"My 2-year-old isn't talking much and doesn't seem to play the same way as other kids. Could this be autism?"
As a speech-language pathologist, I understand how overwhelming it can be when you notice differences in your child's communication and social development. Autism Spectrum Disorder (ASD) affects communication, social interaction, and behavior in unique ways for each child. Early identification and intervention can make a tremendous difference in supporting your child's development.
Let's explore the communication signs of autism across different ages and how speech-language pathologists can support children and families throughout their journey.
Early Red Flags: Birth to 4 Years
Here are key communication red flags to watch for in very young children:
12-18 Months:
- Limited or no babbling by 12 months
- No pointing, waving, or other gestures by 12 months
- Not responding to their name consistently
- No imitation of actions or sounds by 16 months
- Limited eye contact during interactions
- No shared enjoyment or social smiling
18-24 Months:
- Few or no words by 18 months (fewer than 10 words)
- No copying actions and words - imitation is crucial for learning
- Difficulty with nonverbal communication - not understanding or using gestures, facial expressions, or body language
- Limited social engagement - doesn't seek to share experiences with others
- Repetitive behaviors with toys (lining up, spinning) rather than functional play
- Loss of previously acquired skills at any age
2-3 Years:
- Very limited vocabulary compared to peers
- No two-word combinations by 24 months
- Echolalia - repeating words or phrases over and over
- Difficulty with back-and-forth communication
- Limited pretend play or unusual play patterns
- Intense focus on specific interests to the exclusion of other activities
3-4 Years:
- Difficulty with social communication - trouble with greetings, sharing interests, or engaging in play with others
- Repetitive or unusual language patterns
- Difficulty adjusting communication for different people or situations
- Challenges with nonverbal communication - limited use of gestures, facial expressions, or understanding of others' nonverbal cues
- Restricted interests that interfere with learning and social interaction
Signs in School-Age Children (5 and Older)
Sometimes autism isn't identified until children enter school and face new social and academic demands. Here are communication and social signs that may become more apparent in school-age children:
Ages 5-8 (Early Elementary):
Communication Challenges:
- Difficulty with back-and-forth conversation - may talk extensively about preferred topics but struggle with reciprocal dialogue
- Literal interpretation of language - trouble understanding jokes, sarcasm, or figurative expressions
- Challenges with pragmatic language - difficulty knowing when and how to join conversations
- Unusual prosody or speech patterns - may sound "robotic" or use unusual tone/volume
- Difficulty understanding nonverbal cues from teachers and peers
Social Differences:
- Challenges making and keeping friendships
- Difficulty with unstructured social times (recess, lunch)
- May prefer adult interaction over peer interaction
- Struggles with group activities and cooperative play
Ages 9-12 (Late Elementary):
Communication Challenges:
- Difficulty with abstract language and concepts
- Challenges understanding implied meanings and social context
- May dominate conversations with special interests
- Trouble adjusting communication style for different listeners
- Difficulty with written expression and organizing thoughts
Academic and Social Challenges:
- Struggles with group projects and collaborative work
- Difficulty navigating complex social hierarchies
- May be seen as "quirky" or "different" by peers
- Challenges with executive function affecting communication
- Difficulty understanding social rules and expectations
Ages 13+ (Middle and High School):
Communication Challenges:
- Difficulty with increasingly complex social language
- Struggles with understanding teenage social dynamics
- May have advanced vocabulary but difficulty with social nuances
- Challenges with perspective-taking in conversations
- Difficulty with abstract reasoning and inferential language
Social and Academic Challenges:
- Increased social isolation as peer relationships become more complex
- Difficulty with self-advocacy and expressing needs
- Challenges with unwritten social rules and expectations
- May struggle with increasing independence demands
- Difficulty with job interviews and workplace communication skills
How Speech-Language Pathologists Help at Each Stage
Preschool Age (2-5 years):
Early Communication Skills:
- Building fundamental communication through gestures, pictures, and early words
- Developing joint attention and shared engagement
- Teaching functional communication to reduce frustration
- Supporting play skills and social interaction
Language Development:
- Expanding vocabulary and early sentence structure
- Teaching requesting, commenting, and social communication
- Addressing echolalia and developing meaningful language use
- Supporting comprehension and following directions
Elementary Age (6-11 years):
Academic Language Support:
- Developing classroom communication skills
- Teaching conversation skills and social language rules
- Supporting reading comprehension and written expression
- Addressing literal interpretation and understanding figurative language
Social Communication:
- Teaching peer interaction skills
- Developing friendship and relationship skills
- Understanding social cues and nonverbal communication
- Supporting self-advocacy and expressing needs
Middle School (12-14 years):
Complex Communication:
- Navigating more sophisticated social situations
- Understanding abstract language and concepts
- Developing presentation and discussion skills
- Supporting organizational and executive function skills through language
Social Navigation:
- Understanding changing social dynamics
- Developing age-appropriate communication styles
- Teaching conflict resolution and problem-solving communication
- Supporting identity development and self-expression
High School (15-18 years):
Preparation for Adulthood:
- Developing workplace and professional communication skills
- Teaching interview skills and job-related communication
- Supporting college-level academic language demands
- Developing independent living communication skills
Advanced Social Skills:
- Understanding complex social relationships
- Developing leadership and advocacy skills
- Supporting community participation and citizenship skills
- Preparing for post-secondary education or employment communication demands
The Importance of Early Intervention
You can often see signs and symptoms of autism in very young children, but sometimes these signs and symptoms are not very noticeable—and they might not be recognized until school age or even adulthood. This is why early screening and intervention are so crucial.
Early speech-language intervention can help children:
- Develop functional communication skills
- Reduce challenging behaviors often related to communication frustration
- Build social connections and relationships
- Prepare for academic success
- Develop independence and self-advocacy skills
Working with Families
Speech-language pathologists don't just work with children—we partner with families to:
- Provide education about communication development
- Teach strategies for supporting communication at home
- Help families understand their child's unique communication style
- Connect families with resources and support networks
- Advocate for appropriate services and accommodations
Beyond the Diagnosis
It's important to remember that autism is a neurological difference, and autistic individuals have valuable perspectives and contributions to share. Our role as SLPs is to support each child in developing their communication skills in ways that honor their individual strengths and needs.
We focus on:
- Supporting authentic communication, whether verbal or nonverbal
- Teaching functional skills that increase independence
- Honoring each child's unique communication style
- Preparing children for success in their chosen paths
When to Seek Help
If you notice any combination of the red flags mentioned above, don't wait. Early screening and intervention can make a significant difference. Trust your instincts—you know your child best.
Consider seeking evaluation if:
- Your child isn't meeting communication milestones
- You notice regression in previously acquired skills
- Your child has difficulty with social communication
- Teachers or other caregivers express concerns
- Your child shows repetitive behaviors that interfere with learning or social interaction
Moving Forward with Hope
An autism diagnosis or concerns about autism can feel overwhelming, but remember that you're not alone in this journey. Speech-language pathologists are trained to support children with autism and their families, and speech therapy can make a tremendous difference.
Every child deserves to have their voice heard and their communication supported. Whether your child communicates with words, gestures, pictures, or technology, we're here to help them connect with the world around them.
At Talk Soon Speech Therapy LLC, we specialize in supporting children with autism and their families. We understand that each child is unique, and we create individualized treatment plans that honor your child's strengths while addressing their communication needs.
Contact Talk Soon Speech Therapy LLC today to discuss your concerns or to schedule a comprehensive evaluation. Together, we'll help your child develop their communication skills and reach their full potential.
Remember: This information is for educational purposes and is not a substitute for professional evaluation. If you have concerns about your child's development, please consult with qualified professionals including speech-language pathologists, developmental pediatricians, or psychologists trained in autism assessment.
Located in Southern Costa Rica, TalkSoon provides comprehensive speech-language pathology services for children and families in the Southern Zone. Contact us today to learn more about how we can support your child's communication journey.