Q: My son is 2 1/2 years old and has a great level of oral motor difficulty and has been diagnosed with autism. He has only one word that he can produce on command, and that is “mom.” He tries very hard to talk and things come out a jumble.

We are working on letter sounds with him as he really enjoys letters. He can make the sounds for the letters S, M, H, A, U, E. It sometimes takes him 15-20 seconds to produce the sound and he seems to move his tongue around as he tries to produce the sound. When my son was between the ages of 4-10 months is was not uncommon to hear him coughing to bring on sounds something like this “cough, cough, ah, ahhhh, ahh.” I truly feel that my son really wants to speak and can’t figure out how. On occasion we have heard him say “mom,” “I love you,” “no,” “grandma,” and “hello.” He does this by accident and is not quite sure how to do it again. He does know some sign language. We have been told that he has really good imitative skills and joint attention. Is there any information or literature you can recommend?

This is my experience: Children with autism are highly selective about what they will say for a very long time, especially during early language acquisition.

Therefore, it is almost impossible to get them to say what we want them to say. They will say what they want to say, however. So that’s what we have to go with. If your child is interested in the alphabet, teach it to him. If he wants to count numbers, and those are the words he will say, let him count away.

I have worked with many autistic children who, in the early years, would say nothing except letters, numbers, and other rote productions (e.g., prayers and songs) for a very long time. But gradually, they began to add other words.

For some, the entire world seems to revolve around the ABC’s for a long time. I always have had the sense that they seem to know that the spelling of words will unlock for them the “language world” that is puzzling them. I have seen children go from naming letters over and over, to reading words over and over, to spelling words over and over, to finally speaking words over and over.

In terms of my materials, I suggest Becoming Verbal with Childhood Apraxia as a starting point. In the book, I talk bout helping the child learn to become more vocal, imitative, and verbal.