Why Is Conversation So Hard for People with Autism?

The majority of people with autism do use spoken language. Few, however, use it in exactly the same way as people without autism. In some cases, the differences are quite marked. In others, while the differences are subtle, they are obvious to native speakers of the same language.​​ Some differences relate to the correct use of spoken language and grammar. In addition, however, many differences relate not to the selection of correct words but to intonation, eye contact, and body language.

Little boy shouting with colorful sound waves
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How Children With Autism Are Taught to Converse

Children with autism very often have delayed or "disordered" speech. They may recite scripts from television without understanding their meaning, repeat phrases, or make sounds that have no meaning. Most work with speech and behavioral therapists to learn the correct use of spoken language. More advanced language users are taught how to use language appropriately and interactively.

Social skills therapists and coaches also work on speech and conversation skills. Some of the specific skills they teach, for example, are how to ask and answer a question; how to choose appropriate topics of conversation; how to make eye contact; and how to use and notice body language. For example, social skills therapists may teach a person with autism how to recognize sarcasm and humor by watching facial expressions and body positioning.

Why People With Autism Have Difficulty With Conversation

Lots of training and practice can certain improve fluency and skill. But very few people on the spectrum become so fluent in conversation that they sound and appear absolutely ​typical. There are also some issues that can actually be caused by social skills training. Here are some of the challenges autistic conversationalists face:

  1. Quite a few people on the spectrum don't process language as rapidly as typical peers. As a result, they may take longer to make sense of a statement, craft an appropriate response, and then say what's on their mind. Most typical conversation moves rapidly, and thus people on the spectrum are often left behind.
  2. Most people on the spectrum have difficulty with separating sarcasm and humor from statements of fact. Abstract ideas and idioms are also tricky. As a result, they are likely to respond inappropriately—unless the speaker is careful to explain his or her meaning or intent.
  3. People with autism often speak with a different rhythm, prosody, and/or volume than typical peers. Thus, even if the words themselves are appropriate, they may sound flat, loud, soft, or otherwise different.
  4. It's not unusual for people with autism to "script" their conversations. In other words, they may borrow phrases from TV, videos, or even social skills groups or social stories. This strategy allows them to respond quickly with appropriate language—but when someone recognizes the phrases as coming from Sponge Bob or Thomas the Tank Engine, the results can be embarrassing.
  5. In some cases, people with autism repeat themselves more often than their typical peers. So a perfectly reasonable question ("When are we going to dinner?" for example) can turn into a refrain when the question is asked over and over again in exactly the same way, with precisely the same intonation.
  6. People with autism are often over-focused on their particular interests. As a result, they may use conversational tools as a "wedge" to create an opportunity to talk at length about their preferred topic ("Who's your favorite Disney character? Mine is Belle. Belle is French, and she..."). This is fine in some situations, but it often leads to frustration on the part of conversational partners.
  7. Social skills training, while it can be helpful, can also create misunderstandings about how spoken and body language should be used in specific settings. For example, while hand-shakes are appropriate in formal situations they are rarely appropriate within a group of children. And while the question "How was your weekend?" is perfectly reasonable in the office, it's inappropriate in a playgroup.
  8. Some social skills are over-emphasized by therapists, leading to odd behaviors. For example, while it's probably a good idea to look your conversational partner in the eye for at least a second or two, eyeball-to-eyeball conversations are very uncomfortable for most people.

Few people with autism are able to master the art of conversation to the point where they are indistinguishable from their neurotypical peers. Most, however, are more than capable of developing solid conversational skills, and, in most cases, interact successfully in a variety of settings. For most people, a combination of therapies, video modeling, and plenty of practice are the keys to success.

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  1. Paul R. Interventions to improve communication in autismChild Adolesc Psychiatr Clin N Am. 2008;17(4):835–x. doi:10.1016/j.chc.2008.06.011

Additional Reading
  • Ryan, G., Brady, S., Holloway, J., & Lydon, H. (2018). Increasing appropriate conversation skills using a behavioral skills training package for adults with intellectual disability and autism spectrum disorder. Journal of Intellectual Disabilitieshttps://doi.org/10.1177/1744629517750744

  • Smart C., Denman K. (2017) Student and Supervisor Experiences of Learning and Teaching Conversation Analysis and Discursive Psychology for Autism Spectrum Disorder Focused Research: A Reflective Approach. In: O'Reilly M., Lester J., Muskett T. (eds) A Practical Guide to Social Interaction Research in Autism Spectrum Disorders. The Language of Mental Health. Palgrave Macmillan, London