Typical versus Atypical Communication and Social Skills in Toddlers With or Without Autism Spectrum Disorder
Parents of toddlers (ages 18-36 months) receiving speech-language services often tell me that they are confused about their child’s social interactions and overall communicative skills. Some statements frequently made regarding these toddlers are as follows:
“[My toddler] gets my attention and looks at me when he wants a snack, but he doesn’t respond to his name when I call.”
“She smiles and laughs when I do something funny, but she doesn’t laugh or even seem to care when she sees children perform the same action.”
“He plays with his siblings and older/younger children but will not play with kids his own age.”
“She is social in some ways and totally asocial in others. I just don’t get it!”
If you have ever been confused or concerned by your child’s communication and social skills, know that you’re not alone. Many parents wonder whether their child is adequately communicating and socializing with peers and adults. Communication and social interaction skills are closely connected and delays in both areas often go hand-in-hand1. Every time we interact verbally with another person, we employ our vast knowledge of social language and appropriateness in order to know how, when, and where to convey our message. It’s no easy task! Consider stepping into your toddler’s shoes for just a moment: he is just beginning to learn how to communicate effectively with others, and not only does he need to learn the right words and order in which to put them, but with whom he should share these words and why he should want to share them in the first place. It’s a tough skill to master, especially for infants and toddlers who exhibit speech-language delays.
Significant, persistent deficits in communication and social interaction are concerning and may be (but are not necessarily) indicators of Autism Spectrum Disorder (ASD)2. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 5th Edition, ASD is characterized by social deficits and communication difficulties, stereotyped or repetitive behaviors and interests, sensory issues, and in some cases, cognitive delays.
Recognizing the aforementioned deficits in children under 3 years of age can be difficult or sometimes impossible as symptoms of ASD may be present but not fully recognized in some children until the elementary- or middle-school years3. To further complicate the matter, toddlers with ASD may exhibit significantly delayed language skills but demonstrate socially-appropriate behaviors such as smiling and establishing eye contact with a play partner most of the time4. Recent studies conducted regarding early intervention for infants and toddlers with ASD indicate that the following social language behaviors are not typical and should be taken seriously by parents and professionals4:
- Not responding to name. Toddlers may respond to hearing their name by turning toward the speaker, looking at the speaker, vocalizing, jumping or startling, or running away from the speaker (particularly if they suspect they might be in trouble).
- Not persisting in a communicative attempt. Toddlers are hard-wired to get the attention of their communicative partner, even if it takes multiple attempts. They may do so by tugging or pulling on their desired listener, repeating a name or question several times, or raising their voice to be heard.
- Communicating to express a want or need, but not initiating a communicative exchange for the purpose of sharing or calling attention to an item. Toddlers love sharing!… just not in the ways that you and I think of as sharing. They love to share by showing you their prized possessions or creations, pointing out exciting animals and items, and relating simple, recent experiences with gestures and words. Children who are not yet talking may try to tell or show you something important by crawling or walking toward you, looking at you and pointing to the item of interest, or looking at you and then looking at the item of interest.
- Not showing any interest in peers. Typically developing infants and young toddlers under 18 months of age may not have the desire to play with other children their age, but they often observe others and watch (or even imitate) their peers with curious interest. Children 18-24 months old begin to engage in joint play with peers, rather than avoidance of or play alongside of peers, and may even request play time with friends.
This is certainly not a comprehensive list but rather a compilation of a few red flags which are often strong indicators of a significant deficit in social communication and interactions. If you are concerned about your child’s communication skills and/or social language, speak with a speech-language pathologist about ways to bolster verbal and social language skills. If you suspect that your child may have ASD, speak with your pediatrician about being referred to a diagnosing professional such as a developmental pediatrician.
- Gabrielsen, Terisa P. et al (2015). Identifying Autism in a Brief Observation. Pediatrics. doi: 10.1542/peds.2014-1428
- Landa, R., & Garrett-Mayer, E. (in press). Development In Infants With Autism Spectrum Disorders: A prospective study. Journal of Child Psychology and Psychiatry.
- Michelotti, Janine D. et al. (2002). Follow-up of Children With Language Delay and Features of Autism From Preschool Years to Middle Childhood. Developmental Medicien & Child Neurology, 44, 812-819.
- Rogers, Sally J. (2009). What are Infant Siblings Teaching Us About Autism in Infancy? International Society for Autism Research, 2, 125-137. doi: 10.1002/aur.81