Autism and speech delay are often interrelated. Problems with verbal language are among the most common signs of autism because a child with autism generally experiences considerable speech problems. However, speech delay also may indicate other health problems. Early diagnosis and treatment of autism and any similar condition can help a child significantly improve speech skills.
Autism is one of five pervasive developmental disorders, characterized by problems with language, speech, communication and social skills that present in early childhood. The other four pervasive developmental disorders are Asperger's syndrome, childhood disintegrative disorder, Rett's syndrome and pervasive developmental disorder-not otherwise specified.
Autism is often diagnosed by age two, generally when key developmental milestones are missed. Symptoms of autism range from mild to severe impairments in communication and social skills. Common autism symptoms may include the following:
- Limited to no verbal speech
- Echolalia or repeating words out of context
- Problems responding to verbal instruction and may ignore others who speak directly to him
- Preference to play alone and no interest in making friends
- Does not like to be cuddled and may even get upset when touched
- Needs strict routine and gets upset when routine is interrupted
- Repetitive and obsessive behaviors such as rocking back and forth, hand flapping or licking objects
- No pretend play
- Unusual play such as fixation on items that are not toys, spinning objects or lining up objects for hours at a time
- May have sensory issues and experience an unusual reaction to certain sounds, sights, physical sensations or tastes
About Autism and Speech Delay
A child with autism generally experiences a delay in speech. Speech and language developmental milestones estimate that a 12 month-old child begins speaking words such as "mama" and gains a vocabulary of about 10 words by 18 months. The first sign of speech delay is when a baby does not babble or baby talk by 12 months. The child may be completely nonverbal and prefer to use gestures instead of words or use a few words without signs of expanding to an age-appropriate vocabulary.
It is also important to realize that some children with speech delay are simply late talkers and go on to develop an age-appropriate vocabulary and speech skills. In these cases, the children may not have any underlying medical condition.
Other Medical Conditions with Speech Delay
Speech delay does not always indicate autism. The language problem can also indicate other health conditions such as the following:
- Hearing impairment: The inability to hear can result in speech delay because babies begin early speech by imitating sounds. Hearing loss can also occur from chronic ear infections.
- Oral impairment: An unusual oral structure such as a short frenulum on the tongue can limit the free movement of the tongue for speech.
- Intellectual disability: Intellectual disability is one of the most common causes of speech delay.
- Expressive language disorder: A child with expressive language disorder has normal development in areas such as social skills and intellectual ability but has trouble expressing ideas in speech without appropriate intervention.
Speech Delay as a Symptom of Autism
When autism is the cause of speech delay, the young child has significant developmental delays and impairments related to communication and social interaction. The most important difference between speech delays caused by autism versus another medical condition is the presence of other autism symptoms. A doctor can screen for autism as well as determine the true cause of a speech delay.
Speech Therapy for Autism
Speech therapy is the best way to improve speech skills and allow a child with autism to communicate effectively.
Speech therapy for autism may involve expanding a vocabulary or teaching a nonverbal communication system as an alternative. A licensed speech therapist can help a child with autism do the following:
- Build vocabulary and encourage verbal speech
- Understand word meaning and context
- Figure out speech pragmatics in order to understand the proper use of speech in social situations
- Participate in two-way conversation
- Learn a nonverbal communication method such as the Picture Exchange Communication System (PECS)
Finding an Autism Speech Therapists
When searching for a speech-language therapist, parents should make sure that the therapist is licensed and experienced in dealing with autism. It is also a good idea for parents evaluate how well their child interacts with and responds to a therapist when choosing a new practitioner. Consult the American Speech Language Hearing Association website to find a list of licensed speech-language therapists that specialize in autism throughout the country.
Hope for Improving Speech Skills
There is hope for a child with autism and speech delay to expand his vocabulary and speech ability through therapy. Even in cases where a child with autism remains nonverbal, there are effective methods of nonverbal communication that allow the child to express himself and communicate. Early intervention is essential to treating autism and speech delay for the best possible outcome.