Autism spectrum disorder (ASD) presents a wide range of developmental paths, particularly concerning speech and language. Understanding these diverse trajectories is important for parents and caregivers. While some children develop speech within typical timelines, others may experience delays or differences in their communication journey. This variability is a hallmark of autism.
Speech Development in Autistic Children
Speech and language development in autistic children varies significantly. Children begin to babble with both vowels and consonants around 10 months and utter their first words between 9 and 12 months, with a vocabulary expanding to about 50 words by age two. Some autistic children start speaking around this typical age range, between 12 and 18 months, and may develop phrases by 18 to 24 months.
Delayed speech is common, with many autistic children starting to speak later, around two to three years of age or even beyond. This delay can be linked to challenges in developing early social communication skills like joint attention, where a child and caregiver focus on the same object or event. Language regression is another aspect, where a child develops some words or phrases and then loses them. This regression occurs between 15 and 30 months, with a mean age of onset around 20 months, and is reported in approximately 25% to 40% of autistic children.
While about 70-75% of autistic children are considered verbal, around 25-30% may be non-verbal. Even when verbal, autistic children might use language differently, such as repeating words or phrases (echolalia) or having difficulty coordinating speech movements (apraxia).
Beyond Spoken Words
Communication extends beyond spoken language, encompassing a range of pre-linguistic skills that lay the groundwork for later speech development. These foundational skills include intentional communication, using gestures, making eye contact, and engaging in joint attention. Autistic children may find it challenging to develop these pre-linguistic skills, which can impact their ability to speak.
Autistic individuals communicate through various other means. This can involve body language, facial expressions, sounds like squeals or grunts, and the use of objects to convey needs or feelings. Augmentative and Alternative Communication (AAC) methods support communication. These methods range from low-tech options like picture exchange communication systems (PECS) and communication boards to high-tech devices such as speech-generating devices and communication apps on tablets. AAC tools do not hinder speech development; instead, they can promote and enhance communication skills by providing a reliable way for individuals to express themselves.
Encouraging Communication Development
Early identification of developmental differences and prompt intervention can significantly improve communication outcomes for autistic children. Research indicates that children who begin intervention programs at younger ages often make greater gains in language and social skills compared to those who start later. Therapeutic approaches often include speech-language therapy and applied behavior analysis (ABA) therapy, which can teach language content and increase speech intelligibility.
Parents and caregivers play an important role in fostering communication development at home through everyday interactions. Practical strategies include using clear and simple language, avoiding complex sentences, and providing specific instructions. Incorporating visual supports like schedules or picture boards can aid understanding and reduce anxiety. Encouraging non-verbal communication, such as gestures or sign language, and responding to all communication attempts helps build a foundation for language. Creating a language-rich environment, following the child’s interests, and providing opportunities for turn-taking during play also support communication growth.