Speech-Language Pathology & Audiology

Practice Guidelines

Considerations for Clients with Autism Spectrum Disorders

The number of children diagnosed with an Autism Spectrum Disorder (ASD) has increased dramatically over the past ten years. As a result, speech-language pathologists (SLPs) are assessing many more clients with this diagnosis. Further, SLPs may evaluate individuals with ASD who have yet to be diagnosed, and the speech-language evaluation may be a critical component for that diagnosis.

To be effective, SLPs must be cognizant of the broad range of communication skills that individuals with ASD possess. For those clients with moderate to severe forms of ASD, the communication disorder will be apparent. However, for clients with mild to moderate ASD, the communication disorder may not be apparent without a thorough speech-language evaluation. For example, clients with mild to moderate autism or with a diagnosis of Asperger's syndrome often pass traditional language tests. However, their communication disability might be apparent when assessing other skills that are not easily identified through traditional tests, such as:

• Ability to develop appropriate peer relationships
• Nonverbal behaviors including eyegaze, physical positioning, and gestures
• Understanding of abstract language such as metaphors, irony, and sarcasm
• Ability to make inferences and associative links
• Ability to talk about a topic without providing significant background information when the listener indicates he/she already shares that background information (shared frame of reference)
• Ability to function relatively well in a quiet one-on-one setting, but have great difficulty in a noisy setting with significant visual stimulation

The SLP should ensure that assessment procedures are used that properly evaluate an individual who may have ASD. Procedures should include, but may not be limited to:

• parent/caregiver interview
• observations in individual and group settings
• dynamic assessment
• language sampling in a variety of contexts, environments, and over time
• traditional language and speech tests
• school- or work- related tasks

The use of a variety of assessment procedures is effective in ensuring that those communication delays found in clients with mild to moderate forms of ASD are identified. Only after such assessment takes place can appropriate treatment and referral decisions be made for clients with ASD.