Is It A Speech Delay or Autism?

When your child falls behind in speaking, it’s natural to ask yourself “is it just a toddler speech delay or autism?”

While only your doctor can definitively answer that question, there are a few tell-tale signs that differentiate a speech or language delay from autism spectrum disorders.

Let’s take a look at them, shall we?

When your child falls behind in speaking, it’s natural to ask yourself “is it just a toddler speech delay or autism?” While only your doctor can definitively answer that question, there are a few tell-tale signs that differentiate a speech or language delay from autism spectrum disorders. Let’s take a look at them, shall we?

Since speech and communication challenges are often a part of autism, it’s easy to get worried when you’re dealing with a toddler speech delay. As a parent, you start to think “could my child be autistic?” The answer really depends on WHY your child has the speech delay to begin with. Not all children with language delays are autistic, just like not all autistic children have language delays.

Read on to learn more.

Read more►►Speech Delay in Toddler Boys: When Should You Be Concerned?

Is it a Toddler Speech Delay or Autism?

To truly understand the difference between a speech delay and autism, we need to look at the characteristics of each. As you read, keep in mind that you will see some crossover between the two.

Again, this does not mean that your child does or does not have autism. Please don’t take this as medical advice. If you suspect either a language delay or autism, it’s vital that you speak to your child’s pediatrician as soon as possible so you can both get the help and support that you need.

What is a Speech Delay?

One thing that may surprise you: a speech delay and a language delay are two totally different things. I know that surprised me because I often see them used interchangeably. Put in the simplest terms, a speech delay has to do with problems forming the words that come out of your child’s mouth, while a language delay has to do with understanding the words going into his ears.

Your child could understand every word in the dictionary yet still have difficulty saying “cat.” Likewise, your child could theoretically say words as complex as “supercalifragilisticexpialidocious,” yet have a problem understanding the word “cat.” Some children can have problems with both. Since we’re focusing on speech delays today, we’ll talk a bit more about that.

It’s important to remember that your child can outgrow a speech delay. Yes, he may need therapy for several years, but eventually he’ll “graduate.” Later, many kids have no tell-tale lingering signs that they ever had a delay! If you think about it, that makes complete sense, since the word “delay” itself means “late,” or “slow.” When you are delayed by traffic, you still reach your destination eventually, right?

One last thing to remember: a child with a speech delay could be right on track with all of his other milestones. He could have perfect social skills, cope well with changing routines, and follow instructions flawlessly. He just has a hard time expressing himself verbally. That’s important to remember as we head into the characteristics of autism.

Characteristics of Autism

Unlike speech delays, where your child has one pretty clear-cut “sign,” autism can literally run the spectrum and comes with a slew of other potential warning signs. Just about every mom with an autistic child that I know says the same thing: it starts with a feeling. Even before their child begins displaying the clinical signs, they just “knew” that something was up.

While autism manifests in many, many ways, let’s take a look at a few of the more common signs.

Difficulty interacting with others:

Children with autism often have difficulty playing with, interacting with, or relating to other people. If your toddler is perfectly content to play in a group of other kids, you’re most likely looking at a speech delay. If, on the other hand, your toddler often sits away from the group and gets agitated when other kids approach, it’s time to talk to your doctor about autism.

Little to no eye contact:

Toddlers on the autism spectrum often refuse to meet your eyes or will quickly turn away when you initiate eye contact. Not all children who shy away from eye contact will fall on the autism spectrum. In fact, I know many adults who have a difficult time maintaining eye contact, and it has nothing to do with autism (and no, it isn’t because they’re lying!).

Some people just don’t feel comfortable with it for their own reason.

Repetitive movements:

These include things such as flapping, tapping, and spinning. Keep in mind that not all repetitive movements are a sign of autism. Some kids can develop motor ticks (or “habits”) for many other reasons.

Lack of interest in the world around them:

signs may include a lack of curiosity about surroundings, lack of interaction, and a child that seems to live entirely in her own little world. While you may notice this sign as early as a couple of months of age, it becomes more evident in the toddler years. Toddlers are naturally curious, so we expect our kids to test their boundaries and be a bit adventurous.

Not understanding or using speech and language:

This is where speech delays and autism cross paths. Many kids on the autism spectrum have a difficulty understanding language and/or a complete lack of ability to or interest in communicating verbally.

What about Asperger’s?

Asperger’s is an exception to many of the classic autism signs. In fact, children with Asperger’s develop b both speech and language at a “normal” (or even above normal) rate. In fact, according to Autism Society, a child must NOT have a language delay in order to be diagnosed with Asperger’s.

While these are not the only signs of autism, they are among the most common. Please remember, though, that every child is different. Even if your child exhibits some of the signs above, it doesn’t necessarily mean an autism diagnosis.

Other issues ►►What Other Issues Can I Expect When Dealing with a Speech Delay?

As you can see, autism is not only about a delay in speech, but also social skills and other developmental delays. Just because your child isn’t talking at the same rate as your best friend’s toddler doesn’t mean that he is autistic. On the other hand, if your tot does exhibit all of the other signs, or even if you just feel like something is “off,” it can never hurt to bring it up with your pediatrician.

Remember, only a professional can diagnose either a speech delay or autism. If you try to make the diagnosis yourself based on what you’ve read on the internet, or even on someone else’s experiences, you could waste precious time getting both you and your child the right kind of help and support.

Have you ever been concerned about whether your child had a speech delay or autism? Tell us your stories and leave advice for others in your shoes below.

36 thoughts on “Is It A Speech Delay or Autism?”

  1. Hi, I’ve just come across this interesting blog post following a search on Pinterest. I’m on the autism spectrum and want to share something myself. One old school report states that I didn’t start speaking until I was 3 years old. Growing up during those early years, I wouldn’t say words until I could say them perfectly. I attended mainstream school, but needed some degree of support until that was no longer deemed necessary, as the teaching staff were satisfied with my progress.

  2. As the article mentioned that some mothers “just get a feeling”. That is exactly what I experienced with my son. From the moment I held him he didn’t make any eye contact. I shrugged it off because he was a newborn, but it continued on until he was 3 months old. I brought it up to his pediatrician who told me it wasn’t unusual for a 3 month old to not make eye contact so I waited. 4 months, 5 months, 6 months…and so on. No improvement. Then other signs of autism developed. Lack of interest, no speech, repetitive behaviors, constant pacing, fascinations with wheels and fans, the list goes on. The evidence has been quite overwhelming. We have just went for his 4th evaluation for autism as we are quite certain along with his care providers.

    It’s upsetting that some children with only a speech delay can end up misdiagnosed. I feel like as a parent it is up to us to really advocate for our children as we know them the best. I know this post is older, but I felt compelled to give my input. There’s no doubt in my mind that my son is actually autistic rather than a simple speech delay. I do hope we can help him through via various speech and occupational therapy.

    1. Hi Shyla, i hope your son is ok, I’m an occupational therapist from Argentina, and I can see how children with autism diagnosis can get lots of benefits from o.t and speach theraphy
      Veronica Bortolotto

  3. Thanks for this article, it opened my eyes to the fact that speech delay and language delay are indeed not the same. I just took it that its was the same. Again, thanks for the article.

  4. I realize this is an old post but has anyone ever experienced something like this? I have a friend whose daughter was diagnosed with autism at the age of 2. Pretty young for a full diagnosis. As she went through speech and OT she eventually got way better. To the point where her mother really didn’t think she needed any of the services anymore nor the did she feel like she actually had it. But the “autism” diagnosis followed her through to when she started school. The school made her Daughter have a one on one aid and go to special ed classes. But she was so good, she really didn’t want to or need it. Her daughter was a little sassy thing and any outburst she made about her situation was considered her autism. To this day she still has to fight the school system to keep her in a regular class. I am so afraid. My daughter has a speech delay with a few of the autism signs. I don’t want her to be misdiagnosed like my friends kid and have it follow her throughout school. My pediatrician isn’t the best and keeps flipping on what she thinks my daughter has. Any advise?

    1. I haven’t had a lot of luck w Pediatricians. It seems they don’t want to refer you for a diagnosis unless they are 100% sure in the 5mins they spend in the office visit. Googling will only make you paranoid. Im guessing your child is too old for Baby Net so your only chance of getting your child help is to constantly question your child’s pediatrician until they make a referral. It’s really challenging but keep at it, keep calling their office. Squeaky wheel gets greased.”

  5. How would you recommend a second option of ASD specially the level diagnosed. My son is a hybrid SPD ADHD he was diagnosed medically ASD& ADHD around the same time. His speech changed improved among other education concepts significantly once ADHD was treated with medication. My insurance provider only seems to send me to one office 40min away who based his level and diagnosis before addressing / diagnosing ADHD.
    Before he was 3yrs old he was screened at clinical level thru Tri Counties agency. Whom concluded no ASD.

  6. Children with speech delay who then start to talk often still have their “autism” diagnosis, truly “muddying” the autism waters, basically making the entire autism diagnosis a hot mess. It’s a crisis of misdiagnosis in the ASD community. So many kids with ADHD, speech delay or other developmental disabilities being labeled autistic by extremely ignorant medical professionals who are not educated on what autism is.

    1. It is not fair to call medical professionals ignorant for making the ASD diagnosis for a child who is demonstrating the signs and symptoms . I am a licensed speech language pathologist in the NYC area. As we all know, There is no blood test for ASD. We all do our best as a team of professionals to diagnose and refer for early treatment when the signs are there. As we know, the spectrum is wide. Better to refer for early treatment than not! Any diagnosis is not written in stone. Schools are seeing something that mom may not be seeing. Parents have to work together with teachers and special teams to decide best steps moving forward for any child’s educational plan. Parents have the last word ALWAYS! If you’re not comfortable with aids and services, then cha he them. This doesn’t mean that medical professionals or any other professional is ignorant! Please reconsider YOUR opinions before making ignorant statements.

  7. My son is 20 with severe autism, the doctors didn’t listen to me early on so I made a long list of the issues that I was seeing in my son then called the doctor’s office told the nurse everything on my list. The dr called back within minutes and referred him to a psychologist who tested and diagnosed him. Be your own advocate!

  8. disqus_6STjxzdART

    my Grandson is slow in his speech and he’s 3 years old and my daughter has had him to different Doctor’s and they say he will talk when he wants to he hasn’t been Diagnosed with anything he”s just seems to be holding back they told her not to worry about it . But to take him to Speech Therapist we have other children in the Family that have went through this stage before and then they took off talking with no Hesitation so it’s good and we didn’t have to worry it’s Great that we have Speech Therapists.

  9. my son was diagnosed with Autism at age 3…. we took all availabe services when he was young such as Speech, PT, OT ect… He went thru school with a one on one aide and was finally able to function with out one. These kids are very smart.

  10. My youngest son also experienced speech delay at the age of 3, we took him to a Developmental Pediatrician and we found out that he had Expressive and Responsive Language Disorder. He took sessions in OT and Speech Theraphy, At the age of 4, he got his regular schooling and up to now, there is no trace of speech delay or the disorder to him, He is now going grade 4, he excelled in Mathematics and Logical reasoning. Just give enough attention and time to our children to correct or to help them overcome their difficulties.

  11. Talking to your pediatrician is a wonderful thought however, it is just that, a thought. My son will be turning 3 this August and has a significant speech delay, as well as violent tantrums, acting out against himself (ex. Head banging, hair pulling, grinding his teeth), the need for routine, among other obvious autism “red flags”. I am going on 2 years of trying to get him help and/or a diagnosis, as well as any sort of treatment for whatever is going on with him. His primary care physician, as well as several other physicians in the practice, have told me not to worry. “He can’t hit his head hard enough to actually hurt himself” “You are simply dealing with terrible twos, welcome to parenthood” (he is the second of my 3 children, I believe I’ve experienced parenthood before this) “He’s just being a boy”. All of these are things I have been told since he was 1 1/2 years old, BY LICENSED “PROFESSIONALS”. I, being the hardheaded stubborn person I am, have not taken these answers lightly. It has made me question whether anyone actually cares about these children or if they are just trying to quickly get through their day. As I am nearing the 2 year mark of working towards a solution for myself and ultimately my son, I find myself more discouraged than ever. I envy those parents who are going through the tedious therapy sessions, or the feared endless medical testing, and even every parent still questioning the thought of autism and the sleepless nights that accompany those thoughts. My son and I are the grey area. We are the ones that the multiple systems in place for these children, have failed. I love my son no matter what and I always will. Despite the medical community failing us this far, I refuse to end up having these same physicians tell me “well if we had just caught it sooner..” So just as I began this post, I will end it the same way. “Talking to your pediatrician is a wonderful thought however, it is just that, a thought.”

    1. I know that your post is old here but I just wanted to tell you I had the same experience. I started noticing signs in my son before his 24 month checkup. I was able to get his pediatrician to refer him to speech therapy but in order to get further, I had to get him involved with early intervention and the speech therapist referred him to OT, the OT referred him to a developmental pediatrician and with the help of early intervention the developmental ped administered the ADOS but my pediatrician had no interested in this facts or helping me get there. I hope you were able to get your son what he needed.

    2. Hi. I understand your worries..My son who was born early and born small used to have speech delay. At age 3 he still cant say a word and would always be in tantrum pit and would bang his head on the floor or wall and scream and cries out in frustration. I was extremely worried then that he might have autism as some member of my husband family have. I brought my toddler to my pediatrician and later to a speech pathologist who confirmed that it was speech delay and to allow my son to take his time. I proactively enrolled my son to a pre-school.program and devote all my time talking to my baby. Boila! I was surprised when his first word was “MOMMY” in clear loud voice. Now at 11, his smart, talkative and a very affectionate boy.

    3. Federal and state guidelines for special education begin early. For very severe children, services may begin at birth. If you have any concerns Before the age of three,,, contact your pediatrician . If you still have concerns, contract your public school district. They can refer you to appropriate programs who conduct screenings etc.. Right before the age of three, you can again contact your public school district with your concerns. Screenings and possible assessments will be discussed. If child found eligible for services, an INDIVIDUAL Educatuon Program will be developed noting present levels, goals. Etc. You will be part of this team developing the IEP. No assessment takes place without your written consent. And all paperwork is confidential. Children who act out can be expressing frustration with their lack of. communication skills. Pauline Benson retir d speech path. Public schools

      I urge you to have your child screened by a speech pathologist and possible other professionals. while they do not diagnose children in the autism spectrum , they are part of the assessment team.

    4. I hear you loud and clear! I have a 2 year old AND a 3 year old who both have many signs of Autism, both delayed speech, etc. I have yet to get any real help or diagnosis. We do get Early Steps visits once a week, but I had to finally insist to their pediatrician that we need to see a development specialist. The wait for these doctors is about 8 months! But, we finally have an appointment in July for the 3 year old. Hopefully, we’re going to get some answers and help!

  12. I was just talking to someone about this very topic. I am going to share this post with her. Thanks for posting all of this!

  13. My daughter just turned 3 and is very speech delayed. I always get worried with all the stuff i read that my daughter might be high functioning autistic, but her doctors & speech therapist keep telling me not to worry myself because she doesn’t have any of the other characteristics besides the no speech & that if she were to be eventually diagnosed & on the spectrum they would all be kind of shocked because of how social she is. You just never know though.

  14. These are all good tips to know. Some of them, like the eye contact, I probably wouldn’t even pay attention to, if I hadn’t read your post.

  15. This post is very informative. It’s always best to read and research about these things. I didn’t know until now that eye contact ( amongst other things of course ) could help identify autism.

  16. I think way too many people jump to the “Autism” diagnosis before it is even warranted. I worried about my sons speech delay until 4 doctors told me he was normal and to not worry about it, he would talk in his own time. Sure enough, now he won’t stop talking. :)

  17. Talking to your pediatrician is definitely the way to go. Many times a child is just not ready to speak–and sometimes it is because they have nothing to say. One of my friends kids didn’t say a word for the longest–then one day———she has yet to stop talking!!

  18. I have always wondered why I had problems making eye contact. I have all of these symptoms. Maybe I have autism.

  19. I agree that any cause for alarm should be discussed with a pediatrician. As an educator, I have seen SO many parents self diagnose their children and really harm them in the process. Although; your list is an excellent starting point for parents who may not even be aware of the signs.

  20. I have a couple of friends with children who have been diagnosed with autism. They want a very strict routine, won’t look people in the eye and really don’t like to be hugged. But, super smart in specific areas.

  21. Robin (Masshole Mommy)

    I think the best advice is to go talk to your pediatrician. Since there are so many possible diagnoses, there’s just no way for a parent to know without talking to a professional.

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