Speech ability is often used to measure progress in child development. Most children are expected to speak about five to six words by the time they reach their first birthday and increasingly expand their vocabulary as they grow older.

 

However, sometimes they are unable to meet this standard. Parents should be alarmed if their children's speech development lags, as it might indicate some possible anomalies.

Speech and language disorders can be corrected by speech therapy and other medical techniques, said speech-language pathologist Nittaya Kasemkosin, with the Division of Communication Disorders at Ramathibodi Hospital. She recommends that parents bring their children to a psychiatrist or an otolaryngologist if signs of autism, mental retardation, cerebral palsy, hearing impairment or specific language impairment appear.

About autism

 

According to Nittaya, autism is the most common disorder among speech therapy patients in her department, as modern parents are familiar with the disease and are able to notice the signs at early ages.

A child with autism will not follow the usual developmental patterns, such as smiling at the age of two months, making a variety of noises at five to seven months old, and communicating with body language soon after.

In addition, the autistic child will often exhibit abnormal social interaction behaviour, even with their own parents. While other children will run to their parents and hug them when scared, the autistic ones tend to simply run away.

The sooner, the better

 

Unfortunately, Nittaya's otolaryngology department has found that many parents do not bring their autistic children to the therapist immediately after they notice the signs. Instead, they usually wait until the age of three years old when the children have already been rejected from enrolling in kindergarten due to their inability to communicate with teachers.

"When the parents find a sign of disorder, they should bring the children to the therapist early on, as the treatment will be easier and more effective on younger children," said Nittaya.

If at one year old, the child cannot speak or follow simple instructions such as waving goodbye or doing the "catch the black crab" hand gesture (a Thai traditional game played to facilitate hand-eye coordination by holding and squashing hands), or if they cannot speak at least two consecutive syllables of words at the age of 18 months, then they are already showing signs of autism.

If parents deny this and refuse to bring them in for therapy, they will miss a golden opportunity to treat the disease. The earlier that treatment is provided, the better results it will generate. So, time is of the essence.

 

The speech-language pathologist said all patients who have gone through the therapy eventually improve their speech ability, although the time required may vary. The therapy tends to be more effective with younger children.

Symptoms of autism

Children with autism may show various speech-related symptoms to varying degrees, but some of the most common ones are slow speech, inability to use appropriate vocabulary or sentences in accordance with their age or to the situation, a lack of understanding of the meaning of their own speech, difficulty constructing sentences, and trouble with grammar. Some children may even develop their own language.

Consultation and therapy

First-time patients will be tested on hearing as well as their behaviour and development. The children may be given toys to play with, while observers evaluate their levels of muscle, mind, emotional, social interaction, and language development. A combination of tests may be used to estimate the degree of speech and semantic disorders.

Once a child has been evaluated, the therapist will introduce appropriate activities, such as role-playing, to stimulate speech and communication skills. The parents, too, will be taught how to guide the activities of the child at home.

"The best practice is to advise and to teach the parents to train their children at home. My job is to counsel them. If the parents are attentive and understanding, and able to consistently conduct the activities at home, they will see results soon," said speech-language pathologist Worawan Wattanawongsawang, or "Khru Ann".

Obstacles to therapy

Worawan said one of the obstacles to the treatment of autism is a lack of bonding between the parents and the children, as many parents are too preoccupied with work and other duties to the point that they are no longer aware of the actual mental state of their children. This can become a serious problem for autistic children who are rarely able to express their feelings and thoughts.

The therapist said one of her major principles in consultations is to "bring childhood" back to the parents, so that they can better understand their own children. Even if the parents do not have a lot of time to be with their children, they can still attempt to truly listen to them.

She identified three other common problems related to parental attitudes and perceptions:

1. Lack of commitment to the therapy and practice. In this case, the parents often complain that they do not have time and would rather leave the whole task to the speech-language pathologist. However, according to Worawan, the parents only need about 20 minutes with the child each day, provided they can be fully attentive.

2. Lack of understanding of autism. Some parents do not have a good understanding of autism and, thus, are not able to evaluate the severity of the conditions and may believe the problem is a minor one. This can easily occur when parents don't spend enough time with their child.

3. Misperception. Some parents only notice the physical growth, rather than the mental growth of their children. They believe their children are normal as long as they are still going to school, but they rarely notice if the child can actually communicate with others.

"If the parents can change their attitudes and allocate some time to conduct activities to encourage the child to speak, the condition will certainly improve," said Khru Ann.

Without some attention from the parents, children with autism will typically become more and more introverted, isolating themselves from the others and eventually developing problems with social interaction. They will also be unable to communicate with others.