Pragmatic Speech Delays in Autism

speech bubbles surround woman

Most people with autism (though by no means all) do have the ability to talk. In fact, some people with autism talk a great deal. Most of the time, though, people with autism talk differently from neurotypical people. Most of those differences are really about understanding and responding to cultural expectations.

Differences in use of speech which compromise an individual's ability to communicate effectively are called pragmatic speech delays.

What do autistic problems with pragmatic speech sound like? While autistic speech patterns vary from person to person, individuals with autism may....

  • be louder or quieter than is culturally expected
  • speak in a flatter voice or use a different intonation than usual
  • repeat entire chunks of scripts from television shows, videos, or movies
  • talk about what seems to be an off-topic subject
  • dominate the conversation with talk about a topic of interest only to themselves
  • say the same things over and over again (either literally stating the same facts over and over, or using the same phrases in the same way over and over -- for example, saying "that's great" in response to every statement)
  • ask questions or volunteer information about topics that are usually considered taboo or at least sensitive (for example "So, are you really upset about your recent divorce?" or "I went to the doctor yesterday and had to give a urine sample.")
  • enter conversations when they are not invited, and/or leave conversations before the discussion appears to be over
  • have a hard time recognizing sarcasm, jokes, idioms and expressions such as "the pot calling the kettle black" unless they are explained
  • use language that seems inappropriate to the situation (too formal, too informal, trying to be funny in a serious situation or trying to be serious in a silly situation)
  • ask questions simply in order to state their own ideas or opinions (for example "Do you like telescopes?  I like telescopes; I have three of them.  One of them is a Celestron..."
  • tell the truth, without awareness of whether truth-telling will have a negative outcome ("yes, that dress does make you look fat")
  • fail or refuse to engage in the type of small-talk that usually smooths interactions among new acquaintances or in tense situations (weather talk, for example)

Both speech therapists and social skills therapists work with autistic children to overcome pragmatic speech delays.  Family and friends can also help by actively teaching, modeling, and role-playing appropriate speech patterns and language use. Unlike some therapies, speech and social skills therapies can make a significant difference for both children and adults.

Improvements in pragmatic speech skills can make a huge positive difference in others' response to people with ASD. It's important to note, however, that it is possible to "overtrain" autistic children, in particular, to the point where their language use is technically correct but socially "off." Strange but true, a child with autism who shakes hands with an adult, looks him in the eye, and says "It's a pleasure to meet you" is behaving, not like a child, but like a business peer!


Social Language Use (Pragmatics) article in the American Speech-Language-Hearing Association website. 1997-2008 American Speech-Language-Hearing Association.

Continue Reading