How Do Children with Autism Develop Speech?

People have many questions about autism speech. This post is about Autism and speech. What words do students with Autism need to learn?

Watching toddlers develop speech is an exciting milestone for all parents to watch. But when young children are delayed in developing those early communication skills, it’s typical to seek an evaluation.

By the time a typically developing child is two, it’s generally expected that they will be using some words to communicate.  The vocabulary of the typically developing toddler might contain somewhere between 75-225 words.  When young children do not develop those early words, that is a signal for further investigation.

A recent article highlighted Researchers at Bryn Mawr College’s Child Study Institute who have identified a list of 25 words that they suggest every (typically developing) child should be using by age two.

Here is their list of 25 common words that they say should form the building blocks of a (typically developing) toddler’s vocabulary:

  • all gone
  • baby
  • ball
  • banana
  • bath
  • bye bye
  • book
  • car
  • cat
  • cookie
  • daddy
  • dog
  • eye
  • hat
  • hello/hi
  • hot
  • juice
  • milk
  • mommy
  • more
  • no
  • nose
  • shoe
  • thank you
  • yes

It’s an interesting list. . .typical food items, body parts, clothing.  The targeted words are those that are most commonly integrated into early interactions with young children during the course of daily activities. They are learned because they have functional purpose in the child’s life.

Perhaps the most used words on that list that young children speak are “no,” “yes,” “more” and “all gone.”

Statistics vary, but as many as 40% of young children with autism are non-verbal or delayed in developing speech.  Speech Therapy or some type of early intervention program is recommended when those children are identified.

After looking at the above list, I have an important question.  What vocabulary should be targeted in early Speech Therapy or in the early intervention setting for children with autism?  How does that coordinate with this list of early words for typically developing children?

Sometimes educators working with young children with autism establish a goal to see how many picture cards the child can label. The problem with that approach to teaching speech is that children may learn to label the pictures but if the vocabulary doesn’t have a functional use in their daily life activities, they won’t develop the ability to use that vocabulary in a functional way.

So, how do therapists, teachers and parents select which vocabulary to teach to children with autism?

Please comment on your most important vocabulary.

Choosing the right vocabulary is important to help children with Autism with speech .

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  1. As an SLP, I would agree with most of this list as common first words for children around or just under 2 years old. Although, I would consider this ‘language development’ not ‘speech development’ (which encompasses the sounds a child can make to create words).

    For therapy with any child, including one with autism, lots of other things need to be considered such as what is communicatively motivating to the child, what the parents feel is important in their everyday lives, as well as ensuring that the child have different types communicative contexts at their disposal. What I mean by that is that they can use language to make requests (more, cookie, ball), comment (all gone, hot), and to interact socially (hi, bye). So while many of the above words would turn up in the sort of language I would attempt to stimulate from a young child with or without autism, I wouldn’t look exactly like that all the time and would be different and tailored to each child and situation.

    1. I agree with your comments too. Individuality and motivation are key for children with autism. I know that I’ve learned somewhere along the road that “more” is not a great word for children with autism. For them, it’s not specific enough so I’ve stayed away from that being a first word; although it’s definitely one I’d teach more typically developing children. Something I’ve noticed from the list is a lack of verbs. I like to teach some verbs or words that result in an action early on as well (go, up, open).

  2. As a SLP for children three years old and under, there is an emphasis on word list above. Emphasis is ongoing also on what collegues call “power words”: NO, stop, mine, my turn, I want, more, all done, please (always a parent preference), and eat, drink, play, walk.

    As toddler communicates the above vocabulary (verbally or non-verbally) the adult reciever is able to expand and model (i.e. child reaches and parent says “more cookies”). This offers opportunity to enrich child’s receptive language skills. This also encourages the adult to use nouns, verbs, adjectives, and adverbs when they speak.

    It is not unusual to work on calling family members in play activities (to decrease pulling/dragging of adult / increasing breath support, jaw movement, CVCV pattens).

    Thank you.

  3. I agree with the list overall,to build vocabulary and language, but like Kimberly; would suggest addtional power words such as : me, help, want , stop, look; in order to help facilitate social pragmatic functions/acts of speech and interactive communication.

  4. I agree with the list. Typically, when beginning vocabulary development with autistic students we start with yes/no, bye (good-bye), thank-you. These are also easily embedded into social activities.
    They may need 26 words on the list “mine” or is that a three-year-old phase:)?

  5. As a parent of a HF autistic with no language delays, I have a different perspective. Our home was rich with language. I focused on talking to and responding to my children. We used a lot of rhythmic language, also. This was my way of developing my children’s abilities in pre-reading. Looking back, I realize it probably directly helped my autistic son with language. Now, as a teenager, he often tells me how he pushed himself in language and reading in order to compete with his older brothder. If our home had not emphasized language, I doubt my son would have developed the good language skills he has now. He still has communication difficulties, but not through lack of vocabulary.

  6. In my preschool special education classroom we don’t focus on specific “words” rather language development. most of the children are language delayed; not all have autism.

    1. I agree with you Karen. Plus a lot of the language in my preschool intervention class is on communication – so it focuses on interests as well as needs.
      For my students with severe language issues we use sign as well and help, more, want, drink, eat, toilet are thought as important as the rest of the words on your list.

  7. yes– i was wondering why “help” was not in the original list. That word has been a “breakthrough” in communication for dealing with behavior with several of the little ones Ive worked with

  8. One of the first words I like to use is “More” because it can expand to so many 2 word combinations. It can be used for more juice, more cookies, more puzzle pieces, more books, more therapy, etc. I do use a lot of animal names and sounds since a lot of my kids love to “Sing” Old MacDonald. Other vocabulary include things that help in their Special Needs PreK classroom, such as “No running, Sit down, All done, Help and Clean-Up”. Eat is also a big one. Time to “Eat” lunch, snack, etc. I don’t usually go for lots of individual foods at this time. I teach body parts and clothing with Potato Head and a song I made up about things I am wearing (shirt, shoes, socks, hat, pants, glasses), so I use a lot of those words. I use others, but often start with these. I usually don’t have to teach “No” because that seems to come easily to many. I do work on “Yes” which seems more difficult. I love to sing, so I tend to use other signs, symbols or gestures with a variety of songs too.

      1. It’s interesting to read the comments from this post. You can see that many people have different opinions about vocabulary choices. That’s why it’s important for parents to work with a Speech Therapist to help make decisions about selecting vocabulary and teaching their young children. Remember, each child is different and that means vocabulary choices may be different. The list in the blog post is from evaluating children who are developing speech in a “typical” way. Some hildren with autism may develop speech following the same patterns. OR, they may follow a different learning path. That will make a difference in vocabulary choices.

        For example, the word MORE. Some children learn the concept behind the word and then they learn to pair that word with another word . . . like “more cookie.”

        But for some children with autism the concept of the word MORE means “I WANT SOMETHING.” They will use it in a more generic way. It might sound a bit confusing as I try to describe it, but these children don’t generate word combinations the same way as other children.

        Another example. I observed a girl who had been taught the word red. The therapist wanted her to put 2 words together so she used a red car. But for the girl, the word car became “red car.” Every car was “red car” no matter what color. It can become confusing.

        In my experience as a therapist, words that help the child get something they want are usually good power words to start wit. Also, remember that using pictures can be helpful for children to learn words.

  9. I always include words from each of six major semantic categories, i.e. names of people/animals/common objects, action words, early modifiers, pronouns, social words, existence/non-existence/recurrence. This vocabulary easily develops into 2-word sentences.

  10. My son was really struggling with forming all his consonants and vowels at that age, so we had to be extremely selective about which words we tried to teach. I find that the list is full of extraneous words (“hat”? “eye”?) not to mention niceties such as “thank you” that have no functional meaning for many children with autism. Even “more” is overrated: “I want” or “Give me” are more useful.

    If you have a child who is slow to learn language, the priority must be to teach that child how to get his needs met. Self advocacy is a life skill, after all. Since it can be hard to tell at that age what the child’s upside will be in terms of language, I think it’s best to boil the list down to the real essentials.

    The true basics?
    “all done”
    “I want/give me”
    objects that are important to the child like “bear,” “train,” “book”
    “yes/no” – although these words represent concepts that can be really difficult for a lot of children with autism

  11. “All done” is so important for children with autism. Not only to help them understand transitions, but to let each child verbalize/sign/use a picture to indicate that he/she is finished with an activity. A child’s ability to communicate “all done” with an activity is helpful in decreasing challenging behaviors.

  12. I work with school age students who have language many times well below
    expected. This list was very helpful as many times I am trying to have
    students learn this list with minor variations like sibling names,
    protest, favorite toys, etc while parents and other professionals want the
    students to know the alphabet names, numbers, etc. Thanks for publishing
    a formal list. I will be sharing it!

  13. I agree with your list, but I also feel the word “help” is equally important as is “all done”. Being able to communicate these words with speech or sign helps to decrease challenging behaviors in children.

  14. It’s interesting that a toddler can learn around 200 words. My sister has a son that she just learned has autism and is wondering when to take him to speech therapy. I’ll be sure to share this with her as she continues her research about Autism.

    1. A communication evaluation should be a part of an early assessment to identify the learning needs of a young child with autism. It’s not just about how many words he uses. A Speech Therapist will ask a lot of questions about how your nephew communicates his wants and needs, how he responds when his parents talk to him and a variety of other topics. Communication is complex and a Speech Therapist can help your sister understand how to improve her communication with her son.

  15. Language is totally different thing then vocabulary.. My Son 6.5 years now has mastered over 1500 words…can read, know more then 10 rhyms, colours, shapes, everyday objects, flowers, transport, count objects etc… But he is zero in language… he knows nothing about yes-no, big-small, proposition or comprehension., no matter how much we teach him. . please guide how to resolve this language problem..

    1. Yes. . . you are bringing up a very important point. Labeling picture cards is a very different skill from using words for other purposes such as making a request, making a choice, answering a question or giving information. Some therapy approaches focus on teaching students to label pictures. But they don’t teach the student how to communicate other functions. Many students need to be taught how to use their words in different ways. I hope you are working with a Speech Therapist who understands more about teaching functional communication. Please contact me if you need more information.

  16. Wow, it stood out to me when you mentioned that as many as 40% of young children with autism have delayed speech development. It seems like it would be a good idea to enroll your child in some kind of speech therapy program as soon as possible after you find out that they have autism. This would probably help them start their speech development as soon as possible.

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