Early Signs of Autism


Today, 1 in 68 children are diagnosed with autism. Autism is diagnosed based on the child’s presenting symptoms. Children with autism often present with deficits in social communication, speech and language, and restricted activities and interests. Although there is an increased prevalence, children may not be diagnosed with autism until at least four years of age or older. However, children can be diagnosed as early as two years old. Receiving early intervention will yield the best results for a child who is diagnosed with autism. Therefore, it is important that parents are aware of the early signs and symptoms of autism. Continue reading to learn about the early red flags for autism.

Red Flags for Autism (retrieved from Hanen)
Appearing by 12 months:

  • No babbling
  • No pointing (to show interest, for requesting, to get someone’s attention)
  • Lack of gestures (asking to be picked up, waving, shaking their head “no”)
  • Lack of joint attention (an individuals ability to attend to a conversation/activity with another)
  • Poor eye contact
  • Repetitive actions or movements
  • Limited play with toys
  • Poor imitation of sounds or actions (imitation of speech sounds, or actions such as clapping hands)
  • Not responding to his or her name when being called

Appearing between 18-24 months:

  • A loss of words, skills, or social connection

If your child presents with any of the above symptoms or you have concerns about their development, it is important seek a medical diagnosis. While a speech-language pathologist cannot diagnose autism, they are able to assess the child’s overall communication skills, including the social communication deficits that are often observed in children with autism.

For more information on the early signs of autism, visit:

Nicole Sullivan MA CF-SLP TSSLD



16060StutteringI recently came across an article on the ASHA Leader Blog that took me by surprise. U.S. Customs and Border Patrol at Hartsfield-Jackson Atlanta International Airport detained a college student who was returning from studying abroad because of her stutter. The student was questioned for an hour after stuttering when telling the staff member she had travelled from Costa Rica. According to the article, the student felt “intimidated, bullied, and silenced” as she was being probed. The student, however, is using this negative experience as an opportunity to educate others on stuttering. She has asked U.S. Customs and Border Patrol to train all staff on how to more efficiently work with people who stutter.

It is important to know what to do and how to respond when speaking with a person who is dysfluent. Keep reading to learn a few ways to more effectively communicate with a person who stutters.

  • Give the person enough time to say what they want to say
  • Try not to finish their sentences or fill in words
  • Do not interrupt the person when speaking
  • Avoid putting additional time pressure on the speaker (this may actually increase dysfluencies!)
  • Wait patiently until they are finished speaking
  • Maintain eye contact and do not appear to be alarmed during a moment of stuttering
  • Avoid telling the individual who stutters to “relax” or “slow down”

When communicating with an individual who stutters, simply be patient and be a good listener!

Click the link below to read the entire ASHA Leader Blog article.

To find out more about stuttering, visit:

Nicole Sullivan M.A. CF-SLP TSSLD

Apraxia of Speech

I recently came across a great blog post on the ASHA Leader, about a speech-language pathologist who had previously successfully treated clients with apraxia of speech. However, because apraxia of speech presents differently in each individual, she had missed her own child’s symptoms of the motor planning disorder. Continue reading to learn more about apraxia of speech and early symptoms of the motor planning disorder!bottom-line

Childhood apraxia of speech is a motor speech disorder characterized by the inability to plan and sequence the volitional movements of the oral musculature (jaw, lips, tongue) required for speech production. These children often present with inconsistent speech sound errors, effortful speech production, and increased difficulty producing more complex utterances. Children with apraxia of speech may also present with groping behaviors when trying to coordinate the oral musculature for speech production.

It is important to remember that all children with apraxia of speech may present differently. Below you will find some early symptoms of apraxia of speech (Retrieved from ASHA Leader):

  • Limited babbling
  • Limited phonetic diversity (few consonant or vowel sounds in their repertoire)
  • Inconsistent errors
  • Predominant use of simple syllable shapes
  • Difficulty producing increasingly complex utterances
  • Omissions
  • Vowel errors/distortions
  • Excessive, equal stress (might also sound monotonous, or stress the wrong syllable)
  • Loss of previously produced words
  • More difficulty with volitional speech production
  • Better automatic speech production (rote counting, days of the week)
  • Better understanding of language than use

An early diagnosis of the motor planning disorder may yield better results for the child. If you have concerns about a motor planning disorder, it is important to have your child evaluated by a speech-language pathologist to rule out other speech sound disorders.

To read the ASHA Leader Blog post, click here:

For more information on apraxia of speech, click here:

Nicole Sullivan

Will the use of an AAC device hinder speech development?

aac-devicesAccording to the American Speech-Language Hearing Association, an augmentative and alternative communication (AAC) device serves as an alternate mean of communication used to supplement or replace speech in individuals who are unable to communicate effectively. AAC devices may be utilized for children with autism who present with significant speech or language difficulties or adults whose speech is no longer functional after sustaining a stroke or traumatic brain injury. Individuals who cannot access speech for functional communication may experience frustration, as they are unable to communicate their thoughts, needs, and desires. The implementation of an AAC device provides a way for these individuals to express themselves.

While AAC devices are recommended as an alternate system of communication for those individuals who otherwise have no way of communicating, parents or family members voice similar concerns. Caregivers of AAC users express apprehensions that the use of an AAC device will hinder the development of speech in children or the return of speech production in adults. Parents and family members also feel as though they are giving up on the idea of speech development or production by choosing to implement an AAC device. These concerns have been shown to be invalid.

According to a systemic review published in the American Journal of Speech-Language Pathology, researchers determined that AAC interventions do not impede speech production in children with Autism, but rather support speech development. It is important to note that all children are different, and gains in speech development may vary from case to case.

To conclude, the use of an AAC device will not hinder speech development. AAC devices should be utilized for individuals who cannot access speech for functional communication. An AAC device will allow the individual to communicate more effectively and experience a sense of independence in their daily lives.

Read the systemic review here:

Learn more about AAC here:

Nicole Sullivan M.A., CF-SLP TSSLD