Inner Speech Therapy Offers New Hope for Managing Emotions in Autistic Children

Children on the autism spectrum frequently experience difficulties with emotional regulation, often leading to outbursts that disrupt daily life for both themselves and their families. A novel approach called Thinking in Speech (TiS) is emerging as a promising intervention aimed at improving internal dialogue among autistic children, thus helping them manage their emotions more effectively.

Recent research conducted by a team at the University of Pittsburgh and collaborators investigated whether training autistic children in inner speech could enhance their ability to self-regulate. The study involved 22 children aged 7 to 11, recruited from the Pitt+Me Registry. Participants were randomly assigned to either immediate or delayed therapy groups. Certified speech-language pathologists, trained in the TiS method, delivered sixteen 30-minute telehealth sessions over 8 to 10 weeks.

During therapy, practitioners modeled internal speech by verbalizing their own thought processes during challenging moments and encouraging children to do the same. This involved helping children recognize signs of frustration and providing language cues to express their feelings, such as saying "This is what 'hard' feels like," and prompting the child to respond with phrases like "I need help." The goal was to empower children to use internal dialogue as a coping mechanism.

Caregivers completed assessments on emotional regulation before and after the intervention. The study utilized a crossover design, meaning each child experienced periods with and without the therapy. Results showed significant improvements in emotional dysregulation scores, particularly on the Dysphoria scale of the Emotion Dysregulation Inventory, suggesting reduced emotional distress. Marginal improvements were also observed in reactivity measures. Although gains were notable when the therapy was in effect, some improvements declined by the follow-up period at 10 weeks.

While these preliminary findings are encouraging, the study's small sample size and lack of a comparison group mean further research is necessary. Nonetheless, the concept that teaching autistic children to speak internally through modeling and practice could provide them with tools to better understand and manage their emotions is compelling. This approach could enable therapists and caregivers to give children an inner voice—one that offers clarity and control over emotional reactions.

Source: https://medicalxpress.com/news/2025-06-speech-therapy-easing-autistic-children.html