Should a Speech and Language Therapist be part of every Autism Assessment Team?
The short answer is yes. Here’s why.
An autism assessment is a highly detailed process. When carried out properly, according to NICE guidelines, it should involve the expertise of several, diverse professionals, who work together to create a comprehensive profile of an individual. Within this multidisciplinary team, a Speech and Language Therapist (SaLT) plays a crucial, and often central, role. This is because a SaLT’s specialist knowledge of communication, language, and social interaction is essential for accurate diagnosis, as well as for creating meaningful, person-centred recommendations for support.
Communication is a core diagnostic criterion
Autism is defined, in part, by persistent differences in social communication and interaction. A person’s communication abilities and challenges are therefore a fundamental piece of the diagnostic puzzle. And SaLTs are the experts in this field.
During an assessment, a SaLT can:
Assess social communication: Evaluate how the person uses language in social contexts, which includes everything from taking turns in conversation to understanding non-literal language, like sarcasm or idioms.
Examine verbal and non-verbal skills: Look at both the person's spoken language abilities and their non-verbal cues, such as eye contact, gestures, and body language.
Determine language function: Go beyond a simple assessment of vocabulary or sentence structure to understand how they use language to express their feelings, needs, and desires.
A holistic, individual communication profile
Autism is a spectrum, and communication differences can vary greatly. A SaLT's assessment will capture all the nuances of a person’s communication profile, which is vital for effective support.
A SaLT's contribution clarifies whether an individual is:
Non-speaking or has limited speech: Identifying the potential need for alternative and augmentative communication (AAC) systems, such as visuals, signs, or communication technology.
Highly verbal but with pragmatic difficulties: For those who are verbally fluent, a SaLT can identify subtle but significant challenges, such as misinterpreting ambiguous language or struggling with the back-and-forth of conversation.
Masking or camouflaging: Recognising when the person has developed conscious or unconscious strategies to hide their differences, which can be particularly relevant for older children and adults. A SaLT can observe the communicative strain that this places on the person, which may be missed by others.
Is it autism? Aiding differential diagnosis
A SaLT's expertise is critical for distinguishing autism from other developmental or communication disorders, ensuring an accurate diagnosis. Communication differences can be a symptom of various conditions, including:
Developmental Language Disorder (DLD): Identifying whether language difficulties are part of a broader autism presentation or are better explained by a separate language disorder.
Social anxiety: Considering whether social communication difficulties stem from anxiety rather than underlying neurological differences.
Next steps. Developing meaningful, actionable recommendations.
The goal of any assessment is not just to provide a diagnosis, but also to offer a clear path forward for the individual and their family. A SaLT’s input is critical here, as they’re able to provide specific, actionable strategies based on the person’s communication strengths and needs.
Following an assessment, a SaLT can recommend:
Environment adaptations: Using visual supports, managing the sensory environment, and providing clear, unambiguous language.
Social interaction strategies: Providing guidance on how to navigate different social situations and support the person’s relationships.
Intervention pathways: Delivering personalised therapy that is neurodiversity-affirming, focuses on functional communication, and builds on the person's interests.
Having a Speech and Language Therapist on the autism assessment team is not just valuable, it’s fundamental to the diagnostic process. It ensures that a complete and accurate picture of a person’s communication strengths and challenges is captured. A SaLT will also help lay the groundwork for effective, personalised support, empowering the person with the skills and strategies they need to be able to communicate and connect with the world around them.