Does my child have autism or speech delay? Autism and speech delay are often situations that confused by parents. While speech delay may be a symptom of autism, there are some important differences between these two groups. Learning these differences means giving your child the best support they need as soon as possible.
Speech is one of the most effective methods of communicating. Thanks to speech, children’s ability to communicate increases, sharing of emotions becomes easier and learning accelerates. Accordingly, the development process continues effectively. Correctly identifying the causes of delays in speech abilities can be effective in the early detection of neurodevelopmental disorders such as autism. Although speech delays are not a sufficient symptom to diagnose alone, they may be a preliminary symptom in the detection of neurodevelopmental problems.
One of the first questions asked by many parents who realize that their children do not speak as expected for their age is “Is my child autistic?” Although speech delay and autism spectrum disorder are quite different conditions, they are not completely unrelated. Because of the fact that speech delay can be one of the most important indicators of autism. In order to understand whether your child has a speech delay, you first need to know what is expected of the child according to his/her normal language development and age. If you observe that your child’s language and speech skills are behind his/her peers, then you should not forget that this may be due to many different reasons, as well as a sign of autism.
Although speech delay is a common condition in children on the autism spectrum, there are certain differences between children with speech delay and children with autism.
Even though each autistic child has very different characteristics, not all autistic children fit into all categories. The main differences observed between children with speech delay and children with autism can be listed as a common interest, using mimics and gestures, imitation skills, play skills, eye contact, interest in the environment, being sensitive to one’s name, comprehension (receptive language) skills, and echolalia.
The vast majority of autistic individuals limit their ability to communicate for different purposes and functions. It is like the child can name objects very well but doesn’t know how to use them at the time of a request. Or vice versa, like making a request and not having any idea about that word.
Another challenge is that autistic individuals use their own unconventional ways of communicating for different purposes. Verbal autistic individuals use immediate echolalia or delayed echolalia. It is very common to use echolalic utterances in the right context for communicative purposes. It’s like the child repeating the echolalia “When we pick up the phone, we say hello” when trying to play on the phone and to indicate this.
While the autistic child wants to communicate, the therapist must draw logical conclusions about the purpose of communication. The biggest problem in drawing conclusions is understanding whether the autistic individual wants to communicate or not.
Verbal autistics demonstrate efforts to use jargon, repeat advertisements, or communications relevant to the current context with delayed echolalia. They do this without approaching or looking at the person they want to communicate with. Clues that they intend to communicate are in the form of melody or sound changes, repetitions of phrases until someone answers.
The concept of the word includes not only the spoken language but also all kinds of concepts that help communication such as written language, pictures, and mimicking. When autistic individuals learn their first words, they have problems establishing the word-concept relationship. The kid learns to say chips and says chips for whatever he wants. Instead of these different concepts, it becomes a general concept meaning ‘I want’. Autistic children who know a few different words will repeat those words over and over when they feel they need to say something.
It is important not that autistic individuals learn many words, but that they can use the words they learned in different contexts. The child should be taught that the ball is not only a soccer ball but also has different appearances such as basketball, tennis, and ping pong. It is easier for autistic children to learn word names than to talk about that word. They can construct sentences without affixes, conjunctions, and pronouns. In particular, they do not make pronoun changes to’ I-you’ in sentences.
The biggest problem in individuals with autism is the lack of verbal output. One of the most important elements of communication is verbal language. As a result of the research, supportive communication systems have been developed for autistic children who do not have verbal output. In some autistic children, verbal output was achieved by using this system.
About half of individuals on the autism spectrum cannot develop useful language even by the age of 5. On the other hand, many autistic people communicate with sign languages, picture boards, computers, and similar tools.
Speech Delay
Speech delay can be defined as the inability of children to show the verbal expression skills expected at their age. Compared to their peers, it can be observed as not speaking at all, using fewer words than expected for their age, or not being able to form sentences. In order to be able to recognize speech delay, it is necessary to know the speech development stages in children. Although normal speech development varies between children, it follows a certain order.
- Babies start crying after the 2nd month and continue with babbling consisting of syllables such as “ba ba” between the 4th-6th months.
- The first words that are said meaningfully usually start at the age of 1 and the number of words gradually increases until the 18th month.
- At the age of 2, simple two-word sentences begin to be formed and they can use 50 words.
- Between the ages of 2-2.5, they can make sentences of two or three words.
- By the age of 3, they can form sentences of three to five words and their speech is sounded mostly intelligible to others.
There are misconceptions about speech delay such as “he should wait until the age of 4” and “it is normal in boys”. Because of these beliefs, specialists are not consulted and the understanding of some important disorders may be delayed. Contrary to what is known, speech delay is an important condition that must be evaluated by a specialist.
Speech delay can have many different causes. The most common cause is developmental delay. However, one of the situations that should be considered in children with a speech delay is whether the child has autism symptoms. Because autism is one of the important causes of speech delay as well.
Children who are thought to have speech delay should undergo a detailed psychiatric evaluation. The first symptom of many psychiatric diseases may be speech delay. Families often have insufficient knowledge about how much vocabulary the child should have at which age period. Having thoughts that he will get better when he grows up and that he speaks late because he is a male who delays getting appropriate help. It is very important to detect this problem in the earliest period and to make appropriate interventions. It is recommended that children with suspected speech delay should consult a child psychiatrist.
The education level of the mother and the conversation with the child is important for speech delay or impairments. If some mothers speak 300 words, their children can learn up to 300 words. If the parents read a lot and talk to the child with a rich language, then that child hears and learns much more words and sentences. Vocabulary learning also means that they start forming sentences earlier than their peers.
From the age of 3, it is recommended that children start to go a kindergarten. Children also learn part of speech by interacting with their peers. In peer relations, their language is enriched and they learn to establish social relations, share, make eye contact, and social rules. Kindergarten is recommended, especially for children whose speech is delayed due to a lack of stimuli.
If the child’s speech delay is due to a lack of stimulus, then it is recommended that parents constantly talk to their children, play games, and give stimuli. If children’s speech is very delayed for their age, for example, if they are 3 years old and speak as much as a 1-year-old, this is a huge delay. In such a case, it is not enough for the mother to give rich stimuli or for the child to go to kindergarten. Then it is necessary to seek help from a speech therapist. In this way, these children learn to make eye contact, their sharing develops, they learn how to communicate with people and how to express emotions, and they also learn how to show their own emotions.
How Does Speech Delay Present in Autism?
Identifying the difference between autistic speech delays and other delays is fairly easy for the attentive caregiver. To explain with an example;
Imagine a 2-year-old child. He doesn’t speak or use any words at all, but he creates a communication language of his own in order to communicate with the people around him. He makes different sounds, uses body language, or points to what he wants. In this way, he actually interacts with people around him. He enjoys playing with his parents, siblings, or friends and gets restless when left alone.
On the other hand, imagine a child who is 2 years old and shows very different developmental steps. He has a few words in his vocabulary, but he does not speak and he does not use words to communicate. He repeats these words to himself. He doesn’t know how to use any signs, gestures, or facial expressions to get what he wants. His parents also say it is unlikely to keep their child’s attention on anything specific for more than a few seconds.
The first mentioned child may have a speech delay. It requires early intervention. There may be different reasons. For example; hearing loss, apraxia, cognitive difficulties, and a few other disorders. On the other hand, the second mentioned child shows more autistic symptoms. These are the symptoms that can be considered early signs of autism.
Could Speech Delay Be a Symptom of Autism?
Speech delay is a condition observed in children with autism. Speech delay affects children on the autism spectrum in different ways and with varying degrees of severity. For this reason, personalized individual therapy plans should be developed according to the child’s deficiencies and goals. This type of therapy encourages the independence of these children. It also uses visual aids to highlight the child’s strengths during therapies.
An autism therapy plan is shaped according to the needs of the person. If therapy is needed for speech delay, therapy should be planned to help develop expressive, receptive, or pragmatic language skills.
- Expressive Language: When we express our thoughts with words, we use our expressive language skills. Many children on the autism spectrum have problems and delays in this issue. Some children on the spectrum do not speak completely, while others speak later than their peers or have less vocabulary than their peers. The most effective method for improving expressive language skills is considered to be ABA therapy. In this way, the communication and interaction skills of these children are supported.
- Receptive language: The ability to understand what the other person is saying stems from our receptive language skills. If a child has difficulty answering questions or following directions, they may have receptive language deficits. These children also have trouble communicating, understanding gestures, and identifying objects.
- Pragmatic Language: Deficit of pragmatic language, which refers to the use of language in a social context, is a very common condition observed in children on the spectrum. While gestures and mimic understanding develop intuitively and automatically in children who complete their development normally, these situations can be quite confusing for children on the spectrum. They find the social language quite enigmatic and challenging. Pragmatic language skills also vary depending on the situation and the audience, as they are shaped by the social context. It is also used for varying purposes, such as greeting someone, asking for something, or giving information. Since the ability to follow traditional speech rules also stems from pragmatic language, this deficiency is quite evident in children on the spectrum.
Speech delays are very common among children on the spectrum. However, it should not be forgotten that it can also be observed in children who are not on the spectrum. However, there are differences between autistic speech delays and other types of delays. These differences can be observed even by non-experts. Speech delays may be a cause for some concern, but they are not always a sign of autism.
Difference of Speech Delay in Autism From Other Delays
As babies develop, they learn naturally and instinctively that they need to communicate to get what they want. They follow certain steps before they learn to use the spoken language. They make eye contact, mutter, or point at objects. Over time, they learn to use words and spoken language. Also typically developing children;
- They are motivated by social responses such as smiles and hugs.
- They tend to imitate the actions of the people around them.
- They start observing people, and this may take more time than observing objects.
- When left alone, they quickly get bored and lonely. They tend to be social beings.
Children on the autism spectrum have social communication problems. This problem they have also prevented them from making any meaningful social connections. While children with high-functioning autism may be more socially prone than children with more severe autism, the same issues are valid for other children on the spectrum. Thus, children on the autism spectrum;
- They can be more easily motivated by their own interests.
- They rarely or never imitate the actions of people around them.
- Their interest in certain things is greater than that of other people and is excessive.
- When they are alone, they are more peaceful than other people. They tend to be alone.
All of these differences have led to different behaviors, desires, and outcomes. Children on the spectrum may have difficulty using nonverbal communication and may be less interested in social communication. As a result, they have very delayed speech.
In speech delay, the child often uses non-verbal communication patterns. They explain or try to explain what they cannot express verbally, in non-verbal ways, that is, with gestures, facial expressions, and movements. On the other hand, children on the spectrum have no use of nonverbal communication patterns or very little compared to children with speech delay or language impairments.
In autism, there is a possibility of persistence in some obsessive behaviors and repetitive movement patterns. In children with delayed speech diagnosis, repetitive movements are not observed and obsessive behaviors are less likely. It would be appropriate to make a note in this regard. Sometimes obsessive behaviors can be observed in children with speech delay. Therefore, it is not incomprehensible that children who have difficulty in expressing themselves determine some constants for themselves.
While sensory integration problems can be observed in both groups, it is more likely to be more severe in children on the autism spectrum.
Joint attention, that is, the adult and child’s interest in the same thing for a short time, is more likely to be more limited in the group on the autism spectrum. Children on the spectrum also lack imitation skills. Children with delayed speech are less likely to have this condition.
The way of playing the game also differs for these two diagnoses. Children on the autism spectrum may show delays in the development of the play. They have a tendency to use age-appropriate toys for repetitive behaviors such as shaking them instead of playing as expected. This situation is not expected when children with speech delays play games.
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