Understanding Nonverbal Autism

Little girl standing near the stairs.

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Nonverbal autism isn't an actual diagnosis. It's a term used for a subgroup of people with autism spectrum disorder (ASD) who never learn to speak more than a few words. An estimated 25% to 35% of autistic children are considered nonverbal.

Nonverbal autism tends to occur in people with high support needs, or what is known as level 3 autism. In some cases, a child will eventually learn to speak. For those who don't, new approaches and technologies are making it possible for autistic kids to communicate in other ways.

What Is Nonverbal Autism?

Despite the prevalence of autistic people who don't speak, the term "nonverbal autism" has no official status as a diagnosis. In part, that's because there is no clear line between verbal and nonverbal autistic people.

Some people with nonverbal autism do develop the ability to use a few words in a meaningful manner but are unable to carry on any kind of significant conversation. For example, they may say "car" to mean "let's go for a ride." Yet they would not be able to answer the question, "Where should we go?"

Some have the ability to speak but use language in a repetitive way. They may "echo" scripts from television or expressions they've been taught by therapists. Instead of using these scripts to communicate ideas or desires, they seem to use "scripting" as a way to calm themselves.

What Causes Nonverbal Autism? 

No one really knows why some autistic people can't, or don't, use spoken language. It is especially puzzling because quite a few nonverbal people on the spectrum can and do choose to communicate using American Sign Language, picture cards, and a range of digital tools.

Some autistic people also have childhood apraxia of speech, a neurological disorder that makes spoken language extremely difficult. But most nonverbal individuals on the autism spectrum don't have apraxia.

Until relatively recently, it was assumed that all nonverbal autistic children were intellectually disabled for the simple reason that their IQ scores fell under 70; those who score below 70 are considered intellectually disabled.

It became clear that typical IQ tests are poor tools for measuring intellectual ability in autistic children, particularly when those children are nonverbal. The reasons for this are:

  • IQ tests, for the most part, depend upon the test taker's ability to quickly understand and respond to verbal information. Nonverbal autistic children have challenges with speech that may or may not have any connection to basic intelligence.
  • Most IQ tests require an ability to understand and respond to social norms and expectations, and to respond within a specific period of time. These expectations are very challenging to autistic kids, whether verbal or not.
  • Sensory issues that don't affect neurotypical children may distract autistic children. Nonverbal autistic children may not have the ability to let testers know about such issues.
  • Testers are rarely trained to work with, engage with, or "read" children considered to be living with disabilities, especially children who are nonverbal. If they can't engage the child, it is very unlikely that the child will present their highest level of ability. 

Ideally, determining the IQ of a nonverbal autistic child should include both nonverbal IQ tests and non-test-related observations. 

The TONI (Test of Nonverbal Intelligence) is one example of a nonverbal IQ test that is usually a better option for nonverbal kids and autistic children in general. Observation of nonverbal children in familiar settings can also provide evaluators with real-world information about abilities versus test-taking skills.

Diagnosing Nonverbal Autism

Diagnosing a child with nonverbal autism is challenging.

For one thing, it's not always easy to distinguish between children who are nonverbal (no spoken language), preverbal (younger children who have not yet developed verbal language), or non-communicative (have neither verbal nor nonverbal communication skills).

A nonverbal child may be interviewed by a healthcare provider, though a fuller picture comes from talking to guardians and teachers, too, about the child's history and if there's been any improvement in the child's ability. For example, the presence of even one word, or some echolalic speech, appears to be a significant predictor for the acquisition of spoken language after five years of age.

Research has revealed differences in brain function in nonverbal autistic people using instruments such as electroencephalograms (to measure brainwaves) and magnetic resonance imaging (to measure brain activity). The studies are an effort to better understand what is going on inside the mind of a person who does not or cannot talk.

Other Autism Traits

Autism traits are present in all children with ASD, whether they are verbal or nonverbal. Autistic people with these traits can:

  • Have trouble making eye contact
  • Be slow to read (or completely miss) social cues
  • Be limited in expressing emotions and reading those of others
  • Feel overwhelmed by sensory challenges (noise, touch, or visual stimuli)
  • Engage in repetitive body movements (rocking, flapping, spinning, running back and forth) 
  • Display ritualistic behaviors (lining up objects, repeatedly touching objects in a set order)
  • Engage only on narrow or extreme interests in specific topics
  • Express resistance to changes in routine

Other potential causes of being non- or minimally verbal may have nothing to do with autism, and these will likely be ruled out before attributing them to autism. These include hearing problems, selective mutism, neurological disorders, and intellectual disabilities.

Will My Child Learn to Talk?

Quite a few autistic children with delayed speech gain the ability to communicate with spoken language. Some become quite fluent. Others, however, never gain more than a few words, if that.

There are many techniques for encouraging and improving spoken language for autistic children. There is no guarantee that any particular approach will be effective for any given child. Different approaches that can improve verbal communication include:

Other Ways to Communicate

While some nonverbal autistic people aren't able to use spoken language effectively, they may be able to communicate with written language, American sign language, picture cards, or digital communication devices.

Once an autistic person can effectively communicate, even without spoken language, their ability to engage in the world expands dramatically.

In recent years, numerous apps have been developed to help nonverbal autistic kids communicate more effectively. One of these is Proloquo2Go, in which users touch images on the screen to express their ideas, and the app “speaks” for them.

However, it's important to steer clear of hoaxes that sound too good to be true. In the world of autism, one of these potential pitfalls is "facilitated communication," in which a therapist "supports" the arm of an autistic person while they type.

This approach is still available but has been debunked by numerous studies that show that it is the therapist, and not the autistic person, who is guiding the typing finger.

A Word From Verywell

If a child isn't hitting their developmental milestones for speaking or using words to communicate, talk to a healthcare provider for an initial evaluation. They can then refer you to autism specialists. The sooner a child is diagnosed as nonverbal, the sooner they can receive treatment that may improve their ability to speak and communicate.

Frequently Asked Questions

  • What kind of future do nonverbal autistic children have?

    Depending on their intellectual and cognitive abilities, many nonverbal people can get jobs that don't require speaking, such as being a janitor, a gardener, or working in a library restocking shelves.

  • Can you teach a nonverbal autistic child to write?

    Yes, nonverbal children can learn to read and write, depending on their intellectual abilities. Various strategies, devices, and apps can help nonverbal children express themselves in writing.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.