A child’s first word is a magical milestone. If there is a delay in the commencement of spoken language this milestone may become a minefield of stress for parents. According to research (Giacomo & Fombonne, 1998) a delay in the onset of spoken language is frequently the most worrying aspect expressed by parents of children with autism spectrum disorders (ASD).
In this article, language development of children with autism will be examined. Spoken language delays and subsequent consequences will be investigated with a concentration on relevant research. The success of early intervention strategies and solution-focused approaches to facilitate language acquisition and skills will also be discussed.
How does autism affect a child’s language development?
Babies start to absorb language as soon as they are born, mainly through interaction with parents and caregivers. However, autistic children, who are not thought to be motivated by social interaction, may not seek out opportunities to interact and may not develop language skills in the way that typically developing children do.
A neurotypical child will usually engage in canonical (babble containing a vowel and a consonant) babbling by 10 months. A study by Oller et al. (1998) suggests the late onset of canonical babbling as an early marker of abnormal development.
Children with autism also seem to prefer non-speech sounds to speech sounds (Kuhl et al., 2005). Their preference for non-speech stimuli and their lack in motivation to engage socially with caregivers may deprive them of chances to develop language and speech skills.
Baby talk
We may roll our eyes when we hear someone babbling “googoo ga ga”, but even the most eloquent sophisticate will resort to baby talk or child-directed speech (CDS) given half the chance by a chubby cheeked infant.
CDS is a way of speaking to a baby that is often characterized by things like a slower pace of speaking, a higher pitched voice, repetitions, and a sing song manner. Babies do respond to CDS, and some research suggests it may be a helpful tool on a baby’s speech and language acquisition path—in contrast other studies have shown typical language development without CDS.
As research suggests, a child with autism spectrum disorder may respond less (or pay reduced attention) to CDS in comparison to typically developing children, and these children may then have fewer language learning opportunities (Watson et al., 2011).
CDS is just one way in which experts believe children acquire language skills or learning. The role of a caregiver’s interaction and the expressive language used with a baby is also highlighted, with emphasis on communicative behaviors like facial expressions and gestures utilized to promote early language development.
Children with autism may not show the same interest in parents and caregivers in the first year of life (in comparison to typically developing children). Rather, interest may be focused on non-social stimuli and they may experience decreased interest in speech. Expectations that children on the spectrum will acquire language in a similar fashion to neurotypical children, may therefore be problematic and unfair.
Not your typical talk
Language and speech development is complicated with many variables but, when it comes to language and speech delays for those on the spectrum, research often points to differences in brain circuitry, reward systems, motivation, and brain activity—a combination which would explain a completely different language trajectory.
This may be even more relevant for nonverbal children with autism. A study (Ortiz-Mantilla et al., 2019) recorded electrical activity in the brains of nonverbal children with autism and revealed that the typical wave of brain activity involved in linking objects with their names did not show up.
Even when children with autism are verbal, they may not converse in a neurotypical manner. Instead we often observe behavior like:
- Echolalia: This happens when a child repeats or imitates words and phrases uttered by someone else. For example, when asking a child whether they need to go to the bathroom, they’ll answer by saying “bathroom” instead of answering in the affirmative or negative
- Apraxia: Apraxia of speech is a condition often associated with autism (according to a study by Tierney et al., 2015, nearly two-thirds of children with autism also had apraxia). The child may have problems coordinating the complicated oral movements necessary for speech. This is evident when kids look like they know what they want to say but they just can’t seem to get the words out
Accepting your child with autism may not develop language like a neurotypical peer is the first step. The second is to find a way to guide your child to acquire communication or language skills to help gain control over his/her environment.
Dr. Ron Malcolm, an expert with years of experience facilitating communication in children on the spectrum, emphasizes the empowering aspect of communication and language. He says that, in his many years of working with children with autism, he knows that, whenever he gets a phone call about a severe behavioral issue or reaction, it’s almost always linked to the child trying to communicate but lacking in verbal skills to do so successfully (Extracted from Dr. Malcolm’s presentation, Educational Options for Your Child with Autism, Autism Parenting Summit, April 2021).
Leading and following your child’s language development
Keeping in mind that your child with autism may not seek out social interaction, parents may have to step in to create opportunities to acquire and develop language.
The following tips may encourage development of language skills:
Early intervention
Children with autism may benefit from early intervention to improve communication and language development. Early intervention strategies are based on the hypothesis that intervention is most effective when the brain is developing, before core autism symptoms appear. Not everyone endorses early intervention, but most experts do encourage prioritizing language development when a child is diagnosed with autism.
Pivotal response treatment (PRT) is an example of early intervention treatment proving to be successful in improving children’s social communication skills (Gengoux et al., 2019). The success of the treatment is probably because it is initiated by the child and because it’s based on play.
Create communication opportunities
Children with autism may be less responsive or tuned into their parents (and their attempts at interaction), they may also gesture and babble less. These deficits in early communication development may lead to infants receiving less input or feedback from parents (who may be despondent at the lack of reciprocity)—leading to further deficits in language and speech acquisition.
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To counter this, parents could create communication opportunities throughout the day. To create quality communication opportunities, parents may need the help of a speech-language pathologist or other professional, especially when dealing with a nonverbal or minimally verbal child on the spectrum. An insightful book by Carol Potter and Chris Wittaker (Enabling Communication in Children with Autism) gives practical advice on how to create enabling communication environments for children with autism.
Responsive parenting
Time and again, responsive parenting is linked to language gains for both neurotypical children and those with autism. Responsive parenting follows the child’s lead and it recognizes the child’s cues, non-verbal communication, and body language.
Start small when building your child’s language
How should parents use information from all these studies to foster better language development for their child with ASD? Well, here are some suggestions:
- Let your child lead the process. If you dictate and lead with your own goals you may end up with nothing more than a tantrum as your child tries to avoid something that scares him/her. Respond to your child’s interests (or special interests) to create communication opportunities. If your child loves lining up toy figures, use the figures to help your child acquire new words
- If your child is nonverbal don’t inundate him/her with words and long sentences. By following your child’s lead, according to responsive parenting principles, use minimal words but encourage communication with gestures, body language and visual aids
- Allow and provide the space (and required silence!) for your child to communicate his/her needs. If you make a habit of anticipating needs, you may deprive your child of one of the easiest ways to develop language—communicating needs and wants
- Get down to your child’s level and interact in a way that motivates and makes sense to him/her. If your child has a special interest in cars, this may be the perfect opportunity to point to the car and introduce the word. Your child is interested, motivated, and you are responding in a way that makes sense to him/her. Praise your child when he/she imitates the word or, in the case of a nonverbal child, encourage him/her to point to the car when you use the word
In conclusion
Parents with austistic children may face one of their biggest battles in helping develop language and speech. However, the tears and frustration are worth it as experts believe children who are verbal are happier and they feel they have more control over their lives.
A study by Wodka et al. (2013) also found that most nonverbal children on the spectrum do acquire language skills and many become fluent speakers. As a parent, it is empowering to know you can participate responsively in this journey to attain a goal that will help your child navigate the complicated neurotypical world.
References:
De Giacomo, A., & Fombonne, E. (1998). Parental recognition of developmental abnormalities in autism. European child & adolescent psychiatry,7(3), 131–136. https://doi.org/10.1007/s007870050058
Gengoux, G. W., Abrams, D. A., Schuck, R., Millan, M. E., Libove, R., Ardel, C. M., Phillips, J. M., Fox, M., Frazier, T. W., & Hardan, A. Y. (2019). A Pivotal Response Treatment Package for Children With Autism Spectrum Disorder: An RCT. Pediatrics, 144(3), e20190178. https://doi.org/10.1542/peds.2019-0178
Kuhl PK, Coffey-Corina S, Padden D, Dawson G. Links between social and linguistic processing of speech in preschool children with autism: behavioral and electrophysiological measures. Dev Sci. 2005 Jan;8(1):F1-F12. doi: 10.1111/j.1467-7687.2004.00384.x. PMID: 15647058.
Oller, D. Kimbrough & Eilers, Rebecca & Neal-Beevers, A. & Cobo-Lewis, Alan. (1998). Late Onset Canonical Babbling: A Possible Early Marker of Abnormal Development. American journal of mental retardation : AJMR. 103. 249-63. 10.1352/0895-8017(1998)103<0249:LOCBAP>2.0.CO;2.
Ortiz-Mantilla, S., Cantiani, C., Shafer, V. L., & Benasich, A. A. (2019). Minimally-verbal children with autism show deficits in theta and gamma oscillations during processing of semantically-related visual information. Scientific reports, 9(1), 5072. https://doi.org/10.1038/s41598-019-41511-8
Potter, C., & Whittaker, C. (2001). Enabling Communication in Children with Autism. Jessica Kingley Publishers.
Tierney, C., Mayes, S., Lohs, S. R., Black, A., Gisin, E., & Veglia, M. (2015). How Valid Is the Checklist for Autism Spectrum Disorder When a Child Has Apraxia of Speech?. Journal of developmental and behavioral pediatrics : JDBP, 36(8), 569–574. https://doi.org/10.1097/DBP.0000000000000189
Watson, Linda & Roberts, Jane & Baranek, Grace & Mandulak, Kerry & Dalton, Jennifer. (2011). Behavioral and Physiological Responses to Child-Directed Speech of Children with Autism Spectrum Disorders or Typical Development. Journal of Autism and Developmental Disorders. 42. 1616-29. 10.1007/s10803-011-1401-z
Wodka, Ericka & Mathy, Pamela & Kalb, Luther. (2013). Predictors of Phrase and Fluent Speech in Children With Autism and Severe Language Delay. Pediatrics. 10.1542/peds.2012-2221.
