Speech-language pathologists working in early intervention often consider a young child’s lack of response to their name as a potential sign of autism spectrum disorder (ASD). It can also be an indicator of issues with receptive language skills.
Sometimes, the parent reports their child does respond to their name, but you notice otherwise. So we need to dig beyond just asking the parent whether they feel like their child responds to their name.
The first step when identifying a child is not responding to their name (or other sounds) involves a referral to audiology. Ruling out a hearing loss is vital and the first step in the process of evaluation. If results from an audiology evaluation indicates normal hearing, here are some tips to figure out what's happening.
Here’s the thing—kids might respond at some times, but not at others. One of the challenges experienced by young kids, especially those with ASD, is generalization of skills. Performing a skill—like responding to their name—in a session is different from doing the same in various locations and with a variety of people. So what should SLPs consider when looking for response to name in early-intervention clients and how do we explain this to parents?
SLPs need to determine if the child needs assistance with this skill or not, as well as if it is a sign of ASD. These insights work for me when evaluating a young child’s response to name:
Even during sessions, a child might focus so much on a particular type of activity or favorite toy that they tune out their name. A child who likes organizing, stacking or lining up objects, for example, might not respond to their name while in the process of this type of play.
A child might ignore their name or parent’s verbal cues during active play. Some kids don’t respond to their name while participating in movement. When climbing, running and jumping the child gets so focused on movement that they dismiss an adult calling their name.
I don’t solely rely on parent report to find out if a child responds to their name. I’ve evaluated thousands of children where their parent reported the child could perform this skill consistently.
Let the child play with a preferred toy during an evaluation and ask the parent to call their child’s name—preferably from behind because sometimes parents use visual cues along with calling the name. If the child responds to their parent, ask another adult to call them as a second source of data.
I think it’s important for parents to see for themselves what we want to happen in evaluating response to name. If you can set up a few moments in an evaluation or in a session where the child practices their response, this helps the parents understand what you expect and what you’re looking for in this aspect of an evaluation.
Defining the skill more specifically for parents also helps us explain why it is such an important foundational skill and how it falls into the category of receptive language skills. If you notice the child can’t perform the skill consistently, you can target the skill in treatment to make sure the child can perform it in all settings before moving on to more difficult receptive language skills.
Also, because a child not responding to their name consistently is a red flag for ASD, we need to keep a close eye on the skill in our work with young children.