Speech Language Therapy for Children with Pervasive Developmental Disorder
The term Pervasive Developmental Disorder is widely used by professionals to refer to children with autism and related disorders. The term can be confusing because "PDD" is not a specific diagnosis, but an umbrella term under which specific diagnoses are defined. Diagnosis of PDD, autism or any other developmental disability is based upon the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-4).
Diagnostic Criteria for Pervasive Developmental Disorder are as follows:
- Autistic Disorder (ASD) is complex neurobiological disorder that presents as a range of symptoms, especially communication disorders and impaired social interaction. Associated manifestations may include one or more repetitive and stereotyped patterns of behavior. Autism is a spectrum disorder, with symptoms ranging from mild to severe, and with the level of developmental delay unique to each individual.
- Aspergerís Disorder is defined by "severe and sustained impairment in social interaction and the development of restricted, repetitive patterns of behavior, interest and activity." In contrast to Autistic Disorder, there is no significant delay in language.
- Rettís Disorder
- Childhood Disintegrative Disorder
- Pervasive Developmental Delay (PDD-NOS) is defined by "severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills; and stereotyped behaviors, interests and activities". The criteria for Autistic Disorder are not met because of late age onset; atypical and/or sub-threshold symptomotology."
According to the Autism Society of America, it is important to note that "whether a child is diagnosed with Autism Spectrum Disorder or PDD-NOS, his or her treatment will be similar".
Speech Language Therapy
For children diagnosed with Autistic Spectrum Disorder or Pervasive Developmental Disorder early intervention is critical to achieving maximum benefit from educational interventions and recommended therapies. There are many different educational programs available, differing in philosophy and strategy. Treatment may include a focus on behavioral interventions such as ABA (Applied Behavioral Analysis), speech language therapy, occupational and physical therapies, and educational programs. Speech therapy activities, goals and objectives are typically shared with a team of professionals and caregivers on a regular basis.
PROMPT therapy is often recommended for children with Autistic Spectrum Disorder for several reasons:
- Many children with ASD present with sensory integration disorder and impaired motor planning skills. (Sensory information, arising from movements of the jaw, lips and tongue during speech production, combined with input from hearing and vision, is critical for learning and remembering movement patterns for speech production.) PROMPT speech therapy provides input to the tactile–kinesthetic system to guide the childís oral muscular movements for speech production.
- In PROMPT therapy, speech actions are trained in the context of functional communication activities, providing many ASD children with the combination of input needed to help them use speech for social interaction. This approach is highly effective in treating pragmatic language disorder, or impairment in the social use of language.
- PROMPT therapy is used not only to facilitate movements for speech production, but also to direct attention to the act of interpersonal communication. This helps children with Autistic Spectrum Disorder or Pervasive Developmental Delay to associate movement patterns for speech with the meaning of the represented word(s), building cognitive as well as motor planning skills.
- The PROMPT system of treatment emphasizes the importance of sharing of information with team members to maximize opportunities for generalization and practice using sound and words in multiple settings throughout the day.
- PROMPT can be used in conjunction with PECS and other augmentative communication strategies to facilitate speech development while building communicative intent, academic skills and social learning.
Clinical Note: Lee
Lee received his initial PROMPT evaluation in our office when he was approximately three years old, at which time he was not capable of oral communication. He produced few sounds pr–linguistically. His ability to control and coordinate the oral musculature for speech production was compromised by low muscle tone, sensory processing disorder and motor planning deficits in addition to more global issues related to his diagnosis of Autistic Spectrum Disorder... Learn More