Some autistic people are nonspeaking, meaning they don’t use words when speaking. They may communicate in many other ways instead.
The term “nonverbal” means without words or speech, so it’s not entirely accurate to describe some autistic people who don’t speak. That’s because many of them understand words and can write or type to communicate. So, they do have words, they just don’t speak them.
You might also hear the term “minimally verbal.” This refers to autistic people who use a small number of words in speech.
It’s important to remember that whether or how much an autistic person speaks isn’t always an indicator of what they understand. Many of them listen with high comprehension to the things that you say.
Researchers estimate that about 25% to 30% of autistic children are nonspeaking or don’t use language in a functional way.
Society is built around communication with speech, so it can be hard for nonspeaking or minimally speaking autistic people to connect with verbal people. That’s why it’s helpful to learn more about nonspeaking autism and explore other ways to communicate.
Nonverbal autism usually means when an autistic person doesn’t use speech to communicate.
Instead, you might see behavioral responses or gestures. They might make some sounds, and they might simply appear as though they haven’t heard what you’ve said.
Typically developing children use their first words around
Some nonspeaking autistic children eventually begin to talk.
Autistic people can still communicate even without the use of spoken language. There’s a range of augmentative and alternative communication (AAC) options available.
AAC includes any communication method that isn’t talking, such as:
- facial expressions
- pointing to letters to spell words
- pointing to photos, text, or drawings
- using an electronic device to generate speech or assist with communication in some way
As autistic children learn literacy skills, many develop the ability to spell, form sentences, and communicate with language. So even if they’re nonspeaking, they can often type or write.
There’s a wide range of linguistic skills in the autistic community. Some people use single words or short and simple phrases while others can write as well or better than allistic (non-autistic) people.
They can also communicate using materials and technology developed specifically for nonspeaking people, such as the following:
Picture Exchange Communication System (PECS)
PECS is an AAC system that allows nonspeaking or minimally speaking people to initiate communication.
PECS uses simple images that represent high-frequency words or tasks. Users can point to them or show them to others. The images are on small, Velcro-backed cards and stored in a communications binder.
This system was created in the United States by Andy Bond and Lori Frost. The Delaware Autism Program was the first to implement this system. It has since become a worldwide autism communication tool.
Voice output communication aids (VOCA)
Also called speech-generating devices, VOCAs are tools that produce digitized (recorded and played back) or synthesized (computer-generated) voices to communicate for the nonspeaking person.
TouchChat is an example of a VOCA. It’s an iPad app that uses PECS-like images and text in squares across multiple linked screens. The user selects squares to communicate and can build full sentences that the app will read aloud.
A speech-language pathologist (SLP) can collaborate with an autistic person and their family to find a suitable AAC option. Some autistic people use more than one, like elementary-aged students who use both PECS and VOCAs.
It’s unclear why some autistic people don’t speak. Researchers have focused much of their efforts on verbal autistic children without significant cognitive (thinking) impairments because they tend to be more able to tolerate sensory issues during testing. For example, MRI (brain scan) technology can be loud, and it requires that the child resists the urge to move during scans.
The study found that nonverbal and minimally verbal autistic people showed delayed responses to auditory tones, compared to verbal autistic and typically developing people.
While the verbal autistic children had some time delay, the difference was most pronounced in the nonverbal and minimally verbal groups. Time delays were connected to weaker language ability.
Nonverbal autism and minimally verbal autism are not independent diagnoses. Instead, they’re forms of autism spectrum disorder.
The word “spectrum” means there’s a broad range of ways in which autism can present. This includes variations in speech use.
When a young and undiagnosed child demonstrates a speech delay, clinicians can assess their developmental history for a potential autism diagnosis. They may start with developmental monitoring and screening to determine whether to test for autism.
There are no medical tests for autism. Instead, doctors use behavioral assessment tests to arrive at a diagnosis.
Examples include the following:
- Autism Diagnostic Observation Schedule (ADOS-2), is a test that compares social and repetitive behaviors with typically developing peers.
- Autism Diagnostic Interview-Revised (ADI-R) is an interview with a parent to discuss the child’s developmental history.
- Childhood Autism Rating Scale Second Edition (CARS-2) is a questionnaire that can help clinicians differentiate autism from other conditions that may be present.
If your child has a speech delay but shows no signs of autism, your doctor can investigate other possible causes, like:
The goal of therapy and support is to foster communication. Science-backed approaches include:
- applied behavior analysis (ABA)
- early intense behavioral intervention (EIBI)
treatment and education of autistic and related communication handicapped children (TEACCH)
Other options to consider include:
- Speech therapy. Speech therapy with an SLP can help you find a suitable AAC method for your child, as well as recommended activities you can do at home between sessions.
- Floortime. Floortime is an at-home support strategy where you sit with your child and provide single-word labels for the toys or objects they’re paying attention to.
- Music therapy. Music therapy with a credentialed therapist can encourage communication through musical expression.
- Animal-assisted therapy. Animal-assisted therapy, including service dogs for autism, can inspire engagement and gains in communication. This is supported by a 2020 study involving autistic children and trained dogs.
- Therapeutic horseback riding. Also called equine-assisted therapy is another therapy that may encourage social communication in autistic people.
Nonspeaking autism means that an autistic person doesn’t use speech to communicate. The term “nonverbal” implies that they don’t use language, but this isn’t always the case. Many nonverbal autistic people understand speech and writing.
Nonspeaking autistic people can communicate in other ways, like through writing, drawing, and gestures. They can also use tools like PECS and VOCA technology to help them connect with other people.
Early diagnosis and support mean that a nonverbal child has more time to develop language and communication skills.
The Centers for Disease Control and Prevention (CDC) has a page with links to early