What do 707 Autistic Preschoolers Teach Us About Spoken Language Outcomes?

If you work with preschoolers with autism and you care about spoken language outcomes, this episode matters. A lot.

In today’s episode of The Preschool SLP Podcast, we unpack the largest study to date examining why some autistic children do not develop spoken language, even after receiving high-quality, evidence-based early intervention.

The takeaway is blunt:
Motor imitation doesn’t matter a little. It matters a lot.

Inside this episode, we cover:

• Why one-third of autistic preschoolers in a large, multi-site study did not advance in spoken language despite receiving ~10 hours/week of evidence-based intervention
• How motor imitation emerged as a key distinguishing factor between children who advanced in speech and those who did not
• What neuroscience tells us about mirror neurons, empathy, perspective-taking, and speech development
• Why speech develops from the inside out: core → proximal → distal → speech. And, what happens when we skip the body and go straight to the mouth
• How motor imitation supports:
  • Entry into peer play
  • Social communication
  • Speech motor planning and execution
  • Prefrontal–cerebellar connectivity
  • Why this research gives us a “crystal ball”—not to maintain the status quo, but to do something different earlier
  • You can’t build speech on a system that can’t yet support posture, movement, imitation, and motor planning.
  • If motor imitation is weak, speech outcomes are at risk, pretending otherwise doesn’t help children.

Clinical bottom line:

If a child presents with:

• Severe autism presentation
• Limited or absent spoken language
• Poor motor imitation

Then motor imitation must be intentionally built into intervention, alongside AAC, multimodal cueing, movement-based learning, and robust communication supports.

This episode challenges us to stop treating mouths—and start treating children.

🎧 Want practical ways to integrate motor imitation, movement, AAC, and literacy?

Join the SIS Membership for ready-to-use, movement-based, evidence-informed activities designed for real preschoolers in real settings:
👉 https://www.kellyvess.com/sis

Vivanti, G.L, et al. (2025). Proportion and profile of autistic children not acquiring spoken language despite receiving evidence-based early interventions. Journal of Clinical Child & Adolescent Psychology. https://doi.org/10.1080/15374416.2025.2579286

What if the problem with treating the R sound isn’t the child—but the way we train it?

In today’s episode, we step outside the field of speech-language pathology and borrow powerful, evidence-based principles from exercise science and kinesiology to rethink how we treat speech sound disorders. Why? Because exercise science has done what our field largely hasn’t: isolated what actually works using controlled trials, precision, and specificity.

Speech is a complex neuromuscular skill. Treating it like flashcards and passive listening don’t make sense—and they don’t produce durable change.

In this episode, you’ll learn how five core principles from exercise science directly apply to improving the R sound efficiently:
• Why “practice makes permanent” and how the 80% challenge point prevents habituating errors
• How progressive overload explains why complex clusters outperform isolated sounds
• Why auditory bombardment is passive and inefficient when therapy time is limited
• How compound training (paragraphs, clusters, movement, literacy) creates system-wide linguistic change
• Why specificity matters—and why speech therapy must look like real speech to generalize

This episode challenges the status quo in therapy and makes the case for treating speech as the neuromuscular endurance task it actually is.

If you’re tired of plateaus, endless cueing, and R programs that don’t generalize, this conversation will change how you think about treatment starting Monday morning.

👉 Ready to treat the R sound more efficiently—without guessing?
Inside the SIS Membership, you’ll find high-impact treatment targets, complex R clusters, and ready-to-use paragraphs designed to apply these principles immediately—so you can stop planning and start seeing change.

Get access to efficient, evidence-informed R targets at
https://www.kellyvess.com/sis

Train smarter. Challenge appropriately. Create real change.

Are consonant clusters really “too complex” for kids with severe speech sound disorders—or have we been aiming too low?

This episode tackles one of the most persistent myths in speech therapy: that children with childhood apraxia of speech, autism, or severe speech delay aren’t ready for clusters. I’m unpacking the real science behind complexity, coarticulation, and system-wide change—and why waiting for “readiness” often slows progress rather than supporting it.

Let's break down three common myths that are not evidence-based:
• Myth 1: Children must master single sounds before clusters
• Myth 2: Clusters should always come later in treatment
• Myth 3: Consonant deletion must be fixed first

You’ll hear why speech doesn’t develop like a geyser, how the waterfall effect actually works, and why starting with complex targets can accelerate gains across the entire sound system—even in preschoolers.

This episode also walks through how to do this in therapy: using dynamic tactile-temporal cueing, maintaining an 80% challenge point, and choosing treatment targets that improve motor planning, programming, and verbal working memory simultaneously.

If clusters feel uncomfortable, slow, or messy—that’s the point. Challenge creates change.

Want treatment targets that already do this work for you—without reinventing the wheel every week?
Join the SIS Membership for ready-to-use, research-informed activities designed to create real speech change while protecting your time and energy.
https://www.kellyvess.com/sis