Speech & Language Evaluation

Why is a speech and language evaluation an important part of an Autism Spectrum Disorder evaluation?

  • By definition, Autism, or Autism Spectrum Disorder (ASD), is a developmental disability that is complex in nature and encompasses a broad range of symptoms that affects a person’s verbal and non-verbal communication, as well as social skills and social interactions. Verbal communication difficulties, non-verbal communication difficulties, and social interaction difficulties may be evident in the processes of hearing, language, and/or speech. A comprehensive speech and language evaluation will assess these very areas. The Speech Language Pathologist is trained to differentiate difficulties in these areas and determine whether the difficulties are due to ASD, Social Communication Disorder, or Receptive and/or Expressive Language Disorder. It should be noted that if a hearing deficit is in question, a referral to an audiologist will be warranted.

What does a speech and language evaluation include?

A speech and language evaluation through TAAAG will include assessment in the areas of speech, receptive and expressive language, and pragmatic language.

Speech:

  • Articulation - production and intelligibility of speech sounds
  • Fluency - flow of speech production
  • Voice - vocal quality, pitch, volume, and resonance during the production of speech

Receptive and Language:

  • Forms of language - understanding and appropriate use of phonology, morphology, and syntax
  • Content of language - understanding and appropriate use of semantics

Pragmatic Language:

  • Understanding and functional use of the above listed components of language formulated into the understanding and use of socially appropriate communication. This can include (but is not limited to) the appropriate understanding and use of gestures, facial expressions, eye contact, joint attention, initiation and maintenance of conversation, and following the social rules of conversation.

Refer to www.asha.org/policy/RP1993-00208/ for further explanation.

What is a Social Communication Disorder?

The American Speech Language and Hearing Association (ASHA) states that a Social communication disorder is characterized by difficulties with the use of verbal and nonverbal language for social purposes. Primary difficulties are in social interaction, social cognition, and pragmatics. Specific deficits are evident in the individual’s ability to:

  • communicate for social purposes in ways that are appropriate for the particular social context;
  • change communication to match the context or needs of the listener;
  • follow rules for conversation and storytelling;
  • understand nonliterate or ambiguous language; and
  • understand what is not explicitly stated.

This definition is consistent with the diagnostic criteria for Social (Pragmatic) Communication Disorder detailed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; American Psychiatric Association [APA], 2013).

Social communication disorder can result in far-reaching problems, including difficulty participating in social settings, developing peer relationships, achieving academic success, and performing successfully on the job.

Social communication disorders may be a distinct diagnosis or may co-occur with other conditions, such as:

  • intellectual disability
  • developmental disabilities
  • learning disabilities
  • spoken language disorders
  • written language disorders
  • attention-deficit/hyperactivity disorder (ADHD)
  • traumatic brain injury (pediatric and adult)
  • aphasia
  • dementia
  • right-hemisphere damage

In the case of autism spectrum disorder (ASD), social communication problems are a defining feature, along with restricted, repetitive patterns of behavior. Therefore, social communication disorder cannot be diagnosed in conjunction with ASD.

Source:
https://www.asha.org/Practice-Portal/Clinical-Topics/Social-Communication-Disorder/


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