Autism is a complex neurodevelopmental disorder that affects communication and social skills. About 25-30% of children with autism remain minimally verbal or nonverbal. This means they have very limited functional speech, or don’t speak at all.
For parents of nonverbal autistic children, communication barriers can be frustrating and isolating. But with the right tools and support, these children can find their voice.
What is Nonverbal Autism?
“Nonverbal autism” refers to autistic individuals who are unable to communicate through spoken language. However, this doesn’t mean they can’t communicate at all.
Many nonverbal individuals with autism:
- Can understand some or all of what is said to them
- May occasionally use certain words or phrases meaningfully
- Can learn to communicate through writing, sign language, pictures, and assistive technology
Being nonverbal does not necessarily equate to having intellectual disability. In fact, a growing body of research indicates that nonverbal autism has more to do with motor planning challenges and anxiety as opposed to cognitive deficits.
Common Causes of Nonverbal Autism
There are several theories on why some individuals with autism remain nonverbal:
Apraxia
Also known as verbal apraxia or childhood apraxia of speech (CAS), apraxia is a motor speech disorder that makes it very difficult to plan and produce the precise, highly coordinated muscle movements required for intelligible speech.
Many autistic children who are nonverbal struggle with apraxia. However, apraxia alone does not cause nonverbal autism.
Anxiety
Speaking requires a great deal of social interaction and communication, which can provoke intense anxiety in autistic individuals. This anxiety may cause some children to avoid speech altogether.
Motor Planning Challenges
Many autistic children have motor planning challenges that affect both fine and gross motor skills. This makes it very difficult to coordinate the complex mouth movements required for speech.
Sensory Processing Differences
Atypical sensory processing is common in autism. Noises, textures, smells, and other sensations that neurotypical people filter out can be overwhelming. This constant sensory overload makes it very difficult to process speech.
Signs of Nonverbal Autism
While every autistic child is unique, common signs of nonverbal autism include:
- Very limited speech or no speech at all
- May make vocalizations like grunting, babbling, or laughing
- Uses some words or phrases repeatedly without communicative intent
- Relies primarily on nonverbal communication like gestures, pictures, or sign language
- Shows frustration when unable to communicate wants and needs
- Exhibits other symptoms of autism like repetitive behaviors, sensory issues, and social challenges
Getting an Accurate Diagnosis
Identifying nonverbal autism can be tricky. It’s important to partner with medical and therapeutic professionals who have experience with autistic individuals.
Some key components of an accurate nonverbal autism diagnosis include:
- Developmental history – Track speech and language milestones from early infancy. When did delays become apparent? Have there been any gains?
- Observation – Observe the child interacting in familiar vs. unfamiliar settings. What nonverbal communication skills do they demonstrate? How do they respond to speech from others?
- Testing – Formal autism screening and diagnostic tools tailored to nonverbal individuals. Testing of speech, language, IQ, motor skills.
- Medical workup – Rule out issues like hearing loss, intellectual disability, and neurological disorders.
- Multidisciplinary input – Feedback from teachers, therapists, psychologists, and other professionals.
Getting the right diagnosis opens the doors to tailored treatment and support.
Can Nonverbal Children with Autism Learn to Speak?
For parents hoping their child will speak, the big question is – can nonverbal autism be reversed? The short answer is maybe.
Here are some key points:
- Speech gains are possible – With intensive therapy, some nonverbal children develop speech, from simple words and phrases to full sentences. However, outcomes vary dramatically.
- Early intervention is key – Children who receive targeted therapy before age 5 have the best prognosis for developing speech. But gains are still possible in older children.
- Focus on functional communication – Whether or not speech emerges, teaching functional communication using any means (sign language, pictures, devices) is crucial.
- Augmentative and alternative communication (AAC) options – From simple picture boards to speech-generating devices, AAC tools can give nonverbal children a voice.
- Support is lifelong – Even with gains in speech, most nonverbal individuals need ongoing support with communication challenges.
While speech gains are great, they should never be the sole focus. The ultimate goal is meaningful communication using any means necessary to improve quality of life.
Effective Therapies for Nonverbal Autism
Several therapies show promise for developing communication skills in nonverbal children on the spectrum:
Speech Therapy
Speech-language pathology focuses on improving speech clarity and teaching functional communication skills. For nonverbal children, speech therapy techniques include:
- Oral-motor exercises to improve coordination for speech sounds
- Communication boards/books with pictures, symbols, letters
- Sign language education
- Voice output communication aids and devices
- Social skills training to reduce anxiety around speaking
Applied Behavior Analysis Therapist
Applied behavior analysis (ABA) uses positive reinforcement to teach communication and other critical skills. Proven ABA methods include:
- Discrete trial training to reinforce individual words or signs
- Picture exchange communication system (PECS)
- Functional communication training to replace problem behaviors with communication
- Social skills training to build language in natural contexts
- Augmentative and alternative communication (AAC)
Occupational Therapy
Occupational therapy develops foundational skills needed for communication, like motor planning, sensory processing, and visual perception. Common techniques include:
- Oral-motor skill building
- Sensory integration therapy
- Visual supports and schedules to ease anxiety
- Handwriting and typing instruction
Assistive Technology
From simple picture boards to speech-generating apps and devices, assistive technology removes barriers to functional communication. Options include:
- Low-tech solutions like picture symbols, communication boards, and visual schedules
- Speech-generating and text-to-speech apps and software
- Dedicated speech-generating devices like TobiiDynavox
With a mix of therapies tailored to the child’s needs, communication can improve dramatically.
Tips for Supporting Communication Development
Parents and caregivers play a critical role in helping nonverbal children communicate. Here are some tips:
- Learn your child’s unique nonverbal communication system and respond consistently.
- Create a total communication environment using any means available – signs, pictures, writing, speech.
- Use visual supports like picture schedules to promote understanding.
- Narrate activities and routines to expose your child to language.
- Set up a system for your child to initiate communication, like picture exchange.
- Follow your child’s lead and build on their interests to motivate communication.
- Work closely with your child’s therapy team to implement consistent strategies.
- Stay positive – every little bit of progress is a victory!
With dedication and the right support, nonverbal children can connect, engage, and share their thoughts and needs in meaningful ways. Don’t underestimate their potential!
In-Home ABA Therapy in Maryland from Jade ABA
At Jade ABA, we understand the challenges faced by nonverbal children with autism and their families. Our compassionate team has extensive experience using the proven methods of ABA to unlock communication and maximize independence.
We offer customized 1:1 ABA therapy right in the comfort of your Maryland home. Your child’s lead therapist will conduct an in-depth assessment, then design an individualized treatment plan targeting functional communication, social skills, behavior, daily living skills, and more.
Jade ABA’s high quality, center-based level therapy in a natural home setting provides the best chance for your nonverbal child to reach their full potential. Contact us today at (410) 616-0901 to get started!
References
- Anderson, D.K., et al. (2007). Gains in nonverbal communication skills in children with autism following short-term intervention with a robotic pet. https://doi.org/10.1109/IROS.2007.4399242
- Ganz, J.B., et al. (2012). A meta-analysis of single case research studies on aided augmentative and alternative communication systems with individuals with autism spectrum disorders. https://doi.org/10.1177%2F1088357611428435
- Kasari, C., et al. (2008). Communication interventions for minimally verbal children with autism: A sequential multiple assignment randomized trial. https://doi.org/10.1097/CHI.0b013e318185e703
- Mody, M., & Belliveau, J.W. (2013). Speech and language impairments in autism: Insights from behavior and neuroimaging. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665327/
- Rogers, S. J., et al. (2006). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology. https://doi.org/10.1207/s15374424jccp3504_8