Speech Delay and Autism: What’s the Connection?

Curious about the difference between autism and speech delay?

On the other hand, maybe you’re concerned about your child’s lack of language development. Perhaps you want to know if it’s connected to autism or if your autistic child’s delayed speech will improve over time.

Whatever your question, today we’re discussing both autism and speech delays.

Additionally, we’ll discuss important differences between the two as well as when to seek support from a speech-language pathologist.

speech delay autism child facing speech therapist who is smiling while holding up a fake egg

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What is a Speech Delay?

A speech delay refers to a child who is unable to use words at the generally expected times. Additionally, this child may also struggle with language comprehension or not understanding words.

In the end, a child with a speech delay will say their first words later, but will follow the typical pattern to develop language. Ultimately, that child goes through the process later than a neurotypical child.

Before we dive into speech delays any further, let’s look at developmental milestones as a whole.

What are Developmental Milestones?

From conception, humans go through a general series of developmental milestones.

Think about those charts your pediatrician sends home after each of your child’s well-visits.

Remember those?

Well, the developmental milestones listed on those sheets fall under several categories.

(Personally, I was always focused on my kids’ height and weight, but I know those other details were there. Anyhoo…)

Some of those childhood developmental milestone categories are:

  • Communication skills
  • Motor skills
  • Social skills

Let’s quickly take a look at a few examples of each developmental category.

Example Childhood Milestones

Using examples from the CDC, we’ll look at four points in time: 2 months, 1 year, 2 years, and 3 years.

  • 2-month-old:
    • Social Interaction: Looks at your face
    • Communication: Reacts to loud noise
    • Motor: Holds up head when on tummy
  • 1-year-old
    • Social: Joint attention (for example, playing Pat-a-Cake with a caregiver)
    • Communication: Says, mama or dada
    • Motor: Pulls up to stand
  • 2-year-old
    • Social Interaction: Notices when others are sad
    • Communication: Says at least two-words together
    • Motor: Runs
  • 3-year-old:
    • Social Interaction: Notices other children and joins them in play
    • Communication: Asks “wh-” questions (Who, What, Where, Why, When)
    • Motor: Puts on own clothes

This is just a sampling of some categorical developmental milestones for each age bracket. It’s not at all exhaustive, but it gives us an idea of what we’re talking about.

Now that we have a general idea about childhood developmental milestones, let’s talk about developmental delays.

What’s a Developmental Delay?

speech delay autism.  developmental milestones image of a baby doing tummy time looking up smiling

According to Yale Medicine, a developmental delay is,

When a child’s progression through predictable developmental phases slows, stops, or reverses.

Because every child is different, pediatricians monitor children over time to determine if a child is developmentally delayed in a specific area.

They look at the larger picture rather than at just one area of development at one specific time.

What are Language Milestones?

Ok. You get the basic idea of developmental delays and milestones. But, what about speech and language skills specifically?

According to Stanford Medicine, by approximately 2 years of age, children “should” have a vocabulary of at least 50 words. Additionally, they “should” be able to say 2-word sentences.

By the time children are 3 years of age, they “should”:

  • String 3 words together,
  • Use prepositional language such as in and on
  • Utilize pronouns such as you and me
  • Begin using plurals
  • Ask questions using the proper intonation

These speech and language milestones give parents and doctors a general framework of expected speech development.

Learn More in Behind the Behavior Book!

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Late Talkers vs Speech Delay

As stated earlier, kids move through different developmental stages at different rates and that’s to be expected.

While generally, children begin to say single words around the age of a year, not all do.

So, what if this is your child? Can your child be one of those “late talkers”?

Is there a difference between a late talker and a child with a speech delay?

To answer this question, I reached out to a friend and colleague, Randi Smith. Randi is a former speech-language pathologist turned curriculum writer at Peanut Butter Fish Lessons.

Here’s what she says,

Late talkers are those whose speech development progresses at a slower rate but will eventually progress without speech therapy. A child with a speech delay needs some intervention to develop their speech.”

What are the Signs of a Speech Delay?

According to Randi, there is a lot of variability in speech and language skills between 18-27 months.

Further, she recognizes the pressure that moms are under to make sure their children are “on track.”

Therefore, she offers some clear early signs of speech-language delay that may prompt you to seek support.

  • lack of non-verbal communication
  • not babbling
  • very little variation of speech sounds
  • child appears to not understand you

In the end, if you’re concerned, it never hurts to talk to your doctor.

speech delay autism pin 2 teal background with several different colors of speech bubbles

What are the Causes of Speech Delay?

Not sure if this is good news, but I’ll frame it for you as encouragement.

According to the American Academy of Pediatrics, communication delays are the most common developmental delays in children. They say that up to one in five children will have an expressive language delay.

So, what causes these speech delays? Some potential root issues behind a child’s language impairments include:

Regarding that last one. It’s a good idea to take your child for a hearing test with a qualified audiologist.

Difference Between Speech Delays and Speech Disorders

Let’s clear up any confusion about the difference between a speech delay and a speech disorder.

A speech delay simply means that a child says their first words later but follows the same general pattern as a typically developing child.

A speech disorder is one of many developmental disorders characterized by a child having difficulty producing proper speech sounds.

Further, speech disorders and language disorders are two different things.

Speech and Language Disorders

speech pathologist with long brown hair and green sweater puckering her lips to demonstrate how to make a speech sound as she faces her young child client

A speech disorder is related to the production of speech and includes:

  • Childhood Apraxia of Speech
    • the brain has difficulties planning and executing the physical act of speech
  • Dysarthria
    • muscles responsible for speech are weak and underdeveloped
  • Stuttering
  • Articulation disorders

Language disorders are related to understanding and using language. Let’s look at two language disorders typically identified in preschool children.

  • Expressive language disorder
    • Problems using language to express ideas
  • Receptive language disorder
    • Difficulties with language comprehension

Fortunately, due to routine developmental screening in the first five years of life, these are more easily identified. Other language-based disorders are often picked up once children enter their elementary school years. Those include learning disabilities such as dyslexia and auditory processing disorders.

Diagnosis Options

When you and your doctor believe it’s time, you’ll want to get the right diagnosis and treatment plan. For children under the age of three, your child’s doctor will likely refer you to one of a few specialists.

  1. the local early intervention program
  2. private speech-language pathologist
  3. a developmental pediatrician

After the age of three, options are typically the same except that your child now has the option to be evaluated by your local school district.

A Note About Behavioral Issues

Often children with language disorders may appear “disobedient” when they have trouble following directions. However, it’s not disobedience but a lack of understanding. This is a very common reason why autistic, ADHD, and other neurodivergent children are hurt when we don’t look for the root of behavioral and academic challenges.

Signs of Autism and Speech Delays

Now that we’ve covered the basics of speech delays, let’s quickly discuss the signs of autism in young children. As we know, Autistic children often develop differently from neurotypical children. According to Reframing Autism, an autistic-led group of autism experts, there are some key differences between non-autistic and autistic children.

Some of these early signs of autism include:

  • Early feeding challenges
  • Sleep challenges
  • Sensory processing differences
  • Non-autistic play experiences
    • lining up cars by color or other forms of organizational play
    • collecting toys, bugs, letters
  • Repetitive behaviors or stimming behaviors
    • hand-flapping, bouncing, hair-twirling
  • Differences in communication
    • often engage in echolalia
    • unique social-communication
    • different social responses
    • may not make eye contact

To get a diagnosis of autism in the United States, parents need to work within the limits of the current medical model. This means, for now, autism is pathologized rather than embraced as a unique neurotype.

Medical Model of Autism

Under the medical model, the DSM-V diagnostic term is autism spectrum disorder or ASD. Unfortunately, traits of autism are considered symptoms instead of differences.

As such, developmental pediatricians, psychiatrists, and other professionals look for traits based on a controversial diagnostic manual that changes every 5 to 7 years. The DSM-V criteria for autism uses terminology that often hurts those on the receiving end of the diagnosis.

For example,

  • “abnormal”
  • “unusual”
  • “inflexible”
  • “highly restricted”

I bring this to light for the sake of the millions of autistic children who will one day grow into adults. Language matters. Fortunately, the autistic community is growing in ways that will benefit the next generation of autistic children.

Speech Delays in Autism

Let’s dive into the relationship between speech delays and autism. We know that a hallmark sign of autism is differences in communication. And we know that many autistic children have speech delays as well as speech and language disorders.

Interestingly, recent research showed that in children under the age of two, atypical speech development can be predicted by structural brain differences. On the other hand, however, we know that some autistic children are hyperverbal and demonstrate early speech.

Others end up using alternative forms of communication including sign language and AAC devices. However, with supportive intervention, most autistic children will develop fluent speech. So, now let’s move on to what speech intervention can look like.

quote about speech delays and autism with mom and daughter working on a craft in the background

Speech and Language Communication Treatment Options

Regardless of whether or not your child is autistic, there are many speech and language support and treatment options.

The first step is to find a strengths-based speech-language pathologist to be a part of your child’s team. Together, you’ll focus on speech and language goals that best serve your child. (If a therapist doesn’t value your input, find another one.)

Additionally, occupational therapy is a valuable resource to help with motor coordination challenges. Those with motor-related speech disorders such as apraxia will benefit from private occupational therapy.

And since many autistic children and adults struggle with motor coordination, an occupational therapist will be a vital member of your child’s team anyway.

How Does Occupational Therapy Help with Speech?

A PRIVATE neurodiversity-affirming occupational therapist is an essential member of your child’s support team. They can help with:

Strengthening these areas can lead to positive results in speech, behavior, emotional regulation, and learning.

Why I Recommend Private Occupational Therapy

In this quick video, I share why I value private OT for behavior, academics, language, and more. What do you think?

Power of Relationships

Even more importantly, you can greatly impact your children’s communication skills whether verbal or through AAC. Let me tell you one reason why.

One report studying autism-related speech delays and communication variances emphasized the importance of joint attention in the development of speech. Specifically, they noted that,

…a crucial factor in a child’s ability to develop joint attention is interaction with stable and available adults.

Regardless of the cause of your child’s speech delay, prioritize your relationship. This is a powerful way to support your child’s speech development.

  • Play with your child,
  • Take an interest in their special interests,
  • Talk to your child, and most importantly,
  • Listen to your child with curiosity

Create a safe space in your relationship. In the end, our children’s strong social connections start with those they have with us. Don’t underestimate the power of your relationship with your child. It’s your most powerful parenting tool.

Recap: Autism and Speech Delay

So, are speech delays related to autism? Yes and no. Yes, autistic children often experience social-communication challenges with non-autistic children. Additionally, we do see speech delays in autistic children.

However, we also know that not all children with language problems and speech delays are autistic. In the end, if you’re concerned about your child’s speech, talk to your doctor.

Early intervention services such as speech therapy, occupational therapy and play with safe care-givers can influence a child’s ability to develop speech. On the flip side consider this.

If your child wasn’t designed to speak, provide them with the communication tools that will allow them to thrive as themselves. They’ve got gifts to share with this world. If you don’t see them yet, start looking. I promise you. They’re there.

caucasian woman wearing black v-neck long-sleeved shirt sitting crossed legged with a black and white havanese dog in her lap

About the Author:

Lindsay is a trauma-informed educator with a Master’s Degree in Teaching. Her mission is to support moms to equip neurodivergent kids (ADHD, Autism, Dyslexia, Anxiety) to thrive as exactly who they’ve been created to be. Wait until you hear the story that led to it all…

Note About Language:

No one knows more about autism than those who’ve lived it. Autistic adults generally reject the diagnostic term Autism Spectrum Disorder or ASD.

At A Heart for All Students, we strive to honor the autistic community in our choice of words. As such, we don’t pathologize by using neurodiversity-affirming and strengths-based language.

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