Nonspeaking autism is not a distinct diagnosis but a description of a certain set of symptoms of autism spectrum disorder (ASD). Having nonspeaking autism does not mean that a person cannot communicate or understand language. With the right support, a nonspeaking autistic person can become a strong communicator, with or without verbal language.
Having nonspeaking autism means that an autistic person does not speak or can only say a few words. The term nonverbal, which many people use to describe these individuals, is inaccurate, as it encourages the incorrect assumption that nonspeaking autistic individuals are entirely unable to use words.
Additionally, it does not mean that nonspeaking autistic people are less intelligent than those who do speak. Many nonspeaking autistic people lead full, happy lives. However, some nonspeaking autistic people may require support to help them communicate effectively via other means.
A 2013 study of autistic children with speech delay found that 47% became fluent speakers after the age of 4 years and that 70% began using phrases.
This article explores nonspeaking autism in more detail, including its symptoms, causes, diagnosis, early signs, support, and outlook.
What is nonspeaking autism?
As nonspeaking autism is not a specific diagnosis, definitions vary.
Some people consider nonspeaking autism to mean that a person does not spontaneously speak in sentences or words that others can understand. Others consider it as having the ability to speak meaningfully at times but not being able to speak at all at other times.
Having nonspeaking autism does not mean that a person does not communicate, cannot communicate, or does not understand language.
Some nonspeaking autistic individuals write and verbally communicate in other ways, such as via typing or special communication devices. The absence of speech does not mean a lack of understanding.
People should not presume that a nonspeaking autistic person does not understand speech because they cannot speak themselves or that they are incompetent.
Symptoms
Nonspeaking autism affects a person’s verbal skills. Some symptoms include:
not spontaneously initiating or responding to conversation
using only a few words or not speaking in complete sentences
using sounds as opposed to words to communicate — although, in some cases, parents and caregivers may understand the meaning of these sounds
not relying on spoken language as a primary form of communication
A lack of speech does not necessarily mean that a person cannot understand language. However, there is still much that researchers do not understand about nonspeaking autism.
In a 2021 paperTrusted Source, autism researchers called for a clearer definition and criteria to explain nonspeaking autism. They also mentioned the need for more research to find more neurobiological factors that can explain the diversity of communication among autistic people. This knowledge may, in turn, help scientists design more appropriate supports for autistic people who may need them.
Causes
Autism is a complex condition. The diagnosis does not provide much information in itself, as autism causes a spectrum of symptoms.
Some potential factors in the development of autism include:
Genetics: Researchers have identified some genetic factors that appear to increase the likelihood of autism. A person is also more likely to be autistic if a close family member is autistic.
Genetic and chromosomal disorders: People with certain genetic or developmental disorders, such as tuberous sclerosis and fragile X syndrome, are more likely to be autistic.
Development during pregnancy and in infancy: Exposure to certain drugs while in the womb may increase the chance of autism.
Research indicates that no specific factor is likely responsible for language development in autistic people. However, it is likely that early intervention supports that target an autistic child’s play, attention, and imitation abilities may help increase their communication abilities.
Diagnosis
Nonspeaking autism is not a distinct diagnosis from ASD. Instead, it is a description of a person’s symptoms. Nonspeaking autism includes a continuum of behaviors, from never speaking at all to only speaking in some situations.
No single test can diagnose autism. Instead, a healthcare professional diagnoses autism based on a person’s symptoms.
the back-and-forth of communication
sharing interests or emotions
understanding or responding to social interactions
nonverbal communication, such as the inability to understand gestures or subtle body language or make eye contact
developing, understanding, or maintaining relationships with others
A person must also have a restricted range of interests and behaviors, which may be highly repetitive. Some examples include:
stereotypical behaviors or movements, such as repeating things that other people say, lining up toys, flapping the arms, or using objects in atypical ways
difficulty with change and a high need for a routine
hyperfocus on particular interests
over- or underreactivity to sensory input, such as being very sensitive to light or sound
For a person to qualify for a diagnosis, the symptoms must:
be present in early childhood
cause impairments in one or more areas of daily life or functioning
not be due to another diagnosis, such as a head injury
Early signs
have delayed language skills or language skills that appear and then disappear
do not use gestures to communicate by 12 months
do not understand pointing by 18 months
are not interested in other children
do not engage in pretend play by 2.5 years
do not have typical happy, sad, or angry facial expressions by 9 months
do not respond to their name by 9 months
are unable to maintain eye contact or actively avoid it
Treatment
Support for ASD focuses on caring for people with the diagnosis and helping them learn new skills. Some options includeTrusted Source:
Therapy: A wide range of behavioral therapies can help autistic people learn new skills. Speech therapy, occupational therapy, and similar interventions may help them function more independently. Behavioral therapy can focus on the development of social skills.
Psychotherapy: Psychotherapy can help autistic people understand their diagnosis and deal with symptoms of anxiety, depression, and other common issues. Family therapy may help a family better support an autistic person while offering parents or caregivers new skills for managing the child’s condition.
Accommodations: Autistic people may need certain accommodations at work or school.
Medication: Medication can help with symptoms that tend to co-occur with autism, such as anxiety, attention issues, and depression. There is no approved medication that can treat all of the symptoms of autism.
Applied behavioral analysis
Applied behavioral analysis (ABA) is one of the most common support interventions for autistic people. However, it is also controversial, potentially because of its origins. A psychologist developed ABA in the 1960s and referred to it as discrete trial training (DTT). At that time, this intervention used aversive or punishment-based methods to get people to stop exhibiting socially unwanted behaviors.
Although modern ABA therapy has significantly evolved since that time and rarely uses aversive therapy, modern critics of the ABA approach argue that as its goal is still to induce more “normal” behavior, it may punish typical autistic behavior.
These days, in many cases, ABA therapy tends to be play-focused, especially when it is for autistic children. Supporters of ABA therapy argue that rather than trying to force an autistic person to behave like a neurotypical person, it helps them develop the skills they need to live as independently as possible while still remaining true to their identity. It can do this by, for instance, helping them improve their language and communication skills.
People considering autism interventions such as ABA should weigh the risks and benefits, including:
its effect on the autistic person’s mental health
whether or not it stigmatizes harmless behaviors
how the autistic person feels about it
A person should also keep in mind that the increase in the number of support providers means that their quality may vary. It is important to monitor the intervention to make sure that it is positive and helpful rather than aversive.
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