Language Delay vs Autism: The Critical Differences

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When young children, especially toddlers, are struggling with communication it can be difficult to know what the underlying cause is. The question of language delay vs autism can be clarified with some insight and more information. In the following article, you will learn about language delay, autism, and the biggest differences between them. I’ll also go over when it is appropriate to get an evaluation done for your little one.

What is language delay?

Language delay is also known as “late language emergence”. Language delay can happen any time between two and four years old.

Language delay is when a child is not meeting their developmental milestones in the area of speech and language. Children with a language delay can have delays in receptive language (what they understand) and expressive language (what they can say or communicate), or a combination of both.

Some children with language delays will catch up to their peers eventually, and some will be diagnosed with a disability.

The evidence suggests that 10-20% of two-year-olds exhibit a language delay. (The good news is that 50-70% of children with language delay catch up to their peers by the time they get to kindergarten.) Additionally, males are three times more likely to be language delayed than females. And children who have a family history of language delay are more likely to have a delay themselves.

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. (This could just mean not pointing to show someone what they want, not putting their hands up for when they want to be picked up, or not waving.)

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.

What is autism?

Autism is a spectrum, meaning there are varying degrees of impairment. A child on the autism spectrum ALWAYS has two main characteristics.

The first characteristic is some type of difficulty in social communication. The second difference is restrictive or repetitive interests or activities.

Social communication deficits in toddlers can mean that the child does not understand or use words as much as other children their age. It also means that children will have a hard time with social interactions. At a young age that means they may not look at something with you (like you point and look at a fun toy, and they don’t look at the same toy you are looking at). They also might not go back and forth with you in pretend conversation. (This would be if you say something to them and they never try to say something back, not even “ah” or something simple.)

The restrictive or repetitive interests can mean a number of things, too. Sometimes it means your child only ever plays with toys by putting them in lines. (While it’s normal to sometimes want to put things in a line, if this is all your child does, it can be a red flag.) It also might mean that they NEED the same repetitive routine every day. If there is a change in schedule, it could be very hard for them.

Signs of Autism Spectrum Disorder

The three main characteristics of autism spectrum disorder include :

• difficulty with social communication
• difficulty with language development and related cognitive skills
• behavioral and emotional challenges

Autism spectrum disorder (ASD) is indeed a spectrum. Some people with ASD have above average cognition while others have low cognition and low langauge skills. There is a very wide range of possibility for people on the spectrum.

Social interaction deficits affect a wide range of skills like going back and forth in conversation. Although babies cannot have back and forth conversations as we think about, typically developing babies often do try to “talk” back and forth with caregivers. Autisic children may not do this.

Other social deficits include not being able to regulate emotions, and not being able to read someone else’s emotions.

Language development might look different for autistic children as well. Children with ASD often use words and then “lose” them. They often demonstrate echolalia, which means they repeat what others say immediately after they say it with little understanding of the words.

Autistic children may have a hard time with nonverbal communication. They may not use early gestures, or they may overuse some gestures, like pulling on someone’s hand to pick up something for them. Children may also not use as many facial expressions, nor will they understand other’s facial expressions.

Once children with autism do start talking, they may have an odd tempo when they speak, sounding a little robotic.

Autistic children may have a hard time with flexible thinking, problem solving, reading and reading comprehension.

Children might experience a range of behavior difficulties. Some kids with autism have sensory challenges (like walking on tip toes or being annoyed by the tag on their shirt). This can also include difficulty with eating. Some autistic children have a hard time eating a variety of foods because of the texture or the way it’s presented (too hot or cold, cut up or not, etc.)

All of these things (and more) can be signs of autism spectrum disorder. However some children with ASD only have some of these characteristics, and some kids without ASD have a few of these characteristics. It is not a cut and dried diagnosis.

What are the biggest differences?

So I’m actually going to start off this section by saying what the similarities are when thinking about language delay vs autism.

Both language delay and autism can mean your child is not talking very much. Both children with language delay and ASD may have a hard time understanding commands and other language. Both can mean that your child is late to gesture or babble.

But there are several differences.

Why is it so hard to know the difference when it comes to language delay vs autism?

As you can see from the above comparison, it is really hard to know the difference when it comes to language delay vs autism because there are similar characteristics when it comes to language development.

All children are different, and so it can be hard to know if they are “just a little behind”, or if there is a deeper issue going on. And when children are so young, it can be especially hard to know what is going on.

When should I get help?

If you have any concerns, talk to your doctor. They should know some of the basics about autism and language delay and will hopefully send you in the right direction.

If you think your child might be on the autism spectrum, take this quick questionnaire to get some more insight. (It’s from Autism Speaks which is a great resource to check out!)

You can also look at this comprehensive resource for speech and language norms from the American Speech-Language and Hearing Association (ASHA). I also used the ASHA pages as a reference for both language delay (they use the term “late language emergence) and autism spectrum disorder.

Lastly, if you want my favorite tips for children who are behind in language, check out my article here.