What Is Nonverbal Autism?

About a Third of People with Autism Use Little or No Spoken Language

Nonverbal Autism
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According to study by Boston University, about 30% of people diagnosed with autism spectrum disorder "never learn to speak more than a few words." Non-verbal autism is poorly researched, and little is known about the thought processes of people who don't speak. Nevertheless, some research is ongoing -- and new technologies are opening doors of communication and understanding.

What Is Non-Verbal Autism?

Nearly a third of people on the autism spectrum use no spoken language or only a few words.

All of these individuals could be described as having nonverbal autism. Yet the term "nonverbal autism" has no official status, and their is no such diagnosis as "nonverbal autism."

In part, that's because there is no clear line between verbal and non-verbal individuals with autism. "Non-verbal" people with autism are not silent, and some actually use words -- but with minimal meaning or intent. Many people with autism use non-spoken communication quite effectively.

  • Some people with non-verbal autism do develop the ability to use a few words in a meaningful manner, but are unable to carry on any kind of significant conversation. For example, they may say "car" to mean "let's go for a ride," but would not be able to answer the question "where should we go?"
  • Some "non-verbal" people have the ability to speak, but lack the ability to use language in a meaningful way. These individuals may "echo" scripts from television or expressions they've been taught by therapists. Instead of using these scripts to communicate ideas or desires, however, they seem to use "scripting" as a form of self-calming stimulation.
  • Quite a few non-verbal individuals can't use spoken language effectively, but are able to communicate with written or typed language, American sign language, picture cards, or digital communication devices. Once an individual is effectively communicating, even without spoken language, their ability to engage in the world expands dramatically.

    Why Don't Non-Verbal People with Autism Learn to Talk?

    One of the strangest aspects of nonverbal autism is the fact that no one really knows why some people with autism can't - or don't - use spoken language.

    True, some people with autism also have childhood apraxia of speech, a neurological disorder that makes spoken language extremely difficult. But most nonverbal individuals on the autism spectrum don't have apraxia -- they just don't speak. Clearly, there are differences in brain function that inhibit spoken language, but at this point there is no agreement on just what those differences are or how they impact any given individual.

    Studies are making use of instruments such as electroencephalograms (to measure brainwaves) and MRI's (to measure brain activity) in an effort to better understand what is going on inside the mind of a person who does not or cannot talk. Others are measuring eye gaze. So far it seems clear that people with non-verbal autism understand much more than they communicate -- but how much more, at what level, remains unclear.

    Will My Child with Autism Learn to Talk?

    Very often, therapists use the term "pre-verbal" rather than "non-verbal" to describe autistic children who do not use spoken language.

    Sometimes this term is accurate: quite a few autistic children with delayed speech gain the ability to communicate with spoken language. Some become quite fluent. Others, however, never gain more than a few words -- if that.

    In theory, IQ tests can help determine whether a child will gain spoken language. IQ tests, however, are generally intended for verbal children -- which, of course, makes such tests fairly meaningless.  There are a few IQ tests that are measure non-verbal intelligence, but even those are a bit problematic. As a result, while some researchers state that non-verbal children have low IQ's, they may be mistaken.

    According to an NIH Workshop publication on Non-verbal School-Aged Children with Autism, "...it is a very significant challenge to assess these individuals with traditional standardized instruments. Our current measurement tools have relatively low reliability and validity for this population. The presence of even one word, or some echolalic speech, appears to be a significant predictor for the acquisition of spoken language after five years of age. In both research and treatment planning, it is important to distinguish whether children are nonverbal (i.e., no spoken language), preverbal (i.e., younger children who have not yet developed verbal language), or non-communicative (i.e., having neither verbal nor nonverbal communication skills)."

    How Can I Encourage My Child to Speak (or at Least Communicate)?

    There are many techniques for encouraging and improving spoken language for children with autism, though there is no guarantee that any particular approach will be effective for any given child. Research suggests that speech therapy, behavioral interventions, and even play therapy can improve verbal communication. Some early research also suggests that music therapy and related techniques can make a positive impact on speech.

    Parents of children who don't yet have the ability to communicate effectively with spoken language should be aware of the following important - and often surprising - facts:

    • Late language acquisition is not necessarily an indication of low IQ or poor prognosis.
    • Children with autism may develop language much later than typically developing children, which means that it is worthwhile to continue speech therapy.
    • Communication using non-verbal techniques (PECS picture cards, sign language, etc.) can be very important in establishing communication. Children who build communication skills using these techniques often gain spoken language skills at the same time.
    • It is well worth parents' time, money, and energy to invest in digital pads, apps, and software that allow their child to communicate by tapping on images (or, in some cases, on keyboards). 
    • "Facilitated Communication," in which a therapist "supports" the arm of an autistic person while he or she types, has been debunked by numerous studies that show that it is the therapist, and not the autistic person, who is guiding the typing finger.

    Sources:

    Berdick, Chris. Cracking the code of silence in children with autism who barely speak. Boston University website. July, 2015. Web. http://www.bu.edu/research/articles/autism/.

    Layton, T.L. Language training with autistic children using four different modes of presentation. J Commun Disord. 1988 Aug;21(4):333-50.

    National Institute on Deafness and Other Communication Disorders. Autism and Communication. NIH Pub. No. 09-4315, Updated July 2009.

    National Institute on Deafness and Other Communication Disorders. NIH Workshop on Nonverbal School-Aged Children with Autism. April 2010.

    Pickett, E. et al. Speech acquisition in older nonverbal individuals with autism: a review of features, methods, and prognosis. Cogn Behav Neurol. 2009 Mar;22(1):1-21.

    Wan, C.Y.  et al. From music making to speaking: Engaging the mirror neuron system in autism. Brain Res Bull. 2010 Apr 28.

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