Most people who hear the term "speech therapy" probably think of sessions that teach children how to pronounce letters they struggle with, or help them overcome a stuttering problem. Speech therapy can do that, of course, but the kind of work speech-language pathologists do is much broader.
What can speech-language pathologists do?
Everyone will probably know that speech therapists, officially called speech-language pathologists, can help people who struggle with things like:
- Articulation — this can include being unable to produce certain sounds and not speaking clearly.
- Stuttering — involuntarily repeating sounds or syllables.
- Voice — maybe sounding hoarse, not speaking loudly enough for people to understand, nasal talking, and so on.
Speech-language pathologists can also, however, play a role in helping people who have trouble swallowing or eating, who have lost their ability to speak after an injury or medical event, who have trouble "translating" the thoughts in their heads to words others can understand, and who who struggle to read and write.
Speech-language pathologists can even play a role in teaching how non-verbal communication — which is, after all, definitely part of all human languages — works, through, for instance, teaching about appropriate volumes, tone, and even gestures, how to know it's your turn to talk, or how close to stand to someone during a conversation. (This field is called pragmatics.)
Autism and speech-language pathology: What a speech therapist might do on the 'administrative side of things'
Speech-language pathologists are often part of the diagnostic team when someone is being assessed for autism — they can evaluate a person's verbal and non-verbal communication skills, both in terms of how well they understand what is said to them, and how well they can express themselves.
A speech-language pathologist also often communicates with the relatives of the person being assessed (often even if they're adults, since autism manifests during childhood and relatives will better be able to report what a person was like early in life than the person themselves). They can also help rule out other conditions, such as hearing loss.
If a diagnosis of autism is made, a speech-language pathologist can, as part of a wider team, make treatment or support recommendations.
What treatment might a speech-language pathologist offer to an autistic person?
Keep in mind that autism spectrum disorder can be diagnosed with or without language delays or impairments. Every autistic person is unique — according to some research, more so than people without autism.
Some autistic people are nonverbal or minimally verbal. (This doesn't mean they cannot communicate.) Others will have a vocabulary that far exceeds that of most people you meet on the street and use it with exceptional skill.
Some autistic people will have self-studied neurotypical body language and have learned to mimic it, while others find the unwritten rules of body language puzzling. Some autistic people speak unusually loudly or quietly, or are hard to understand. Many find it hard to know how to start and participate in conversations, especially ones with unpredictable elements.
The kind of assistance a speech-language pathologist can offer to an invidual will, then, vary (greatly) widely depending on the person's needs, but can include:
- For nonverbal people, getting them set up with AAC (augmentative and alternative communication) systems and teaching a person how to use these effectively. This can include sign language and picture cards, but also written communication and Stephen-Hawking-esque computer devices.
- Where needed, teaching relatives and caregivers of autistic children strategies for more effective communication, and advocating for autistic people in school and other educational settings.
- Improving a person's vocabulary and grammatical skills.
- Teaching conversational skills — which can include timing, what to say, practicing scripts, how to start conversations, and much more.
- Teaching intonation and volume skills — how to speak in a tone and volume that is considered socially appropriate.
- Teaching about body language and other non-verbal aspects of communication, such as facial expressions — both using them and interpreting them in others.
- Teaching about other aspects of communication autistic people often struggle with, such as metaphors, sarcasm and other kinds of jokes, and inferences.
They're often a small part of a wider team that may also include behavioral therapists, occupational therapists, physical therapists, and nutritionists, among others. A speech-language pathologists may also be the only medical professional an autistic person sees to work on improving the skills they want to target, especially during adulthood.