Speech-language pathologists (SLPs) play a central role in the screening, assessment, diagnosis, and treatment of persons with ASD. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research. See ASHA's Scope of Practice in Speech-Language Pathology (2007).
Appropriate roles for SLPs include
- providing information to individuals and groups known to be at risk for ASD, to their family members, and to individuals working with those at risk;
- educating other professionals on the needs of persons with ASD and the role of SLPs in diagnosing and managing ASD;
- screening individuals who present with language and communication difficulties and determining the need for further assessment and/or referral for other services;
- conducting a culturally and linguistically relevant comprehensive assessment of language and communication, including social communication skills;
- assessing for the need for and requirements for using augmentative and alternative communication (AAC) devices as a mode of communication;
- diagnosing the presence or absence of ASD ( typically as part of a diagnostic team or in other multidisciplinary collaborations);
- referring to other professionals to rule out other conditions, determine etiology, and facilitate access to comprehensive services;
- making decisions about the management of ASD;
- participating as a member of the school planning team (e.g., whose members include teachers, special educators, counselors, psychologists) to determine appropriate educational services;
- developing treatment plans for speech and language services, including social language goals and goals for literacy development and for assisting the student with self-regulatory and social interactive functions to allow him/her to participate in the mainstream curriculum to as great an extent as possible;
- providing treatment, documenting progress, and determining appropriate dismissal criteria;
- providing training in the use of AAC devices to persons with ASD, their families and caregivers, and educators;
- counseling persons with ASD and their families regarding communication-related issues and providing education aimed at preventing further complications related to ASD;
- consulting and collaborating with other professionals, family members, caregivers, and others to facilitate program development and to provide supervision, evaluation, and/or expert testimony, as appropriate;
- partnering with families in assessment and intervention with individuals with ASD;
- remaining informed of research in the area of ASD and helping advance the knowledge base related to the nature and treatment of ASD;
- advocating for individuals with ASD and their families at the local, state, and national levels;
- serving as an integral member of an interdisciplinary team working with individuals with ASD and their families/caregivers and, when appropriate, considering transition planning;
- providing quality control and risk management.
There is great heterogeneity in the ASD population, evidenced by the broad range of cognitive, social, communication, motor, and adaptive abilities. Some individuals with ASD have intellectual disabilities, while others have intellectual functioning within the normal range. Individuals with ASD, regardless of intellectual functioning, have a developmental disability that affects social communication skills and can limit independence in home, school, work, and community environments and participation in social networks.
As indicated in the Code of Ethics, SLPs who serve this population should be specifically educated and appropriately trained to do so.
Interdisciplinary collaboration in assessing and diagnosing ASD is important due to the complexity of the disorders, the varied aspects of functioning affected, and the need to distinguish ASD from other disorders or medical conditions. Ideally, the role of the SLP is as a key member of an interdisciplinary team whose members possess expertise in diagnosing ASD. In cases when there is no appropriate team available, an SLP, who has been trained in the clinical criteria for ASD and who is experienced in the diagnosis of developmental disorders, may be qualified to diagnose these disorders as an independent professional (Filipek et al., 1999).
Some state laws or regulations may restrict the scope of practice of licensees, however, and prohibit the SLP from providing such diagnoses. SLPs should check with their state licensure boards and/or departments of education for specific requirements.