Speech Delay or Autism: A Practical Guide for Australians

Speech delay vs autism: side-by-side

This table shows how the two usually differ, though every child is an individual and many children have both.

What is a speech delay?

A speech delay means a child’s speaking or language skills are developing later than expected for their age.

• A child may use fewer words than expected, or may understand more than they can say.
• It can stand alone, or it can be one part of a wider picture such as autism or a language disorder.
• Early support is available, and a GP can refer you to a speech pathologist and a hearing check.

What is autism speech?

Autism speech is not a single pattern, because autistic people communicate in many different ways.

• Some autistic people are non-speaking; around 30% may be (Raising Children Network).
• Some are very talkative about favourite topics and find back-and-forth conversation harder.
• Some have speech that is clear but use language differently in conversation, which an assessment can explain.
• About 40% of autistic children are also diagnosed with a language disorder (Raising Children Network). Some families call this an autism speech disorder, but only an assessment can say whether a language disorder is present.

Our guide to echolalia in autism explains repeated words and phrases, which is another speech pattern some autistic people use.

Key differences between speech delay and autism

These are the differences families most often ask about.

1. 1Scope. A speech delay relates to speech and language; autism also involves social communication, interests, routines and sensory experiences.
2. 2Range of speech. Autistic people may be non-speaking, have typical speech or speak a great deal, while a speech delay means speech is behind what is expected.
3. 3Who assesses. A speech pathologist can assess speech and language, while an autism assessment is usually led by a paediatrician, psychologist or psychiatrist.
4. 4Overlap. The two can occur together, so one result does not rule out the other.

Late talker vs autism and language delay vs autism

A late talker is a child who starts using words later than expected; language delay is a wider term that includes understanding as well as speaking.

• Ask for both talking and understanding to be assessed, not only the number of words the child says.
• Note how your child uses gestures, eye contact, play and responding to their name, and share these observations at appointments.
• Ask the speech pathologist whether an autism assessment is also worth considering, and ask for the reasons.

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

Reasons for speech delay other than autism

Many things can sit behind slower speech, so a full assessment looks at the whole child.

• A language disorder, which can occur on its own or alongside other conditions; the Australian ADHD Guideline lists language disorders as common in children with ADHD (AADPA).
• ADHD, which a professional may consider alongside speech and language; see our guide to ADHD and speech delay.
• Hearing, which a GP or audiologist can check as part of the assessment.

2 year old not talking: autism or something else?

A toddler who is not talking yet is a reason to ask for an assessment, not a reason to assume a diagnosis.

• Book a GP visit and ask about a developmental check, a hearing test and a speech pathology referral.
• Read our guide to signs of autism in toddlers to see what professionals look for.
• Use Autism Connect (1300 308 699), a free national helpline run by Amaze, if you want to talk it through (Amaze).

3 year old speech delay, not autism?

Some 3 year olds with a speech delay are not autistic, and a speech pathologist can explain the speech findings. If concerns continue, ask your paediatrician what else could be considered.

Hyperlexia, hyperverbal autism and the autism accent

Some autistic children have speech patterns that look quite different to a speech delay.

• Hyperlexia — a term used when a child reads words unusually early; some hyperlexic autistic children read well but find spoken conversation harder.
• Hyperverbal autism — some autistic people speak a great deal and in detail about favourite topics, even when two-way conversation is harder.
• Autism accent — some people notice that an autistic person’s speech has a different rhythm, tone or pitch from those around them.
• Next step — a speech pathologist can describe how speech is working, and a diagnostic team can say whether autism is part of the picture.

Which is right for you?

Match what you are seeing to a first step, then follow up with a professional.

When to talk to a GP or specialist

• Your child is not using words or is using far fewer than other children of their age.
• Your child seems not to respond when called or does not point, wave or share attention.
• Your child loses words or skills they once had.
• You are worried about hearing, behaviour or development, even if others say to wait.

In an emergency, call 000.

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

Your next step

If you are supporting a child or family while you wait for assessments, we can help. TQN Care offers a range of NDIS services across Sydney, Melbourne and surrounding areas (NSW & VIC), including community access and help around the home. Make a referral and we will call you back to talk about what would help your family.