What Does Speech Therapy (ST) Look Like for Autistic or High Support Kids?

Written By Sarah Lively

Speech and language therapy helps your child communicate more easily in daily life. It starts with a warm, play based assessment to learn how your child understands and shares ideas. We look at speech sounds, language, social connection, and how your child shows wants and needs. We also ask about your goals and routines. Guidance from the American Academy of Pediatrics supports early referral and early help. AAP

What sessions look like

Sessions feel like guided play. We join your child’s interests and build skills in small, clear steps. Many therapists use naturalistic developmental approaches where practice happens inside play and daily routines. Strong research shows these methods can strengthen language and social communication. PMC+1

Parent coaching

You are part of the team. We coach you on simple strategies to use at home and in the community. This helps progress carry over faster and stick. The CDC and AAP both encourage family participation in care. CDC+1

AAC is common and helpful

Some children benefit from augmentative and alternative communication such as pictures or a speech device. AAC does not stop speech. Reviews show AAC can support or even increase spoken words. Newer work also suggests pairing AAC with naturalistic teaching may boost gains for children with limited speech. PubMed+1

For kids with limited speech

Our SLPs will target joint attention, play, and first words with approaches that are neurodiverse affirming, like expanding on special interests and building upon current communication strengths. Sessions are mostly focused on pragmatic language therapy, or the USE of language, which would include increasing communication frequency and functions (not just requesting). Total Communication is often used so all forms of communication, like body movements, gestures, vocalizations, and AAC are accepted forms of communication deserving a response from a communication partner (attributing meaning strategy). Studies report improvements in early spoken language and social engagement. PMC

How progress is tracked

During our initial speech evaluation with your child we will evaluate their strengths, and areas of opportunity to set clear goals for a strong and effective Plan of Care. Our SLPs collect data and continually assess goals every session to adjust as your child’s communication skills grow. We document progress with a SOAP note which can be found here if you are a current client https://app.fusionwebclinic.com/portal/livelyspeechandlanguagetherapy. Re-evaluations are conducted at least once a year but progress towards goals over time can also be viewed in your child’s portal. 

Where to learn more

  • AAP overview of autism care and supports (practical guide for families). AAP

  • CDC treatment page for autism. CDC

  • ASHA Practice Portal on autism. ASHA

References (APA)
American Academy of Pediatrics. (2024, January 18). Considerations for prescribing and recommending common supports and services for children on the autism spectrum. https://www.aap.org AAP
American Speech Language Hearing Association. (n.d.). Autism and autism spectrum disorder [Practice Portal]. https://www.asha.org ASHA
Centers for Disease Control and Prevention. (2024, May 16). Treatment and intervention services for autism spectrum disorder. https://www.cdc.gov CDC
Pope, L., Gevarter, C., & Hancock, A. B. (2024). The effect of naturalistic developmental behavioral interventions with and without AAC on language in autism. Journal of Speech, Language, and Hearing Research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208088/ PMC
White, E. N., O’Shea, A. G., & Lamberth, J. (2021). Augmentative and alternative communication and speech development in children with autism spectrum disorders. Journal of Autism and Developmental Disorders. https://pubmed.ncbi.nlm.nih.gov/33511525/ PubMed
Kasari, C., et al. (2023). Spoken language outcomes in minimally verbal autistic preschoolers in early intervention. Journal of Child Psychology and Psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460274/ PMC
Note: These links are general resources. Your child’s plan should be individualized by a licensed SLP who knows your child.
Sarah Lively