Nonverbal and minimally verbal autism

Nonverbal or minimally verbal autism means an autistic child uses no spoken words or only a few. Newer research also says "nonspeaking," and the label is about speech alone. It isn't a separate diagnosis or one of the levels of autism. It also doesn't measure what a child understands. Some of these children understand much more than they can say.

There's no agreed cutoff, and studies use different word counts and ages. Many young children with autism aren't talking yet and later learn to talk. So the label fits older children better than toddlers. A 2013 review by Tager-Flusberg and Kasari found that about 3 in 10 autistic children of school age stay minimally verbal.

Your child can still communicate without speech. Goals can include gestures such as sign language, or pictures used to share thoughts, as in picture exchange communication. Devices that speak for your child are another option. All of these are forms of augmentative and alternative communication (AAC). The American Speech-Language-Hearing Association (ASHA) says a child doesn't need any skills first to start AAC. It also says AAC may help speech when it's used with other ways to communicate.

• Understanding and speaking: Ask your child's speech-language pathologist (SLP) to check what your child understands separately from what they say.
• A hearing test: Ask whether your child has had a hearing test, since an SLP may refer your child for one to make sure their hearing is normal.
• AAC in therapy: Ask your Board Certified Behavior Analyst (BCBA) how your child's AAC system will be used in sessions and at home.