Nonspeaking autism is not a distinct diagnosis but a description of a certain set of symptoms of autism spectrum disorder (ASD). Having nonspeaking autism does not mean that a person cannot communicate or understand language, and with the right support, a nonspeaking autistic person can become a strong communicator with or without verbal language.

a mother holding her young son in the parkShare on Pinterest
Cavan Images/Getty Images

Having nonspeaking autism means that an autistic person does not speak or can only say a few words. According to xMinds, the term nonverbal is inaccurate, as it encourages the incorrect assumption that nonspeaking autistic individuals are unable to use words entirely.

Around 25–40% of autistic individuals are nonspeaking or minimally speaking. Although this can make communicating with other autistic people and neurotypical people challenging at times, it is important to note that the absence of verbal communication does not mean that an autistic person is not communicating.

Additionally, it does not mean that nonspeaking autistic people are less intelligent than those who do speak. Many nonspeaking autistic people lead full, happy lives. However, some nonspeaking autistic people may require support to help them communicate effectively via other means.

Doctors used to think that it was rare for children over the age of 5 years to learn how to speak. However, newer research suggests that this is not true. A 2013 study of autistic children with speech delay found that 47% became fluent speakers after the age of 4 years and that 70% began using phrases.

This article explores what nonspeaking autism is, including its symptoms, causes, diagnosis, early signs, treatments, and outlook.

Because nonspeaking autism is not a specific diagnosis, definitions vary.

Some people consider nonspeaking autism to mean that a person does not spontaneously speak in sentences or words that others can understand. Others consider it as the ability to speak meaningfully at times but not being able to speak at all at other times.

Having nonspeaking autism does not mean that a person does not communicate, cannot communicate, or does not understand language.

Some people with nonspeaking autism communicate via typing or special communication devices. The absence of speech does not mean an absence of understanding. Indeed, some nonspeaking autistic individuals write and verbally communicate in other ways.

People should not presume that a nonspeaking autistic person does not understand speech based on their ability to speak themselves. They should also not assume that they are incompetent.

Autism is a spectrum diagnosis, which means that a person may have a range of symptoms that affect daily life in ways ranging from mild to severe. In one area, such as verbal communication, a person may have significant difficulties, even as other abilities remain intact and other symptoms are mild.

Nonspeaking autism affects a person’s verbal skills. Some symptoms include:

  • not spontaneously initiating or responding to conversation
  • using only a few words or not speaking in complete sentences
  • using sounds as opposed to words to communicate, though, in some cases, parents and caregivers may understand the meaning of these sounds
  • not relying on spoken language as a primary form of communication

Their lack of speech does not necessarily mean that a person cannot understand language. However, there is still much that researchers do not understand about nonspeaking autism.

In a 2013 paper, autism researchers called for more research into nonspeaking or minimally verbal autistic people. They also highlighted some of the difficulties associated with researching this form of autism, as traditional language-based assessments may not work.

Autism is a complex diagnosis. The mere presence of this diagnosis does not provide much information about an individual, as autism causes a spectrum of symptoms.

Researchers are still not sure what causes autism or whether different factors might increase the chance of different autism symptoms.

The development of autism also varies, from appearing quickly over a few days or weeks to developing slowly over time.

Some potential factors in the development of autism include:

  • Genetics: Researchers have identified some genetic factors that appear to increase the likelihood of autism. A person is also more likely to be autistic if a close family member is autistic.
  • Genetic and chromosomal disorders: People with certain genetic or developmental disorders, such as tuberous sclerosis and fragile X syndrome, are more likely to also be autistic.
  • Development during pregnancy and in infancy: Exposure to certain drugs during pregnancy may increase the chance of autism.

There is still no evidence to suggest that vaccines cause autism, even in people with a high chance of the condition.

One 2013 study looked at factors that predict language development in autistic children. Researchers assessed 535 autistic children who were at least 8 years old and who did not begin speaking in phrases before the age of 4 years. Of those, 70% began speaking in phrases after the age of 4 years, and 47% began speaking fluently after the age of 4 years.

The study did not find that demographic or psychiatric factors affected whether or not a child began speaking. The factors that predicted fluent speech were:

  • higher nonverbal IQ
  • fewer social difficulties
  • more internalizing behavior, which is the tendency to turn unpleasant emotions on oneself rather than others

Sensory interests and repetitive or stereotyped behaviors did not influence the development of language.

Nonspeaking autism is not a distinct diagnosis from ASD. Instead, it is a description of a person’s symptoms. Nonspeaking autism includes a continuum of behaviors, from never speaking at all to only speaking in some situations.

No single test can diagnose autism. Instead, a doctor or another clinician diagnoses autism based on a person’s symptoms.

The diagnostic criteria for autism are as follows.

A person must have ongoing difficulties with social interaction in multiple contexts. Some examples include:

  • difficulties with the back-and-forth of communication, difficulty sharing interests or emotions, and difficulty understanding or responding to social interactions
  • difficulty with nonverbal communication, such as the inability to understand gestures or subtle body language or make eye contact
  • difficulty developing, understanding, or maintaining relationships with others

A person must also have a restricted range of interests and behaviors, which may be highly repetitive. Some examples include:

  • stereotyped behaviors or movements, such as repeating that things other people say, lining up toys, flapping arms, or using objects in atypical ways
  • difficulty with change and a high need routine
  • hyperfocus on particular interests
  • over- or under-reactivity to sensory input, such as being very sensitive to light or sound

To qualify for a diagnosis, the symptoms:

  • must be present in early childhood
  • must cause impairments in one or more areas of daily life or functioning
  • must not be due to some other diagnosis, such as a head injury

Some characteristics to look for in infants and young children include:

  • has delayed language skills or language skills that appear and then disappear
  • does not use gestures to communicate by 12 months
  • does not understand pointing by 18 months
  • is not interested in other children
  • does not engage in pretend play by 2.5 years
  • does not have typical happy, sad, or angry facial expressions by 9 months
  • does not respond to their name by 9 months
  • is not able to maintain eye contact or actively avoids it

Treatment for autism focuses on supporting people with the diagnosis and helping them learn new skills. Some options include:

  • Therapy: A wide range of behavioral therapies can help autistic people learn new skills. Speech therapy, occupational therapy, and similar interventions may help them function more independently. Behavioral therapy can focus on the development of social skills.
  • Psychotherapy: Psychotherapy can help autistic people understand their diagnosis and deal with symptoms of anxiety, depression, and other common issues. Family therapy may help a family better support an autistic person while offering parents new skills for managing their child’s condition.
  • Accommodations: Autistic people may need certain accommodations at work or school.
  • Medication: Medication can help with certain symptoms that tend to co-occur with autism, such as anxiety, attention issues, and depression. There is no medication approved to treat all of the symptoms of autism.

Certain interventions for autism, especially applied behavioral analysis (ABA), are increasingly controversial. The ABA approach to treatment aims to induce more “normal” behavior and may even punish typical autistic behavior.

People considering autism therapy should weigh the risks and benefits, including:

  • the effects of therapy on the autistic person’s mental health
  • whether or not the therapy stigmatizes harmless behaviors
  • how the autistic person feels about the therapy

There is no cure for autism, but various interventions and ongoing accommodations at work or school can make life easier for autistic people.

Some autistic children have few or no symptoms in adulthood, especially if they get supportive therapy. However, this is rare.

One small 2013 study compared neurotypical children with those with an autism diagnosis whose symptoms improved. The researchers found no significant differences in most social skills and other autism-related behaviors between the two groups, though children with an autism diagnosis continued to struggle with face recognition. This suggests that, for a small subset of autistic people, symptoms may disappear with age or time.

Additionally, autistic people may mask or camouflage their symptoms as they grow. As a result, clinicians might not see as many autistic behaviors in an autistic adult, even though autistic traits persist.

The notion of autism as a disease or disability is controversial among some autism advocates. Some autistic people prefer to think of it as an alternative way of thinking and being.

They believe that autism, like most ways of viewing and interacting with the world, poses some challenges but also comes with some benefits. For example, autistic people may be highly adept at detecting patterns or memorizing long strings of information.

Having nonspeaking autism can make certain interactions more difficult and may change the way that people respond to others. It does not, however, mean that a person cannot communicate.

With the right support and a willingness to accept alternative forms of communication, many nonspeaking autistic people become exceptional communicators, with or without verbal language.