a fixed idea of how an autistic person will behave. In reality, autistic people are as diverse as the rest of the population, and you wouldn’t necessarily know from talking to someone that he or she is autistic.
  • Various studies suggest that an autism diagnosis is on a scale of 3:1 for males and females, with the outcome being that many autistic features for females are noted instead as ‘anxiety’ due to the strong gender stereotypes.

• The role of speech and language therapist in assessing and diagnosing autism

  The role of speech and language therapist in assessing and diagnosing autism

  Some speech and language therapists (SLT) work as part of a multi-disciplinary team with paediatricians and other professionals in assessing, diagnosing and supporting autistic children and young people. These SLTs are specifically trained in assessing the following areas that will support the diagnosis of autism:

  • Social communication
  • Social interaction
  • Play, imagination and flexibility of thought (e.g. difficulty with coping in sudden changes in routine or seeing things from other people’s point of view)
  • Restricted and repetitive patterns of behaviours or interests

  Please see our jargon buster page for more information about the above areas.

  The SLT with specialist or highly specialist knowledge of autism may use one or more of the following methods and/or tools to contribute towards your child’s overall autism assessment: 

  

  • Observing your child in their most appropriate setting (e.g. at their home or in nursery or
     school). The SLT will observe the above areas. If specific speech and/or language needs are identified, then a referral to the community SLT service will be discussed with you. Further assessment and advice will be provided by your community SLT.
  • Administering Autism Diagnostic Observation Schedule (ADOS) Second Edition (ADOS-2) or Brief Observation of Symptoms of Autism (BOSA) assessment. This would usually take place in clinic with your child individually or as part of a joint assessment clinic with a paediatrician. Please see section Positives of Neuro-Diversities, Lived Experiences more information about the different types of assessments.

  Once all the information has been gathered the paediatrician will offer you an appointment to discuss the outcome of the assessments and the next steps. The SLT may also be present during this appointment.

• Play

  Play

  Play is a very important part of a child’s development. It helps them to develop many skills including:

  • Understanding and using words
  • Imagination and problem solving
  • Shifting attention between, for example, the adult and the toy they’re playing with
  • Physical and social skills (for example turn taking)
  • Exploring how things work

  The different stages of play

  • Exploratory play: exploring the toys using senses such as how it feels, sounds, looks and moves
  • Functional play: playing with toys in their intended way (for example, pushing the train on the train track)
  • Pretend play: using real objects (for example, feeding dolly with a spoon)
  • Pretend play : either feeding dolly with an invisible spoon, or using another object instead of the spoon)
  • Role play: pretending to be someone else and acting out a story
  • Rule based play such as board games

  Autism and play

  Autistic children may play differently for example:

  • Playing repetitively (doing the same thing over and over)
  • Having restricted interests (playing with a very small range of toys)
  • Using toys in unexpected ways, such as spinning the wheels on the car instead of pushing it along, or tearing up paper instead of drawing on it
  • Playing with objects not intended to be toys such as stones or feathers

  Children may play alone or on their own terms, and can find it difficult to allow others to join in with their play. Some children don’t play with toys or objects at all and prefer physical play, such as running, jumping, climbing or spinning.

  If children do any of these things, it doesn’t mean they are playing in the ‘wrong’ way, just that they have different play interests. Adults can support their child’s play by following the advice below:

  Try out different types of toys and play to see what your child enjoys. For example:

  • Cause and effect (pop up or wind-up toys)
  • Water, sand or playdough
  • Shape sorters or puzzles
  • Construction toys (bricks or Lego)
  • Pretend play (doll/ teddy, small world)
  • Rule based games such as board games

  

  
  
  

• Top tips on supporting autistic children and young people

  Strategies for developing and supporting interaction

  • Face to face- going down to your child’s level. This will help you to see what your child is interested in and lets them know they have your attention.
  • Follow the child’s lead- take a moment to look at how your child is playing and then follow their lead, avoid directing or changing their play.
  • Including their interests – you will know your child’s preferred toys and activities and can have those at the centre of the play and interaction.
    • Interpreting your child’s actions - Talk about what your child can see and what they are doing. Keep your language simple, matching it to the level of your child. Respond by interpreting their signals for example, a reach or a point may mean they want more, leading you by the hand may mean they want you to follow.
    • Respond to all types of communication for example, verbal and non-verbal communication, for example; reaching, pointing, using gestures, looking, vocalising, and using words.
  • Copying and turn-taking – When your child makes a sound or action you copy with the same sound or action, this is a great foundation to start an interaction. Take several turns just copying your child and once you have an interaction going you can try adding a new sound or action and leave a pause to allow your child the chance to copy you.
  • Be playful -It’s best to play like the child first and then add one simple play action. Remember that toys can be used in a variety of playful ways (for example, if they like throwing balls, you could bring a bucket and see if they can throw it in there. If your child starts to line up cars, you can use another car to crash into one of the cars). Remember to have fun and be playful, this includes using fun words and intonation (wow! Ooooo! Pop!)
  • People games - People games are games that the child needs another person (for example, playing chase, peekaboo, tickles, splashing with water in the sink)
    • To begin with interactions are easier when there are no toys or objects as it puts less demand on the child shifting their attention between you and the object.
    • When playing it is important to make sure you pause, waiting for your child to send a message to you by making a sound, or an action, to continue with the game. Your child will learn that those looks, sounds or actions have an impact and this will encourage them to interact more.

  Strategies for developing and supporting communication

  • Creating opportunities – placing motivating items just out of reach, so your child can see them but can’t reach them by themselves. Wait for your child to request that they want the item (for example, favourite foods or toys).
  • You can also put your child’s favourite toys or foods in containers that are difficult to open, when you respond to your child you can model ‘open’, ‘help’ or ‘more’.
  • Give items or food bit by bit and then wait for your child to communicate that they want more (for example, instead of providing an entire packet of crisps, place some into a bowl and allow them to request more).
  • Building anticipation - Joining in with and adding something new or exciting to your child’s play will support the growth of their attention skills alongside using an animated face and voice or “ready, steady… go” games such as blowing bubbles
  • Offer choices - Show your child a choice of two items of food or toys for example, “Do you want apple or banana?”, give them the one they reach for, naming it for them. Getting the item they want and hearing the word for it as they do so is a powerful way of supporting their communication development.
  • Encourage spontaneous communication by doing something unexpected (for example, giving a fork instead of a spoon to eat their yoghurt) then wait for your child to say something, if they don’t model the language they would use if they could (for example, no mummy, spoon please).
  • Commenting and extending – when modelling language to your child add another word to what your child has said (for example, child says “car” adult could model “fast car”, “blue car”, “driving the car”).

  Visual support

  • Use and encourage pointing, gestures and signing alongside spoken language to support understanding, encourage interactions and use of language.
  • Show objects as you talk about them, and as a means of showing children what will happen next (for example, show a plate to show it is dinner time or shoes to show it is time to go out).
  • Visuals can include:

  • Objects of Reference(for example, plate for meal, shoes for going out)
  • Photos or pictures
  • Now and Next and/or visual time lines
  • Draw the upcoming activity or routine
  • Show a picture of the upcoming activity or routine on your phone

  

  Strategies for supporting school-aged children and young people

  Supporting children and young people with social skills is all about working out which strategies are helpful for them – not every strategy will work for every child or young person, but there are lots of useful strategies you can try. Professionals who work with your child may also recommend specific strategies for your child or young person. Here is some information about strategies that may be helpful for your child or young person:

  • To support children and young people with social skills and social communication, we need to make sure that communication is:
    • Meaningful and desirable – for example, using motivating materials and activities, including your child’s interests, and making it fun, adjusting the group size to allow successful interaction, using a visual grid to help your child ask and pay for something in a shop, or using a chart to help your child play or speak to a range of different children in the playground.
    • Predictable:
      • Visual support (support that involves anything you can see) – for example, pictures, photos, diagrams, props, written words, checklists, visual timetables, calendars) is often particularly helpful for children and young people with autism or social communication difficulties. Visual support will also help with the following:
        • Supporting transitions between activities and routines.
        • Steps within the activity.
        • Managing changes in routines.
      • Interpersonal support (support between people) – for example: adults using language that is well matched to the level of the child or young person’s language, supporting children and young people to interact with each other.
  • Comic strip conversations:
    • Comic strip conversations involve drawing a comic strip to show what happened during an event or situation. You can use different colours for different feelings, ‘speech bubbles’ and ‘thought bubbles’. This may help children and young people to understand their own emotions and support them to see other people’s point of view.
    • Makes the abstract more concrete, especially understanding what others are thinking and how this relates to what they say.

  

  • Social stories:
    • Social stories were developed by Carol Gray, a teacher with several decades of experience working with children and young people with autism and social communication difficulties.
    • Social stories help children and young people to understand what to expect or do in a particular situation.
    • They use pictures and words that are matched to the level of a child or young person’s language.
    • They give specific information from the child or young person’s point of view.
  • The National Autistic Society website has more information about comic strip conversations and social stories:
    www.autism.org.uk/advice-and-guidance/topics/communication/communication-tools/social-stories-and-comic-strip-coversations
    
  • The Zones of Regulation:

    The Zones of Regulation may be helpful in supporting children and young people in understanding, expressing and regulating their emotions:  
    https://www.zonesofregulation.com/

  Further information

  Click on the link for detailed information about Autism, assessments and post diagnostic support.