toddler speech therapy

Early Signs of Autism: A Different Perspective

I am thrilled to feature this guest post by Megan Myatt, M.S., CCC-SLP, speech-language pathologist and owner of a speech-language pathologist and owner of Growing Together: Speech-Language Therapy. She provides speech-language evaluations and therapeutic supports for young children and their families in Carroll County, Maryland. www.growtogetherslp.com

In honor of Autism Acceptance Month, and in anticipation of Better Language and Communication Month, I’d like to talk about the benefits of early identification (and resulting therapeutic supports) of autism. But first, let’s go over a few definitions...

What is autism? 

The DSM-5 defines autism as “persistent deficits in social communication and social interaction” paired with “restricted, repetitive patterns of behavior, interests, or activities” that cannot be better explained by other disorders/disabilities (e.g., intellectual disability).  

While this definition provides specific insight into the social and behavioral presentation of autism, I find it to be somewhat negative. It implies that autistic individuals have “deficits” or “atypical behaviors,” when really, they’re just wired differently. 

Over the years, I’ve noticed that some parents (definitely not all) avoid early identification, or quickly seek to change their child’s “deficits,” in fear of what they perceive autism to be. 

As a parent of an autistic child, I completely understand this fear. Our society has long supported the notion that autism is a bad thing. The media presents only the best and worst parts of autism. Parents want the best for their children- whether that be love, acceptance, happiness, you name it, and autism may be viewed as a barrier to those experiences. 

So let’s talk about another definition: 

What is ableism? 

Ableism is defined as the “discrimination and social prejudice against people with disabilities and/or people who are perceived to be disabled. Ableism characterizes people who are defined by their disabilities as inferior to the non-disabled.”

The diagnostic criteria for autism is clearly written from an ableist perspective. And it’s time to shift our language and views to celebrate and embrace the differences that autistic individuals have to offer. This change is not going to happen overnight, but I believe it starts with the early identification/diagnostic process. 

I propose the idea of using different, strengths-based language to talk about autism. Limiting words like “deficits,” “impairments,” “atypical,” or “odd.” As professionals and/or parents, we can still acknowledge our child’s social, communication, and behavioral challenges, and leave out the ableist terminology. 

So- back to the main topic: are you concerned about your child’s development? Do you notice differences in their communication, social interaction, play, and behavior? Here are some early characteristics or traits of autism (Please note- this is not an all-inclusive list, and not all traits are necessary for an autism diagnosis): 

  • Differences in language and communication

    • May demonstrate challenges with verbal communication (e.g., may not use words, or may repeat phrases)

    • May prefers physical communication (e.g., pulling/guiding)

    • May use fewer communicative gestures (e.g., pointing)

    • May not always respond to their name

  • Differences in social communication

  • May prefer to be the leader in their own play (i.e., may play next to other children rather than with them)

  • May show differences in social reciprocity (e.g., may not understand the social expectation of responding to hello/goodbye)

  • May demonstrate differences in gaze/eye contact and facial expressions (e.g., may not give everyone eye contact)

  • May not show and share interests as expected (e.g., pointing out interesting toys, sharing objects for play)

  • Differences in play and behavior

  • May find different ways to play/use objects (e.g., aligning toys)

  • May be detail-oriented (e.g., notices blemishes on preferred toys)

  • May prefer repetition and routine

  • May demonstrate special interests in certain topics or objects 

  • May have different sensory experiences (e.g., sensitive to lights or loud noises) 

  • May express emotions in physical ways (e.g., flapping hands)

So, what’s the benefit of early identification/diagnosis?

Early identification leads to early intervention, which can provide your child with the opportunity to build engagement and connections with others, grow their communication skills to advocate for their wants, needs, and interests, and begin to learn how to regulate their emotions and sensory experiences in this world. 

It also provides answers- for parents, families, etc. Early identification may lead to a greater understanding of autism- helping parents to understand their child, communicate with them, understand their behaviors and meet their sensory/emotional needs, and connect on a deeper level.  

The risk of “wait and see” and/or the fear of diagnosis plays into the ableist perspective. It may also prolong communication challenges for autistic children- particularly in a world that wasn’t designed for them (at present time). Autism does not have to be negative, and it does not need to be “fixed.” Early interventionists can identify and foster your child’s strengths, and support your family in meaningful ways. 

If you’ve noticed any of the above signs/traits of autism, reach out to your local early intervention program or related professionals. And remember, acceptance starts with you. Neurodiversity is beautiful. 

Realistic Screen Time Recommendations

Cellphones, iPads, TVs, and computers are all around us these days. They are integrated into our every day lives in a way that many couldn’t have even imagined 20 years ago! Screen time is a hot topic that I’m often asked about, and is associated with a lot of parent guilt; is it REALLY that bad? How can we work it into our day? Here are my go-to tips surrounding screen time.

The “official” recommendation: The American Academy of Pediatrics recommends 0 screen time for children under 18 months with the exception of interactive video calls, limiting to only educational programming with a parent 18 months - 24 months, and limiting screen time to 1 hour on week days, 3 hours on weekend days for children 2-5.

The “why”: Research shows that increased screen time is correlated with expressive language delays; here’s some data:

  • A study from the Hospital for Sick Children in Canada followed almost 900 young children between six months and two years of age [2]. They found that the toddlers who were exposed to more handheld screen time were more likely to have delayed expressive language skills (i.e., the child’s ability to say words and sentences was delayed). They also found that for every 30-minute increase in daily handheld screen time, there was a 49% increased risk of expressive language delay.

  • Another study surveyed over 1,000 parents of children under the age of two. They found that toddlers who watched more videos said fewer words. For each additional hour of videos that eight- to 16-month-old infants watched in a day, they said an average of six to eight fewer words.

  • Additional problems associated with screen time: Sleep problems, academic difficulties, weight problems, mood problems, poor self-image and body image issues

How to plug in: We know that the AAP’s recommendation is a lofty goal in realistic parenting. While it’s good to always aim for minimal screen time, (this is especially true if your child is already presenting with a language delay,) not all screen time is created equal. A goal here can be “joint media engagement,” meaning that you interact with your child around screens just like you would interact with your child around any kind of media (books, arts and crafts, etc). When you read a book, you point to pictures and label. Try the same for on-screen visuals! When you paint, you talk about the colors, actions and show what you’ve made. Talk about actions in apps or in shows, and carry over concepts into real-life activities (e.g., Daniel Tiger pretends to be a doctor, you play doctor!) Opt for video calls with family, open-ended apps (“choose your own adventure,” “fill in the blanks,” etc.) and TV shows that allow for fill-ins and movement opportunities (think, “you try it!”). The biggest factor that makes screen time more beneficial for your child is parent involvement. If you can watch a show with your child, add comments as you’re watching! “The boy is running! He’s so fast!” “They’re dancing! Let’s dance, too.”

The Take Away: Always aim for minimal screen time. We know that children learn best through every day interactions and traditional play, so that should always be the focus! That being said, all screen time is not created equal. An episode of educational programming here and there is not likely to harm your child, and there’s no need to feel guilty for allowing it! Join in whenever possible to add language models, interaction opportunities, and movement breaks to make screen time more beneficial, and choose your content carefully.

Jackie Anderson, MS CCC-SLP is the owner of Ascend Speech Therapy, LLC, and a licensed speech-language pathologist. Jackie provides in-home speech therapy services in Ocean County, New Jersey and Monmouth County, New Jersey, and offers teletherapy for all of New Jersey and Maryland.

Book-Linked Play: The Why and The How!

Before we get started… Ascend Speech Therapy has moved! We are thrilled to be offering services in Ocean County, New Jersey and Monmouth County, New Jersey. We will continue to offer teletherapy to all of Maryland and New Jersey area! Now, let’s get to it!

It is well known that reading to your children from birth (and even before!) can help to develop early literacy and language skills. Adding in toys that match characters or objects within your book is a great way to take the language concepts from the story and bring it to life! Allowing your child to have this multi-sensory experience while hearing the vocabulary that matched what they are experiencing is a perfect recipe for language learning and generalization (taking a skill from one context, and applying it in another!) It’s also an excellent way to model and practice pretend play, another big player in language learning and development!

You’d be surprised at how many items you have around the house already that will be helpful to use when reading a book! For example, if you’re reading a book with a Lion, look around for a lion toy or figurine. If you’re reading a book about fruit, grab a real apple or a toy apple! As you read each page, model the words and actions from the book with your toy (“the lion is jumping! jump, jump, jump!” “the lion is sleeping, shhh!” “He is eating the apple!” ) Remember to keep your language concrete (“jump, jump, jump!” vs. “honey, look over here at the lion jumping so high!”) Encourage your child to play along, and enjoy this new twist to your story time!

Jackie Anderson, MS CCC-SLP is a certified speech-language pathologist, and owner of Ascend Speech Therapy, LLC.
Ascend Speech Therapy offers in-home and community based pediatric speech therapy and evaluations in Ocean County, NJ and Monmouth County, NJ,
in addition to teletherapy services for all of New Jersey and Maryland.