Abstract
The goal of this article is to present a developmental perspective on language acquisition that can serve as a framework for understanding, describing, and treating the speech, language, and communication challenges faced by children on the autistic spectrum. The profiles of five children on the autistic spectrum are discussed to illustrate the application of a Developmental Social-Pragmatic Model in our clinical work with children and their families.
ALTHOUGH developmental approaches to language therapy are not new (Bloom & Lahey, 1978; Lahey, 1988), their place in intervention programs for young children with developmental delays, and particularly children on the autistic spectrum, has recently been minimized. This is in part the natural result of the ever-growing contemporary interventions available for children with challenges in relating and communicating, many of which are designed for the purpose of enhancing language and communication development. Treatment options such as auditory integration training, Fastforword, the Picture Exchange System, applied behavior analysis, and the Developmental Individual Difference Relationship-based approach (Greenspan & Wieder, 1998) are incorporated into intervention programs regularly;in fact, both experimental data and clinical wisdom suggest that they are all extremely helpful for many children. Nonetheless, the language acquisition process of children on the spectrum, perhaps more than any other aspect of their development, continues to challenge educators, therapists, and parents. The goal of this article is to present a developmental perspective on language acquisition that can serve as a framework for understanding, describing, and treating the speech, language, and communication challenges faced by children on the autistic spectrum.
Regardless of the specific discipline, developmental approaches begin with the assumption that
all strategies of intervention, regardless of the target group or desired outcome, can be derived from normative theories of development. That is to say, the general principles of development apply to all children independent of their biological variability or the range of environments in which they live (National Research Council, 2000).
In keeping with this perspective, the heart of the Developmental Social-Pragmatic Model DSPM) rests on the universals, processes, and facts of typical language acquisition. This information clarifies what must be learned at each point in development to assure the child's acquisition of a symbolic language system and his or her access to the power and pleasures of social communication.
When developmental language models are applied to atypical children, each child's individual differences are honored and seen as alternative roadblocks or pathways to learning. Those clinicians who embrace a developmental approach to language intervention do so with the understanding that the universal and unique features of the language acquisition process of children with autism, as with all children, can best be understood, explained, and responded to with a keen awareness of the forms and functions of typical language acquisition.
One of the more worrisome issues permeating language intervention being done with children on the autistic spectrum is the mistaken definition of language being used to generate treatment goals. In many programs and approaches, language is thought to be synonymous with speech or production. This narrow view of language, which leads to narrow views of language intervention, overlooks all that must be accomplished before a child begins to talk or use signs or picture symbols symbolically and all that contributes to language acquisition throughout the stages of development. Perhaps the fact that typically developing children "talk" so easily and so early leads us to the mistaken belief that a child begins language acquisition with the production of his first words, as with Pinker's (1994) reference to the phenomena of a "baby born talking." In fact, the kinds of developments that occur before the child's first words at about 12 months of age are particularly challenging for young children on the autistic spectrum. For many of the children, it is these challenges in affective, social, and cognitive domains that, in large part, account for the difficulties they experience with language and, ultimately, with talking.
For the developmentalist, the steps in the process of language assessment and intervention remain constant, beginning with the identification of where the child is functioning on the "map" of language acquisition; assessing where the child's strengths and challenges lie in the components of language-phonology, syntax, morphology, semantics, pragmatics; determining where the child's next step in the language acquisition process needs to be taken; and finally, considering how his or her unique patterns and strengths can be used to advantage.
Finally, the developmentalist believes that what serves best as a paradigm from which to address the diversity of children with language and communication difficulties is not a diagnostic category, but rather a perspective on language. The developmental speech language pathologist (SLP) does not generate ideas about where to begin language intervention by asking, "How do we work with a child who is autistic?" but rather by asking, "How do we work with a child who is preintentional or a child who is prelinguistic?"-in other words, by identifying the child's stage of language development. Similarly, the SLP does not begin intervention by asking, "How do we work with a child who is cognitively challenged?" but rather asks, "How do we work with a child who is at the sensorimotor stage of development?"