Autism vs. Speech Delay: How to Tell the Difference

Autism Spectrum Disorder (ASD) and Speech Delay share some symptoms, making it difficult to distinguish their difference.

While speech delays are common in children with ASD, not all children with speech delays have autism. Understanding the differences between the two can be helpful for your child’s development.

In the following sections, we will look deeper into:

  • what is speech delay and autism
  • key differences between the two, and
  • the next steps you can take as a parent.
Keep reading to learn more!
Speech Delay

What is Speech Delay?

Do you have a child who’s struggling to speak fluently and accurately? This could be speech delay, where children may substitute, omit, or distort sounds in words, making it hard for others to understand them.

While developmental delays are a common factor of speech delays, there are also other possible causes, such as neurological disorders, motor-speech disorders or physical problems with the mouth. If left untreated, speech delays can lead to frustration, low self-esteem, and social isolation.

Identifying signs of speech delay is crucial for early intervention and treatment. Here are some warning signs to look out for:

    • 4 to 6 Months of Age: not babbling
    • 12 Months: not using two-syllable combinations (“mama”, “papa”)
    • 18 Months: trouble imitating sounds , no gestures such as pointing, reaching or waving
    • 2 Years (or 24 Months): using fewer than 50 words, uses gestures more often than words, doesn’t combine consonant and vowel sounds to make words or word-like sounds
    • 3 Years: understood by parents less than 75% of the time, doesn’t produces sounds at the end of the words (“ca” instead of “cat”)
    • 4 Years: understood by parents less than 90% of the time, gets stuck when they try to start saying words, becomes frustrated when trying to communicate

It’s good to identify these signs, but early diagnosis through a speech-language pathologist is better. Upon diagnosis, they can work with your family to create a personalized plan for your child’s speech and communication skills.

It’s also important to know that speech delay is different from language delay, which affects a child’s ability to understand and use words.

About Speech and Language

Speech skills refer to the ability to articulate the sounds used in words, while language skills refers to their ability to express needs, wants, and desires, not how they say it.

Language delay has different categories too:

    • Children with an expressive language delay can produce correct sounds and words. But they struggle to use them to form meaningful phrases or sentences.
    • Children with receptive language delay have difficulty understanding what others are saying. They struggle to process information, learn new words, and understand verbal or written communication.

It is crucial to understand the difference between speech and language delays before discussing developmental disorders like autism.


What is Autism?

Autism is a developmental disorder that affects how a person communicates and interacts with others. It’s an umbrella term that includes a wide range of social communication deficits. It may also include repetitive sensory-motor behaviors.

The exact cause of ASD is unknown. Some researchers believe that certain genetic disorders and family history may be linked to ASD. They also believe that certain exposure during pregnancy may also play a role. However, research has shown that vaccines do not cause autism. More research is needed to understand the full causes of ASD and develop effective treatments.

People with ASD may have trouble with social skills, repetitive behaviors, and communication. Here are a few signs of autism to consider:

    • can’t understand gestures and non-verbal communication
    • doesn’t keep eye contact
    • repeating words and phrases persistently (a.k.a. echolalia)
    • doesn’t respond to their name by 12 months
    • difficulty beginning or maintaining a conversation
    • slow to respond to their name or other attempts to gain their attention
    • trouble expressing their needs and wants–may use behaviors like temper tantrums to communicate appearing to look through people and lacking an awareness of others

Observing these signs does not necessarily mean a child has autism. Only a licensed professional can diagnose autism spectrum disorder.

Autism is a spectrum, and each case is different with their own sets of symptoms. An early evaluation will help you understand their challenges, and get more accurate recommendations.

Autism vs. Speech Delay - How to Tell the Difference

Catching Differences Between Speech Delay and Autism

At this point, you may already have an idea about the differences, but some points may still be confusing. Here are a few more key differences between children with speech delay and autism that can help:

Social Skills and Engagement

    • Children with speech delays are still motivated by social responses. They respond positively to attention, and seek out close personal relationships. They actively attempt to communicate and mimic other people. Like typical children, they may become bored, upset, or lonely when left alone.
    • Children with autism have social communication challenges. They may be more motivated by their own interests than social interactions. Autistic children also rarely mimic the actions of others, may not respond when called by name, and may prefer to be alone.

Children with speech delays look forward to building social connections and relationships. Children with autism can do it too, but it may be more difficult to manage.

Body Language / Non-Verbal Communication

    • Children with speech delays learn the use body language, facial expression and eye contact over time. They follow typical developmental patterns, but they reach these milestones at a slower rate. They can still catch up despite these developmental delays.
    • Children with autism spectrum disorder may have difficulty understanding and using non-verbal communication. They may prefer repetitive actions such as lining up cars at eye level or repeating body movements.

Speech Sounds and Development

    • Children with speech delay may struggle with producing speech sounds and saying certain words.
    • Children with autism may have the same trouble making speech sounds, but they may also use persistent repetition of words or phrases. They may use few words or none at all, or repeat the same phrases over and over.

In general, children with speech delay are falling behind on speech developmental milestones. Children with autism, on the other hand, may have difficulty with more areas, not just speech. These areas may include nonverbal communication, social skills, and behavior.

Children with speech delay may eventually catch up with peers. Children with autism may need more interventions to reduce or manage their symptoms (which can last a lifetime).

It is important to note that there may be no possible “cure” for ASD. However, with the proper guidance and therapy, the child can still become an effective individual in the future.

Is Delayed Speech a Warning Sign for Autism?

Being a late talker is not always a warning sign for autism, but it can be a common characteristic for it.

Speech delays are common in both autistic and non-autistic children. It’s important to be also be aware of other indicators and signs of autism, such as difficulty with non-verbal communication and repetitive behaviors, such as hand spinning or flapping.

What Parents Can Do Next to Help

What Parents Can Do Next to Help

In either cases of speech delay or autism, early intervention is recommended to start as soon as possible.

Autism Spectrum Disorder is a complex diagnosis. It may need several points of support including speech therapy. Some children with ASD may also need medication as well to manage their symptoms.

Parents who notice some warning signs should contact their pediatrician or family doctor. They can give a more individualized recommendation according to your child’s needs. They may also give referrals to Speech-Language Pathologists that can assist.

Contacting a Speech-Language Pathologist

Speech therapy is key to either cases of speech delay or ASD. Whenever a child struggles with communication, finding a qualified speech therapist is crucial. Your pediatrician or family doctor may have a recommendation on your visit.

These speech therapists assess the child’s speech and language abilities to determine the source of the problem. And then, they work closely with families to come up with an individualized treatment plan appropriate for your child’s needs.

Speech therapists that have worked with similar cases in the past (like Apheleia) can help improve your child’s progress in a short amount of time. Reach out to us today to learn more about how we can cater to your child’s specific needs.

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Lauren Templeton - Apheleia Speech Therapy
Lauren Templeton

Owner & Speech-Language Pathologist

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