Autistic SLT

Time for a reintroduction 🙋‍♀️

I'm Emily Price, an Autistic Speech and Language Therapist based in Greater Manchester. I provide Neurodivergent-Affirming speech and language therapy for children and adults, alongside support for families, schools, and professionals in healthcare and education.

As an Autistic SLT, I bring both clinical expertise and lived experience to my work. I offer a range of services:

💜 Communication assessments
💜 Therapy sessions
💜 Parent advice sessions and consultations
💜 Supervision and training

I predominantly support Autistic children and adults, as well as their parents/caregivers. Appointments are available across Manchester for those in my area - and online throughout the UK.

Some parents may be wondering whether their child could be Autistic. I can support this process by identifying their communication needs and gathering evidence of possible indicators, helping you to navigate conversations with healthcare and education services.

📧 [email protected]
🌐 www.autisticslt.com

The medical model often follows a familiar pathway - the difficulty is located within the person.

1. SLTs diagnose a disorder.
2. Prescribe intervention.
3. Determine dosage.
4. Measure change.

This model makes sense in medicine; if someone has an infection, we identify it, prescribe treatment and monitor whether symptoms improve. But communication is not an infection, and neurodivergence is not a disease. Yet SLT has often borrowed the logic of medicine and applied it to communication. In doing so, we can unintentionally position , and otherwise neurodivergent people as the problem and the target of change.

With this thinking, the approach has often been "How do we change the person? or "How do we help them become more typical?"

A neurodiversity-affirming approach begins somewhere different. Drawing on social model thinking, Disability Justice, lived experience knowledge and decolonial perspectives, we seek to understand a person in context. We recognise that communication never happens in isolation. It is shaped by relationships, environments, culture, power, identity and access.
We ask: What is happening between this person and the world around them?

This means:

• Understanding how race, class, poverty, gender, migration, trauma and educational experiences shape communication and its interpretation.
• Learning from those most impacted. The knowledge of autistic people, disabled people, users, , and should shape our practice.
• Valuing interdependence rather than treating independence as the ultimate goal. Communication is relational, multimodal and collaborative.
• Creating collective access. Access should be built into environments from the beginning.
• Seeing the whole person. Not a collection of targets, but a human being of value whose sensory experiences, identity, relationships, culture, fatigue, distress and joy all matter.

The question is not about changing the person it is about identifying and fostering the conditions that allow this person to communicate, participate, connect and flourish as themselves.

The outcomes we measure shift too.
Medical model outcomes often prioritise:
• symptom reduction
• behavioural change
• normative performance
• therapist-defined goals

Neurodiversity-affirming outcomes prioritise:
• autonomy and agency
• communication access and choice
• self-advocacy in all forms
• emotional safety
• meaningful participation
• identity development
• quality of life
• belonging

Perhaps the most important shift in neuro-affirming SLT is instead of us asking, "Is the intervention effective?" we ask "Is this person's life better?"

Clinical knowledge and skill are necessary - but this alone is insufficient.

www.divergentperspectives.co.uk

"Use a First–Then board"

Elaine (from Access Communication Ltd) and I talk a lot about widely used tools used with Autistic children. This has been one of the most common answers to questions like: "How do I get this autistic child to do...?"...“How do I get them to stop...?” to leave...?” etc

Visual schedules, timers, countdowns and First - Then / Now and Next supports are not inherently problematic. They can be useful ways of increasing predictability, reducing uncertainty and supporting transitions for some people, in some situations.

Too often, First – Then schedules are implemented without sufficient curiosity about the child's experience, regulation, priorities or perspective. The focus becomes the child having to adapt to the demands of the environment rather than exploring whether the environment, expectations or transition itself might also need to change.

When an autistic child is deeply engaged in monotropic flow, immersed in an interest, regulating through movement, or finding safety within a familiar activity or object, the question should not automatically become, "How do I get them to move on?" or “How do I get them to let go of this?”

Yes, there are times when transitions are necessary. The issue is though – are we approaching this transition collaboratively, respectfully and with an understanding of what the child needs in this moment?

Do we consider, what this activity or object provides that the next activity or object may not?

When an autistic child is moving back and forth between activities and doesn't appear able to settle to one thing for long, the automatic response shouldn't necessarily be - "They need a schedule."

There are other important questions to consider before making assumptions and introducing solutions unilaterally. Does moving quickly between activities help them explore and express preferences? Does movement reflect curiosity, sensory-seeking, uncertainty, anxiety, overwhelm, or difficulty finding something that feels meaningful or safe? Does movement tell us something about how they are experiencing the activities, the demands being placed upon them, or the environment itself?

What might we miss if we move immediately to directing and organising their engagement?

What would happen if we gave them more time, more agency and more opportunities to communicate preferences before introducing a ‘First – Then’ as a directive? How can we navigate the experience of exploring and transitioning collaboratively?

It's important to examine the assumptions underneath the use of visual supports. Consider whose agenda is being prioritised? Whose needs are being met? Whose definition of a "successful transition" are we working towards?

There is an important difference between supporting a transition and securing compliance with a transition. One is grounded in communication, collaboration and respect. The other risks are becoming compliance at the expense of agency, autonomy and trust.

www.divergentperspectives.co.uk

Today I was reminded why I don't use widely used Autism interventions with children I support.

Today I attended a group with my child. They were shown an exciting bag of toys. My child was immediately drawn to an object and approached to explore. They reached out to touch it and were told "My turn...you can have a turn soon". That turn never came by the way.

I watched my child wait and their frustration grew. Eventually, they walked away and slumped to the floor, saying, "I wanted to play mummy". I said "I know you did, darling". This happened twice with 2 different toys. It was demoralising and sad.

What struck me was that my child wasn't demonstrating a lack of attention - quite the opposite. They were deeply engaged and curious...self-advocating and communicating clearly. Yet the intervention goal appeared to be to teach them to wait, watch, and comply with the adult's agenda before accessing what interested them.

As and educators, we should ask ourselves: what are we actually teaching in these moments? Because if a child leaves a session feeling frustrated and misunderstood, we have to question whether we've achieved anything meaningful at all.

www.divergentperspectives.co.uk
www.autisticslt.com

Autistic SLT | Emily Price | Empowering Autistic children and adults I’m Emily, an Autistic Speech and Language Therapist in Greater Manchester, UK. I provide neurodivergent-affirming speech and language therapy for autistic children, teens and adults, supporting communication in a way that respects neurodivergence. I combine lived experience with clinical expertis...