Non-significance of early speech delay in children with autism and normal intelligence and implications for DSM-IV Asperger's disorder.
In smart autistic kids, late first words do not predict later language or social skills, so drop speech delay as a deciding factor.
01Research in Context
What this study did
The team compared 71 traits in autistic kids with normal IQ. Half had early speech delay. Half hit words on time. They checked language, social skills, and repetitive actions. All kids were school age. The goal: see if late talking predicts later problems.
What they found
No difference. Late talkers and on-time talkers scored the same on every measure. Language scores, autism traits, even friendship skills matched. Early speech delay did not shape later life. The result questions DSM-IV's rule that speech delay splits autism from Asperger's.
How this fits with other research
Camodeca et al. (2020) seems to disagree. They found that babies who liked speech at 9 months had better language at 2 years. The key is age and skill. D et al. looked at school-age kids who already had normal IQ. Amy et al. tracked babies before any diagnosis. Speech interest matters in infancy; speech timing does not matter in bright autistic children.
Baixauli et al. (2016) backs this up. Their meta-analysis showed high-functioning autistic kids still tell weaker stories. So, language gaps exist even when early delay is absent. D et al. adds that the gap is not tied to when talking started.
Wolchik (1983) set the stage. Parents of autistic toddlers spoke like parents of language-matched typical kids. Poor input could not explain delay. D et al. extends the null: early delay itself loses predictive power in cognitively able youth.
Why it matters
Stop using early speech history to place bright autistic clients in boxes. Focus on current language and learning needs instead. A child who spoke late can share the same goals as one who spoke early. Write plans based on today's data, not old milestones.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Review your caseload: if a child has normal IQ, erase 'history of speech delay' from the diagnosis line and base targets on current assessment only.
02At a glance
03Original abstract
According to the DSM-IV, children with Asperger's disorder do not have significant cognitive or speech delays, whereas children with autistic disorder may or may not. In our study, children with normal intelligence who had clinical diagnoses of autism or Asperger syndrome were divided into two groups: those with and without a significant speech delay. The purpose was to determine if clinically meaningful differences existed between the two groups that would support absence of speech delay as a DSM-IV criterion for Asperger's disorder. No significant differences were found between the 23 children with a speech delay and the 24 children without a speech delay on any of the 71 variables analyzed, including autistic symptoms and expressive language. Results suggest that early speech delay may be irrelevant to later functioning in children who have normal intelligence and clinical diagnoses of autism or Asperger syndrome and that speech delay as a DSM-IV distinction between Asperger's disorder and autism may not be justified.
Autism : the international journal of research and practice, 2001 · doi:10.1177/1362361301005001008