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Speech Sound Development & First Sounds in Children with Autism Using ABA Techniques

Dr. Mary Barbera

As you may know, I’m an autism mom and Board Certified Behavior Analyst. I am also the author of The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders. As a Behavior Analyst, I know that any behavior (including speech sound development) can be increased using proven ABA strategies. In this week’s video blog, I’m going to discuss techniques I use when working with a child who is non-vocal or minimally vocal.

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Assessing Speech Sound Development

The first step to changing any behavior is to complete an assessment. Before working on getting a child to talk, we must first assess not just his language but we need to assess the whole child and the supports and services that are currently in place. We can’t just zone right in on the child’s language and only focus on assessing what speech sounds a child is currently saying.

We need to take a step back, take a look at their whole situation – including things like feeding. I have found that most children with autism who are not speaking by the age of 2 or 3 usually also have feeding issues. They might still be using a bottle or a pacifier or they might refuse mushy foods on utensils or be extremely picky. For example, if the child is still taking a bottle or drinking out of a spill-proof sippy cup, it may be reasonable to put in a plan to teach open cup and straw drinking as this may help with vocal speech.

Professional Help with Speech Sound Development

There’s also limited availability of Speech and Language Pathologists (SLPs). Especially SLPs with ABA knowledge or expertise. I believe children with autism, especially those without any vocal speech, really need a team of professionals helping them so the child can make the most progress possible.
I’m fortunate to have worked with several speech pathologists along the way and they have taught me a ton about how to get initial speech sounds and first words. I’ve also developed some interventions to help parents improve articulation and get their children talking a lot more with “pop-out” words. When I say pop-out words, I’m referring to a word here or there on their own terms.

How to Assess Speech Sounds

After the full assessment, you need to assess specifically the speech sounds or words the child can say. If your child or client is non-vocal or minimally vocal, it’s probably because you do not have echoic control. This is when I say “say ball” and if I had echoic control, the child would say “ball” with no ball present. We are going to assume that your child or client cannot echo sounds or words on command at this point.

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Speech Sound Development: Babbling

The next step is to assess whether the child is making any sounds, word approximations, or saying any words spontaneously. A lot of infants babble. They start babbling “ba ba ba ba” and “da da da da.” They might be babbling all these different speech sounds to get reinforcement. When the baby’s dad hears da da da da, the dad gets excited and starts reinforcing that da da da da. When the baby babbles “Baba” for a bottle, the child then may get the bottle. The same thing happens with “Ma ma ma ma”. This is the way language gets shaped up.
With our non-vocal children with autism, we have to ask the question, “Are they babbling at all?” Next assess if they have any word approximations, or “pop-out” words. They may not say much, but they have been heard to say different words throughout the day or maybe a couple of times a week? You need to be a little bit of a detective here. If the mom says, “My child does say some things here and there.” Okay, what are those things? Is it mama? Does he say hi? Bye-bye? Is it da da? Is it a movie?

Assessment Strategy: Make a List

Another strategy I came up with many years ago is to formulate a list of words that you have heard your child or client say. Sit and watch your child and record spontaneous babbling and word approximations. Take 15 minutes of data when they are engaged in playing Legos or something alone. Then take 15 minutes of data when you are swinging them or bouncing on a ball. And then another 15 minutes of where you are giving them little bits of reinforcement while saying words.

Speech Sound Development: Stimulus-Stimulus Pairing

Once we have our baseline assessment done, we want to use stimulus-stimulus pairing throughout our days to try to get the babbling up and to try to get word approximations and sounds up.
Now the term stimulus-stimulus pairing sounds really complicated but it’s not. It is basically saying a word 3x before delivering reinforcement. You want to sit with the child. I usually like to sit catty-corner. We want to hold the reinforcers to our mouth. Make the sound or word loudly and elongate if possible. So if we are having the child build a simple inset puzzle and we are holding a puzzle piece of a pig up, we say “pig, pig, pig” as we hand the child the puzzle piece.
With each pairing, we want to get the reinforcer a little closer and we don’t want to hold out. We want to deliver the reinforcer after a successful sound or after the third try, whichever comes first.
You also want to be pairing words all the time. So, if you’re going up the stairs instead of saying, “Johnny, let’s go up the stairs. Johnny is a good boy,” you just want to say, “Up, up, up.” And then take a couple of steps up.
In conclusion, we want to always assess the situation, assess the whole picture, and specifically focus on feeding and spontaneous babbling, speech sounds, and words. We then want to pair sounds and words with reinforcement throughout the day, both at table teaching sessions and within the natural environment.

I hope you found this video blog on speech sound development helpful. If you’d like this information in one handy place, download your cheat sheet here. And if you’re interested in learning more about turning autism around for your child or client, make sure to download my free 3-step guide today.

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