Understandably, parents get nervous when their child isn’t reaching key developmental milestones at the same time as their peers. There’s one milestone in particular that makes many parents nervous: learning to speak.
Most experts recommend using development timelines as a general guide rather than concrete evidence of developmental delays. Still, as a parent it’s hard not to be concerned if you think your child isn’t talking like other kids their age.
If your child has difficulty with speaking, it might be considered a speech delay. Depending on the severity, delays in speech can range from not talking at all to difficulty pronouncing words or even having trouble forming sentences.
Most people assume that a language delay or speech disorder will have a long-term impact on a child’s ability to excel in school and beyond. But a lesser-known condition called Einstein syndrome proves this isn’t always the case.
Einstein syndrome is a condition where a child experiences late onset of language, or a late language emergence, but demonstrates giftedness in other areas of analytical thinking. A child with Einstein syndrome eventually speaks with no issues, but remains ahead of the curve in other areas.
As you might have guessed, Einstein syndrome is named after Albert Einstein, a certified genius and — according to some biographers — a late-talker who didn’t speak full sentences before the age of 5. Consider the impact Einstein had on the scientific world: if he was a late-talker, it certainly wasn’t a stumbling block for him.
The concept of Einstein syndrome was coined by the American economist Thomas Sowell and later supported by Dr. Stephen Camarata — a respected practicing physician and professor from the Department of Hearing and Speech Science at Vanderbilt University School of Medicine.
Sowell noted that while late-talking can be a sign of autism or other developmental conditions, there’s a significant percentage of children who are late-talkers but later thrive, proving themselves to be productive and highly analytical thinkers.
The truth is that there hasn’t been enough research on Einstein syndrome. It’s a descriptive term with no agreed upon medical definition or criteria, which makes it difficult to research. We don’t really know how widespread this condition is, whether it’s genetic or environmental, or whether it shows up with other conditions, like autism, that cause language and speech delays.
It’s believed that a segment of children diagnosed as late-talkers outgrow this developmental delay and prove themselves to be gifted and exceptionally bright. These children would qualify as candidates for being said to have Einstein syndrome.
In an interview with the MIT Press, Camarata stated late speech is too frequently accepted as conclusive proof in diagnosing autism. In reality, there are a wide range of reasons a child may talk later, ranging from working through a developmental stage at their own pace to physical issues such as hearing loss.
Population studies have proven that only a small percentage of children who are late-talkers have autism spectrum disorder (ASD). Camarata’s research suggests that 1 in 9 or 10 children in the general population are late-talkers, whereas 1 in 50 or 60 children exhibits a symptom of ASD.
Camarata cautions that, often, clinicians trying to diagnose a late-talking child may look for symptoms of autism rather than attempting to rule it out.
He feels that this practice is problematic because many of the signs of normal development in toddlers could be mistaken as symptoms of autism. He calls this a “confirmatory” diagnosis, rather than a differential diagnosis.
Camarata suggests if your late-talking child is diagnosed with ASD, you should ask your clinician what else, besides the language delay, informed that diagnosis.
For a late-talking child who has no other underlying conditions, an ASD diagnosis would be inaccurate, the label could be damaging, and any therapies recommended wouldn’t be productive.
Hyperlexia is when a child can read far earlier than their peers, but without understanding most of what they’re reading. Einstein syndrome and hyperlexia are both conditions that can lead to children being misdiagnosed with ASD.
A child with Einstein syndrome does eventually speak with no issues. A child with hyperlexia may not necessarily be diagnosed with ASD, but studies show there is a strong correlation. About 84 percent of children with hyperlexia are later diagnosed with ASD.
It can be helpful to think more broadly when examining the link between ASD, hyperlexia, and Einstein syndrome. A language delay is very common in children with ASD, but not the only marker for diagnosis.
So how can you tell if your child has Einstein Syndrome? Well, the first clue is that they’re not talking. They’re likely delayed in meeting speech milestones according to recommended guidelines for their age.
Beyond that, Thomas Sowell’s 1997 book “Late-Talking Children” outlines general characteristics he describes in children who have Einstein syndrome:
- outstanding and precocious analytical or musical abilities
- outstanding memories
- strong-willed behavior
- very selective interests
- delayed potty training
- specific ability to read or use numbers or a computer
- close relatives with analytical or musical careers
- extreme concentration on whatever task is occupying their time
But again, Einstein syndrome is not well defined and it’s hard to tell how common it is. Strong-willed behavior and selective interests can describe many toddlers — even those who aren’t late-talkers.
There’s plenty of evidence that shows late-talking isn’t always a telltale sign of mental disability or diminished intellect. There’s also no smoking gun indicating that every child who may have Einstein syndrome is exceptionally gifted, with an IQ above 130.
In fact, of the case studies highlighted as success stories for late-talkers in Sowell’s 1997 book, most of the children had average IQs around 100 and very few had IQs above 130.
The most important thing to do if you’re concerned that your child is a late-talker is to get an evaluation. As mentioned earlier, if you’re confident that your child is bright and engaged in the world around them, but just a late-talker, you need to ensure that your clinician is using a holistic approach to determine a diagnosis.
Relying on speech alone can lead to a misdiagnosis. A misdiagnosis can lead to the wrong treatments and might unintentionally slow your child’s speech progression.
Specifically, you’ll want a clinician who is alert to nonverbal cues to see that your child is listening and engaged in the evaluation.
Don’t be afraid to question the diagnosis or even request a second or third opinion. However, if you decide to have your child evaluated by another clinician, opt for someone who is not in the same professional circle as your initial clinician to avoid further confirmation bias.
It’s worth noting that misdiagnosis can go both ways. There’s also a risk that a child may receive an early diagnosis of ASD because they’re thought to be only a late-talker. This is why a holistic approach to diagnosis that examines factors other than talking, such as hearing and nonverbal cues, is so important.
Who should you see?
If you’re concerned that your child might have a speech delay because they’re a late-talker, you’ll want to meet with your child’s doctor. They can perform a thorough medical assessment and refer you to a speech-language pathologist and other experts, if needed.
Most experts recommend that early intervention is best. So, as soon as you begin to suspect that your child isn’t meeting their speech milestones, you should schedule an appointment for an evaluation.
When you meet with a speech-language pathologist, understand that it may take several sessions before they form a diagnosis and create a therapy plan.
Will my child be diagnosed with Einstein syndrome?
Since there’s no accepted medical definition of Einstein syndrome and it doesn’t appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), don’t expect to receive a formal diagnosis.
Likewise, don’t be afraid to push back on a diagnosis that you feel is inaccurate. If you know that your child is responsive to your conversation and engaged in the world around them, an ASD diagnosis may be inaccurate.
Other measures, like having your child’s hearing checked, are also critical to ensure that there aren’t physical impairments preventing your child from talking.
Regardless of whether your child has Einstein Syndrome or just a form of speech delay, you should start therapy to improve the condition. In addition to therapy sessions with a licensed professional, there are also activities you can practice at home to help your late-talking child master new and more words.
The recommended therapy will be customized to the delays your child exhibits in the evaluation. For example, your child may be found to have an expressive language delay, where they struggle to speak but understand what’s being said and are responsive. In this case, you may receive a list of recommended activities at home along with formal speech therapy.
Expressive and receptive language delays (struggling to speak and understand what’s being said) may require further evaluation and more intensive therapy.
Einstein syndrome is a compelling idea that may explain the way many late-talking children go on to achieve notable success and live happy, normal lives.
It’s not a formal diagnosis embraced by speech-language pathologists. But the theory behind Einstein shows the importance of a full evaluation before diagnosing a late-talking child as having ASD.
In the meantime, explore new ways to communicate with your child. You might just uncover their unique gifts.