By age 3, most children have passed predictable milestones on the path to learning language; one of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he hears his name, points when he wants a toy, and when offered something distasteful, makes it clear that the answer is “no.”

Each person with an ASD has different communication skills. Some people may have relatively good verbal skills, with only a slight language delay with impaired social skills. Others may not be able to speak at all or have limited ability or interest in communicating and interacting with others. About 40% of children with ASDs do not talk at all. Another 25%–30% of children with autism have some words at 12 to 18 months of age and then lose them. Others may speak, but not until later in childhood.

People with ASDs who do speak may use language in unusual ways. They may not be able to combine words into meaningful sentences. Some people with ASDs speak only single words, while others repeat the same phrases over and over. Some children repeat what others say, a condition called echolalia. The repeated words might be said right away or at a later time. For example, if you ask someone with an ASD, "Do you want some juice?" he or she might repeat "Do you want some juice?" instead of answering your question. Although many children without ASDs go through a stage where they repeat what they hear, it normally passes by age 3. Some people with ASDs can speak well but may have a hard time listening to what other people say.

People with ASDs may have a hard time using and understanding gestures, body language, or tone of voice. For example, people with ASDs might not understand what it means to wave goodbye. Facial expressions, movements, and gestures may not match what they are saying. For instance, people with ASDs might smile while saying something sad. They might say "I" when they mean "you," or vice versa. Their voices might sound flat, robot-like, or high-pitched. People with ASDs might stand too close to the people they are talking to, or might stick with one topic of conversation for too long. They might talk a lot about something they really like, rather than have a back-and-forth conversation with someone. Some children with relatively good language skills speak like little adults, failing to pick up on the “kid-speak” that is common in their peers.

Here are some examples of communication difficulties-

• Repeats words/phrases of others (Echolalia)
• Uses own language (jargoning)
• Repeats a word or phrase
• Reverses pronouns I/me/my and you/your
• Refers to self by name
• Does not respond to conversational initiation
• Gives unrelated answers to questions
• Makes comments unrelated to conversation topic
• Does not point
• Does not respond to pointing
• Uses few or no gestures
• Talks in monotone or robot-like
• Does not respond to own name
• No pretend play; doesn’t understand pretend play
• Does not understand jokes, sarcasm, idioms, teasing, or similes