What is autism?

Autism is one of the autism spectrum disorders, a 

group of conditions that vary in their severity and 

the age at which a child first may show symptoms. 

Autism spectrum disorders fall under a broader 

category known as pervasive developmental disorders 

(PDDs). PDDs cause delays in many areas of childhood 

development, such as the development of skills to 

communicate and interact socially. 

Autism typically is diagnosed during a child’s second 

year and is lifelong, although symptoms may lessen 

over time. There is no cure for autism, but appropriate 

treatments can help a child develop life skills to 

function more independently.

Who is affected by autism?

Autism is one of the most common developmental 

disabilities. It affects people of every race, ethnic 

group, and socioeconomic background. Boys are 

four times more likely to have autism than are girls. 

According to a study by the Centers for Disease 

Control and Prevention (CDC), autism spectrum 

disorders were found to affect an average of one out 

of every 110 8-year-old children.

How does autism affect 

communication?

The word “autism” has its origin in the Greek word 

“autos,” which means “self.” Children with autism 

often are self-absorbed and seem to exist in a 

private world where they are unable to successfully 

communicate and interact with others. Children with 

autism may have difficulty developing language skills 

and understanding what others say to them. They 

also may have difficulty communicating nonverbally, 

such as through hand gestures, eye contact, and 

facial expressions. 

Not every child with an autism spectrum disorder 

will have a language problem. A child’s ability to 

communicate will vary, depending upon his or her 

intellectual and social development. Some children 

with autism may be unable to speak. Others may have 

rich vocabularies and be able to talk about specific 

subjects in great detail. Most children with autism have 

little or no problem pronouncing words. The majority, 

however, have difficulty using language effectively, 

especially when they talk to other people. Many have 

problems with the meaning and rhythm of words and 

sentences. They also may be unable to understand 

body language and the nuances of vocal tones. 

Below are some patterns of language use and 

behaviors that are often found in children with autism.

• Repetitive or rigid language. Often, children 

with autism who can speak will say things that 

have no meaning or that seem out of context in 

conversations with others. For example, a child may 

count from one to five repeatedly. Or a child may 

repeat words he or she has heard over and over, 

a condition called echolalia. Immediate echolalia 

occurs when the child repeats words someone has 

just said. For example, the child may respond to a 

question by asking the same question. In delayed 

echolalia, the child will repeat words heard at 

NIDCD Fact Sheet

Communication Problems in 

Children with Autism

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES ∙ NATIONAL INSTITUTES OF HEALTH ∙ NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS voice, speech, language language
an earlier time. The child may say “Do you want 

something to drink?” whenever he or she asks 

for a drink. 

Some children with autism speak in a high-pitched 

or singsong voice or use robot-like speech. Other 

children with autism may use stock phrases to start 

a conversation. For example, a child may say “My 

name is Tom,” even when he talks with friends or 

family. Still others may repeat what they hear on 

television programs or commercials.

• Narrow interests and exceptional abilities.

Some children may be able to deliver an in-depth 

monologue about a topic that holds their interest, 

even though they may not be able to carry on a 

two-way conversation about the same topic. Others 

have musical talents or an advanced ability to count 

and do math calculations. Approximately 10 percent 

of children with autism show “savant” skills, or 

extremely high abilities in specific areas, such as 

calendar calculation, music, or math. 

• Uneven language development. Many children 

with autism develop some speech and language 

skills, but not to a normal level of ability, and their 

progress is usually uneven. For example, they may 

develop a strong vocabulary in a particular area 

of interest very quickly. Many children have good 

memories for information just heard or seen. Some 

children may be able to read words before 5 years 

of age, but they may not comprehend what they 

have read. They often do not respond to the speech 

of others and may not respond to their own names. 

As a result, children with autism sometimes are 

mistakenly thought to have a hearing problem.

• Poor nonverbal conversation skills. Children 

with autism often are unable to use gestures—

such as pointing to an object—to give meaning 

to their speech. They often avoid eye contact, 

which can make them seem rude, uninterested, or 

inattentive. Without meaningful gestures or the 

language to communicate, many children with 

autism become frustrated in their attempts to make 

their feelings and needs known. They may act out 

their frustrations through vocal outbursts or other 

inappropriate behaviors. 

How are the speech and language 

problems of autism treated?

If a doctor suspects a child has autism or another 

developmental disability, he or she usually will refer 

the child to a variety of specialists, including a speechlanguage pathologist. This is a health professional 

trained to treat individuals with voice, speech, and 

language disorders. The speech-language pathologist 

will perform a comprehensive evaluation of the child’s 

ability to communicate and design an appropriate 

treatment program. In addition, the pathologist might 

make a referral for audiological testing to make sure 

the child’s hearing is normal. 

Teaching children with autism how to communicate 

is essential in helping them reach their full potential. 

There are many different approaches to improve 

communication skills in a child with autism. The best 

treatment program begins early, during the preschool 

years, and is tailored to the child’s age and interests. 

It also will address both the child’s behavior and 

communication skills and offer regular reinforcement 

of positive actions. Most children with autism respond 

well to highly structured, specialized programs. Parents 

or primary caregivers as well as other family members 

should be involved in the treatment program so it will 

become part of the child’s daily life. 

For some younger children, improving verbal 

communication is a realistic goal of treatment. 

Parents and caregivers can increase a child’s chance 

NIDCD Fact Sheet

Communication Problems in 

Children with Autism

voice, speechlanguage
of reaching this goal by paying attention to his or 

her language development early on. Just as toddlers 

learn to crawl before they walk, children first develop 

pre-language skills before they begin to use words. 

These skills include using eye contact, gestures, body 

movements, and babbling and other vocalizations to 

help them communicate. Children who lack these skills 

may be evaluated and treated by a speech-language 

pathologist to prevent further developmental delays. 

For slightly older children with autism, basic 

communication training often emphasizes the 

functional use of language, such as learning to hold 

a conversation with another person, which includes 

staying on topic and taking turns speaking. 

Experts estimate that as many as 25 percent of 

all children with autism may never develop verbal 

language skills. For some of these children, the goal 

may be to acquire gestured communication, such as 

the use of sign language. For others, the goal may 

be to communicate by means of a symbol system in 

which pictures are used to convey thoughts. Symbol 

systems can range from picture boards or cards to 

sophisticated electronic devices that generate speech 

through the use of buttons that represent common 

items or actions.

What research is being conducted to 

improve communication in children 

with autism?

The federal government’s Combating Autism Act 

of 2006 brought attention to the need to expand 

research and improve coordination among all of 

the components of the National Institutes of Health 

(NIH) that fund autism research. These include the 

National Institute of Mental Health (NIMH), which is 

the principal institute for autism research at the NIH, 

along with the National Institute on Deafness and 

Other Communication Disorders (NIDCD), the Eunice 

Kennedy Shriver National Institute on Child Health 

and Human Development (NICHD), the National 

Institute of Environmental Health Sciences (NIEHS), 

and the National Institute of Neurological Disorders 

and Stroke (NINDS).

Together, these five institutes have established the 

Autism Centers of Excellence (ACE), a program of 

research centers and networks at universities across 

the country. Here, scientists study a broad range of 

topics, from basic science investigations that explore 

the molecular and genetic components of autism to 

translational research studies that test new types of 

behavioral interventions. Some of these studies, which 

could be testing new treatments or interventions, 

might be of interest to parents of children with autism. 

Go to http://clinicaltrials.gov and enter the search term 

“autism” for information about current trials, their 

locations, and who may participate.

The NIDCD supports additional research to improve the 

lives of people with autism and their families. Recently, 

a group of NIDCD-funded researchers developed 

recommendations calling for a standardized approach 

to evaluating language skills in young children with 

autism spectrum disorders. The new benchmarks will 

make it easier, and more accurate, to compare the 

effectiveness of different intervention strategies.

NIDCD-funded researchers in universities and 

organizations across the country also are looking at:

• Better ways to predict early in infancy if a child is at 

risk for an autism spectrum disorder.

• Whether or not treatment interventions for at-risk 

infants can influence the development of speech 

perception and speech preferences.

more
• How infants with autism spectrum disorders 

“visually” scan their environment during their 

earliest social interactions and how this influences 

their development of language and communication 

skills.

• How genes and other potential factors predispose 

individuals to autism spectrum disorders.

Where can I find additional 

information?

Additional information from other centers and 

institutes at the NIH that participate in autism research 

is available at http://health.nih.gov/topic/Autism.

In addition, the NIDCD maintains a directory of 

organizations that provide information on the normal 

and disordered processes of hearing, balance, smell, 

taste, voice, speech, and language. Please see the list 

of organizations at http://www.nidcd.nih.gov/directory.

Use the following keywords to help you search for 

organizations that can answer questions and provide 

printed or electronic information on autism:

• Autism

• Speech-language development

• Learning disabilities

For more information, additional addresses and phone 

numbers, or a printed list of organizations, contact:

NIDCD Information Clearinghouse

1 Communication Avenue

Bethesda, MD 20892-3456

Toll-free voice: (800) 241-1044

Toll-free TTY: (800) 241-1055

Fax: (301) 770-8977

Email: nidcdinfo@nidcd.nih.gov

NIDCD supports and conducts research and research training on the 

normal and disordered processes of hearing, balance, smell, taste, 

voice, speech, and language and provides health information, based 

upon scientific discovery, to the public.

voice, speech, languagehearing, balancesmell, taste

NIDCD Fact Sheet: Communication Problems in Children 

with Autism

Publication No. 10-4315

Updated February 2010

For more information, contact:

NIDCD Information Clearinghouse

1 Communication Avenue

Bethesda, MD 20892-3456

Toll-free Voice: (800) 241-1044

Toll-free TTY: (800) 241-1055

Fax: (301) 770-8977

Email: nidcdinfo@nidcd.nih.gov

Internet: http://www.nidcd.nih.gov

The NIDCD Information Clearinghouse is a service of the 

National Institute on Deafness and Other Communication 

Disorders, National Institutes of Health, U.S. Department 

of Health and Human Services.