Kristine wrote:  “This really got me to thinking and
comparing this to speech v. language. I have been personally struggling
a lot with when to address the SPEECH issues and when to address
communication issues- and can they be done concurrently….if, for
example, a child has both autism (communication probs) and verbal
apraxia (speech issues). Comparing it to your separating the
composition from the writing- would this be the same as separating the
speech and communication? And if so, what would be the logistics of
that in therapy (and, more generally, in play, activities, school,
etc…?”

Excellent point Kristine.  I think it is a very similar issue.  Content vs. clarity.  And I think the big picture is content (language/composition).  Without content, the clarity (articulation/handwriting) doesn’t really matter.  So in day-to-day life I would focus primarily on language.  Creating an atmosphere of facilitation and acceptance for whatever communication the child produces.  And for children with limited communication, our demands/expectations regarding clarity may actually limit their communication efforts.  As their language develops, the focus can than shift to articulation.  What you can do is model back correct articulation without making demands on the child changing what they are saying.  So when the child says “tookie”  you can say “Oh you want a cookie.  Here is a cookie.”   In speech therapy sessions, the therapist may focus on both, although not necessarily at the same time.