Have you had a recent full audiology exam? I don't mean to scare you, but my daughter's profound hearing loss got missed by multiple SLP's, ABA therapists, teachers, and me because all the symptoms got chalked up to autism.

I agree with Adrisab above. I think the answer to your question could be very complicated. I would consider going back to the basics and adding some basic movement and sensory work to your son's program, if you haven't already. I have learned from reading writings by "nonverbal" autistic people that our kids' understanding of speech many not be truly correlated with their response, simply because they are not able to carry out their responses. Ido Kedar has a fascinating book that describes his autism as an "output" disorder (for example, when the therapist asked him to hand her the picture of an elephant, and he knew which one it was, he would reach out frustratingly grab the giraffe picture). No matter the cause and specifics of our kids' language issues, I think they can all benefit from motor planning/OT/sensory work that can help them process and respond to language and the world around them.

I don't know how old your son is. But it may be helpful to look into his processing skills.

Hello Fighting Autism, Congratulations on your son's improvements in expressive language. That is excellent news. It's always great when our kids make progress. Now you would like to see increases in Receptive Language. Just to be sure, I checked out the definition of Receptive Language, and here is one component: Receptive language means the ability to understand or comprehend language heard or read.

A more detailed definition is this one: Receptive language skills describe the comprehension of language. Comprehension involves attention, listening, and processing the message to gain information. Areas of receptive language skills include: attention, receptive vocabulary, following directions, and understanding questions.

My first recommendation would be to observe your son around the house, and take some notes. Does he react to sounds in his environment, for example, turning his head when the phone rings, looking at the door when someone opens it? Does he respond to his name in any way (even a slight twitch of the shoulders can indicate awareness). It can be helpful to make a list of all the ways he pays attention to sounds, words and events in his environment (this is the foundation skill for paying attention).

Once you have a list, reinforce him every time he performs one of the responses on the list. Reinforce him every time he makes even the smallest physical movement to indicate that he is noticing something in his environment. When he realizes that he is getting treats, attention and praise from Mom for noticing things in his environment, he will start noticing and reacting to more things. Once he is noticing more often, you can experiment with different activities. Say a word and see if he turns to you or reacts in some way; if so, reinforce him. Keep practicing this until he is turning to you every time you speak. Hold out an interesting object and ask him to "touch." If he reacts in any way to your request (even if it is just looking at the object), reinforce him.

You can build up his attending and noticing skills with positive reinforcement. Once these skills are strengthened, you will spot opportunities to introduce words and, eventually, comments and directions for him to respond to.

The use of positive reinforcement is one of the key principles of Applied Behavior Analysis (ABA). Positive reinforcement causes a behavior (physical movement of the body) to happen again.

Best wishes!