Autism spectrum disorder (ASD) is an umbrella term used to identify a variety of neurodevelopmental disorders. These disorders are grouped together because of how they similarly interfere with a person’s ability to communicate, socialize, behave, and develop.

Many autistic individuals have some difficulties or delays with communication and speech. These can be on a spectrum from mild to severe.

But some people with autism may not speak at all. In fact, as many as 40 percent of children with ASD are nonverbal.

Keep reading to learn about nonverbal autism and options for improving communication.

The main identifying factor for nonverbal autism is whether or not someone speaks clearly or without interference.

Autistic people may have difficulty talking to or carrying on a conversation with another person, but those who are nonverbal don’t speak at all.

There are several reasons for this. It may be because they have apraxia of speech. This is a disorder that can interfere with a person’s ability to say what they want correctly.

It may also be because they haven’t developed the verbal language skills to speak. Some children may also lose verbal skills as symptoms of the disorder worsen and become more obvious.

Some autistic kids may also have echolalia. This causes them to repeat words or phrases over and over. It can make communication difficult.

other symptoms of nonverbal autism

Other symptoms 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 They may be shy and withdrawn.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 people may not respect personal space. Others may resist all physical contact entirely. These symptoms may leave them feeling isolated which can ultimately lead to anxiety and depression.
  • Behaviors. 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 flit from one activity to another. Each person’s behavioral symptoms differ.
  • Development. Autistic individuals develop at different rates. Some children may develop at a typical pace for several years, then face a setback around age 2 or 3. Others may experience delayed development from an early age that continues into childhood and adolescence.

Symptoms 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.

We don’t yet know what causes autism. However, researchers do have a better understanding of some factors that may play a role.

factors that may contribute to autism
  • Parental age. Children born to older parents may have a higher chance for developing autism.
  • Prenatal exposure. Environmental toxins and exposure to heavy metals during pregnancy may play a role.
  • Family history. Children who have an immediate family member with autism are more likely to develop it.
  • Genetic mutations and disorders. Fragile X syndrome and tuberous sclerosis are two causes being investigated for their connection to autism.
  • Premature birth. Children with a low birth weight may be more likely to develop the disorder.
  • Chemical and metabolic imbalances. A disruption in hormones or chemicals may impede brain development which could lead to the 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 vaccines. However, additional research debunked that report. In fact, the researchers retracted it in 2010.

Diagnosing nonverbal autism is a multi-phase process. A child’s pediatrician may be the first healthcare provider to consider ASD. Parents, seeing unexpected symptoms such as a lack of speaking, may bring their concerns to the doctor.

That provider may request a variety of tests that could help rule out other possible causes. These include:

  • a physical exam
  • blood tests
  • imaging tests like an MRI or CT scan

Some pediatricians may refer children to a developmental-behavioral pediatrician. These doctors specialize in treating disorders like autism.

This pediatrician may request additional tests and reports. This 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, and 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 Childhood Autism Rating Scale, Third Edition (GARS-3), can be used with nonverbal children.

These tests help healthcare providers determine if a child meets the criteria for autism.

One-third to one-half of parents of autistic children report that they first noticed symptoms before their child’s first birthday.

The majority — 80 to 90 percent — saw symptoms by 24 months.

Early signs

Early signs of autism include:

  • not responding to their name by 1 year
  • not babbling or laughing along with parents by 1 year
  • not pointing to objects of interest by 14 months
  • avoiding eye contact or preferring to be alone
  • not playing pretend by 18 months
  • not meeting developmental milestones for speech and language
  • repeating words or phrases over and over
  • being upset by minor changes to schedule
  • flapping their hands or rocking their body for comfort

There’s no cure for autism. Instead, treatment focuses on therapies and behavioral interventions that help a person overcome the most difficult symptoms and developmental delays.

Nonverbal children will likely require daily assistance as they learn to engage with others. These therapies help your child develop language and communication skills. Where possible, healthcare providers may also try to build speech skills.

Treatment for nonverbal 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.
  • Medicine. There’s no medicine specifically for autism, but certain drugs may be helpful for some related conditions and symptoms. This includes anxiety or depression, and obsessive compulsive personality disorder. Likewise, antipsychotic meds may help with severe behavioral problems, and medicines for ADHD may 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 nonverbal autism.
Where to find help if you think your child may have autism

If you think your child has autism, these groups may provide help:

  • Your child’s pediatrician. Make an appointment to see your child’s doctor as soon as possible. Make note or record behaviors that are concerning to you. The earlier you begin the process of finding answers, the better.
  • A local support group. Many hospitals and pediatrician offices host support groups for parents of children with similar challenges. Ask your hospital if you can be connected to the group that meets in your area.

Autism has no cure, but a great deal of work has been done to find the right types of treatment. Early intervention is the best way to help any child have the greatest chance for future success.

Therefore, if you suspect your child is showing early signs of autism, talk to their pediatrician right away. If you don’t feel like your concerns are being taken seriously, consider a second opinion.

Early childhood is a time of great change, but any child who begins to backslide on their developmental milestones should be seen by a professional. This way, if any disorder is the cause, treatment can begin right away.

As many as 40 percent of autistic children don’t speak at all. Others may speak but have very limited language and communication skills.

The best way to help your child build their communication skills and potentially learn to speak is to begin treatment as soon as possible. Early intervention is the key for people with nonverbal autism.