Is Late Speech a Sign of Autism?

Speech delays are very common among children with autism, but they are also common in children without autism. There are, however, very real differences between autistic speech delays and other types of delays. In many cases, these differences are evident even to non-experts. Significant speech delays are always a cause for some concern, but they are by no means always a sign of autism.

As typical babies develop, they quickly learn that communication is the key to getting what they want. Long before they learn to use spoken language, little ones make eye contact, pull on sleeves, babble, point, and otherwise work hard to get their point across to adults and older children. Over time, typical children learn to use spoken language because they get positive results from doing so. In addition, typical children:

• Are highly motivated by social responses such as smiles and hugs
• Are naturally inclined to imitate that actions of people around them
• Are likely to spend much more time observing people than observing things
• Tend to be social beings who become quickly bored or lonely when left alone

Children with autism, however, have social communication challenges that stand in the way of any kind of meaningful social connection. While children with high functioning autism may be much more socially inclined than those with more severe autism, the same issues hold true across the spectrum. Thus, for example, a child with autism:

• Maybe more motivated by his or her own interests than by social responses
• May rarely or never imitate others' actions
• Be more interested in things than in people
• Be content when left alone to pursue their own interests

All of these differences lead to different behaviors, desires, and outcomes.

The difference between autistic speech delays and other delays is fairly easy to spot. If you recognize your child in Bobby, it may be a good idea to consider having your child evaluated for ASD.

• Johnny isn't talking at all at age 2. But while he isn't using words yet, he's using babbling sounds and body language to communicate with the people around him. He's pointing, pulling people toward things he wants, and engaging with other people. He actively enjoys playing with his parents and siblings and is frustrated when left alone to take a nap.
• Bobby is the same age as Johnny. Bobby does have a few words, but he doesn't use them to communicate. Instead, he repeats them over and over to himself. Bobby has not yet figured out how to use gestures, sounds, or words to ask for something he wants. His parents find it almost impossible to hold his attention for more than a few seconds.

Johnny may have a speech delay that requires some form of early intervention; possibilities include (but are not limited to) hearing loss, apraxia of speech, and cognitive challenges. Bobby, however, despite the fact that he does have the use of a few words, maybe exhibiting early signs of autism.

In addition to late speech, there are a number of other communication-related issues that could be signs of autism. In general, children with autism are more likely to:

• Fail or be slow to respond to their name or other verbal attempts to gain their attention
• Fail or be slow to develop gestures, such as pointing and showing things to others
• Coo and babble in the first year of life, but then stop doing so
• Develop language at a delayed pace
• Learn to communicate using pictures or their own sign language
• Speak only in single words or repeat certain phrases over and over, seeming unable to combine words into meaningful sentences
• Repeat words or phrases that they hear, a condition called echolalia
• Use words that seem odd, out of place, or have a special meaning known only to those familiar with the child's way of communicating

Speech delays and differences are a hallmark of autism, and even those individuals who develop speech at a typical rate as toddlers may have a difficult time using spoken language effectively as they get older. They may use different vocal patterns, have a hard time reading or using body language, or continue to repeat sounds as a form of self-stimulation rather than as a means of communication. Speech delays alone, however, are not an indication of autism. If you do have concerns (even if your pediatrician does not) it's a good idea to have your child evaluated. If your child does have a significant speech delay or signs of autism, you'll be able to start therapy early and give your child the best chance of gaining typical communication skills.