Understanding Nonverbal Autism

Little girl standing near the stairs.

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Nonverbal autism isn't an actual diagnosis. It's a term used for a subgroup of people with autism spectrum disorder (ASD) who never learn to speak more than a few words. An estimated 40% of people with ASD are considered nonverbal.

Nonverbal autism tends to occur in what's known as severe autism, or level 3 autism. In some cases, a child will eventually learn to speak. For those who don't, new approaches and technologies are making it possible for kids with autism to communicate in other ways.

What Is Nonverbal Autism?

Despite the prevalence of people with autism who don't speak, the term "nonverbal autism" has no official status as a diagnosis. In part, that's because there is no clear line between verbal and nonverbal individuals with autism.

Some people with nonverbal autism do develop the ability to use a few words in a meaningful manner but are unable to carry on any kind of significant conversation. For example, they may say "car" to mean "let's go for a ride," but would not be able to answer the question "where should we go?"

Some have the ability to speak but lack the ability to use language in a meaningful way. They may "echo" scripts from television or expressions they've been taught by therapists. Instead of using these scripts to communicate ideas or desires, they seem to use "scripting" as a way to calm themselves.

What Causes Nonverbal Autism? 

No one really knows why some people with autism can't, or don't, use spoken language. It is especially puzzling because quite a few nonverbal people on the spectrum can and do choose to communicate using American Sign Language, picture cards, and a range of digital tools.

Some people with autism also have childhood apraxia of speech, a neurological disorder that makes spoken language extremely difficult. But most nonverbal individuals on the autism spectrum don't have apraxia; they just don't speak.

Until relatively recently, it was assumed that all nonverbal children with autism were intellectually disabled for the simple reason that their IQ scores fell under 70; those who score below 70 are considered intellectually disabled.

It's recently become clear that typical IQ tests are in poor tools for measuring intellectual ability in children with autism—particularly when those children are nonverbal. The reasons for this are:

  • IQ tests, for the most part, depend upon the test taker's ability to quickly understand and respond to verbal information. Nonverbal children with autism have challenges in those areas which may or may not have any connection to basic intelligence.
  • Most IQ tests require an ability to understand and respond to social norms and expectations, and to respond within a specific period of time. These expectations are very challenging to kids with autism, whether verbal or not.
  • Sensory issues that don't cause issues for neurotypical children may distract children with autism. Nonverbal children with autism may not have the ability to let testers know about such issues.
  • Testers are rarely trained to work with, engage with, or "read" children with disabilities, especially children who are nonverbal. If they can't engage the child, it is very unlikely that the child will present their highest level of ability. 

Ideally, determining the IQ of a nonverbal child with autism should include both nonverbal IQ tests and non-test-related observations. 

The TONI (Test of Nonverbal Intelligence) is one example of a nonverbal IQ test that is usually a better option for nonverbal children and for children with autism in general. Observation of nonverbal children in familiar settings can also provide evaluators with real-world information about abilities versus test-taking skills.

Diagnosing Nonverbal Autism

Diagnosing a child with nonverbal autism is challenging.

For one thing, it's not always easy to distinguish between children who are nonverbal (no spoken language), preverbal (younger children who have not yet developed verbal language), or non-communicative (have neither verbal nor nonverbal communication skills).

A nonverbal child may be interviewed by a doctor, though talking to guardians and teachers about the child's history and if there's been any improvement in the child's ability to speak gives a fuller picture. For example, the presence of even one word, or some echolalic speech, appears to be a significant predictor for the acquisition of spoken language after five years of age.

Research has revealed differences in brain function in people with nonverbal autism using instruments such as electroencephalograms (to measure brainwaves) and MRIs (to measure brain activity) in an effort to better understand what is going on inside the mind of a person who does not or cannot talk.

Other Signs of Autism

The main symptoms of autism are present in all children with ASD, whether they are verbal or nonverbal. These include:

  • Difficulty making eye contact
  • Difficulty reading social cues
  • Problems expressing emotions and reading emotions of others
  • Sensory challenges (feeling overwhelmed by noise, touch, or visual stimuli)
  • Repetitive body movements (rocking, flapping, spinning, running back and forth) 
  • Ritualistic behaviors (e.g. lining up objects, repeatedly touching objects in a set order)
  • Narrow or extreme interests in specific topics
  • Resistance to changes in routine

Other potential causes of being non- or minimally verbal may have nothing to do with autism, and these will likely be ruled out before attributing them to autism. These include hearing problems, selective mutism, neurological disorders, and intellectual disabilities.

Will My Child Learn to Talk?

Quite a few autistic children with delayed speech gain the ability to communicate with spoken language. Some become quite fluent. Others, however, never gain more than a few words, if that.

There are many techniques for encouraging and improving spoken language for children with autism, though there is no guarantee that any particular approach will be effective for any given child. Different approaches that can improve verbal communication include:

Other Ways to Communicate

While some nonverbal people with autism aren't able to use spoken language effectively, they may be able to communicate with written language, American sign language, picture cards, or digital communication devices. Once an autistic person can effectively communicate, even without spoken language, their ability to engage in the world expands dramatically.

In recent years, numerous apps have been developed to help nonverbal kids with autism communicate more effectively. One of these is Proloquo2Go, in which users touch images on the screen to express their ideas, and the app “speaks” for them.

However, it's important to steer clear of hoaxes that sound too good to be true. In the world of autism, one of these potential pitfalls is "facilitated communication," in which a therapist "supports" the arm of an autistic person while they type.

This approach is still available but has been debunked by numerous studies that show that it is the therapist, and not the autistic person, who is guiding the typing finger.

A Word From Verywell

If a child isn't hitting their developmental milestones for speaking or using words to communicate, talk to a pediatrician for an initial evaluation. The doctor can then refer you to autism specialists. The sooner a child is diagnosed as nonverbal, the sooner they can receive treatment that may improve their ability to speak and communicate.

Older nonverbal children may find it inspiring to read books by nonverbal people with autism, such as The Reason I Jump, by Naoki Higashida.

Frequently Asked Questions

  • How many autistic children are nonverbal?

    It is estimated that up to 40% of children with autism are nonverbal.

  • What kind of future do nonverbal children with autism have?

    Depending on their intellectual and cognitive abilities, many nonverbal people can get jobs that don't require speaking, such as being a janitor, a gardener, or working in a library restocking shelves.

  • Can you teach a nonverbal child with autism to write?

    Yes, nonverbal children can learn to read and write, depending on their intellectual abilities. Various strategies, devices, and apps can help nonverbal children express themselves in writing.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  10. Sharda M, Tuerk C, Chowdhury R, et al. Music improves social communication and auditory-motor connectivity in children with autism. Transl Psychiatry. 2018;8(1):231. doi:10.1038/s41398-018-0287-3

  11. Center for Autism Research. American sign language.

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  14. Autism Speaks. Teaching nonverbal children with autism to read.

Additional Reading
  • Berdick, Chris. Cracking the code of silence in children with autism who barely speak. Boston University website.

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.