🗣️ Speech Delay vs Autism — How to Tell the Difference?
A clear guide for parents, teachers, and clinicians
Not all children who speak late have autism. Some simply have speech delay, some have developmental language disorder, some have hearing impairments or excessive screen time, and some fall under the autism spectrum.
In India, most parents are told:
“Boys talk late.”
“TV de do, shuru ho jayega.”
“Woh sab normal hai, baad mein theek ho jayega.”
But precious years get lost while waiting. This article will help you understand the difference between speech delay and autism-related communication difficulties — and what steps to take early.
✅ Understanding the Basics
| Term | What It Means |
|---|---|
| Speech Delay | Child understands but has difficulty producing words or clear sounds. |
| Language Delay | Child struggles to understand and/or express words, sentences, meaning. |
| Autism Spectrum Disorder (ASD) | Child has delays in speech + poor social interaction + repetitive behaviours. |
| Selective Mutism | Child speaks in some environments (home) but not in others (school) due to anxiety. |
| Hearing Loss | Child doesn’t respond to name or sound → appears like autism or speech delay. |
🔍 Speech Delay vs Autism — Key Differences
| Feature | Speech Delay | Autism (ASD) |
|---|---|---|
| Eye Contact | Normal | Reduced/avoids eye contact |
| Response to Name | Yes | Often absent or inconsistent |
| Social Smile / Play | Engages with parents, enjoys games | Prefers to play alone or with objects |
| Gesture Use (Pointing, Waving) | Uses gestures to communicate needs | Rarely points or waves bye-bye |
| Understanding (Comprehension) | Understands instructions appropriately | Struggles with understanding emotions, social cues |
| Interest in People | Likes interaction | More interested in objects or routines |
| Repetitive Behaviours | No | Yes (hand flapping, lining toys, spinning) |
| Sensory Issues | Rare | Common (covers ears, picky with clothes/textures) |
| Imitation | Copies actions (clap, wave) | Limited imitation |
| Imagination / Pretend Play | Pretends to feed doll, drives toy car | Little or absent pretend play |
👶 Early Signs of Autism-Like Speech Delay (Red Flags)
By 1 year:
❌ No babbling
❌ No eye contact or smile
By 18 months:
❌ Doesn’t point to ask for things
❌ Doesn’t say words like “mama,” “papa”
By 2 years:
❌ No 2-word sentences (“mummy water”)
❌ Doesn’t follow simple instructions
By 3 years:
❌ No pretend play
❌ Repeats ads or rhymes without understanding (echolalia)
🛑 Is It Just Mobile Addiction or Autism?
(Very common confusion in Indian households)
| Feature | Mobile-Induced Speech Delay | Autism |
|---|---|---|
| Watches mobile for hours | Yes | Sometimes |
| Repeats rhymes/songs | Yes | Yes |
| Eye contact | Usually present when engaged | Often poor |
| Communication intent | Pulls parent to show what they want | May not pull or point |
| Social reciprocity | Smiles, hugs, shows toys | May not engage or share interest |
| Sensory behaviours | No repetitive/stimming | Yes, common |
| Improves rapidly after screen removal? | Yes (within months) | Not completely |
🎯 Screening Tools for Parents & Doctors
| Tool | Age | Type |
|---|---|---|
| M-CHAT-R | 16–30 months | Autism screening |
| CARS / ISAA | 2–9 years | Autism severity assessment |
| Receptive-Expressive Emergent Language Scale (REELS) | 0–3 years | Language development |
| Audiometry / BERA | 6 months+ | Hearing assessment |
🛠️ What Should Parents Do First?
✅ Step 1: Hearing test (audiometry/BERA)
✅ Step 2: Child psychiatrist / developmental pediatrician evaluation
✅ Step 3: Start Speech Therapy + Occupational Therapy
✅ Step 4: Remove/limit mobile phones & TV
✅ Step 5: Home stimulation – talk, play, read, respond
👪 How to Stimulate Speech at Home (Practical Tips)
✔ Call your child’s name frequently
✔ Use gestures + words together (“bye-bye”, “come”)
✔ Read picture books, name objects
✔ Encourage imitation (clap, jump, touch head)
✔ Talk during daily activities (bathing, feeding)
✔ Reduce background TV/mobile completely
✔ Reward attempts at speech — do not shame mistakes
🌟 Hope for Parents
-
Speech delay is treatable, especially before age 5
-
Autism is manageable with therapy, early stimulation, and acceptance
-
Many children start speaking after consistent speech therapy + screen detox + parental involvement
-
Delay is not failure — delay without action is the problem
👨⚕️ About the Author
Dr. Srinivas Rajkumar T
MD (AIIMS), DNB Psychiatry
Consultant Child & Adolescent Psychiatrist
Mind & Memory Clinic – Apollo Clinic (Opp. Phoenix MarketCity), Velachery, Chennai
📞 +91-8595155808 | 🌐 www.srinivasaiims.com
Expert in Speech Delay, Autism, ADHD, AuDHD, Developmental Delay, Behaviour Therapy & Early Intervention.