Speech Delay vs. Autism

Your child is 2 years old and you’ve noticed that your little one is not talking as much compared to their peers. Your child may be able to verbalize a couple of words but does not demonstrate fluent speech. 

Is this a sign of autism spectrum disorder (ASD)? Not necessarily.  

While many parents of children with autism express concern with delayed speech, it is important to differentiate that not all speech delays are the same and may not indicate autism. In fact, your child can have delayed speech for a multitude of reasons whether it be due to hearing loss, decreased exposure and opportunities for language, or intellectual disability.

It is important to educate yourself on typical milestones for speech and identification of abnormalities so you can best help your child. Let’s take a closer look!

Speech Delay Versus Language Delay

Speech refers to the child’s ability to produce and manipulate sounds into patterns of sequence to formulate words, phrases, and sentences. When a child demonstrates a speech delay, this often means that the child demonstrates normal development of sound production but at a slower rate than their peers.

For example, a child may have a difficult time pronouncing /th/ such as “think” which results in others having a difficult time understanding what message they are trying to convey. The decreased rate of acquisition could be due to a multitude of factors including, but not limited to a motor speech disorder and decreased opportunity at home.

A language delay, on the other hand, can occur as a receptive or expressive language challenges. If your child demonstrates a receptive language delay, this refers to a child’s comprehension of language. Your child may have difficulty learning new vocabulary and understanding what you’re trying to say. An expressive language delay, however, often refers to the child’s ability to connect words into sentences to convey messages to others.

Both speech and language delay have a high prevalence and incidence rate in younger children. While many children with autism spectrum disorder may exhibit a speech and/or language delay, let’s take a look at what differences you might find.

How Does Speech Delay Differ from Autism?

Let’s take a look at the communication milestones below to use as our guide.

Birth to 3 months: Your child is able to react to noises around them, can recognize your voice when spoken to, and is cooing. 

4 to 6 months: Your child is starting to follow sounds with their gaze, notices the change of tone in your voice, may laugh or babble, and can make gurgling noises. 

7 months to 1 year: Your child can understand frequently used words such as “cup” or “bottle”, can follow simple requests such as “come here”, is using gestures to communicate, is attempting to imitate your speech, is babbling with longer sequences of sounds, and may have 1-2 words (e.g. “mama” or “dada”).

1 to 2 years: Your child may know some body parts, can follow simple directions (“kick the ball”), enjoys stories and songs, can point to pictures when named, can put together 2 word phrases (“more milk”), and is starting to use different consonant sounds (p, b, m, w, h). 

2 to 3 years: Your child is starting to use 2-3 word combinations for phrases, and can name objects when asked.

3 to 4 years: Your child can answer simple wh-questions (who, what, where, why), can formulate sentences with 4+ words, can be understood by others 25% of the time.

4 to 5 years: Your child can formulate sentences to converse with you, can answer questions about short stories, can describe objects, and can understood by others 50% of the time. 

A child with speech delay follows the same trajectory of milestones but at a slower rate than their peers. You may notice that they are highly motivated to communicate with those around them either by pulling people in a direction towards the desired object or attempting to imitate actions/words to convey their messages. The child may also be highly motivated by social reinforcement (hugs and smiles) and enjoy the company of others.

A child who may present with autism spectrum disorder will often present with difficulties in social development, communication, and play. 

Social Development

A child with autism spectrum disorder but present with the following characteristics:

  • Your child demonstrates a limited interest in others and activities.
  • Your child has difficulty developing relationships with peers and does not join in activities with others.
  • Your child prefers to be alone. 
  • Your child often avoids eye contact and lacks facial expressions.
  • Your child may have difficulty turn-taking when engaging with others.
  • Your child may lack joint attention, which is the ability to attend to the same object with another individual.


A child with autism spectrum disorder but present with the following characteristics:

  • Your child is not responsive to their name when called.
  • Your child may have difficulty and decreased interest in gesturing/pointing to objects and people.
  • Your child may repeat words and phrases but unable to sequence words together to communicate their wants and needs.
  • Your child may demonstrate echolalia which is the repetition of sounds, words, and phrases without functionality.
  • Your child may babble or coo at first but then stop.
  • Your child may communicate with single words only. 

Behavior and Play

A child with autism spectrum disorder but present with the following characteristics:

  • Your child may have repetitive movements such as rocking back and forth.
  • Your child may have difficulty with adjusting to activities outside of routine with activities and toys.
  • Your child may have sensory difficulties difficulty and refuse to be touched or held.
  • Your child may be easily distractible.
  • Your child may have a high sensitivity to noise.
  • Your child may lack imitative, pretend, and spontaneous play behaviors.

How Can Speech Therapy Help?

Social Behavior

We can improve your child’s understanding of social language and rules and how to apply these rules to building meaningful connections.

  • Conversation– How to initiate, transition between topics, ask appropriate questions, make on-topic comments, and how to close conversation)
  • Non-verbal Communication– How to identify facial expressions, body, language, and tone of voice to help infer perspectives of others and how to respond based on those social clues
  • Problem Solving– How to identify size of problems, find solutions, and apply to real-life scenarios
  • Voice– How to improve tone and pitch when conversing with others 


We can improve your child’s use of language through verbal and nonverbal modalities (PECS, AAC) so they can functionally communicate their wants and needs with those around them. Through a number of strategies, we can address ways to encourage vocalization of thoughts and feelings.

Speech Sound Production

We can help your child coordinate their motor movements of their articulators (teeth, mouth, lips, tongue, etc.) for clear speech sound production.

Recently, there has been a growing push for early identification of autism spectrum disorder to promote early intervention services. Research suggests that the autism can reliably be identified by 2 or 3 years of age. Previously, children were not diagnosed before the age of 3 to 4 years thus delaying intervention for speech and language.

In a study by Paul et al. (2008), researchers found that children with delayed speech and language development were similar to children with autism through their difficulty to demonstrate joint attention, share emotions with others, turn-take, and communicate sequences of words for functional language. Unlike children with ASD, however, delayed speech and language children were able to engage in pretend play and utilize gestures to help communicate with others.

If you are concerned about your child’s speech and language development, schedule a consultation or evaluation with one of our speech-language pathologists today!

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