Early Speech and Language Intervention in a boy with Autism Spectrum Disorder

Poremećaj iz spektra autizma (PSA) prema Dijagnostičkom i statističkom priručniku za duševne poremećaje (DSM-5, 2013) definira se kao neurorazvojni poremećaj kojeg određuju sljedeći dijagnostički kriteriji: A) deficiti u socijalnoj komunikaciji i socijalnoj interakciji, B) ograničeni, repetitivni obrasci ponašanja, interesa i aktivnosti. Dijagnoza PSA postavlja se najčešće oko 4. godine života (Centers for Disease Control and Prevention, 2012). No, uočava se sve ranije prepoznavanje obilježja povezanih s PSA-om te se ističe važnost rane intervencije i utjecaja kojeg ona može imati na razvoj komunikacije, jezika i govora, pri čemu logoped kao član interdisciplinarnog tima ima važnu ulogu. Cilj ovog diplomskog rada je prikazati učinkovitost rane logopedske intervencije kod dvogodišnjeg dječaka s PSA-om. Jednogodišnja podrška se temelji na strategijama za poticanje komunikacije i jezika, koje su se pokazale učinkovitima za poticanje djece rane dobi, a one obuhvaćaju prilagodbu okoline, slijeđenje vodstva djeteta, vizualnu podršku, modeliranje jezika, rutine kao kontekst za poticanje komunikacije i jezika te oponašanje djeteta. U rad s dječakom se uvode tehnike potpomognute komunikacije bez pomagala (geste, manualni znakovi), niskotehnološka pomagala (fotografije, slike) i visokotehnološka pomagala (tablet). Broj i kvaliteta komunikacijskih funkcija i sredstava praćen je prema Pragmatičkom komunikacijskom profilu, a situacijsko i jezično razumijevanje procijenjeno je hrvatskom verzijom Komunikacijskih razvojnih ljestvica (KORALJE). Dječak je po završetku pružanja podrške pokazao napredak u broju komunikacijskih funkcija i komunikacijskih sredstava te situacijskog i jezičnog razumijevanja. Također je uspostavljen partnerski odnos s roditeljima u vidu implementacije strategija poticanja u svakodnevicu.Autism Spectrum Disorder (ASD) according to the Diagnostic and Statistical Manual for Mental Disorders (DSM-5, 2013) is defined as neurodevelopmental disorder characterized by the following diagnostic criteria: A) social communication and interaction deficits, B) atypical patterns of behavior, interests, and activities. The diagnosis of ASD is usually made when child is about 4 years old (Centers for Disease Control and Prevention, 2012). However, earlier recognition of ASD-related features is noticed and the importance of early intervention and its impact on the development of communication, language and speech is emphasized, where speech and language pathologist as a member of an interdisciplinary team plays an important role. The purpose of this paper is to present the effects of speech and language intervention in a two-year-old boy with ASD. One-year support is based on strategies for promoting communication and language, which have proved effective for encouraging children of very young age and include adapting the environment, following the guidance of the child, visual support, language modeling, using routine as a context for promoting communication and language and imitating the child. Techniques of augmentative and alternative communication with no aids (gestures, manual sings), low-tech aids (photos, pictures) and high-tech aids (tablets) are introduced in the work with the boy. The number and quality of communication functions and means were monitored according to the Pragmatic Communication Profile, and situational and language understanding was evaluated by croatian version of Communication Development Inventories (KORALJE). At the end of the intervention, the boy has demonstrated progress in the number of communicative functions and complexity of the means of communication as well as in situational and language comprehension. Moreover, in terms of promoting communication in the everyday life, the partnership with parents has been established