What prevents an autistic child from speaking?
How to Help Your Nonverbal Child with Autism Speak
Approximately one third of children with autism are nonverbal. This means that they never learn to speak more than a few words in their lives.
Why Can’t My Autistic Child Speak?
There may be a couple of reasons that a child with autism doesn’t speak. The primary identifying aspect for nonverbal autism is determining whether or not the individual speaks clearly or with interference.
Although there are individuals with autism that may struggle with having a back-and-forth conversation, these are not nonverbal autistic people. Those who are nonverbal don’t speak at all.
Let’s look at the reasons why this may be happening. Autistic children could lose the ability to speak later on as the disorder’s symptoms worsen over time.
The individual could also be suffering from apraxia. This can cause the person to not be able to say what they want to say.
Autistic individuals could also suffer from echolalia, which is the repetition of words and phrases. This could also hinder clear communication.
In addition, there are social, behavioral and developmental symptoms for nonverbal autism.
Social symptoms: Social interaction difficulties are a hallmark symptom of autism spectrum disorder. Individuals generally avoid eye contact. They don’t respond when their names are called. These could cause the individual to feel left out and isolated and may lead to depression.
Developmental symptoms: Each individual is unique. Every autistic person develops at a different rate. While a child can develop at a typical rate, their developmental progress could be delayed after the age of 2 or 3. This could be the case for speech as well.
Behavioral symptoms: Individuals with autism strictly stick to routines. Interruptions in these routines or schedules could upset them. Some have really specific interests and obsessions about certain objects and topics. They may have a short attention span, causing their focus to switch from one thing to another, which could affect communication. Behavioral symptoms really differ for each person.
Not all individuals show the same symptoms, and symptoms may improve with age as they become less disruptive and severe.
Through speech therapy and speech interventions, nonverbal autistic children could become verbal in time with the right and continuous help and support.
A nonverbal autistic two years old may not respond when their name is called A nonverbal autistic three years old may not play pretend A nonverbal autistic four years old may repeat words and phrases that are not meaningful A nonverbal autistic five years old may have trouble interpreting gestures in communication setting.
Causes of Autism
The definitive cause of autism is still being studied. However, research suggests that there is no single cause for the disorder.
Autism appears to develop from a combination of genetic and environmental factors.
These factors are found to impact and increase the risk of a child developing autism spectrum disorder. Increased risk doesn’t mean that the individual will certainly develop the disorder.
Some of the individuals that have risk factors associated with autism don’t have the disorder.
Studies suggest that the disorder:
- Could be inherited,
- Could result from abnormal levels of chemicals in the brain
- Could be caused by infection or the effects of an environmental toxin
Genetic risk factors: Genetics were found to affect the risk of some forms of autism. It is known that if an individual has a sibling or a parent with ASD, they are more likely to develop the disorder. In addition, some medical conditions were linked to autism spectrum disorder. Genetic disorders such as Fragile X syndrome are included in these conditions.
Environmental risk factors: Some experts suggest that exposure to heavy metals and toxins in the environment may raise the risk of developing ASD. Also, CDC indicates that children born to older parents are at higher risk for developing autism spectrum disorder. Certain prescription drugs such as thalidomide and valproic acid have been linked to autism development as well.
As can be seen, both genetics and environment could determine whether a child will develop autism or not. Autism is NOT caused by vaccines.
An abundance of research conducted on the matter concluded that the disorder is not caused by vaccines. The infamous study done in 1998 suggesting a link between autism and measles, mumps, and rubella (MMR) vaccine has been debunked multiple times and retracted in 2010 .
Diagnosis of Nonverbal Autism
There is no specific single test that determines nonverbal autism. A multi-phase process is conducted to diagnose the disorder.
When your child is at the pediatrician, they will be the first healthcare providers to assess for ASD. Parents and caregivers will sound their concerns to their doctor if they notice any symptoms.
The pediatrician then could request various tests to rule out other possible causes for the concerning symptoms. They may conduct physical examinations, blood tests, and MRI or CT scan imagings.
Pediatricians then refer your child to a specialist if they suspect autism spectrum disorder. Specialists will evaluate the medical history of the child as well as the parents.
After all of the extensive testing, autism-specific tests may be used to confirm the diagnosis of the disorder.
These tests include Childhood Autism Rating Scale Third Edition (GARS-3) and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) They will help clinicians determine whether the child has nonverbal autism.
Do Nonverbal Autistic Toddlers Babble?
Around 40% of autistic children don’t speak. Some others may speak while also having limited language and communication skills.
Babbling occurs when a newborn is practicing for speech. They open and close their mouths, move their tongues in different ways.
When typically developing babies babble, they begin their early development of language.
People with autism sometimes produce certain nonsensical speech sounds. These are called jargon. Sometimes they are self-stimulatory behaviors.
Generally, they are not used to communicating with others. The rate of babbling in nonverbal autistic individuals is low compared to their typically developed peers.
However, babbling could represent precursors to speech in an autistic child with speech-language delay.
Research suggests that the majority of nonverbal 4-year-olds with autism can develop spoken language if they have relatively strong social engagement and don’t have intellectual disability.
If a nonverbal child with autism babbles along with eye contact or gestures directed towards other people, this behavior could be worked on to be used as a tool for meaningful social and communication exchanges.
When is it Decided an Autistic Child is Verbal/Nonverbal?
Each individual develops at their own rate. However, research showed that one third to half of parents of autistic children noticed issues before their child’s first birthday. Also, around 80% to 90% saw problems before the child turned 2.
There are certain symptoms that may indicate that the child has verbal/nonverbal autism. Here are some:
- Not responding to their name by the age of 1
- Not babbling towards parents or caregivers by the age of 1
- Not pointing at objects of interest by the age of 14 months
- Not imitating the parents or caregivers by the age of 18 months
- Repeating words over and over
- Flapping their hands
- Rocking back and forth
- Preferring to be alone
- Avoiding eye contact
- Not meeting developmental milestones in terms of speech and language
How to Teach an Autistic Child to Talk
Although there is no cure for autism, there are therapies and interventions that help the individual to be able to communicate.
It is important to remember that each child is unique. One effort that works with one child may not be helpful for another. In addition, although a child with autism can learn to communicate, this may not alway be through spoken language.
Nonverbal autistic individuals can have and live fulfilling and comfortable lives with the help of therapies and assistance.
Here are some of the treatment options for nonverbal autistic individuals:
Medicine: There is no medicine that will specifically cure autism. However, certain medication could help alleviate related symptoms and conditions. The child could have anxiety or depression, and medication could help with these.
Counselling: Counseling parents and caregivers as well as the siblings of the individual with autism could really benefit from therapy. Through counseling, they can learn how to approach the situation to achieve positive outcomes and to cope with the challenges of nonverbal autism.
Education: Children with autism respond really well to structured sessions. These sessions could help them develop skills and behaviors that will be beneficial in communication. They can gain social and language skills while also getting education and working on their development.
What Does the Future Look like for Nonverbal Children?
Nonverbal children with autism could have a comfortable and quality life. It is important that with the right help, they could equip themselves with the necessary skills to live their life normally.
Although nonverbal, children with autism use other methods to communicate. Certain strategies, which we will discuss here, could be used to leverage these methods and add on to them.
Not being able to speak to communicate should not be seen as a setback, but as a challenge that could be overcome. Although there is no magic cure to achieve speech, your child could go a long way with your support.
Once they understand and learn a way to express what they are feeling, be it verbal or nonverbal, they will have a more positive attitude towards communication.
What Age Do Autistic Children Talk?
Autistic children with verbal communication generally hit language milestones later than children with typical development.
While typically developing children produce their first words between 12 and 18 months old, autistic children were found to do so at an average of 36 months.Since each autistic child is unique in their development, the age when they produce their first words differs.
Until recently, parents and caregivers of children with autism were made to believe that their child would not speak ever if they did not do so by the time they turn 4 or five.
However, a recent study showed that most of the children participating in the study acquired language skills, and almost half of them became fluent speakers. More than 70% could speak in simple phrases. This indicates that language-delayed children with autism could eventually develop speech.
Nonverbal Autism Recovery
There is no “cure” for or “recovery” from autism. It is a lifelong condition that impacts major aspects of the individual. However, it is possible to manage signs and symptoms.
Through early intervention and treatment supports, the individual’s quality of life could increase. They can learn new sets of skills in terms of language and communication as well as behavior.
Techniques to Help Nonverbal Child Communicate
There are certain techniques you can try to encourage your nonverbal child to communicate. Here are a couple:
Encourage social interaction and play: Play, especially pretend play, is a great tool to teach children language skills. This will create fun opportunities for your child to communicate. You can also try certain activities like singing to promote social interaction. Make sure that it is easier for your child to see and hear you clearly during these activities.
Be patient: You may feel the need and urge to fill in the gaps in terms of language when your child doesn’t immediately respond. However, it is important to give the child the opportunity to gather their thoughts and communicate. This may not alway happen through speaking. But when you ask a question, just wait for a few seconds. Observe your child for the sounds and the gestures they make. When they make an attempt, be prompt to respond so that they will get the idea and feel like they are communicating.
Include your child’s areas of interest: Make sure that you are including the things and topics your child is interested in your communication attempts. Don’t interrupt their focus and go along with them. Describe what they are doing with the object of interest. By including what engages your child into these activities, they will be more likely to associate what they learned with the objects, and expand their vocabulary with the things they love.
Technology: There are various assistive technologies and visual aids out there in the market. Their purpose is more than just to replace speech. You can also use picture cards, which work similarly. They can also promote the development of this skill. Devices and applications with pictures and sounds where the child can engage with the object can help them produce words in time.
Otsimo is a great help in this area, as the application has hundreds of games designed to engage and help children learn skills, including speech and language.
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Understanding Nonverbal Autism
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.
Updated on October 16, 2022
Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey.
Table of Contents
Table of Contents
Nonverbal autism isn’t an actual diagnosis. It’s a term used for a subgroup of people with autism spectrum disorder (ASD) who never learn to speak more than a few words. An estimated 25-35% of children with ASD are considered nonverbal.
Nonverbal autism tends to occur in what’s known as severe autism, or level 3 autism. In some cases, a child will eventually learn to speak. For those who don’t, new approaches and technologies are making it possible for kids with autism to communicate in other ways.
What Is Nonverbal Autism?
Despite the prevalence of people with autism who don’t speak, the term «nonverbal autism» has no official status as a diagnosis. In part, that’s because there is no clear line between verbal and nonverbal individuals with autism.
Some people with nonverbal autism do develop the ability to use a few words in a meaningful manner but are unable to carry on any kind of significant conversation. For example, they may say «car» to mean «let’s go for a ride,» but would not be able to answer the question «where should we go?»
Some have the ability to speak but lack the ability to use language in a meaningful way. They may «echo» scripts from television or expressions they’ve been taught by therapists. Instead of using these scripts to communicate ideas or desires, they seem to use «scripting» as a way to calm themselves.
What Causes Nonverbal Autism?
No one really knows why some people with autism can’t, or don’t, use spoken language. It is especially puzzling because quite a few nonverbal people on the spectrum can and do choose to communicate using American Sign Language, picture cards, and a range of digital tools.
Some people with autism also have childhood apraxia of speech, a neurological disorder that makes spoken language extremely difficult. But most nonverbal individuals on the autism spectrum don’t have apraxia; they just don’t speak.
Until relatively recently, it was assumed that all nonverbal children with autism were intellectually disabled for the simple reason that their IQ scores fell under 70; those who score below 70 are considered intellectually disabled.
It’s recently become clear that typical IQ tests are in poor tools for measuring intellectual ability in children with autism—particularly when those children are nonverbal. The reasons for this are:
- IQ tests, for the most part, depend upon the test taker’s ability to quickly understand and respond to verbal information. Nonverbal children with autism have challenges in those areas which may or may not have any connection to basic intelligence.
- Most IQ tests require an ability to understand and respond to social norms and expectations, and to respond within a specific period of time. These expectations are very challenging to kids with autism, whether verbal or not.
- Sensory issues that don’t cause issues for neurotypical children may distract children with autism. Nonverbal children with autism may not have the ability to let testers know about such issues.
- Testers are rarely trained to work with, engage with, or «read» children with disabilities, especially children who are nonverbal. If they can’t engage the child, it is very unlikely that the child will present their highest level of ability.
Ideally, determining the IQ of a nonverbal child with autism should include both nonverbal IQ tests and non-test-related observations.
The TONI (Test of Nonverbal Intelligence) is one example of a nonverbal IQ test that is usually a better option for nonverbal children and for children with autism in general. Observation of nonverbal children in familiar settings can also provide evaluators with real-world information about abilities versus test-taking skills.
Diagnosing Nonverbal Autism
Diagnosing a child with nonverbal autism is challenging.
For one thing, it’s not always easy to distinguish between children who are nonverbal (no spoken language), preverbal (younger children who have not yet developed verbal language), or non-communicative (have neither verbal nor nonverbal communication skills).
A nonverbal child may be interviewed by a doctor, though talking to guardians and teachers about the child’s history and if there’s been any improvement in the child’s ability to speak gives a fuller picture. For example, the presence of even one word, or some echolalic speech, appears to be a significant predictor for the acquisition of spoken language after five years of age.
Research has revealed differences in brain function in people with nonverbal autism using instruments such as electroencephalograms (to measure brainwaves) and MRIs (to measure brain activity) in an effort to better understand what is going on inside the mind of a person who does not or cannot talk.
Other Signs of Autism
The main symptoms of autism are present in all children with ASD, whether they are verbal or nonverbal. These include:
- Difficulty making eye contact
- Difficulty reading social cues
- Problems expressing emotions and reading emotions of others
- Sensory challenges (feeling overwhelmed by noise, touch, or visual stimuli)
- Repetitive body movements (rocking, flapping, spinning, running back and forth)
- Ritualistic behaviors (e.g. lining up objects, repeatedly touching objects in a set order)
- Narrow or extreme interests in specific topics
- Resistance to changes in routine
Other potential causes of being non- or minimally verbal may have nothing to do with autism, and these will likely be ruled out before attributing them to autism. These include hearing problems, selective mutism, neurological disorders, and intellectual disabilities.
Will My Child Learn to Talk?
Quite a few autistic children with delayed speech gain the ability to communicate with spoken language. Some become quite fluent. Others, however, never gain more than a few words, if that.
There are many techniques for encouraging and improving spoken language for children with autism, though there is no guarantee that any particular approach will be effective for any given child. Different approaches that can improve verbal communication include:
- Speech therapy
- PECS (Picture Exchange Communication System)
- Behavioral interventions
- Play therapy
- Music therapy and related techniques, according to some early research
Other Ways to Communicate
While some nonverbal people with autism aren’t able to use spoken language effectively, they may be able to communicate with written language, American sign language, picture cards, or digital communication devices. Once an autistic person can effectively communicate, even without spoken language, their ability to engage in the world expands dramatically.
In recent years, numerous apps have been developed to help nonverbal kids with autism communicate more effectively. One of these is Proloquo2Go, in which users touch images on the screen to express their ideas, and the app “speaks” for them.
However, it’s important to steer clear of hoaxes that sound too good to be true. In the world of autism, one of these potential pitfalls is «facilitated communication,» in which a therapist «supports» the arm of an autistic person while they type.
This approach is still available but has been debunked by numerous studies that show that it is the therapist, and not the autistic person, who is guiding the typing finger.
A Word From Verywell
If a child isn’t hitting their developmental milestones for speaking or using words to communicate, talk to a pediatrician for an initial evaluation. The doctor can then refer you to autism specialists. The sooner a child is diagnosed as nonverbal, the sooner they can receive treatment that may improve their ability to speak and communicate.
Older nonverbal children may find it inspiring to read books by nonverbal people with autism, such as The Reason I Jump, by Naoki Higashida.