Understand the difference between speech and language: This is a major distinction that could make a significant impact on the way you write your treatment plans, consult with a clinical team and provide supervision. The importance of this distinction could be compared to a mechanic working on a car or a surgeon working on a body. It is kind of important for them to know which part needs work and what work needs to be done. Right? If not, you might be attempting to fix the breaks when you need a new tire or operating on a toe when the person needs heart surgery. All too often I have seen this scenario in ABA programs and it’s kind of a big deal.
•Consider speech disorders: It is common for BCBAs and children with autism to struggle with verbal programs. A child might fly through a receptive language program for identifying common objects like ball or cup. But when you start working on imitating sounds or labeling objects, the behaviors go through the roof. In my experience, professionals tend to think this is related to motivation. One might think that increasing reinforcement during these programs could be the answer. Another professional might suggest only working on requesting (manding) with preferred items. I have seen these ideas work just fine in some cases. But if a child is displaying challenging behaviors during speech programs or the rate of skill acquisition in a speech program is not in line with the other skills you are teaching, this is a good indicator there is something more that needs to be addressed aside from motivation, a speech disorder.
•Develop relationships with speech-language pathologists
(SLP): Depending on your situation, this can be easy or a major challenge. At the end of the day, we all want the same thing: to help a child communicate. We can all agree on that. However, there are often differences between the way an SLP looks at a child and the way a BCBA looks at a child. Many times both professionals are saying the exact same thing, but speaking a different language. This can make it difficult to collaborate effectively for the benefit of a child with a speech disorder. If you have working relationships with SLPs, you are likely to be inspired to refer a child for an evaluation if he or she needs it. You are also likely to seek expert advice when developing speech goals for a child. This collaborative relationship could have a major impact on a child’s ability to reach his or her full potential. As you may be aware, some SLPs do not understand your education. your skills or your role. That is common; although it is much better than it was when I entered this field 20 years ago! If you come in contact with an SLP who is not helpful, move on. Keep looking. Do not give up on this. These relationships can mean the difference between a child developing verbal skills or not. That is not a risk any professional should take.
•Familiarize yourself with common pediatric speech disorders: The most common speech disorders I see in children with autism are apraxia of speech (also referred to as dyspraxia), articulation disorders, and phonological disorders. Often times these are all present in one child. Throw in some oral motor weakness and incoordination and you have quite a complicated mystery to solve. Speech-language pathologists go to school for at least 6 years followed up by a fellowship year to learn all of these things. You cannot expect to solve this on your own. This is something I plan to go into more depth. In the meantime, do some research online about those three disorders. It could help give you a better understanding of why it is so important to figure out the root of the problem that cannot be remedied by motivation alone.
Learn to be comfortable with the chaos: I have been working with BCBAs before a BCBA certification was invented, so I know first hand what types of personalities go into your profession! You are highly structured individuals with a plan from point A to point B. You have your charts and your data and you are ready to go. But speech disorders are not always straight forward. It can be difficult to break everything down the way you want it to and that can be frustrating and uncomfortable. Every single detail may not be controlled and that is okay. Understanding the nature of the speech disorder and how to treat it is much more important than accounting for everything and taking data on it. If you were a surgeon, the most important thing would be to know what body part you were working on and what needed to be fixed. The journey in between is going to be different for every child because they have lots of different body parts working in different ways. If done effectively, it should feel a bit chaotic. Knowing this could help to ease your mind as you work to help your clients reach their full potential.