Mental Health Neurodevelopmental Disorders Autism Traits 13 Speech and Communication Problems in Autism By Lisa Jo Rudy Updated on August 25, 2023 Medically reviewed by Jonathan B. Jassey, DO Print Most autistic people (though by no means all) do have the ability to talk. Most of the time, though, autistic people speak differently than their neurotypical peers. Some of the differences relate to actual production and use of spoken language, while others relate to challenges with reading nonverbal "body language," and other social and cultural cues and expectations. South_agency / Getty Images What Is a Pragmatic Speech Delay? The American Speech-Language Hearing Association (ASHA) describes pragmatic speech as having three components: Using language for different purposes, such as Greeting (e.g., hello, goodbye)Informing (e.g., I'm going to get a cookie)Demanding (e.g., Give me a cookie)Promising (e.g., I'm going to get you a cookie)Requesting (e.g., I would like a cookie, please) Changing language according to the needs of a listener or situation, such as Talking differently to a baby than to an adultGiving background information to an unfamiliar listenerSpeaking differently in a classroom than on a playground Following rules for conversations and storytelling, such as Taking turns in conversationIntroducing topics of conversationStaying on topicHow to use verbal and nonverbal signalsHow to use facial expressions and eye contact Of course, the rules of speech and communication vary from community to community and may be completely different from nation to nation. But the ability to observe, make sense of, and use these rules (and make appropriate changes in different social settings) is the key to pragmatic speech and communication. How Autism Affects Pragmatic Speech For autistic people, pragmatic speech is almost always a challenge at some level. Obviously, a nonverbal person is struggling with very different challenges than a highly verbal person, but both are likely to need help in understanding facial expressions, nonverbal cues, turn taking, and so forth. While autistic speech patterns vary from person to person, autistic individuals may: Be louder or quieter than is culturally expectedSpeak in a flatter voice or use a different intonation than usualRepeat entire chunks of scripts from television shows, videos, or moviesTalk about what seems to be an off-topic subjectDominate the conversation with talk about a topic of interest only to themselvesSay the same things over and over again (They either literally state the same facts over and over or use the same phrases in the same way over and over; for example, saying "that's great" in response to every statement.)Ask questions or volunteer information about topics that are usually considered taboo or sensitive (for example "So, are you really upset about your recent divorce?" or "I went to the doctor yesterday and had to give a urine sample.")Enter conversations when they are not invited, and/or leave conversations before the discussion appears to be overHave a hard time recognizing sarcasm, jokes, idioms, and expressions such as "the pot calling the kettle black" unless they are explainedUse language that seems inappropriate to the situation (too formal, too informal, trying to be funny in a serious situation or trying to be serious in a silly situation)Ask questions simply in order to state their own ideas or opinions (for example "Do you like telescopes? I like telescopes; I have three of them. One of them is a Celestron and ....")Tell the truth, without awareness of whether truth-telling will have a negative outcome ("yes, that dress does make you look fat")Have difficulty with or refuse to engage in the type of small-talk that usually smooths interactions among new acquaintances or in highly tense situations (weather talk, for example) How Therapists Can Help With Pragmatic Speech Both speech therapists and social skills therapists work with autistic children and adults to overcome pragmatic speech delays. Family and friends can also help by actively teaching, modeling, and role-playing appropriate speech patterns and language use. Unlike some therapies, speech and social skills therapies can make a significant difference for both autistic children and adults. Improvements in pragmatic speech skills can make a huge positive difference in others' response to autistic people. It's important to note, however, that it is possible to "overtrain" autistic children, in particular, to the point where their language use is technically correct but socially "off." Strange but true, an autistic child who shakes hands with an adult, looks them in the eye, and says "It's a pleasure to meet you" is behaving, not like a child, but like a business peer! 1 Source 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. American Speech-Language-Hearing Association. Social Language Use (Pragmatics). 2017. Additional Reading Brukner-Wertman, Yael et al. Social (pragmatic) communication disorder and its relation to the autism spectrum: dilemmas arising from the DSM-5 classification. Journal of Autism and Developmental Disorder. August 2016, Volume 46, Issue 8, pp 2821–2829. Adams, C. (2015). Assessment and intervention for children with pragmatic language impairment. In D. A. Hwa-Froelich (Ed.), Social communication development and disorders (pp. 141–170). New York: Psychology Press. By Lisa Jo Rudy Rudy is a writer, consultant, author, and advocate who specializes in autism. Her work has appeared in The New York Times and Autism Parenting Magazine. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit