I know the unease in the voice of the parents who ask this. The child is talking later than expected, and the internet swings them between two extremes: "don't worry, it'll pass" and "could it be autism?" Neither helps. In this post I want to explain, in plain language, what a speech and language therapist actually looks at when distinguishing these two pictures. Let me say it up front: word count is far less decisive than you'd think.
It's not really about words — it's about communication itself
Parents usually count "how many words" the child says. But what I'm really watching isn't words; it's the intent to communicate and social interaction. A child may not yet say a single word; but if he looks into your eyes, points at the plane in the sky and turns back to you, sharing it as if to say "look!" — that child can't talk yet, but he wants to. This is where the whole difference begins.
What is typically intact in a child who is "only" a late talker
In children whose language alone is lagging (late talkers), these skills are usually in place:
- Pointing to share — not only to request, but to show interest ("look, mum, a dog!")
- Eye contact and reciprocal, shared smiles
- Turning consistently when called by name
- Pretend (symbolic) play — making a banana a phone, feeding a doll
- Trying to get a point across with gestures, expressions, and body language
Early signs that point toward autism
In the autism spectrum, the difference isn't only in speech — it's in the foundation of communication. The following signs move an assessment up the priority list:
- Markedly few gestures around 12 months — waving, pointing, "give/take"
- Not responding consistently when called by name
- Limited or fleeting eye contact
- Even if he points to request, little pointing to share
- Repetitive, narrow interests — lining objects up, spinning wheels
- Strong reactions to small changes in routine
- Losing words or eye contact he previously had (regression) — this should always be assessed
A late talker "isn't talking yet." With autism, the difference isn't only in speech — it's in communication itself.
The "wait and see" trap applies to both
Let me be clear: this distinction cannot be made from a single observation, at home, or from a blog post. Autism calls for a comprehensive assessment — after a screen such as the M-CHAT-R — by a team that sees the child from several angles. My aim isn't to push you toward a diagnosis; it's to explain why you shouldn't wait. Because in both pictures, the winning strategy is the same: early intervention.
My role as a speech and language therapist
I assess your child's language and communication development. I don't make an autism diagnosis on my own — that is teamwork involving a child psychiatrist or neurologist; when needed, I'll point you to the right place. But here's the good news: early communication support doesn't have to wait for a definitive diagnosis. Interaction-based methods like DIR Floortime and ETEÇOM grow communicative intent — starting from the child's own interests — both in the late talker and in the child on the autism path. If you're only wondering about late talking, see my post on late talking; for practical ways to strengthen communication with an autistic child, see my autism tips post.
So what now?
If one of the signs above is gnawing at you, don't lose months to sentences like "does it matter if it's a boy or a girl" or "we had a late talker in the family too." Let's look at your child's communication together in an intro call. If your worry is unfounded, I'll say so plainly so you can breathe easier; and if a step is needed, we'll map the path together.
