Language abilities vary widely among Autistic people. Some communicate using fluent speech while others rely on alternative communication methods, and there can also be significant differences within an individual – for example, they may have strong receptive language but struggle with expressive or pragmatic (social) communication.
Given this variability, a comprehensive speech and language assessment is essential to identify a person's specific strengths and challenges, guiding individualised support strategies to enhance their communication.
Evidence based approaches
There are a number of evidence-based approaches to assist speech and language development, which have primarily been developed for young children.
Naturalistic teaching strategies
Naturalistic interventions involve creating teaching opportunities for learning during naturally occurring situations, rather than using structured or clinician-led therapy sessions. Key features include:
- Child-led interactions: Adults follow the child's focus of attention and interests to create meaningful learning opportunities.
- Embedded learning in daily routines: Strategies are applied in natural settings, such as mealtime, play or dressing, to encourage communication in real-life contexts.
- Use of modelling and expansion: Adults model language and expand on the child’s communication attempts to support language development.
- Reinforcement through natural consequences: Instead of artificial rewards, communication is reinforced through meaningful responses (e.g. if a child gestures for a toy, the adult gives them the toy).
Manualised programs like Hanen More Than Words® are based upon these techniques. The More Than Words® program teaches parents practical strategies – such as observing, waiting and following their child’s lead – to promote communication and social interaction in everyday situations. The program emphasises naturalistic learning, visual supports, and structured routines to help children develop meaningful connections and language skills.
Augmentative and Alternative Communication (AAC)
Augmentative and Alternative Communication (AAC) is used to assist with communication for Autistic individuals who are non-verbal or minimally verbal. AAC is also sometimes used by those with fluent speech at times when they find spoken language difficult e.g. when feeling anxious or overwhelmed. There are a wide range of options available including low and high tech.
Low tech options include the use of gestures (sign language), communication boards, and Picture Exchange Communication System® (PECS).
High tech options include speech generating devices with software such as LAMP™ and Proloquo2go. Broadly speaking, these types of AAC have been shown to be effective in assisting Autistic people to communicate and to facilitate language development. It is important to note that facilitated communication (FC) is a specific method of AAC that relies on a communication partner. FC is a controversial method that has been discredited by many professional organisations and advocacy groups and is not currently supported by research.
General strategies to support receptive and expressive language
Simplifying and modifying language: Use short, clear phrases and emphasise key words. Give one-step directions before progressing to multi-step instructions.
Using visual supports: Use pictures, symbols, gestures, and written words to reinforce verbal instructions (e.g. Picture Exchange Communication System® (PECS), visual schedules). Provide first-then boards to help with comprehension of sequences.
Following their lead: Engage with the person's interests to create meaningful language-learning opportunities.
Allowing processing time: Give extra time for the person to process spoken language and respond. Use pause strategies (e.g. ask a question, wait 5–10 seconds).
Avoid non-literal language: Avoid use of non-literal language such as jokes, idioms or sarcasm.