Is Delayed Speech a Sign of Autism?

Speech delays are very common among children with autism, but they are also common in children without autism. While significant speech delays are always a cause for concern, they are not inherently an autism trait and may be due to other issues, such as hearing loss.

Speech delays in children with autism characteristically occur with other communication issues such as a lack of eye contact, social and emotional passivity, not gesturing or pointing to objects, or a fixation on objects.

This article will cover the reasons for speech delays and help you recognize when they are related to autism.

How Speech Delays Differ in Autism

As most babies develop, they quickly learn that communication is the key to getting what they want. Long before they learn spoken language, they will make eye contact, pull on sleeves, babble, point, and physically or facially interact to get their point across.

Over time, neurotypical children (children without autism) learn to use spoken language because they get positive results from doing so. In addition, most neurotypical children:

• Are highly motivated by social responses such as smiles and hugs
• Are naturally inclined to imitate the 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

On the other hand, children with autism may have communication problems that make social connections difficult.

While high-functioning children who require lower levels of support may be more socially inclined than those with higher support needs, the same issues and challenges hold true across the autism spectrum.

For example, a child with autism may:

• Be more motivated by their own interests than by social responses
• Rarely or never imitate others' actions
• Be more interested in objects than in people
• Be content when left alone to pursue their own interests
• Be content with doing the same thing repetitively

All of these characteristics can lead to significant social challenges. This includes difficulty interpreting nonverbal cues like body language, having little interest in engaging with other kids or caregivers, or having heightened anxiety when faced with changes in routines.

Speech Delay Traits With Autism

The difference between speech delays in children with autism and those without is fairly easy to spot. Take the example of "Johnny" and "Bobby," two fictional children who exhibit significant speech delays:

• Johnny isn't talking at all at age 2. But while he isn't saying words yet, he's making babbling sounds and using 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 he's 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 other forms of intervention. Possibilities causes include:

• Hearing loss
• Apraxia of speech (a problem with the control of muscles used in speech)
• Cognitive impairment (problems with thinking, reasoning, memory, learning, and language skills)

Although Bobby is able to use a few words, he may be showing an early autism trait.

Red Flags Autism by Age

Speech development in children with autism can vary considerably. Some start using words earlier than neurotypical children, while others are nonverbal well into adulthood.

However, studies suggest that children with autism typically start producing words at 36 months, whereas a neurotypical child starts at around 12 to 18 months.

There are other red flags that point to the possibility of autism. These involve the absence of communication or social skills one would expect at certain ages, from 6 months to 2 years.

From 6 to 12 months of age, traits of autism include:

• Having little or no eye contact
• Failure to smile back when you smile at them
  
• Seeming emotionally passive
• Fixating on objects

By 12 months:

• Failure to respond to their name
• Lack of babbling
• Lack of gesturing or imitation
  

By 16 months:

• Having no single words
• Doesn't point to objects or show you objects
• No interest in sharing what they experience

By 24 months:

• Absence of spontaneous two-word phrases
• Lack of any language
  

Other Speech-Related Autism Traits

In addition to delayed speech, there are a number of other communication-related issues that could be autism traits.

In general, children with autism:

• 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

Summary

Children with autism often have speech delays, but that alone does not mean your child has autism. Speech delays with autism usually occur along with other communication issues, such as not using gestures, not responding to their name, and not showing interest in connecting with people.

Other possible causes of speech delays include hearing loss and cognitive problems.