We have been providing speech, language, and social communication supports for children and young adults for over 20 years! At this time, we primarily provide assessments and consultation - helping families and teams understand how appropriate physical activity supports individuals with sensorimotor challenges to achieve natural speech and language development.


By Alana Shabez, B.A., SLP Aide, Communication Development Center


I was greeted by splatter paint walls and a plethora of inner tubes when I walked in for my interview. I was told that the clients had various diagnoses, with the most common one being 'autism.' As I looked around at the trampolines, yellow slide, plush mattress, and assortment of bouncy balls, I realized none of my classes had prepared me for truly seeing, much less treating, a child with autism in this way.

I was absolutely ecstatic as I walked out with a job offer as a Speech-Language Pathology Aide at the Communication Development Center (CDC). Little did I know, that the upcoming year would widen my eyes to the endless possibilities our kiddos were capable of achieving and show me that 'autism treatment' could be all about having fun!

I learned more through my time at the CDC than I did in any class. I used to sit in class, confused, as the professors would discuss the 'proper' ways to handle children 'on the spectrum.' I would cast frustrated, sideways glances at my coworker and fellow classmate, Mattie, as other students would hurriedly jot down things like, "children on the spectrum do not enjoy touch, social interaction, or play." Well, as I was soon to learn, that simply wasn't true! After all, the children and teens at the CDC thrive on playing with friends. They develop creative ways to regulate themselves by jumping on a trampoline, running and skipping down the hallways, flying through the air as they are tossed in a lycra swing, and creating friendships with those at the CDC.

It made me wonder why the basic needs of neurotypical children were being recognized, but the kiddos on the spectrum were being seen as having 'pathologies.' All kiddos need food, sleep, and human connection. If a child can tell you he's hungry, we feed him! But when a child cries and they cannot explain why, he is at risk for being considered 'depressed,' a condition that might be treated with antidepressants.

Such was the case with one of our clients, who received a prescription for antidepressants when his mother was asked if his daily crying in the late afternoons might be 'depression.' The incredibly loving mom agreed to try the antidepressants, but after three days of her child feeling inconsolable, she searched for other solutions, such as providing him with an earlier dinner. Perhaps the hunger was distracting to the point that the child could not actively participate in play - and strong enough that it made him feel sad. Perhaps the child was exhausted by late afternoon after attending school all day and not having enough time to relax and take a break. Maybe the boy just needed to have a playdate!

It should go without saying that every person appreciates and deserves to have time set aside to play with friends - and that every person needs to eat and stay hydrated to maintain their energy throughout the day. Sometimes our kiddos with autism simply use different communicative strategies to express their needs, which may lead to their actions being 'pathologized' if their needs are not understood.

Enter this wonderful client into the room filled with splatter paint! It's a beautiful afternoon, and the hallway is immediately filled with this child's laughter as he shows us how to skip and race with him down the hallway. His smile is brighter than the sun as he realizes he gets to be the leader of his very own game! When his energy wanes, he heads to the fridge to grab a juice box, his way of powering up his body to keep his energy going. He reminds me of myself! I need to drink a lot of water to avoid getting sleepy in the afternoon!

It remains baffling to me that instead of simply seeing our client for the child he is, and contemplating the simple reasons he might experience challenges around the same time each day, someone might prescribe medication. Medicine has its place, of course, but our client reminded me of an important life lesson: sometimes all we need is a dose of sunshine, a bit of laughter, a juice box, and a group of friends to raise our energy up and to bring that smile back on our face.


By Mattie DeHaven, B.A., SLP Aide, Communication Development Center



Preface by Marge Blanc

When I first read Mattie's wonderful blog about her friend and client, printed below, I knew I did not want to edit it in any way. Rather, I wanted to preface it with comments that emerged from my two decades of experience with other friends much like Mattie's. So, this Preface is my take on the 'big picture' conundrum Mattie's friend is facing.

First of all, we know that our complex brains display themselves in infinite arrays. We all are gifted in innumerable ways, and challenged in a multiplicity of ways as well. While any of us might have a preferred learning style in some situations, we employ other/multiple avenues of learning in others. We might prefer certain learning environments at particular times in our lives, and different ones at other times. We try to narrow things down by taking tests of aptitude and 'intelligence,' but we all know that tests don't provide real pictures of our complex selves. We also try to give each other 'labels' that might help describe our 'performance' on tasks, and our learning strengths and challenges. We might be called 'dyslexic' in either the auditory or the visual modality. We might have 'dysgraphia,' and/or 'dyscalculia,' and/or we might be simply 'delayed' in any modality or target area. We might be 'language delayed,' or even 'language disordered,' and struggle with anomia, or aphasia, or other disorder of language or language access. And when it comes to expressing language with speech, we might be 'speech delayed,' or 'speech disordered.' We might be 'dyspraxic,' or 'dysarthric,' or have one of a myriad of voice disorders. Any combination of these challenges is possible, along with any combination of gifts, and we try our best to describe our multi-faceted brain/body.

All of the above is always true - that is, unless you have an 'autism' diagnosis. Then everything changes. Suddenly, humanity becomes binary: everyone without an autism diagnosis is automatically 'neurotypical,' and you are 'autistic.' It's either/or. You are different; you are presumed to have a different way of thinking, a different potential, and a different developmental progression. Last week, the parents of a friend/former client wrote to ask me if I'd ever heard of someone 'with autism' also being dyslexic. Case in point. My answer was that there is nothing about an autism label that precludes any gift or any challenge. As we seem to have forgotten, autism is simply a 'cluster of behaviors,' and in-and-of-itself, describes nothing about learning and thinking, or the expression of them. But once you are 'autistic,' the world ends its exploration into your learning and thinking, and assumes your 'treatment' should address 'autism.'

And this is where a couple other 'binary' forks in the road take place. The first is with this question: Are you 'verbal' or 'non-verbal. The second is: Are you 'high functioning,' or 'low functioning?' As you can imagine, you have to be 'verbal' to be 'high functioning,' but being 'verbal' doesn't guarantee you are 'high functioning.' And as you can also imagine, if you are not 'verbal,' you don't stand a chance at being 'high functioning.' If you are 'non-verbal,' you're pretty much doomed to being called 'low functioning,' even if you display your verbal (language) capacity through exquisite poetry (written, typed, spelled, signed) or airtight logic (any of the aforementioned modalities). If you don't speak (at all/intelligibly/often), you stay in the 'non-verbal' camp until you can say enough that someone questions whether that is an appropriate label. But even then, you don't necessarily get out of the 'non-verbal' camp, if you are deemed too old to continue your upward climb.

As Mattie points out below, 'autismland' is rife with flaws in logic. As she notes, 'verbal' means language understanding and expression, and 'speech' is just one means of language expression. But writing is also a modality of verbal expression. Spelling through letter-pointing is too, and so is sign language - and word-based AAC access. There's nothing special about speech, except that it's expected, and when we don't hear it or understand it, we are confused into thinking it represents lack of language.

But that's another story ...

Blog by Mattie DeHaven:

In the world of autism, the term 'nonverbal' is used frequently and, perhaps always, incorrectly. It might be used to describe an individual who has not developed a means of verbal expression (speech, writing, typing, signing), but typically, it is used to describe an individual whose speech is not intelligible to those around them, and is thus believed to be meaningless. This begs the question, then, of why we use the term 'nonverbal' at all, when notions of being verbal refer to an individual's language abilities and skills, not to their level of speech intelligibility. To understand this distinction, we must first understand the difference between speech and language. While speech is the confluence of multiple motor processes (breathing, phonation/voicing, and articulation) to make what we think of as 'talking,' language is the cognitive content that is expressed through this, or any other, modality-i.e. the thoughts and ideas that the individual wishes to convey. This distinction is the difference between believing unintelligible speech to be meaningless 'babble,' and knowing that reduced intelligibility does not mean reduced linguistic ability - and certainly does not mean reduced communicative capacity with another, even untried, modality.

I have a friend who has gone nearly all of his 11 years with those around him believing his speech was meaningless, simply because they could not understand it. His difficulty coordinating breath support, prolonged voicing, and phoneme articulation meant that his speech often did not accurately represent the linguistic message he was trying to communicate. With the advent of physically supportive speech and language services-which allow him to better coordinate the pieces needed for clear speech-my friend's intelligibility and confidence in his abilities and skills have begun to grow. This growth has also meant that his loved ones are beginning to understand his speech and the linguistic content within it. Pure joy radiated from both my friend and his mom when she was able to confidently repeat back one of his utterances recently-acknowledging both his linguistic message and his progress in speech intelligibility.

When a child is mistakenly dubbed 'nonverbal' because of a low level of speech intelligibility, the boundaries between speech and language abilities become blurred. The conflation of these two entirely-different systems leads to the fallacious idea that a lack of speech clarity is the same thing as a lack of verbal thoughts - and, sometimes even a lack of ideas to communicate. Needless to say, this misunderstanding greatly diminishes the value placed on what the child has to say. The belief that a child is just 'babbling' reduces the responsibility that caregivers, medical professionals, educators, and peers feel to validate and facilitate a child's language development and successful expression. This, in turn, creates a gray area where children who have a multitude of important thoughts to share, but struggle with the physical modality typically used to do so, are left with no effective way to communicate. By introducing physically supportive services that allow children with sensorimotor challenges to access the mechanisms needed for clear speech, and by celebrating the many other valid and effective forms of communication that these children might use, we can bridge this gap and finally begin to hear the beautiful thoughts our kiddos have been trying to share all along!

Natural Language Acquisition on the Autism Spectrum: The Journey from Echolalia to Self-Generated Language

"Natural Language Acquisition on the Autism Spectrum: The Journey from Echolalia to Self-Generated Language is a wonderful resource that provides the most comprehensive consideration of echolalia and language characteristics of persons with autism to date."

"In this seminal work, Marge Blanc, an experienced clinician and clinical researcher, brings us back to a crucial understanding of language characteristics and language acquisition in ASD based on her deep understanding of language development from a social-pragmatic, child-centered perspective. Unfortunately, too many educators and therapists hold on to outdated and disproven perceptions of echolalia and gestalt language and attempt to 'treat' echolalia with a lack of knowledge of the historical context and research basis of our understanding of language development in ASD."

"By looking at echolalia only through a behavioral lens of pathology rather than through a developmental perspective based on research on autism and typical development, such practices may actually be hindering functional language development. It is hoped that this important work will help educators, therapists and parents move to more contemporary understandings and practices."

"This book is a 'must-read' for all who care about supporting social communication for persons with ASD based on research and sound clinical practice."

Barry M. Prizant, Ph.D., CCC-SLP
Adjunct Professor
Brown University

Director, Childhood Communication Services
Cranston, RI

Echolalia unscripted!

Echolalia communicates! And it jump-starts our students' natural language development!

This ground-breaking book will show you how to:

  • Recognize the meaning and intentions behind echolalia
  • Support students on the autism spectrum from echolalia to self-generated language
  • Bring this information to families and your school teams
  • Connect with your students on the autism spectrum, and watch them grow!

NLA Book

Order your copy today by clicking on this link to order from Northern Speech.com:

Natural Language Acquisition on the Autism Spectrum: The Journey from Echolalia to Self-Generated Language

$29.95 plus shipping and handling!

A Picture Speaks A Thousand Words

NLA courses

The second level NLA course has been reviewed:

"I can hardly express how important this information is - it has the potential to revolutionize language therapy for autistic children all over the world. I hope it will become one of our field's 'best practices' to embrace echolalia as the first step in the natural progression of language development for our clients with autism who are gestalt language processors. I believe ALL speech-language pathologists who work with children with autism should have to take this course - it's that important. (I think it is telling that Barry Prizant recently praised Marge's work in his recent book, Uniquely Human.) I plan to strongly recommend Levels 1 and 2 to my students and colleagues. I certainly hope there will be a Level 3 follow-up course, and that NLA will be a topic of discussion ASHA-wide!"

Check out the course here!

What's new on facebook?

Check out this thought-provoking and eye-opening blog post about "Motor Difficulties in Severe Autism," and other links in our CDC Facebook page!

even if you've read the articles on echolalia, you may want to read about: dyspraxic speech support, language retrieval, and self-regulation.

Read more at our articles page.

articles by Marge Blanc

Bringing It Home: Physical Supports for Speech at Home and in Other Environments

It's All Gibberish to Me: Redefining "Non-verbal"

More Than Words (Parts 1-6)

Click here for more articles by Marge Blanc

NLA Study Group

Have you seen the NLA study group on Facebook? Check it out and join!

Students and professionals with background in understanding echolalia and gestalt language development can now share ideas for supporting our kids next steps in language development.

If you have not taken the NLA course through Northern Speech Services, that will bring you up to date.

Please join us, click here for more!

In case you haven't read the NLA book, here's a nice review:

"It is hoped that this important work will help educators, therapists and parents move to more contemporary understandings and practices."

Barry M. Prizant, Ph. D., CCC-SLP
Adjunct Professor
Brown University