Nonspeaking or nonverbal autism refers to cases in which an autistic person has a delay or difficulty with speech. This can range from mild to severe. Some people do not speak at all.
Autism spectrum disorder (ASD) is an umbrella term used to identify a variety of neurodevelopmental disorders. These disorders are grouped together because they have similar effects on a person’s ability to:
When an autistic person doesn’t speak, it’s known as nonspeaking autism. You may also see it described as nonverbal autism. However, the term nonverbal isn’t completely accurate, since it means “without words.”
Even if an autistic person is nonspeaking, they may still use words in other ways (such as in writing). They may also understand the words that are spoken to them or that they overhear.
Keep reading to learn about nonspeaking autism and options for improving communication.
The primary symptom of nonspeaking autism is being unable to speak clearly or without interference.
Autistic people may have difficulty talking to or carrying on a conversation with another person, but those who are nonspeaking do not speak at all.
There are several reasons for this. It may be because they have apraxia of speech, a disorder that affects certain brain pathways. It can interfere with a person’s ability to say what they want correctly.
It may also be because they have not developed verbal communication skills. Some children may lose verbal skills as symptoms of the condition worsen and become more noticeable.
Some autistic kids may also have echolalia, which causes them to repeat words or phrases over and over. It can make communication difficult.
Other symptoms of autism
Other symptoms that are unrelated to communication can be divided into 3 main categories:
- Social. Autistic individuals often have difficulties with social interaction. They may be shy and withdrawn. They may avoid eye contact and not respond when their name is called. Some autistic people may not be mindful of others’ personal space, while some may resist all physical contact entirely. These symptoms may leave them feeling isolated, which can ultimately lead to anxiety and depression.
- Behavioral. Routine may be important to an autistic person. Any interruption in their daily schedule can make them upset, even aggravated. Likewise, some develop obsessive interests and spend hours fixated on a particular project, book, topic, or activity. It’s also not uncommon, however, for autistic people to have short attention spans and move from one activity to another. Each person’s behavioral symptoms differ.
- Developmental. Autistic individuals develop at different rates. Some children may develop at a typical pace for several years, then face a setback around 2 or 3 years old. Others may experience delayed development at an early age that continues into childhood and adolescence.
Symptoms of autism often improve with age. As children grow older, symptoms may become less severe and disruptive. Your child may also become verbal with intervention and therapy.
Researchers do not yet know what causes autism. However, they do have a better understanding of some factors that may play a role.
- Parental age. Children born to older parents may have a higher chance of developing autism.
- Prenatal exposure. Environmental toxins and exposure to heavy metals during pregnancy may play a role.
- Family history. Children who have an autistic immediate family member are more likely to develop autism.
- Genetic mutations and disorders. Fragile X syndrome and tuberous sclerosis are both associated with higher rates of autism.
- Premature birth. Children with a low birth weight may be more likely to develop the condition.
- Chemical and metabolic imbalances. A disruption in hormones or chemicals may impede brain development, which could lead to changes in brain regions that are associated with autism.
Vaccines do not cause autism.
In 1998, a controversial study proposed a link between autism and the measles, mumps, and rubella (MMR) vaccine. However, additional research debunked that report. In fact, the researchers behind the 1998 study retracted it in 2010.
Diagnosing nonspeaking autism is a multiphase process.
A pediatrician may be the first healthcare professional to screen a child for ASD. Parents, seeing unexpected symptoms such as a lack of speaking, may bring their concerns to their child’s doctor.
The medical professional may request a variety of tests that could help rule out other possible causes. These include:
Some pediatricians may refer children to a developmental-behavioral pediatrician. These doctors specialize in treating conditions such as autism.
This medical professional may request additional tests and reports, which could include:
- a full medical history for the child and parents
- a review of the mother’s pregnancy and any complications or issues that arose during it
- a breakdown of surgeries, hospitalizations, or medical treatments the child has had since birth
Finally, autism-specific tests may be used to confirm a diagnosis. Several tests, including the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and the Gilliam Autism Rating Scale, Third Edition (GARS-3), can be used with nonspeaking children.
These tests help healthcare professionals determine if a child meets the criteria for autism.
According to research from 2007, around 30 to 38 percent of parents of autistic children report that they first noticed symptoms before their child’s first birthday. The majority — around 80 percent — saw symptoms by 24 months.
Early signs of autism include:
- not responding to their name by 12 months old
- not babbling or laughing along with their parents by 12 months old
- not pointing to objects of interest by 14 months old
- not playing pretend by 18 months old
- avoiding eye contact or preferring to be alone
- not meeting developmental milestones for speech and language
- repeating words or phrases over and over
- being upset by minor changes to their schedule
- flapping their hands or rocking their body for comfort
Nonspeaking children will likely require daily assistance as they learn to engage with others. Therapies for nonspeaking children will focus on helping them develop language and communication skills. Where possible, healthcare professionals may also try to build speech skills.
Support for nonspeaking autism may include:
- Educational interventions. Autistic children often respond well to highly structured and intensive sessions that teach skill-oriented behaviors. These programs help children learn social skills and language skills while also working on education and development.
- Medication. There’s no medication specifically for autism, but certain medications may be helpful for some related conditions and symptoms. This includes anxiety, depression, and obsessive compulsive personality disorder. Likewise, antipsychotic medications may help with severe behavioral problems, and ADHD medications may help reduce impulsive behaviors and hyperactivity.
- Family counseling. Parents and siblings of an autistic child can benefit from one-on-one therapy. These sessions can help you learn to cope with the challenges of nonspeaking autism.
Where to find help if you think your child may be autistic
If you think your child is autistic, these resources can be helpful:
- Your child’s pediatrician. Make an appointment to see your child’s doctor as soon as possible. Take note of or record behaviors that are concerning to you. The earlier you begin the process of finding answers, the better equipped you and your doctor are in designing a support plan for your child.
- A local support group. Many hospitals and pediatricians’ offices host support groups for parents of children with similar challenges. Ask your hospital if you can be connected to available groups in your area.
A great deal of work has been done to find the right types of support for autism. Early intervention is the best way to help any child have the greatest chance for future success.
If you suspect your child is exhibiting early signs of autism, talk with their pediatrician right away. If you do not feel as if your concerns are being taken seriously, consider a second opinion.
Early childhood is a time of great change, but any child who begins to regress in terms of developmental milestones should be seen by a professional. This way, support can be put into place right away, if necessary.