Speech delay is often the presenting complaint for children who are diagnosed as
having an autism spectrum disorder (ASD). Babbling may be late in developing as
are pre-speech gestures including waving, pointing and showing.
The lack of a desire to communicate and the lack of non-verbal communication strategies including gestures usually accompany the speech delay. These children frequently do not show frustration due to their speech delay. In addition, the quality of
speech may be concrete, rigid and even scripted. They may memorize dialog from
movies or television shows and the repetition of another’s words, called
echolalia, is often seen.
Children with ASDs may appear independent due to their lack of communication interest. They often seek out an object of interest rather than using language to acquire the object. Some children may also show advanced skills in specific language areas including the labeling of colors, shapes, numbers and even letters of the alphabet. Associated with this advanced skill is a relative lack of the incorporation of these same skills into functional language.
Some children with ASDs may also use pop up words that are said without a clear provocation. They may be said frequently for a period of time and then stop as suddenly as they started only to return in the future. They are said out of context and often occur during stressful situations.
Children with ASDs often lack warm expressions during communication and lack an alternating communication pattern that is usually seen between mother and child by 6 months of age. Infants with ASDs will often vocalize without regard to a parents gaze or speech and may not preferentially recognize a parent’s voice. They often disregard vocalizations but appear to be extremely aware of environmental sounds that other children miss. Other patterns include a lack of expressive language and deficits in higher level semantic and pragmatic language skills that indicate a social use of language. Children with ASDs may have difficulty differentiating between the various ways specific phrases can be said to indicate different emotional meanings.
Regression is a common language pattern Children with ASDs often say a few words and then stop speaking. This is often seen between 18 and 24 months of age. This
communication regression also may include a loss of gestural communication
including pointing and waving and social skills such as eye contact and
response to praise. This regression may be sudden or gradual and may be confused
with other environmental or developmental factors. The presence of language
regression is a key hallmark of ASDs.
Children with Asperger Syndrome may have limited or minimal speech delay. This makes diagnosis difficult and often delays the diagnosis. Although the quantity of speech may be near normal the quality is abnormal. They may show an interest in discussing specific topics of personal interest yet have difficulty expressing simple feelings or recognizing the feelings and viewpoints of others. Speech patterns may be overly formal and lack a reciprocal quality. Conversations are difficult to sustain and the
language often is odd, self centered, off topic and monotone. Unique patterns of
speech in terms of intonation, volume, rhythm and pitch are often heard. While
communicating there is often a disregard for personal space and a disregard for
the listeners needs.
A discussion of the feelings, thoughts, words and opinions of others is also deficient. An inability to determine and measure the conversational intent of others is universal. Words and phrases of ambiguous meaning are difficult to understand. this makes the understanding of humor, idioms, jokes and irony difficult.
Children with ASD show various trajectories for the above communication deficits. As a child with an ASD ages he may acquire communication skills that were lacking in his youth. Every child and adult with an ASD is unique and may show all or some of the above patterns.