As anyone who has ever witnessed me engage in sport can attest to, challenges in co-ordination are extremely common in autistic people. Yet, what you may not know is that, within many people on the spectrum , these same motor-function challenges may cause difficulty in speaking.
This may come as a surprise to those who believe that, like communication, issues with speaking are due to our mental rewiring. However, recent studies, such as those found in;Frontiers in Integrative Neuroscience,;theorise that most non-verbal autists find it difficult to speak because either:
This isnt the end of autistic communication though, as research has shown that, within test groups of autists who are unable to create two-word sentences by age 4, 70% can by age 8 with some even going on to speak fluently. Furthermore, close to all autists will learn to understand the meaning of words, but it may be the case that they are diagnosed with apraxia; a condition in which someone isnt capable of replicating movements/commands, even if they understand how and want to.
Age | |
Coos in response to you, smiles | |
6 months | Babbles, turns and looks at new sounds |
8 months | Responds to name, pats self in mirror |
10 months | Shouts to attract attention, says a syllable repeatedly |
12 months | Says 1-2 words; recognizes name; imitates familiar sounds; points to objects |
12-17 months | Understands simple instructions, imitates familiar words, understands no, uses mama dada and a few other words |
18 months | Uses 10-20 words, including names, starts to combine 2 words all gone, bye-bye mama, uses words to make wants known up all done or more; knows body parts |
2 years | Says 2-3 word sentences; has >50 words, asks whats this and wheres my vocabulary is growing; identifies body parts, names pictures in book, forms some plurals by adding s |
2 ½ years | Gives first name; calls self me instead of name; combines nouns and verbs; has a 450 word vocabulary; uses short sentences; matches 3-4 colors, knows big and little; likes to hear same story repeated |
3 years | Can tell a story; sentence length of 3-4 words; vocabulary of about 1000 words; knows last name, name of street, several nursery rhymes, can sing songs |
4 years | Sentence length of 4-5 words; uses past tense; identifies colors, shapes; asks many questions like why? and who? Can speak of imaginary conditions I hope Uses following sounds correctly: b, d, f, g, h, m, n, ng, t, w, y |
As typical babies develop, they quickly learn that communication is the key to getting what they want. Long before they learn to use spoken language, little ones make eye contact, pull on sleeves, babble, point, and otherwise work hard to get their point across to adults and older children.
Over time, typical children learn to use spoken language because they get positive results from doing so. In addition, typical children:
Children with autism, however, have social communication challenges that stand in the way of any kind of meaningful social connection. While children with high functioning autism may be much more socially inclined than those with more severe autism, the same issues hold true across the spectrum.
Thus, for example, a child with autism:
All of these differences lead to different behaviors, desires, and outcomes.
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Autism spectrum disorder is a developmental disability caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop. We still have much to learn about these causes and how they impact people with ASD.
There is often nothing about how people with ASD look that sets them apart from other people. They may behave, communicate, interact, and learn in ways that are different from most other people. The abilities of people with ASD can vary significantly. For example, some people with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives; others can work and live with little to no support.
ASD begins before the age of 3 years and can last throughout a persons life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. In others, symptoms may not show up until 24 months or later. Some children with ASD gain new skills and meet developmental milestones, until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had.
There is this misconception that a baby that doesnt crawl will be a late talker but there is no scientific evidence to support that notion. Some people also think that its not that big of a deal if a child is a late talker. They think theyll catch up and be absolutely fine. And while its true that more than half of kids catch up during kindergarten, its also true that if you follow the late talkers to adolescence, that group on average will score below their peers on language and literacy tests they get into a normal developmental range but they might not ever be as good at language as a peer who never had a language delay.
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To truly understand the difference between a speech delay and autism, we need to look at the characteristics of each. As you read, keep in mind that you will see some crossover between the two.
Again, this does not mean that your child does or does not have autism. Please dont take this as medical advice. If you suspect either a language delay or autism, its vital that you speak to your childs pediatrician as soon as possible so you can both get the help and support that you need.
If your childs speech is delayed due to a hearing loss, hearing aids or cochlear implants may help your child hear speech. Once your child has access to sound , he or she may be able to develop language and even catch up to his or her hearing peers.
If your child hears and understands language, you can encourage him or her to speak by talking as much as you can around them. Describe what youre doing as you do everyday activities. Keep talking. If your child speaks, confirm what he or she is saying. Always provide positive feedback.
Speech and language delays can be frustrating for parents and children. Children who cant express their thoughts and emotions are more likely to act out. They anger easily. They may use unexpected behavior to get your attention. Try to remember your child does want to communicate with you. Read to your child and talk as much as you can. Encourage your child to speak. When he or she tries to speak, praise their efforts.
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Slow to speak:
Babies with autism show behavioral and brain features that differ from those of babies with language delay1. These findings from a new study hint at different biological origins for autism and language delay.
The results, based partly on brain scans, could help clinicians identify and treat subgroups of children with language problems.
The diagnoses we use in clinical practice today are entirely based on behavioral observations and lack any grounding in the underlying biology, says lead investigator Joseph Piven, professor of psychiatry at the University of North Carolina at Chapel Hill.
Children who have autism and language delay show dampened brain activity in two language centers as early as age 1, researchers reported in a 2015 study. Children who have language delay alone do not show this pattern.
In the new study, Piven and his colleagues found that among children who show poor language skills at age 1, those later diagnosed with autism understand and produce speech differently than do those without autism. They also show a different pattern of associations between the size of certain brain structures and language skills.
The term autism was changed to autism spectrum disorder in 2013 by the American Psychiatric Association. ASD is now an umbrella term that covers the following conditions:
People with ASD have trouble with social interactions and with interpreting and using non-verbal and verbal communication in social contexts. Individuals with ASD may also have the following difficulties:
How well someone with ASD can function in day-to-day life depends on the severity of their symptoms. Given that autism varies widely in severity and everyday impairment, the symptoms of some people arent always easily recognized.
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If a baby isnt cooing or making other sounds at 2 months, it could be the earliest sign of a speech delay. By 18 months, most babies can use simple words like mama or dada. Signs of a speech delay in older toddlers are:
A speech delay may mean that their timetable is a little different and theyll catch up. But speech or language delays can also tell something about overall physical and intellectual development. Here are some examples.
Although the scope of this page is children from 2 to 4 years of age, younger children may be referred to an SLP with concerns about language development. Depending on the presenting symptoms, the SLP may conduct a comprehensive speech and language assessment to determine the need for early intervention. The SLP might also refer the child to other professionals, if the symptoms suggest disorders or conditions other thanor in addition tolanguage delay. See ASHAs Practice Portal Page on Early Intervention and information about the Child Find mandate.
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Children learn pretty quickly that they need to communicate to receive what they want. In the cases of neurotypical children, they learn to make eye contact, babble, point, and tug on fingers or sleeves to communicate their needs long before they learn to speak.
Neurotypical children learn spoken language over time because they receive positive results from using it. While neurotypical children may experience speech delays, they exhibit the following behaviors
Any child may face some level of speech development delay in their life. However, a child with autism will exhibit additional signs like difficulty in understanding non-verbal communication.
Signs of ASD range from mild to severely disabling, and every person is different. The following signs are considered to be red flags that indicate your young child may be at risk for autism. If your child shows any of the following signs, please get in touch with your childs healthcare provider to discuss a referral for an autism evaluation.
The signs include the following:
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Case History
See ASHAs Practice Portal pages on Speech Sound Disorders: Articulation and Phonology and .
Assessment is accomplished using a variety of measures and activities, including both standardized and nonstandardized measures, as well as formal and informal assessment tools. SLPs have the obligation to ensure that standardized measures used in assessment show robust psychometric properties that provide strong evidence of their quality . Competency-based tools, self-report questionnaires, and norm-referenced report measures are frequently used. Analog tasks that mimic real-world situations and naturalistic observations can be used to gather information about an individuals communication skills in simulated social situations or in everyday social settings.
See ASHAs resource on;assessment tools, techniques, and data sources;for general information about assessment options. Keep in mind that several factors can affect the way children interact with their caregivers, including
Assessment may result in
Your child may not need treatment. Some children just take more time to start talking. But if your child needs treatment, the type will depend on the cause of the speech delay. Your doctor will tell you the cause of your childs issue and talk to you about treatment options.
Your doctor may refer you to a speech and language pathologist. This person can show you how to help your child talk more and speak better, and also can teach your child how to listen or how to lip read.
Other specialists your doctor may recommend you see include a psychologist , an occupational therapist , or a social worker . Your doctor may also suggest programs in your area such as Early Intervention.
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Imitation is another form of communication, and is a key milestone on the road to verbal speech.
In addition to what Dr. Barbera mentions in her video, other communication signs that a child could have autism in addition to speech delay include a lack of response to their name and/or verbal attempts for attention, babbling and cooing during their first year and then stopping, and being unable to combine words into phrases or sentences .
Dr. Barbera recommends that concerned parents be familiar with milestones and not just those related to language. Self-care and self-regulation skills like feeding oneself and calming oneself are important to note, too. She emphasizes that there is a range in development, however, and not every two-year-old is doing everything. There is no need to panic if your child isnt meeting every milestone, but knowing what milestones they should be meeting can help put you on the right path to understanding what is going on with your child.
According to the CDC, if your child shows the signs Dr. Barbera mentioned and also cant walk, doesnt notice when their caregiver comes and goes, or loses skills at 18 months old, you should contact your pediatrician.
And if your child doesnt use two-word phrases, doesnt know what to do with common items , or doesnt walk steadily at two years old, the CDC recommends you contact your pediatrician.
Learn more in the video below.
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