Does a Speech Delay Mean Your Child Has Autism?

Eileen Bailey Health Guide
  • Parents watch as their young child moves through the developmental milestones, paying attention and worrying when a milestone isn't reached at the "right age" or at the same age as older siblings. Speech is one of the most apparent milestones and when a young child doesn't use language to communicate, it can be a sign of developmental problems. According to the American Academy of Family Physicians, between 3 and 10 percent of all children experience some type of speech delay, with boys impacted more often than girls. [1] Today, with all the talk of autism, you may automatically wonder if your child's delayed speech means he or she has autism. And while delayed speech development can be a sign of autism, there are also other conditions which should be considered.

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    Normal Speech Development


    Children develop at different rates. As with all developmental milestones, doctors cannot pinpoint one exact age when a child should speak their first word, instead, doctors look to see whether a child falls within an age range, for example, a baby is expected to babble between 4 and 6 months old. In order to determine if your child should be assessed for speech and language delays, you need to understand what is considered normal development.


    The following table shows the normal pattern of speech development [2]:


    1 to 6 months

    Coos in response to voice

    6 to 9 months


    10 to 11 months

    Imitation of sounds; says "mama/dada" without meaning

    12 months

    Says "mama/dada" with meaning; often imitates two- and three-syllable words

    13 to 15 months

    Vocabulary of four to seven words in addition to jargon; < 20% of speech understood by strangers

    16 to 18 months

    Vocabulary of 10 words; some echolalia and extensive jargon; 20% to 25% of speech understood by strangers

    19 to 21 months

    Vocabulary of 20 words; 50% of speech understood by strangers

    22 to 24 months

    Vocabulary > 50 words; two-word phrases; dropping out of jargon; 60% to 70% of speech understood by strangers

    2 to 2 ½ years

    Vocabulary of 400 words, including names; two- to three-word phrases; use of pronouns; diminishing echolalia; 75% of speech understood by strangers

    2½ to 3 years

    Use of plurals and past tense; knows age and sex; counts three objects correctly; three to five words per sentence; 80% to 90% of speech understood by strangers

    3 to 4 years

    Three to six words per sentence; asks questions, converses, relates experiences, tells stories; almost all speech understood by strangers

    4 to 5 years

    Six to eight words per sentence; names four colors; counts 10 pennies correctly


    Causes of Speech Delay


    Autism is certainly one cause of speech delay. Some individuals with autism never develop speech and language skills, although the majority can communicate in some way. There are, however, a number of other conditions which can also cause speech delay in young children:

    • Cognitive impairment
    • Learning disabilities
    • Psychosocial deprivation
    • Selective mutism
    • Cerebral palsy
    • Hearing loss
    • Oral impairments (such as tongue or palate problems)

    Early identification and treatment for speech and language delays is important. If you, or your doctor, believe your child has a delay, an evaluation by a speech and language pathologist can help to identify the problem, determine the cause and create a plan of action to work with your child. Besides actual sounds and language development, a speech and language pathologist will look at what your child understands, whether your child uses gestures, such as pointing to communicate and how well your child's mouth, tongue and muscles work together to create speech.


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    Based on the assessment of the speech and language pathologist and an evaluation to look for other early warning signs of autism, your doctor will decide if further evaluation is necessary and may refer you to early intervention services to further help your child's development.


    For further information:


    Signs of Autism


    Diagnosing Asperger's Syndrome


    Similarities and Differences Between Autism and Asperger's Syndrome


    Frequently Asked Questions about Autism


    Autism Risk Higher for Siblings




    [1] Evaluation and Management of the Child with Speech Delay, 1999, Alexander K.C. Leung and C. Ion Kao, 1999, American Family Physician


    [2] Pediatric Primary Care: A Problem Oriented Approach, M. William Schwartz et al, 1990, Mosby, St. Louis, pp 696-700


    "When to Worry if a Child Has Too Few Words," 2010, Feb 8, Perri Klass, The New York Times


Published On: April 27, 2012