Stuttering and Autism
Hello!
I am a graduate student in Speech-Language Pathology with an interest in serving children and adults with autism. I have several years of work experience with individuals with autism, and just last year worked with a particular kiddo with autism who also has a stutter. The SLP that provided therapy to this student had a difficult time addressing his stutter due to the complex deficits of autism. The SLP had a difficult time implementing stuttering therapy techniques due to problem behavior during therapy sessions. Additionally, these therapy sessions mainly targeted functional communication. In your extensive experience, have you ever provided successful stuttering therapy to an individual with autism? If so, what techniques did you find most effective? Thanks!
Hi,
What I have found clinically is that you need to do first is think about what motivates the problem behaviors in therapy. Is it difficulties with transitions, avoidance of an activity that is too hard, etc. If you find the root of this problem and can manage that behavior, then you can start to introduce the fluency strategies. When introducing strategies, you have to keep in mind the client’s cognitive style: are they higher functioning, where they can handle a cognitive explanation of strategies and rationale (either verbally or through a social story). Or do they need more visual cues or models to imitate rather than a cognitive explanation? I have found that once you start to get the client engaged in therapy and present the strategies in line with their learning style they can learn new strategies. For example, if it is someone who likes to monologue on a particular topic, I will use those monologues (rather than squelch them b/c people don’t want to hear them pragmatically…I leave enforcement of those pragmatic rules for other times when not working on fluency) as a speech context for working on strategies. This can get the client “hooked in” to start the work. If the student is only working on functional communication, then maybe you can present a model of using easier speech to say whatever it is they would say. If they are motivated to get a need met or a question answered with their functional communication, they may be just as motivated to follow your model and say it using a fluency strategy. You can introduce the rationale for using the strategy in a way that’s in line with their learning style and level of cognition…i.e., this helps words come out easier, or a more advanced explanation about changing timing and tension. Hope it helps.