How Is Developmental Language Disorder Different From Autism Spectrum Disorder
Neurodevelopmental conditions is a name doctors and scientists give to differences from the expected brain and behavior development during childhood. There are many ways that brain development can be different. One of the most well known neurodevelopmental conditions is autism, which has some similarities with Developmental Language Disorder , but also some important differences.
Autism is a broad term that includes a wide variety of challenges, but people with this neurodevelopmental condition all share the following two traits:
What Are The Signs Of Delayed Speech
If your child does not meet the typical developmental milestones for their age, they may have a speech or language delay.
Speech development can vary from one child to the next. However, these are signs that your child may be speech delayed:
4-6 months: not babbling.
Two years: using fewer than 50 words having trouble playing with and interacting with other children.
Three years: not speaking in brief, simple sentences not using plural words or pointing out body parts.
Four years: unable to share a simple story or form sentences 4-5 words in length. Difficulty understanding pronouns, such as “you” and “me.”
There are several types of speech and language disorders. Speech disorders involve mispronunciations of words or sounds, while language disorders involve getting a message across or understanding a message from others.
When To Seek Professional Evaluation
For children who arent developing critical speech skills, or those who are lagging behind their peers, its important to seek a professional evaluation from a doctor or speech-language pathologist.
A developmental screening and evaluation can help you determine whether your child is speech delayed, has ASD, or both. Better understanding your childs conditions and risk factors can bring you peace of mind and, as mentioned, help you make the most informed treatment decision moving forward.
Until recently, ASD was rarely diagnosed before 3-4 years old. However, current research supports lowering the age of identification, mostly due to the effectiveness of early intervention. Around the age of 18 months to two years is also when speech and language delays become most noticeable. While parents may be able to spot many important signs at home, this is generally the most ideal time to have your child professionally evaluated.
There are a number of tools and methods your doctor or speech-language pathologist will use to determine if a childs speech delay is caused by autism or is unrelated. These include testing and examining his/her social skills , physical responses , and language comprehension .
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How Does Speech Delay Differ From Autism
Lets take a look at the communication milestones below to use as our guide.
Birth to 3 months: Your child is able to react to noises around them, can recognize your voice when spoken to, and is cooing.
4 to 6 months: Your child is starting to follow sounds with their gaze, notices the change of tone in your voice, may laugh or babble, and can make gurgling noises.
7 months to 1 year: Your child can understand frequently used words such as cup or bottle, can follow simple requests such as come here, is using gestures to communicate, is attempting to imitate your speech, is babbling with longer sequences of sounds, and may have 1-2 words .
1 to 2 years: Your child may know some body parts, can follow simple directions , enjoys stories and songs, can point to pictures when named, can put together 2 word phrases , and is starting to use different consonant sounds .
2 to 3 years: Your child is starting to use 2-3 word combinations for phrases, and can name objects when asked.
3 to 4 years: Your child can answer simple wh-questions , can formulate sentences with 4+ words, can be understood by others 25% of the time.
4 to 5 years: Your child can formulate sentences to converse with you, can answer questions about short stories, can describe objects, and can understood by others 50% of the time.
A child who may present with autism spectrum disorder will often present with difficulties in social development, communication, and play.
What Causes Speech And Language Delays
There are many possible reasons for speech and language delays to occur. The most common are:
Hearing loss, including children who have recurrent ear infections and those who are hearing impaired
Difficulty making friends or playing social games
Repetitive behaviors, such as spinning or rocking
Has trouble with minor changes to their routine
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Living With A Speech And Language Delay
If your childs speech is delayed due to a hearing loss, hearing aids or cochlear implants may help your child hear speech. Once your child has access to sound , they may be able to develop language and even catch up to their hearing peers.
If your child hears and understands language, you can encourage them to speak by talking as much as you can around them. Describe what youre doing as you do everyday activities. Keep talking. If your child speaks, confirm what they are saying. Always provide positive feedback.
Speech and language delays can be frustrating for parents and children. Children who cant express their thoughts and emotions are more likely to act out. They anger easily. They may use unexpected behavior to get your attention. Try to remember your child does want to communicate with you. Read to your child and talk as much as you can. Encourage your child to speak. When they try to speak, praise their efforts.
Speech Delay Vs Autism
When I assess a child for delays and autism spectrum disorder, I want to look at the child as a whole so I can get a full picture of whats really going on. This means looking at much more than the number of words a child says compared to typical milestones. We want to assess things like pointing, whether a child responds to their name, their self-care skills and much more. Important behavioral signs like eye contact and body language can offer valuable insights. By looking at the whole picture, we can see much more clearly if a child has just a speech delay vs autism.
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Symptoms Of Autistic Speech Delay
Let us consider the cases of Charlie and Jaimie.
Charlie is currently 2-years old. He isn’t talking at all. While he is a quiet child, he grabs his mother’s fingers, tugs at daddy’s sleeve, and cups his mother’s face when he wants attention. He engages with his parents and interacts with other children his age during playdates. He dislikes naps because his parents leave him alone in his room.
Jaime, on the other hand, does speak a few words. Interestingly, he doesn’t use these words to communicate. He repeats those few words and cannot use or understand gestures. He doesn’t point towards something he wants or needs. Jaime doesn’t engage with other children his age. However, he is quite content when his parents leave him alone. His parents find it difficult to capture his attention for longer than a few seconds.
If you think your child is more similar to Jaime than Charlie, it may be wise to consider having them evaluated for ASD.
Some children with ASD who are on the high functioning end of the spectrum may be more social compared to children with severe ASD.
Almost all children with autism face social communication challenges. However, with extended speech therapy and behavioral therapy, social communications may become somewhat easier for children with autism.
Brain Behavior Distinguish Autism From Language Delay
Bahar GholipourSpectrumSlow to speak:
Babies with autism show behavioral and brain features that differ from those of babies with language delay1. These findings from a new study hint at different biological origins for autism and language delay.
The results, based partly on brain scans, could help clinicians identify and treat subgroups of children with language problems.
The diagnoses we use in clinical practice today are entirely based on behavioral observations and lack any grounding in the underlying biology, says lead investigator Joseph Piven, professor of psychiatry at the University of North Carolina at Chapel Hill.
Children who have autism and language delay show dampened brain activity in two language centers as early as age 1, researchers reported in a 2015 study. Children who have language delay alone do not show this pattern.
In the new study, Piven and his colleagues found that among children who show poor language skills at age 1, those later diagnosed with autism understand and produce speech differently than do those without autism. They also show a different pattern of associations between the size of certain brain structures and language skills.
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Signs Of Language Delay
Children that are 2 years old and have less than 50 words in their vocabulary and no two-word phrases are considered language delayed.
Additionally, children that do not gesture or understand gestures are also at risk for language delay.
Children with language delays often have a hard time pronouncing things correctly as well. They might be more difficult to understand.
Babies younger than 24 months may have a language delay if they do not babble consistently.
The Difference Between Speech Delays And Autism
Speech and language delays are far more common than you may think they affect around 10% of preschool-aged children. Because of this, its important to learn how to recognize a speech delay in your childs first few years of life, so they can get the appropriate assistance early on to help them catch up in their development.
Delayed speech in children can occur for different reasons, some more serious than others. Many who are familiar with signs of autism during childhood development are aware that speech delays are common among autistic children. However, there are differences between some speech delays and those that are directly related to autism.
Children with autism develop other developmental delays and signs that are unique to the presence of autism. Knowing how to tell the difference between speech delay and autism can help you determine what type of developmental assistance your child may require, such as early intervention for autism or speech therapy.
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How To Tell If Your Child Has A Language Delay
The first way to tell if your child or client has a language delay with or without autism is to do an assessment. For instance, if youre doing an assessment to see whether your child can touch his body parts, actually sit on your hands and say, touch belly, touch nose, touch head. Dont do the same movements as part of a singsong game like I did.
You should also be aware of what typically developing milestones look like. Go to the CDC website to find out some of the milestones your child should be reaching both in terms of language as well as other areas. They could be physically delayed they could be socially delayed, and they could be delayed with self-care tasks such as eating with utensils or still drinking from bottles/using pacifiers way too late. The other thing you could do as part of the assessment is to download a free MCHAT and watch my video blog I did on the MCHAT.
Make Appointment With Your Childs Pediatrician
If there are delays between what your child is doing and the milestones, Id go on to step number two. Make a sick appointment with your childs pediatrician. This is something that I never thought of. Especially when I was still in denial that it was autism. There were no well visits between two and three, and my husband and I had some concerns. We just never thought about going to the doctor specifically to discuss those concerns. You want to get a screening done by a professional because as a parent, you just want everything to be okay. But get a professional to help you screen the child and see if you can start early intervention.
Also, in addition to contacting your pediatrician, if your child goes to daycare or preschool, you may want to talk to your childs teacher too. See if theyre falling behind in the classroom. She can give you input potentially on how hes doing with group responding, waiting in line, or getting into trouble at preschool.
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What Causes A Speech And Language Delay
The most common causes of speech delay include:
- hearing loss
- Elective mutism .
- Cerebral palsy .
Living in a bilingual home also may affect a childs language and speech. The childs brain has to work harder to interpret and use 2 languages. So it may take longer for these children to start using one or both languages theyre learning. Its not unusual for a bilingual child to use one language for a while.
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 childs 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 were focusing on speech delays today, well talk a bit more about that.
Its important to remember that your child can outgrow a speech delay. Yes, he may need therapy for several years, but eventually hell 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?
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What Is The Difference Between Speech Delay And Autism
A language delay is different from a speech delay. A language delay may mean a child has some words, usually labels, but they dont communicate their wants and needs to adults or use words functionally. Children with autism spectrum disorder or autistic children often have language problems or developmental delay, and they can also have speech delay. Social communication problems can also result from speech delay and autism spectrum in children.
One way to assess whether a child is a late talker or has more than a speech delay is to look at their imitation skills, pointing, and whether they respond to their name. A good tool to use is the M-CHAT. The Modified Checklist of Autism in Toddlers is a list of 20 questions that can help you determine if your child is showing signs of autism.
You might be wondering if your child has a speech delay vs autism because of all the isolation they are experiencing due to Covid-19. A speech delay can develop because of a lack of social interaction, though you may not notice the signs of a speech delay or autism if your child spends most of their time at home as well. There are many strategies that you can use at home to help develop speech, including singing songs, reading books, and talking with your toddler.
I go over all of these strategies and many more in my online autism courses as well as my book, Turn Autism Around: An Action Guide for Parents of Young Children with Early Signs of Autism.
Signs Of Speech Delay In Autistic Children
If your child is not speaking by the age of 18-24 months, this can be a reason to suspect a speech delay, and you should look for certain signs to determine whether or not it may be related to autism. Fortunately, these signs are fairly easy to spot, even for non professionals, so you can decide whether or not early intervention for autism may be required.
Keep in mind that verbal communication varies greatly among children with autism. Some children who have autism may start using words earlier than other children, while others remain non verbal for years or even for life. On average, however, autistic children start forming words around 3 years of age.
If you start to suspect that your child might be suffering from a speech delay, watch out for the following signs and symptoms of autism speech development problems:
If you spot any of these warning signs, you should take your child to be evaluated by a professional, who can guide you regarding the next steps and a potential treatment plan.
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Repetitive Behaviors And Restricted Interests
Repetitive behaviors can range from self-harm such as banging ones head or biting ones hands to less severe behaviors like hand flapping or rocking back and forth. Restricted interests in autism often look like obsessions or fixations on certain kinds of objects or themes. It can be difficult for individuals to change from one activity to another.
Individuals with DLD, like individuals with autism, struggle with social communication. In DLD, these challenges relate mostly to expressing ones thoughts and comprehending what others are saying, while in autism the problems tend to go beyond just language and extend to difficulty understanding the meaning behind a persons facial expression or body language.
Patterns of restricted interests and repetitive behaviors, as described above, are specific to autism and are not a characteristic of DLD.
Children with autism often have other serious medical conditions, such as seizures, digestive system problems, or sleep disorders. These additional medical problems make it more likely for children with ASD to see a medical provider, which in turn makes diagnosis more likely. In contrast, children with DLD might not have any other obvious medical conditions that would make diagnosis by a professional more likely, which is part of the reason that DLD can often go unrecognized.