A version of this article first appeared on iancommunity.org.
Like many specialists, Ericka L. Wodka, Ph.D., has met with parents who want to know one thing in particular: when, or if, their child with autism will speak.
She looked to research studies for guidance. But “I wasn’t getting my questions answered,” says Wodka, a pediatric neuropsychologist. So she launched her own study using data from the Simons Simplex Collection (SSC), a research project of the Simons Foundation Autism Research Initiative.
Wodka’s team studied 535 children with autism spectrum disorder (ASD) who had “only a few single words at most” at age 4. By age 8, 70 percent had developed phrase or fluent speech, with 47 percent speaking fluently.1
“Phrase speech” means a child will use a two-word statement appropriately, such as “want cookie” when he would like a snack, Wodka explains. Almost half of the children spoke fluently; they could express themselves in complex statements on various topics.
These findings suggest that a greater percentage of children with autism “may be capable of attaining phrase speech than previously reported,” according to the study.1
Late Talkers with Autism
Published in 2013, the study may bring hope to parents who worry that children who are not talking by age 4 or 5 are unlikely to develop speech at all. Some children with ASD develop language after age 5. “There is a burst of kids in the 6 to 7 age range who do get language,” says Wodka, who currently leads recruitment and research efforts for the SPARK study at the Center for Autism and Related Disorders at Kennedy Krieger Institute in Baltimore.
In the 2013 study, 16 percent of the children with low-average intelligence or intellectual disability, and 11 percent with average intelligence, attained phrase speech by age 6 or older, says study co-author Luther Kalb, Ph.D., of Kennedy Krieger.
Wodka has good news for parents and educators. “The results of our study suggest that if you continue to work on the language development and social goals, and continue to persist with those intensely through the early childhood and early school-age years, the majority of kids who are not using meaningful phrases by age 4 will be by the time they're 8,” she says.
The team found that children with higher nonverbal intelligence scores and fewer social delays were more likely to achieve phrase or fluent speech, and at an earlier age. Social delays include difficulties with making eye contact, using facial expressions to communicate, and sharing items, thoughts, or feelings.
Children with intelligence in the typical range — an intelligence quotient (IQ) score greater than 85 — reached phrase speech about seven months earlier than children with IQ scores below that mark.
The children who could speak fluently were older, had higher nonverbal IQ scores, and had fewer social delays. They also had more anxiety symptoms, according to the study.1
Unexpectedly, the researchers did not find a relationship between language development and repetitive behaviors, such as hand flapping, or unusual sensory interests, such as smelling objects. “That was kind of surprising,” Kalb says. Repetitive behaviors seemed like they might interfere with language development, but they did not, he explains.
What Does This Mean for Intervention?
The findings potentially support the use of autism interventions that focus on “social cognition,” such as teaching a child to recognize the feelings and perspectives of others.1
Autism “is not a speech or language disorder,” Wodka explains. “It’s a social communication disorder. Understanding why it’s important to be able to communicate with someone else is not inherent for a child with autism, compared to a typically developing child.”
Interventions that help motivate children to communicate and share experiences with others might help improve speech, she says. Her study calls for more research on the topic.
The results may not apply to children from families who have different characteristics that those in the SSC study. The SSC includes 2,600 families who each have only one member — a son or daughter — with autism. Also, the child with autism does not have a genetic condition such as fragile X or Down syndrome, or a family history of psychiatric disorders.2