Nonverbal Autism: What Is the Difference?, Diagnosis and Treatment

Being a nonverbal is a state that most individuals with autism live through. At some point in their lives, they are unable to speak. In the end, most of them start to speak. Nevertheless, there is a little percentage that remains nonverbal. It doesn’t mean that they are not able to speak. They don’t prefer to speak.

More or less 40% of individuals on the autism spectrum do not speak at all. The rest of them can talk but they may have limited skills in language and communication. Early intervention is very essential at this point for individuals with nonverbal autism. It is very important to get proper help. After some point, the child can speak, talk, and communicate. It is important to get proper interventions as soon as possible.

Speech requires interaction, because of the fact that almost all children diagnosed with autism have delayed language development, nonverbal, or social and emotional relationships are blocked.

Symptoms of Nonverbal Autism

As the name implied, there is one major difference between autism that we know and nonverbal autism. It is speaking or not speaking. It can be a clear speaking or speaking without interference. In general, speaking is a difficult task for individuals on the autism spectrum, however, it is way harder for individuals who are nonverbal. They don’t speak at all. They don’t carry a conversation at all.

Behind this, there are different reasons. The absence of speech acts in children with autism is based on two main causes, the first is being the neuronal dysfunctions in the brain and the consequence of the delay in speech or disruption of the brain, and the second is the psychological-induced condition that develops in the form of the child with autism refusing communization due to the introvert character. The first one is eliminated by the compensation method and the second one by activation of the speech motivation. The reasons behind it can be whether physiological or psychological. Physiological reasons could be apraxia, underdeveloped verbal language skills, and echolalia.

First of all, apraxia is a speech disorder. It directly affects an individual’s ability to talk. That person cannot say what he/she wants to say. Secondly, they may not develop verbal language skills. They may not have enough skills to speak. On the other hand, some of them may lose their skills or it can be worsened or it can become more obvious because of the disorder they have. Thirdly, echolalia is the most obvious and common symptom of autism. Most of them have this. They repeat what they say over and over. This echolalia makes their conversations and communication difficult. And eventually, they may become nonverbal.

  • Social Symptoms: As we know, individuals with autism have difficulties in socializing. They are mostly shy people. Avoiding eye contact, not responding to their names when someone calls them, not respecting others’ personal spaces, resisting physical contact, etc. These are the social symptoms of why they become nonverbal or why they are nonverbal. Because of these symptoms, they mostly feel isolated. This isolation feeling gives them anxiety and eventually depression.
  • Behavioral Symptoms: Having a strict routine is very important for individuals with autism. Even a tiny change in their routine gives them anxiety and makes them upset. They don’t want that at all. As you can imagine, they develop specific interests and they obsessively stick with those interests. They can spend unlimited time with those interests. They can spend their time with one particular book, activity, or topic. On the other hand, even though it is not very common, there are some individuals with autism who have a short attention span. They cannot concentrate on one thing. They can go from one thing to another in a short time. Since it is a spectrum disorder, everyone on the autism spectrum is different from each other and they show different behavioral symptoms.
  • Developmental Symptoms: Each individual develops differently. On the autism spectrum, even more, the difference can be seen in developmental stages. While some of them develop at a regular pace, some of them stay behind the normal developmental stages. Those delays can stay forever, they may not experience childhood or adolescence stages in their lives. These delays can directly affect their speech. They can become nonverbal. Or, because of anxiety that these symptoms give to them, they don’t want to engage in social attractions and stop talking.

Since autism is a spectrum disorder, symptoms vary as well. Symptoms may improve when an individual gets older. Symptoms may become less obvious and less severe. After some point, they can learn how to cope with these symptoms and they may not interrupt their daily lives. It is highly possible that with the proper intervention and therapy, nonverbal individuals can become verbal. It is very important to have proper speech therapy.

Early Signs of Nonverbal Autism

  • They don’t respond to their name when someone calls them after 1-year-old.
  • They don’t babble or laugh after 1-year-old.
  • They don’t point out objects, or anything after 14 months old.
  • They are not good at eye contact. They avoid it always.
  • They prefer to be alone.
  • They don’t pretend to play after 18 months old. They cannot use different objects for different purposes.
  • Their developmental stages are slower than how is supposed to be. Especially about speech and language, they are very low.
  • They have echolalia. They repeat the same words over and over again.
  • They become very upset by tiny changes in their fixed routines.
  • They have stereotypical behaviors, such as flapping and rocking, in order to calm themselves.

Diagnosis of Nonverbal Autism

At the basic level, the diagnosis of nonverbal autism is the same process with the diagnosis of autism spectrum disorder. The difference is it consists of different phases. The child needs to see different professionals and gets different examinations in order to get diagnosed with nonverbal autism.

The child’s pediatrician is the first professional to think about autism after parents thinking that there is a problem with their child. In a nonverbal way, it can be unexpected. The child can stop talking unexpectedly or lack of speech can be observed unexpectedly. In order to understand the cause and eliminate other disorders, professionals can request different tests. These tests are physical exams (articular examination, etc.), blood tests, and imagining tests (MRI, CT scan, etc.).

After these results, the child’s pediatrician can refer to see another pediatrician which is a developmental-behavior. These professionals are more specialized in autism spectrum disorder. They request additional tests. They ask parents about family history, pregnancy, complications, issues, hospitalizations, treatments, and so on about children. After this family background, they want autism-specific tests. These tests are Autism Diagnostic Observation Schedule (ADOS), Second Edition of Autism Diagnostic Observation Schedule (ADOS-2) and the Childhood Autism Rating Scale (CARS), and Childhood Autism Rating Scale Third Edition (CARS-3). They are important for the diagnosis of nonverbal autism.

Treatment of Nonverbal Autism

As we all know, there is not a known cure for autism spectrum disorder. It is the same for nonverbal autism as well. Nevertheless, it is important to get proper treatments, therapies, and interventions. It is possible to talk again or at least it is possible to overcome some symptoms. Proper interventions can improve developmental delays.

Besides therapies and treatments, children with nonverbal autism may require someone who can assist them daily. This person can teach them how to engage with others in daily life. The child can learn from that person to insert what he /she learns during the therapies. They can develop what they learn and build speech and communication skills.

There are different treatment methods available for nonverbal autism. These treatments are educational interventions, medicine (drug therapies), and family counseling.

  • Educational Interventions: This is the most important one for children with nonverbal autism. It works most of the time. Children mostly respond positively to these sessions. These sessions consist of skill-oriented behaviors and help individuals with nonverbal autism learn social and language skills.
  • Medicine (Drug Therapy): As it is known, there is no specific medicine for autism. On the other hand, there are different drugs to reduce to symptoms and consequences of autism. These drugs can be helpful for anxiety, depression, obsessive behaviors, ADHD, impulsive behaviors, and so on. These drugs make their lives easier and livable.
  • Family Counseling: It is important to develop family relations. It makes those relations stronger. Parents and siblings can benefit from those sessions. They can learn how to deal with the challenges of nonverbal autism. They can help the person with autism in order to get over their struggles.

In order for the speeches of children with autism to improve, some situations must be completed. The child should not have a hearing impairment, mental processes should function well, the lips, tongue, palate, larynx, small tongue, vocal cords, and respiratory system, which we call speech organs, should have developed and completed the psychomotor development.

Children with autism have an attitude that hears, but does not pay attention, looks but does not see, even though there is no physical barrier. Therefore, it is difficult for people we call normal to live with individuals with autism. The reason for this is that both parties cannot understand each other because some individuals with autism do not use the verbal language, do not speak in the sense we know, and we, the normal people who created by the majority, try to deal and talk mostly through language.

If we do not understand people with autism, we have difficulty, we are surprised, we are angry, and we think that they do not understand us, however, this impression is misleading. They understand our language very well, they use it only when they want and in the way they want.

The biggest challenge in their education is that they do not react to things that are not related to their own needs, and sometimes they can hurt themselves and sometimes their instructors when they have difficulty. Therefore, the empathy feature of the person who gives the speech training should be very developed. He / She should understand the child’s needs and feelings, and organize the environment so that the child can express himself/herself.

In individuals with autism who have difficulty in speaking or unable to speak, support can be obtained from alternative solutions examined in two different groups. Communication methods with and without additional tools are among the preferred methods for communicating with individuals with autism. In the method called without additional tools, the individual only benefits from his facial expressions, body language, and signs. In the additional method of communication, elements such as communication books and devices that make sound are used.

Communication with individuals with autism who cannot speak can be achieved by using sign systems and visual systems. They play a big role in communicating with the people around them for children with autism who have difficulty speaking with these two methods. In fact, it was observed that the marked communication helps the child to speak and learn some words. However, since there is no form of communication known and learned by society in marked communication, it cannot be easily understood by everyone and can be used in a limited area.

When Does The Child With Autism Start Speech Therapy?

Speech occurs after the acquisition of certain skills and becomes meaningful within these skills. For these reasons, there are certain skills that a child with autism should acquire before starting speech therapy. It has also been proven that any speech therapy without these skills can benefit the child with autism.

All these structures that make up the speech are hierarchical and systematic in themselves. A meaningful and pragmatic speech is achieved through the proper use of all these structures. Considering this information, if we count the skills that an individual with autism should acquire before starting speech therapy, these are; eye contact, attention, imitation, following commands and instructions, taking turns, listening, understanding speech, and object continuity.

Children with autism should start getting help with talking as soon as possible. Parents should start providing their children with help as soon as possible, without waiting for a specific diagnosis, taking into account social and communicative deficiencies and initial symptoms. It is necessary to take into account the conditions of the country in which the therapy should be started as well.

It is not a loss to start speech therapy without the prerequisites we mentioned earlier. However, since the speech therapist will not be able to switch from working on these skills to other skills, she will first try to provide the child with these skills. This will negatively affect the efficiency expected from the sessions. Speech therapy should begin after the development of the ability to receive commands, obey commands, attention, eye contact, queuing and motor imitation, which are gained by special education. This will increase the efficiency that children will receive from speech therapy sessions. And it will enable them to make the most effective use of speech therapy.

A Great Story of an Individual With Nonverbal Autism

Before everything, he wants everyone to know that autism is not a curse, it is another way of being a human. He says that having autism doesn’t mean that they are less human than people who are normally developed. He hated himself when he got diagnosed first because of the others’ reactions. That’s why he wants to fix these misconceptions about both autism and nonverbal autism.

He is the person who has nonverbal autism. But it doesn’t mean that he doesn’t communicate. He does this by typing. He tries to raise awareness about autism. He writes a blog about it. He describes his feelings, experiences, life, and so on. He wants people to understand what it means to have autism.

First of all, he wants people to behave like him. For example, imagine that you cannot talk but you can understand everything around you. You don’t have any problem with your mind. It is like you are talking with yourself in your brain and no one hears you. Other people hear your voice but don’t hear what you mean by those words. Or, they hear unnecessary things with your voice. The misconception here is others think that you can think but in a different way, not in the way that is supposed to be. People around you can see your autistic symptoms and try to make you calm which worsens everything.

He spent many years with ABA which is Applied Behavior Analysis. But it was not enough by itself. It was very hard to communicate for him even after ABA. He believes that everyone should find their own voice. Otherwise, life becomes torture for that one. Communication should be the first thing thought to individuals with autism. In order to carry meaningful communication, they have to say what they want to say. And he wants everyone to know that they are able to do it, they just need help.

He thinks that he was lucky when he was a child. Because his parents have been very supportive all his life. They support their child that there is nothing to be ashamed of. They encourage him to talk about his disorder. They played with him. They talked with him. They explained everything to him. They made their son’s life as normal as possible.

As a result, there have been lots of positive consequences. He has friends. He learns. He is recognized by everyone. He has his own goals and aims. He loves people and he feels he is loved by people as well. He is accepted by the people around him.

After he found his voice by typing, everything has changed in his life. It didn’t happen overnight, but by time life became acceptable for him. He knows that autism is not temporary. He has to live with it all his life. And also he knows that it is not worse or better than being non-autistic. Everyone has a special life. Everyone lives the life they want. He loves his life with autism. He is happy with his autism. So, it is more than enough.

Beneficial Toys for a Child With Autism That You Can Find on Amazon to Improve Speech

Tina’s Toy Company Counting Bears Color Sorting Toys for Toddlers Stacking Cups, Fine Motor Skills Toys, Occupational Therapy Speech Therapy Toys, Homeschool Preschool Learning Math Manipulatives Toddler Learning Toy

This set is an educational and fun set in order to teach colors, numbers, basic math, simple words, matching, and sorting for your little ones. It improves manual dexterity and hand-eye coordination as well. It is a very beneficial set for a child on the autism spectrum. It is a kind of therapeutically set.

LeapFrog Learning Friends 100 Words Book

There are more than 100 words in it in order to introduce and teach these words to toddlers and children who have a problem with speaking. These words are age-appropriate words. Professionals in the related area prepared and chose these words. There are different words from different categories. These categories are animals, food, time, colors, activities, opposites, flowers, fruits, vegetables, and so on. It is a very beneficial set for children on the autism spectrum in order to teach them basic and simple words.

Junior Learning Sentence Flips Toy

It is a great way to teach sentence structure to children. There are different colors for each part of the sentences. They support the learning by exemplifying with pictures. Even though pictures are a little bit questionable, it is an acceptable way to teach sentence at the simplest level. Your child on the autism spectrum will gain lots of benefits from it.

Carson Dellosa Key Education Early Learning Language Library Learning Cards

This set includes 160 cards in order to develop the communication skills of your child. Especially, if your child has any problem, for example, autism, it is a great option. With this set, it is easy to build vocabulary and it makes it easier to communicate. Maybe this is not the most functional and useful way to teach how to communicate, it is a step start to communicate.

Learning Loft Toobaloo Auditory Feedback Phone Accelerate

It is a fun, educational, and beneficial toy for children who has a problem with speech. It will be a good choice for your little one with autism. It is designed in order to improve reading and communicating. Children like to use it because it is very fun.

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