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Autism and communication 

Research suggests autistic people may have different communication styles and preferences to non-autistic people. Communication differences must be present for an autism diagnosis, but these can vary widely between autistic people. 

What do we mean by communication?

Communication includes a wide range of skills and preferences. 

Social communication and interaction 

‘Social communication’ and ‘social interaction’ are often used interchangeably. This includes the use and understanding of spoken (verbal) and non-spoken (non-verbal) communication, such as conversation and body language. It also includes social ‘exchanges’, such as sharing and taking turns. 

Social communication and interaction skills are used to start, build and maintain friendships and relationships with other people, including in your personal life, in education and at work. 

Social communication and interaction differences are part of the criteria for an autism diagnosis, but these differences can vary widely between autistic people. 

Language 

Language is a system of sounds and symbols used in communication. 

Although language differences are not part of the criteria for an autism diagnosis, language is a significant part of social communication and interaction, and research suggests that some autistic people may have differences in how they understand and/or use language. This can vary a lot between autistic people. 

Autistic communication differences

Social communication and social interaction differences (compared to non-autistic people) are a ‘core characteristic’ of autism. For a diagnosis of autism to be made, these differences must: 

  • have been present since birth 
  • have a clinically significant impact on the person’s day to day life. 

However, the presence and noticeability of these characteristics can vary a lot between autistic people. 

Evidence suggests that, in comparison to non-autistic people, autistic people might: 

  • prefer to work, play or spend time alone 
  • use more:  
    • direct language, or less unnecessary or ambiguous language (sometimes interpreted as being ‘blunt’)
    • formal, precise and technical speech
    • pauses without filling them with ‘um’ or ‘ah’ sounds
    • repeated words and phrases (echolalia)
    • unique invented words
  • find it more challenging to: 
    • recognise or read body language or facial expressions
    • choose a tone of voice, volume or speed of speech
    • judge pauses and turn-taking, or to be interrupted during a conversation
    • understand words when they are not used literally, for example in metaphors, idioms, jokes, irony and sarcasm
  • have a different pattern of language development compared to non-autistic people, which may include losing language skills (regression) and a later catch-up in childhood 
  • prefer not to make eye-contact, or find it uncomfortable 
  • use fewer gestures (generally in childhood). 

Visit our page Signs that a child or adult may be autistic for examples relating to social communication and social interaction differences, and other autism characteristics. 

Speech differences 

Autistic children, like non-autistic children, develop speech at different rates. Some have typical speech development, and some show advanced language use; others have delayed speech development with a later catch up. 

Some autistic people do not develop speech or use very limited speech (a few words but not sentences) throughout their lives. This is usually when they have a co-occurring learning disability. 

Some autistic people who often or usually use speech can experience intermittent speech loss or an unreliable ability to speak (their ability to speak comes and goes). This is often related to their situation; for example, they may find it extremely difficult or be unable to speak when they are overwhelmed, stressed or experiencing autistic burnout. 

People who are not able to speak, either temporarily or in the long term, are sometimes described as being ‘non-verbal’. However, some people with lived experience do not prefer this term, because it: 

  • may not be an accurate description of their experience (either because they can sometimes speak, or because they can ‘verbalise’, sometimes speaking words, sometimes using sounds not words) 
  • can be misinterpreted to mean that they can’t communicate, which is wrong (there are other ways of communicating that don’t involve speaking words). 

Describing a person’s individual use of speech is generally preferred to blanket labels. 

Another preferable and commonly used phrase is ‘people who speak few or no words’. While this may be appropriate for people who do not use speech (or who use very limited speech), it is not always relevant for people whose ability to use speech can change over time or depending on the situation (for example when they are overwhelmed.) 

People who do not use speech, or who sometimes cannot use speech, may communicate in other ways, for example by using: 

  • writing 
  • sign language, such as British Sign Language (BSL) 
  • Augmentative and Alternative Communication (AAC), such as picture-based systems or high-tech communication devices 
  • vocalisations (making sounds using their vocal cords but not words) 
  • gestures (pointing, eye gaze). 

Read about the experiences of autistic people and parents on communication differences, including speech differences, in the section below, Insight from autistic people and parents. 

Different social skills

Research into autistic communication 

Research into autistic communication is unfortunately often framed as the study of perceived ‘deficits’ compared to non-autistic people. This ‘deficits-based’ approach can suggest that non-autistic communication styles and preferences are ‘correct’ or ‘superior’, and that autistic people ‘lack’ communication skills in comparison. 

Developments in our understanding of autism suggest that, rather than lacking skills, autistic people might have different skills or communication preferences. (This relates to the ‘double empathy problem', explained below.) 

Some research suggests autistic people may share information more effectively and have greater rapport, flow and empathy with other autistic people than they do with non-autistic people. 

There isn’t enough research into autistic communication differences, including research about autistic people with advanced language skills and autistic people with learning disabilities. 

What does this mean for support? 

Traditionally, support strategies and therapies have expected autistic people to do all the work to bridge the gap in communication styles and preferences between them and non-autistic people.  

These interventions have focused on training autistic people to act more like non-autistic people, often by ‘masking’ their autistic characteristics, communication styles and preferences. But masking can be exhausting and cause considerable stress and anxiety for autistic people, which can lead to mental health problems. 

For information about best practice, see the section Communication support and strategies below. 

The double empathy problem 

The ‘double empathy problem’ is a theory from the autistic autism researcher Dr Damian Milton. It tries to explain why non-autistic people can experience autistic people as lacking in communication skills, including empathy. The theory states that there is a two-way problem, and that autistic people often experience non-autistic people as lacking in these skills too. 

The theory suggests that this is because the two groups of people have different experiences and their different communication styles and preferences can lead to difficulties in relating to each other. Neither is ‘correct’, nor ‘superior’ to the other, they are simply different, and effort must be made on both sides to bridge the gap. 

Evidence from lived experience (from autistic people) and some research suggests the double empathy problem theory may explain the challenges of and differences in communication between autistic and non-autistic people. 

“Simply put, the theory of the double empathy problem suggests that when people with very different experiences of the world interact with one another, they will struggle to empathise with each other. This is likely to be exacerbated through differences in language use and comprehension” 

– Dr Damian Milton, The double empathy problem

The impact of communication differences

Evidence suggests that autistic people’s communication differences, and the way that society fails to accept and accommodate these differences, can lead to: 

  • judgement and rejection by peers (including bullying) 
  • difficulty making and maintaining friendships 
  • tiredness and fatigue after social interaction 
  • anxiety about social situations 
  • feelings of frustration, embarrassment, self-consciousness and low self-esteem 
  • increased risk of feeling isolated and lonely 
  • challenges engaging in education and work 
  • mental health problems (anxiety and depression) 
  • masking – forcing yourself to act like non-autistic people, in line with social ‘norms’, which negatively impacts autistic people. 

Communication support and strategies

Support strategies 

The aim of any communication support or intervention should be to reduce barriers and enhance a person’s ability to communicate and participate equally in society. Planned outcomes should be based on the views and goals of the person, whether they are a child, young person or adult. 

When considering a therapy or intervention, it is important that: 

  • professionals have good autism knowledge, and the therapy should be adapted to meet the person’s specific needs  
  • the autistic person is central to all decisions 
  • potential negative effects are considered 
  • impact should be carefully monitored and regularly reviewed. 

Interventions might include: 

  • speech and language therapy 
  • play-based social learning programmes which should increase parent/carer/teacher/peer’s understanding of and sensitivity to the individual’s style of communication 
  • talking therapies in which autistic people learn strategies to cope with anxiety during social interactions 
  • Intensive Interaction – an approach to develop the communication of people who have not developed speech and people with learning disabilities 
  • Alternative and Augmentative Communication (AAC) – for people who cannot use speech, or use very limited speech, either temporarily or in the long term. 

Please be aware that Facilitated communication (FC) is not recommended as an intervention for autistic people. 

Self-managed strategies 

Some autistic people find strategies such as these helpful: 

  • finding out what to expect before social situations and preparing 
  • enlisting a social ally (a person who can provide support during/after social situations) 
  • being selective about social events (and not being afraid to say ‘no’) 
  • taking time out after social situations, to regulate anxiety and recharge 
  • having a plan if social situations become overwhelming (e.g. using ear defenders and having access to a quiet space) 
  • socialising through online platforms 
  • making connections with people who have similar interests and/or other autistic people. 

What non-autistic people can do 

Some autistic people have said they find it useful when non-autistic people: 

  • show respect and patience for their preferences 
  • break spoken instructions down and allow for extra processing time 
  • accept all forms of communication as valid (not just speech) 
  • recognise that behaviour is a means of communication. 

How is communication assessed in an autism assessment?

Autism assessments can vary, but NICE guidelines recommend that a specialist team of professionals should be involved, including: 

  • a Speech and Language Therapist (SALT) 
  • paediatricians and/or psychiatrists 
  • clinical and/or educational psychologist. 

For more detailed information, visit our page Professionals involved in an autism assessment. 

To better understand a person’s profile and ensure the accuracy of autism diagnosis, NICE guidelines also recommend the specialist team collect information about social communication skills: 

  • from a child’s school/s and nursery/nurseries 
  • from an adult’s workplace/s or other environments that involve social activity (with their consent). 

Further assessment of language and social communication 

Following an autism diagnosis, a more detailed assessment of language and social communication can be sought from a Speech and Language Therapist (SALT) at any point in a person’s life. This is most likely to happen if communication barriers are impacting a child or young person’s access to education. Unlike an autism assessment, this can highlight specific areas of communication that need support. 

Cultural differences 

Tools used to assess autism, such as the ADOS-2, are based on western European and north American cultural norms. It may be more difficult to both accurately recognise and clinically assess differences in social communication and interaction in people from cultures with other norms using these tools. 

When carrying out assessments, professionals should be aware that an individual’s social habits (such as the use of eye contact) may be culturally specific. The language of assessment (and treatment) should also be carefully considered for people from bilingual households. 

Gender differences 

Research suggests that autistic women and girls can differ from autistic men and boys in their social communication. Compared with autistic men and boys, autistic women and girls may: 

  • have social communication and social interaction skills that are more like non-autistic people 
  • express emotion more similarly to non-autistic people 
  • be more likely to mask their social differences and natural style of speech and so appear more like non-autistic people. 

Insight from autistic people and parents

Links, resources and article sources

Related professional practice articles 

The double empathy problem

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What is AAC?

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Speech and language therapy in schools

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A collaborative approach to developing communication: A case study

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