Autism and communication

Also called Autistic communication, ASD communication, Autism spectrum and communication

Autistic people communicate differently, not worse: what the differences are, what respecting them looks like, and why 'non-speaking' never means 'nothing to say'.

What it is

Autism is a lifelong neurodevelopmental difference, and the Health A-Z carries it as autism. This entry is about communication, which is one of the two areas where autistic people differ from the majority. Some autistic people speak fluently and are misunderstood anyway. Some use a few words. Some don't speak at all and type paragraphs. The range is the whole range.

The frame that matters is the double empathy problem, from the autistic researcher Damian Milton: communication breaks down between autistic and non-autistic people because both sides struggle to read the other, not because one side is broken. Autistic people communicate well with each other. Support means meeting in the middle, not training one party to imitate the other.

Who it can help

Autistic people of any age and the people who live and work with them, particularly when the person is non-speaking or minimally speaking and has been assumed not to understand.

It isn't a guide to reducing autistic traits. Eye contact, small talk and answering "how are you" the expected way are not the goals here, and approaches that make them the goals do harm.

How it works

Common differences: taking language literally; finding it hard to process speech quickly, especially with noise; needing longer to answer; communicating through echolalia and scripts; using a flat or unusual tone that says nothing about feeling; finding eye contact painful or distracting; not reading implied meaning or hints; and being direct in ways that non-autistic people read as blunt. Many autistic people speak fluently but lose speech under stress or in a shutdown, and need a written or symbol channel for those times.

Understanding is routinely underestimated. A person who can't answer in the moment may have understood everything. So the partner's job is to slow down, say what you mean, allow silence, accept every form of answer (typing, pointing, a card, a sign) and stop reading a lack of eye contact as a lack of attention.

Where speech is limited, AAC from an early age, modelled without pressure, gives the person a voice in their own words. Many autistic adults who type describe it as the first time anyone heard them.

Getting started

This week: say exactly what you mean, one thing at a time. Give ten seconds of wait time. Replace questions with comments. Write things down as well as saying them.

Offer a second channel and keep it available: a whiteboard, a notes app, a symbol board on a phone. Use it yourself in front of the person so it's normal. Never take it away as a consequence for anything.

Ask the person how they prefer to communicate and when, and write it into a communication passport. For a child, agree with school what an acceptable answer looks like in class; it need not be spoken.

Where to get help

The National Autistic Society has guidance on communication for every age and a directory of local services. Ambitious about Autism focuses on children and young people, and Autistica funds the research and publishes it plainly. Speech and language therapy through the GP or school is the NHS route for AAC and for understanding a person's communication; the RCSLT explains it.