With so much information out there in recent years about autism I thought it would be beneficial to get back to the basics.
Much of the information in today’s news usually relates to causes, treatments, and statistics. I want to talk more about how autism affects speech and language and often eating in individuals who have an autism spectrum disorder.
While many of you reading this article are dealing with autism first hand, many of you are not and only know what you have read.
Autism and Language Skills
First let’s talk about language. Language can be divided into 2 main parts: expressive and receptive.
Expressive language is our ability to convey our thoughts into words with meaning. Basically our ability to talk. Receptive language is our understanding of what is being said to us. Both expressive and receptive language skills are necessary to be an effective communicator. When either is impaired our ability to communicate is impacted. Children on the autism spectrum will always have some sort of a language deficit depending on their actual diagnosis.
Very often expressive language is impacted to a greater degree than receptive language. This is the reason why augmentative communication with these children is so important. Augmentative communication is another means of communication which can involve pictures, picture boards or talking computers (communication devices).
One exception to this is found in children with Aspergers.
These children will usually have advanced language skills both expressive and receptive; however their pragmatic language skills are impacted to a degree which makes understanding the world around them difficult.
Pragmatic Language and Autism
All children on the autistic spectrum will have deficits in pragmatic language to some degree.
Pragmatic language refers to the social use of language. The ability to use the language skills you have to interact with the world around you.
These deficits may be subtle to an outside observer but can be profound to a child experiencing them.
Social skills deficits are very complex and they are usually mistreated and misunderstood. They are also a very emotional issue to all involved.
Imagine spending years watching your child struggle to learn to communicate and once he does you realize he still can’t use these skills to make friends.
Autism and Speech Skills
Another area that is not part of autism but quite often coexists is speech disorders.
Childhood Apraxia of Speech is a severe motor speech disorder that is believed by some to occur in higher percentage of children on the autistic spectrum than in the general population. This speech disorder makes it even more difficult for these children to learn to communicate. Therapy for a severe speech disorder should be intensive and is often not very exciting.
This being said children on the autism spectrum who have other behavioral challenges will have a harder time making progress than a child who does not have an autism spectrum disorder. Minor articulation errors such as lisps will often get overlooked as they are not priorities when looking at the child as a whole.
Autism and Eating
Eating is another area that is very often impacted with a child on the autistic spectrum.
While it is not a speech or language issue it is often treated by a speech language pathologist. It is one of my areas of specialty; so, I thought I would discuss it as well.
Children on the autistic spectrum often fall into the category of resistant or problem eaters.
The most important distinction between a picky eater and a resistant eater is severity. A child who is a resistant eater could put his life at risk by refusing to eat or drink when pushed in the wrong direction by well meaning parents or uninformed therapists.
There is a lot of information out there on picky eating and you will rarely read anything about a child starving himself if not treated properly. This is putting children’s lives at risk. While a typically developing child may not starve himself, a resistant eater might.
The Central Concern of Autism
If you are a parent of a child with autism or a professional working with these children I am sure you realize the importance of getting the right and the best speech language pathologist you can find.
While these children definitely have other significant issues that need to be addressed by other experts, we can all agree that communication is the central concern in autism spectrum disorders.
I have worked with hundreds of children on the autistic spectrum over the years and as a whole they are the most challenging to work with but in turn are the most rewarding.
{ 16 comments… read them below or add one }
Friends and professionals alike have told me to only give my child (picky eater with autism) food options that are healthy and provide variety assuring me that when he is hungry enough he will eat. I have often thought that he would rather starve than eat anything other than a starch. I have pushed him as many as two or three meals and he would never ever even try, no, not even touch any of the other foods offered. So it is good to hear your validation that children may be harmed by such ideas of forcing a change in diet. I have tried lots of things but have given up and I just want him to eat.
Hi Wren,
I am glad you found my blog before following advice that could have harmed your child. To know for sure how to best deal with your son’s feeding issues you should seek professional guidance. It angers me that it is rarely mentioned that some children will starve themselves when preferred foods are withheld.
Good luck, Isa
Is it possible to have autism and never learn to speak? I have an uncle who does not speak and we think it’s autism. He is in his 40s and when he was growing up, no doctors could diagnose his condition b/c the lack of understanding back then of these conditions.
Yes, some individuals with Autism never develop language. Does he have any other special needs other than his lack of speech?
My son was diagnosed as PDD-NOS at age three. He never transitioned to table food as a baby. We went through two different feeding therapy programs, one at age 2 and one at 4, at highly regarded hospitals. He is now 10 and he has not progressed at all. He only eats 3 foods. Should we try another program now that he is older? It has now become a social problem. He is “normal” in every other way. This is the one thing that makes him stand out with his peers.
Hi Lisa,
I would definitely recommend trying another therapist. Especially if it is negatively impacting all of your lives.
Thank you for your question.
Good luck, Isa
Hi Isa,
I have a 9yr old granddaughter who was just diagnosed with aspergers sydrome. I had her eval when she was 31/2 for sensory int disorder, and she did have it. It was affecting all of her senses. She has outgrown/overcome most of her sensory issues except, her eating. This is a big issues. She only eats certain foods. Hot dogs, chicken nuggets, french fries, bacon, waffles, toast, pancakes, dry cereal, pop tarts and popcorn. No fruits or veggies ever. She drinks orange juice, milk, V8 fusion and fruitables, all good juices. She does not eat sweets, only some ice cream. Also she will eat some yogurts. Should we be worried? Should we be taking her to a food therapist? I am so worried about her not getting the proper vitamins. She will not take vitamins.
Looking forward to hearing from you.
It’s great to hear your Granddaughter is doing so well in so many ways. It would be beneficial to see someone who specializes in feeding issues and help her expand her diet. It could be a long road however there is hope for positive change.
Hi. My child is 28 months and is on the spectrum. He only eats dry cereal and drinks milk throughout the day. I hear from many sources that gluten and casein should be eliminated. These are the only sources of his diet. He refuses to eat or even taste anything else aside from the occasional vanilla wafer cookies. Should I try eliminating gluten and casein for the sake of his symptoms improving? Thanks for your help.
There are many different diets out there; so I would not recommend trying the Gluten Free Casein free diet on your child without guidance from a knowledgeable nutritionist. This is especially true given the fact that he has such a limited diet. You want to make sure you are doing what he needs first.
Hi Isa,
Thank you for your response on my granddaughter’s feeding issue. You stated she should be seeing someone who specializes in feeding issues . Can you explain what type of person specilizes in this?
Thank You
Hi June,
You would need to look for a Speech Language Pathologist or an Occupational Therapist with an expertise in feeding. They can often be found in hospital based centers.
Hi Isa
My son is 2 and the doctour said today he may have autism cause he is not puting a bunch of words together can autism just affect his speech?
He is a smart kid he can feed his 2 mouth old brother and holds him when he crys he does all the other normal stuf a 2 year old would do just not putting words together I thank you for all your help
Autism would impact much more than speech and language development. It would impact social skills and behavior as well. Most often doctors use assessment tools to determine if a child should be diagnosed with Autism . I recommend asking your doctor what he sees in your son that would lead him to believe that he has Autism.
Hi Isa,
(From Portugal, I’m sorry if my english is not the best)
I a 4 years old boy (just made) with an ASD (high functioning/ Asperger’s like). He talks to tell us everything he wants and sees, he plays with dolls taking care of them – he feeds them and changes diapers, he dances and sings, and likes to have attention of others. He started to talk about 33 months old; but still has some limitation in use of language. No major motor limitation (he rides bike with little wheel), no visual imparment (he tells almost all colours), no hearing imparment.
He is on ABA (40 h/w) and on DAN diet.
As I know there is no “feeding specialist” in my country.
My biggest concern about him right now is food. I believe he is a resistant eater. My paediatric also said “I’ve never seen a child starving to death, he will eat”.
He eats soap (rice, meat or fish and a sample of vegetables – brocolis, green beans, carrots, peas, but all smashed), smashed fruit, juices (orange, pear, various fruits), and the only solid food he eats is one sort of cookies. I also have some limitation on introduction of food cause he’s diet is no gluten, no caseín, no soja end low on oxalats. He improved a lot on this diet.
When he eats cookies he seems to think how to eat, where he can put the food. He also have trouble while swallowing since he was a baby. He coughs a lot and sometimes even vomits.
I need help to try to help him. Can you help me? Do you know anyone in Portugal / Spain/ Europe that could help us?
Socially we try not to be affected by this. We go out, we encourage him a lot when he eats cookies well.
And we try not to take care about others (even family).
We have already too much to take care of as we also have another boy with 17 months.
Kiss
Rosario
Hi Rosario,
I am sorry to hear about the feeding difficulties you are having with your son. An ABA therapist should be able to help with any behavioral issues around feeding and I would encourage you to speak with the therapist. In regards to the difficulty swallowing I do not have any recommendations for a therapist in your part of the world. It would be beneficial for your son to have a modified barium swallow study which would most likely be conducted in a hospital. I would suggest calling the local hospitals and speaking with them regarding this assessment. They may also know a feeding therapist to refer you to.
Good luck, Isa