In Autism, Speech and Communication Are Not the Same thing

Communication is Much More Than Speech

By Lisa Jo Rudy| Reviewed by Joel Forman, MD

People with autism spectrum disorders may be entirely non-verbal, they may have limited useful speech, or they may be very talkative indeed. No matter what their verbal abilities, though, almost everyone on the autism spectrum has a hard time using speech in social interactions. That's because they are coping with a double challenge: their own difficulties in expressing ideas appropriately, and others' difficulties in understanding and accepting them.

Speech Versus Communication in Autism

Why would a person who can use spoken language run into problems with social communication? There are two reasons. First, people with autism often use speech in idiosyncratic ways. They may recite lines from a movie, talk endlessly about a favorite topic, or ask questions to which they already know the answer. Second, speech is just one part of social communication and, in many cases, spoken language isn't enough.


To communicate effectively, most people use much more than speech. They use body language (use of eye contact, hand gestures, body stance, etc.), pragmatic language (socially meaningful use of language), idioms, slang, and an ability to modulate tone, volume, and prosody (ups and downs of the voice). These relatively subtle tools tell others whether we're joking or serious, platonic or amorous, and much more.


Communicating also requires an understanding of which type of speech is appropriate in a particular situation (polite at school, loud with friends, etc).  Making a mistake can result in serious misunderstandings. For example, a loud voice at a funeral can be interpreted as disrespect, while very formal speech at school can be read as "nerdy."

Why People with Autism Have Problems Communicating

All of the skills involved with social communication presuppose an understanding of complex social expectations, coupled with an ability to self-modulate based on that understanding. People with autism generally lack those abilities.

Often, people with high functioning autism (Asperger syndrome) find themselves frustrated when their attempts to communicate are met with blank stares or even laughter. This happens all too frequently because people with autism may have:

  • Delayed or unusual speech patterns (many autistic children, for example, memorize video scripts and repeat them word for word with the precise intonation of the TV characters)
  • High-pitched or flat intonation
  • Lack of slang or "kidspeak"
  • Difficulty understanding tone of voice and body language as a way of expressing sarcasm, humor, irony, etc.
  • Lack of eye contact
  • Inability to take another's perspective (to imagine oneself in someone else's shoes). This disability is often referred to as lack of "theory of mind."

Many people with autism are able to compensate for social communication deficits by learning rules and techniques for better social interaction. Often, these skills are taught through a combination of speech therapy and social skills training. The reality, however, is that many people with autism will always sound and appear slightly different from their peers.


Resources for Building Social Communication Skills

Most children with autism (and some adults) participate in therapies aimed at improving social communication skills.

  • Speech-Language Therapy can focus not only on correct pronunciation, but also on intonation, back-and-forth conversation, and other aspects of pragmatic speech 
  • Social Skills Therapy may involve autistic individuals in group activities that require practice in sharing, collaboration, and related skills 

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