# Will my autistic child talk? Speech, signing, pictures and AAC

> Many autistic children do learn to talk, often later than other children, and some use few or no spoken words. In one large US study of autistic children who had no phrases at age 4, 70% later used phrases and 47% spoke fluently. Nobody can predict this for one child, so support every way your child communicates now. Signs, pictures and other communication aids (AAC) do not stop children talking.

- Canonical page: https://rocksmakepebbles.co.uk/guides/will-my-autistic-child-talk
- Publisher: Rocks Make Pebbles (https://rocksmakepebbles.co.uk)
- Topic: Communication and play
- Applies to: UK
- Last updated: 28 September 2026. Checked against sources: 28 September 2026
- Professional review: Not yet reviewed (waiting for review by a speech and language therapist)
- Drafted with the help of AI tools and checked against the sources listed below. Editorial policy: https://rocksmakepebbles.co.uk/editorial-policy

## Key points

- Many autistic children talk later than others, and some use few or no words. Nobody can predict this for one child.
- Every way your child communicates counts: looks, reaches, sounds, echoes, signs, pictures and AAC.
- Signs, pictures and AAC do not stop children talking, and your child does not need to be 'ready' for them.
- Follow your child's lead, get face to face, wait, comment and add one word. Short, everyday moments count.
- Ask about a hearing test, and see your GP promptly if your child loses words or skills.
- NHS waits for speech and language therapy are long, so start the everyday ideas at home now.

## Will my autistic child ever talk?

Many autistic children do learn to talk, often later than other children, and some use few or no spoken words. Nobody can tell you for certain what will happen for your child, but the research gives real grounds for hope, and there is a lot you can do now.

Some families and services still say "non-verbal". This guide says [non-speaking](https://rocksmakepebbles.co.uk/glossary#non-speaking) (no spoken words) or [minimally speaking](https://rocksmakepebbles.co.uk/glossary#minimally-speaking) (few spoken words), because a child who doesn't speak may still understand a lot and communicate in other ways. Researchers have no agreed definition of these terms ([Koegel et al. 2020](https://doi.org/10.1007/s10803-020-04402-w)). One major review counted a child as minimally speaking if they used fewer than 30 words to communicate, or could not rely on speech alone ([Brignell et al. 2018](https://doi.org/10.1002/14651858.cd012324.pub2)).

- **Late talking is often not the end of the story.** In a US study of 535 autistic children who had no phrase speech at age 4, 70% later used phrases and 47% spoke fluently by the time they were assessed, at age 8 or older ([Wodka, Mathy and Kalb 2013](https://doi.org/10.1542/peds.2012-2221)). The children came from specialist clinics, so treat this as one large study, not a promise.
- **Some children stay minimally speaking.** Researchers estimate that about 25% to 30% of autistic children do not develop much useful spoken language, or are still minimally speaking into school age, even after years of support ([Brignell et al. 2018, Cochrane](https://doi.org/10.1002/14651858.cd012324.pub2); [Tager-Flusberg and Kasari 2013](https://doi.org/10.1002/aur.1329)).
- **Progress varies most in the early years.** A study that followed 192 children from age 2 to 19 found that language progress differed most between ages 2 and 6 ([Pickles, Anderson and Lord 2014](https://doi.org/10.1111/jcpp.12269)).
- **Older children can still make progress.** After a trial with 61 minimally speaking children aged 5 to 8, the researchers concluded that school-age children "can make significant and rapid gains in spoken spontaneous language" with a play-based programme that included a speech-generating device ([Kasari et al. 2014](https://doi.org/10.1016/j.jaac.2014.01.019)).

In the Wodka study, repetitive behaviours and sensory interests did not predict whether a child went on to talk. Children with stronger problem-solving skills that don't rely on language, and fewer social difficulties, were more likely to. These are averages across many children, not predictions for yours.

None of this is your fault. Large studies suggest autism is mostly genetic ([Bai et al. 2019](https://pubmed.ncbi.nlm.nih.gov/31314057/)), and starting to speak later than other children is one of the signs of autism the NHS lists ([NHS: Signs of autism in children](https://www.nhs.uk/conditions/autism/signs/children/)).

## What counts as communication?

Communication is any way your child gets a message across, not only speech. Looks, reaches, sounds, echoed phrases, signs, pictures and [AAC](https://rocksmakepebbles.co.uk/glossary#aac) (augmentative and alternative communication) all count. Noticing and answering them is where progress starts.

Children use echoed phrases, for example, to ask for things, keep an interaction going, protest and say yes ([Hanen: 3 things you should know about echolalia](https://www.hanen.org/information-tips/3-things-you-should-know-about-echolalia)). Behaviour can carry messages too. The National Autistic Society says behaviour has a function, and that not being able to communicate a difficulty "can lead to anxiety, anger and frustration" ([National Autistic Society](https://www.autism.org.uk/advice-and-guidance/topics/behaviour/distressed-behaviour/all-audiences)). The Royal College of Speech and Language Therapists (RCSLT) says AAC includes signing as well as paper boards, books, tablets and dedicated communication aids ([RCSLT AAC position statement, May 2024](https://www.rcslt.org/wp-content/uploads/2024/05/RCSLT-AAC_position-statement_May2024.pdf)).

| Way of communicating | What it can look like | How you can answer |
|---|---|---|
| Looks and gestures | Looking from you to the biscuit tin, reaching, pulling your hand, pushing things away | Say what you think it means: "Biscuit. You want a biscuit." |
| Sounds and speech | Babble, part-words ("bi" for biscuit), single words | Say the whole word back, then add one: "Biscuit. Big biscuit." |
| [Echoes](https://rocksmakepebbles.co.uk/glossary#echolalia) and scripts | Repeating your words, or a line from TV at the right moment | Answer what it means, not the exact words |
| Signs | [Key word signs](https://rocksmakepebbles.co.uk/glossary#key-word-signing) such as [Makaton](https://rocksmakepebbles.co.uk/glossary#makaton) or [Signalong](https://rocksmakepebbles.co.uk/glossary#signalong), or your child's own version of a sign | Sign back as you say the word |
| Pictures and objects | Handing you a photo, a symbol or their cup | Give what they asked for and name it |
| AAC boards, books and apps | Pointing to a symbol, or tapping a [speech-generating device](https://rocksmakepebbles.co.uk/glossary#speech-generating-device) or app that speaks | Answer as if they had said it aloud |

> **Try this:** For a few days, notice how your child already tells you things: where they look, what they reach for, the sounds they make, what they push away. Jot them down, or film short clips on your phone. It helps you answer more of them, and it is useful to show a speech and language therapist.

## How can I help my autistic child communicate at home?

The most useful help is everyday: follow what your child is interested in, get face to face, wait, and answer every attempt to communicate. These are the shared ingredients of parent programmes such as PACT, a UK approach in which a therapist coaches parents using video of their own play ([Health Innovation Manchester](https://healthinnovationmanchester.com/our-work/paediatric-autism-communication-therapy-pact/)). In UK trials, parents learned to respond more in step with their child, and children then started more interactions ([Green et al. 2010](https://pubmed.ncbi.nlm.nih.gov/20494434/); [Green et al. 2022](https://pubmed.ncbi.nlm.nih.gov/35605069/)).

1. **Follow your child's lead.** Join in with what they are already doing rather than steering them to something new. The Hanen Centre, which runs parent programmes led by speech and language therapists, says children who echo "benefit when adults follow their lead" ([Hanen: Helping children who use echolalia](https://www.hanen.org/information-tips/helping-children-who-use-echolalia)).
2. **Get face to face.** Get down to their level so you can see what they see. You don't need eye contact: many autistic people describe it as uncomfortable or overwhelming ([Trevisan et al. 2017](https://doi.org/10.1371/journal.pone.0188446)).
3. **Wait.** Stop talking, lean in, look interested and count to 5 in your head, going up to 10. Hanen suggests waiting "up to 10 seconds" ([Hanen: Waiting](https://www.hanen.org/information-tips/waiting-the-key-to-supporting-your-childs-communication)).
4. **Comment more than you question.** Talk about what your child is looking at ("Car. Fast car.") rather than quizzing them ("What colour is it?"). Hanen notes that when adults use a lot of questions and commands, children who echo tend to repeat the words straight back without understanding them ([Hanen](https://www.hanen.org/information-tips/helping-children-who-use-echolalia)).
5. **Build routines with a pause.** In a game your child loves, say "Ready, steady..." and wait for any look, sound or movement before "go" ([Hanen: Choosing people games](https://www.hanen.org/information-tips/choosing-people-games)).
6. **Add one step.** If your child says or signs one word, you say two: "Car... red car" ([Binger and Light 2007](https://pubmed.ncbi.nlm.nih.gov/17364486/)).
7. **Use their favourite things.** Build play and talk around your child's [focused interests](https://rocksmakepebbles.co.uk/glossary#focused-interests). In one review, all 20 studies that built children's interests into teaching reported gains ([Gunn and Delafield-Butt 2016](https://doi.org/10.3102/0034654315604027)).
8. **Keep it short and often.** A few minutes at bath time, snack time or in the car counts. Across 144 studies, more hours of intervention did not predict bigger gains ([Sandbank et al. 2024](https://doi.org/10.1001/jamapediatrics.2024.1832)).

These are ideas to add a little at a time, not a test of your parenting. Our guide to [playing with your autistic child](https://rocksmakepebbles.co.uk/guides/playing-with-your-autistic-child) has games that use them.

## Will signing, pictures or AAC stop my child talking?

No. Research consistently finds that signs, pictures and AAC do not stop children talking, and some children speak more after starting them.

- A review of the best studies found that none of the 27 people studied lost speech after starting AAC, mostly signs or picture systems, and 89% gained some speech, though the gains were mostly modest ([Millar, Light and Schlosser 2006](https://pubmed.ncbi.nlm.nih.gov/16671842/)).
- A review of studies with autistic children found that AAC interventions "do not impede speech production" and that most studies reported an increase in speech, though the gains were "rather modest" ([Schlosser and Wendt 2008](https://europepmc.org/article/MED/18663107)).
- In the trial of 61 minimally speaking 5 to 8 year olds, therapy that started with a speech-generating device led to more spontaneous communication, new words and comments than therapy using spoken language alone ([Kasari et al. 2014](https://doi.org/10.1016/j.jaac.2014.01.019)).
- Three autistic pre-school children taught key word signs all began signing, with either no change or an increase in their spoken words ([Tan et al. 2014](https://doi.org/10.3109/17518423.2013.863236)).
- The RCSLT says there are "no pre-requisites to using AAC" and that "early adoption of AAC can assist young children to develop cognitive, language, communication and literacy skills to their full potential" ([RCSLT, May 2024](https://www.rcslt.org/wp-content/uploads/2024/05/RCSLT-AAC_position-statement_May2024.pdf)).

The evidence has limits. A Cochrane review found only two randomised trials of communication support for minimally speaking autistic children, and only one of them tested AAC (picture exchange at school). It rated the evidence "very low" certainty, and found no evidence that the AAC made children speak more often or use more words ([Brignell et al. 2018](https://doi.org/10.1002/14651858.cd012324.pub2)). So think of AAC as a way to communicate now, not a way to make speech happen.

> **Myth:** "If we give him pictures or signs, he won't bother to talk." In the best studies, none of the 27 people studied lost speech after starting AAC, and most gained a little ([Millar et al. 2006](https://pubmed.ncbi.nlm.nih.gov/16671842/)). AAC gives your child a way to communicate now, whether or not speech follows.

Our guide to [signing, pictures and AAC apps](https://rocksmakepebbles.co.uk/guides/aac-signing-and-picture-communication) compares the options and explains how to use them with your child.

## What doesn't help?

Some well-meant habits can get in the way, and NICE advises against some therapies offered to parents.

- **Pressing your child to say or copy a word.** "Say 'juice'. Say it." is a command, and Hanen notes that lots of commands and questions tend to make children who echo repeat words straight back without understanding them ([Hanen](https://www.hanen.org/information-tips/helping-children-who-use-echolalia)). Your child does not need to copy the words you model ([AssistiveWare](https://www.assistiveware.com/learn-aac/start-modeling)).
- **Holding things back until your child says the word.** If your child has asked by reaching, signing, pointing to a picture or leading you by the hand, they have communicated. Give it, and say the word as you hand it over. Treat any look, sound, reach, sign or tap on a picture as your child's turn, and answer it ([Hanen](https://www.hanen.org/information-tips/helping-children-who-use-echolalia)).
- **Making your child look at you.** Children can make progress without it: in one study, children taught picture exchange improved their shared attention and requesting with no change in eye contact ([Lerna et al. 2012](https://pubmed.ncbi.nlm.nih.gov/22938071/)).
- **Taking away their board or app.** A child's way of communicating should be available "at all times" ([Communication Bill of Rights](https://www.asha.org/njc/communication-bill-of-rights/)), so never use it as a reward or remove it as a punishment.
- **Dropping your home language.** Research so far, mostly with children who speak, has found no harm to autistic children's language from hearing two languages ([Uljarević et al. 2016](https://doi.org/10.1111/jcpp.12596); [Gilhuber et al. 2023](https://doi.org/10.1177/13623613221147780)). The RCSLT says parents "should never be advised to abandon home language" ([RCSLT: bilingual children](https://www.rcslt.org/wp-content/uploads/media/Project/RCSLT/5-impact-of-bilingualism-slcd.pdf)). Speak to your child in the language you are most comfortable in ([Hanen: two languages](https://www.hanen.org/information-tips/can-children-on-the-autism-spectrum-learn-two-languages)).
- **Therapies NICE says not to use.** NICE says do not use neurofeedback or auditory integration training for speech and language problems in autistic children ([NICE CG170](https://www.nice.org.uk/guidance/cg170/chapter/Recommendations)).

## How do I get speech and language therapy for my child in the UK?

Start with your local NHS children's speech and language therapy service. How you get in differs by area. Communication Matters, a UK charity for people who use AAC, says contacting your speech and language therapy team "is generally the place to start" and, if you don't have an NHS therapist, to ask your GP for a referral ([Communication Matters](https://www.communicationmatters.org.uk/what-is-aac/assessment/)).

- **Routes vary.** In one NHS trust, parents of pre-school children can book a telephone advice appointment with a therapist, while school-age children are referred through the school SENCO ([Cambridgeshire and Peterborough NHS FT](https://www.cpft.nhs.uk/speech-and-language-therapy-referrals/)). Search online for your area's children's speech and language therapy service, or ask your GP, [health visitor](https://rocksmakepebbles.co.uk/glossary#health-visitor) or your child's nursery or school [SENCO](https://rocksmakepebbles.co.uk/glossary#senco).
- **If your child has an autism diagnosis,** the NHS suggests asking your GP or local autism team about speech and language therapy ([NHS: Supporting an autistic child](https://www.nhs.uk/conditions/autism/supporting-a-child/)).
- **Waits are long.** In England, 66,695 children and young people were on waiting lists for speech and language therapy in April 2026, according to a minister's written answer to Parliament on 1 July 2026 ([UK Parliament written question 11799](https://questions-statements.parliament.uk/written-questions/detail/2026-06-22/11799)).
- **What to expect.** In the trust above, a referral can lead to advice on strategies or a face-to-face assessment, which tends to take place in school and can last an hour or two ([Cambridgeshire and Peterborough NHS FT](https://www.cpft.nhs.uk/speech-and-language-therapy-referrals/)). For young autistic children, NICE recommends considering play-based support from a trained professional that works through parents, carers or teachers and uses video feedback ([NICE CG170](https://www.nice.org.uk/guidance/cg170/chapter/Recommendations)). Therapists may use parent programmes such as PACT or Hanen's More Than Words® ([RCSLT: Autism](https://www.rcslt.org/speech-and-language-therapy/clinical-information/autism/)), but what is offered varies by area, so ask.

While you wait, use the ideas in this guide, try simple signs or pictures, and write down how your child communicates in a [one-page profile](https://rocksmakepebbles.co.uk/printables/one-page-profile) to share with nursery, school and the [speech and language therapist](https://rocksmakepebbles.co.uk/glossary#speech-and-language-therapist). You can start all of this before any assessment or diagnosis.

### Choosing a private therapist

- **Check registration.** You can only call yourself a speech and language therapist or a speech therapist if you are registered with the Health and Care Professions Council (HCPC) ([GOV.UK](https://www.gov.uk/find-licences/speech-and-language-therapist-registration)). Check the name on the [HCPC register](https://www.hcpc-uk.org/check-the-register/).
- **Use a directory.** The [ASLTIP directory](https://asltip.com/find-a-speech-therapist/) of independent therapists is free to use, and its members are HCPC registered and members of the RCSLT ([ASLTIP FAQs](https://asltip.com/faqs/)).
- **Agree costs first.** ASLTIP says a therapist should set out the cost of assessments and sessions, any travel charges, and cancellation and payment terms before you start ([ASLTIP FAQs](https://asltip.com/faqs/)).
- **Ask how they work.** Will they coach you? How do they see echolalia? Will they support signing or AAC, and talk to nursery, school and the NHS team? How will you measure progress on goals you choose together?

> **Scotland, Wales and Northern Ireland:** The waiting list figure above is for England only. Wherever you live, start by asking your GP, health visitor, or your child's nursery or school how to reach your local children's speech and language therapy service.

## Should my autistic child have a hearing test?

Ask your GP or health visitor about one if your child hasn't had a hearing check recently, or you're not sure how well they hear. Children may have hearing tests at health and development reviews and sometimes when they start school, and a GP can refer your child to a hearing specialist, called an audiologist ([NHS: Hearing tests for children](https://www.nhs.uk/conditions/hearing-tests-children/)).

Hearing loss can be missed. A review found that when a child is autistic and has hearing loss, diagnosing one often delays diagnosing the other, and hearing tests that depend on a child's responses can be less reliable in autistic children ([Beers et al. 2014](https://europepmc.org/article/MED/24300947)).

## When should I get help quickly?

Losing skills is different from learning slowly, and it needs checking.

> **Get help now:** If your child stops using words they used to say, or loses other skills such as playing with you, walking or using their hands, see your GP or health visitor promptly. Don't wait for a speech and language therapy appointment. If it happens suddenly or your child seems unwell, call [NHS 111](https://rocksmakepebbles.co.uk/where-to-get-help#nhs-111). Call 999 if your child has a seizure (fit) for the first time ([NHS](https://www.nhs.uk/conditions/epilepsy/)). In Northern Ireland, where there is no NHS 111, call your GP or the [GP out of hours service](https://www.nidirect.gov.uk/articles/gp-out-hours-service).

Losing skills a child used to have is called [regression](https://rocksmakepebbles.co.uk/glossary#regression). NICE guidance says under-3s who lose language or social skills should be referred to the autism team. Children over 3 who lose language, and children of any age who lose movement skills, should be referred first to a paediatrician or paediatric neurologist ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)).

## Where can I get more help?

- **Your GP or health visitor** for referrals, hearing tests and any loss of skills.
- **Your local children's speech and language therapy service,** and your child's nursery or school SENCO.
- **[Communication Matters](https://rocksmakepebbles.co.uk/where-to-get-help#communication-matters)**, a UK charity for people who use AAC, offers people who use AAC and their families a free first year of membership ([Communication Matters](https://www.communicationmatters.org.uk/)).
- **[ASLTIP](https://rocksmakepebbles.co.uk/where-to-get-help#asltip)** for finding a private therapist, and the **[Royal College of Speech and Language Therapists](https://rocksmakepebbles.co.uk/where-to-get-help#rcslt)** for information about speech and language therapy.
- **[Speech and Language UK](https://rocksmakepebbles.co.uk/where-to-get-help#speech-and-language-uk)**, a charity for children with talking and understanding difficulties.
- **[Contact](https://rocksmakepebbles.co.uk/where-to-get-help#contact)** runs a freephone helpline for families with disabled children on 0808 808 3555, Monday to Friday ([Contact](https://contact.org.uk/about-contact/contact-us/)). The **[National Autistic Society](https://rocksmakepebbles.co.uk/where-to-get-help#nas)** has information and support for families.

If you are still waiting for an assessment, our guide to [waiting for an autism assessment](https://rocksmakepebbles.co.uk/guides/waiting-for-an-autism-assessment) covers what you can do now. For repeated words and lines from TV, see [echolalia and scripting](https://rocksmakepebbles.co.uk/guides/echolalia-and-scripting).

## Where our app, Pebble, fits

Pebble's Talk screen is a picture-and-voice board: each tap says the word aloud in a UK English voice, and words stay in the same place as the board grows. A grown-up can switch on a model mode to point to words while they talk. A paper board, signs and gestures work too; what matters most is that the grown-ups use them as well.

Pebble by Rocks Make Pebbles is our free app for autistic children, used together with a grown-up. This guide is written to be useful without it. More: https://rocksmakepebbles.co.uk/pebble

## Questions parents ask

### Will my autistic child ever talk?

Many autistic children do learn to talk, though often later than other children, and some use few or no spoken words. Researchers estimate that about 25% to 30% of autistic children are still minimally speaking into school age. In one large US study of autistic children who had no phrases at age 4, 70% later used phrases and 47% spoke fluently. That is one study, not a promise, and nobody can predict what will happen for your child. Support every way your child communicates now, including gestures, signs, pictures and AAC.

### At what age do autistic children who aren't talking start to talk?

There is no set age. In a large US study, 70% of autistic children who had no phrases at age 4 were using phrases by the time they were assessed, at age 8 or older, so many children begin to use phrases after age 4. In a trial with minimally speaking children aged 5 to 8, children still made gains in spoken language during a play-based programme. Some children stay minimally speaking and use other ways to communicate, such as signs, pictures and AAC. Keep supporting every way your child communicates, whatever their age.

### My autistic child isn't talking at 3. Should I be worried?

It is worth acting on, but it does not tell you how your child's talking will turn out. Many autistic children talk late, and in one long-term study, language progress varied most between ages 2 and 6. Ask your GP or health visitor about speech and language therapy and a hearing test, and start using gestures, signs and pictures alongside your words at home. If your child has stopped using words they used to say, see your GP promptly.

### Will using signs or pictures stop my child from talking?

No. In a review of the best studies, none of the 27 people studied lost speech after starting signs, pictures or other AAC, and most gained a little speech. A review of studies with autistic children also found that AAC did not hold back speech. Signs, pictures and AAC give your child a way to communicate now, whether or not speech follows. The Royal College of Speech and Language Therapists says there are no skills a child needs before starting AAC.

### How do I get speech therapy for my child in the UK?

Start with your local NHS children's speech and language therapy service. Routes differ by area: some services let parents of pre-school children book an advice call, while others need a referral from your GP, health visitor or your child's nursery or school SENCO. If you are not sure, ask your GP. Waits are long: in England, 66,695 children and young people were on waiting lists in April 2026. You can start the everyday ideas in this guide while you wait.

### How do I know a private speech therapist is qualified?

You can only call yourself a speech and language therapist or a speech therapist if you are registered with the Health and Care Professions Council (HCPC). Check the therapist's name on the HCPC register before you book. The ASLTIP directory lists independent therapists who are HCPC registered and members of the Royal College of Speech and Language Therapists. Ask about costs, travel charges and cancellation terms before you start.

### We speak another language at home. Should we switch to English?

No, you don't need to. Research so far, mostly with autistic children who speak, has found no harm to their language from hearing two languages, and there is no evidence that dropping a language helps. The Royal College of Speech and Language Therapists says parents should never be advised to abandon their home language. Speak to your child in the language you are most comfortable in, and tell your speech and language therapist which languages your child hears.

### Is it my fault my child isn't talking?

No. Large studies suggest autism is mostly genetic, and parenting does not cause it. Talking late, or talking very little, is one of the signs of autism the NHS lists. The everyday ideas in this guide are things you can add a little at a time, not signs that you have been doing something wrong.

## Sources

1. [GP out of hours service](https://www.nidirect.gov.uk/articles/gp-out-hours-service), nidirect, 26 November 2024
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3. [Communication interventions for autism spectrum disorder in minimally verbal children](https://doi.org/10.1002/14651858.cd012324.pub2), Cochrane Database of Systematic Reviews (Brignell et al.), 2018
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6. [Communication interventions for minimally verbal children with autism: a sequential multiple assignment randomized trial](https://doi.org/10.1016/j.jaac.2014.01.019), Journal of the American Academy of Child and Adolescent Psychiatry (Kasari et al.), 2014
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10. [3 things you should know about echolalia](https://www.hanen.org/information-tips/3-things-you-should-know-about-echolalia), The Hanen Centre, October 2018
11. [Distressed behaviour](https://www.autism.org.uk/advice-and-guidance/topics/behaviour/distressed-behaviour/all-audiences), National Autistic Society
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13. [Paediatric Autism Communication Therapy (PACT)](https://healthinnovationmanchester.com/our-work/paediatric-autism-communication-therapy-pact/), Health Innovation Manchester
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15. [Paediatric Autism Communication Therapy-Generalised (PACT-G) against treatment as usual for reducing symptom severity in young children with autism spectrum disorder: a randomised controlled trial](https://pubmed.ncbi.nlm.nih.gov/35605069/), The Lancet Psychiatry (Green et al.), 2022
16. [Helping children who use echolalia](https://www.hanen.org/information-tips/helping-children-who-use-echolalia), The Hanen Centre, November 2018
17. [How do adults and teens with self-declared autism spectrum disorder experience eye contact?](https://doi.org/10.1371/journal.pone.0188446), PLOS ONE (Trevisan et al.), 2017
18. [Waiting: the key to supporting your child's communication](https://www.hanen.org/information-tips/waiting-the-key-to-supporting-your-childs-communication), The Hanen Centre, May 2024
19. [Choosing people games](https://www.hanen.org/information-tips/choosing-people-games), The Hanen Centre, March 2025
20. [The effect of aided AAC modeling on the expression of multi-symbol messages by preschoolers who use AAC](https://pubmed.ncbi.nlm.nih.gov/17364486/), Augmentative and Alternative Communication (Binger and Light), 2007
21. [Teaching children with autism spectrum disorder with restricted interests: a review of evidence for best practice](https://doi.org/10.3102/0034654315604027), Review of Educational Research (Gunn and Delafield-Butt), 2016
22. [Determining associations between intervention amount and outcomes for young autistic children: a meta-analysis](https://doi.org/10.1001/jamapediatrics.2024.1832), JAMA Pediatrics (Sandbank et al.), 2024
23. [The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review](https://pubmed.ncbi.nlm.nih.gov/16671842/), Journal of Speech, Language, and Hearing Research (Millar, Light and Schlosser), 2006
24. [Effects of augmentative and alternative communication intervention on speech production in children with autism: a systematic review](https://europepmc.org/article/MED/18663107), American Journal of Speech-Language Pathology (Schlosser and Wendt), 2008
25. [Acquisition and generalization of key word signing by three children with autism](https://doi.org/10.3109/17518423.2013.863236), Developmental Neurorehabilitation (Tan et al.), 2014
26. [Social-communicative effects of the Picture Exchange Communication System (PECS) in autism spectrum disorders](https://pubmed.ncbi.nlm.nih.gov/22938071/), International Journal of Language and Communication Disorders (Lerna et al.), 2012
27. [Communication Bill of Rights](https://www.asha.org/njc/communication-bill-of-rights/), National Joint Committee for the Communication Needs of Persons With Severe Disabilities (ASHA)
28. [Start modeling](https://www.assistiveware.com/learn-aac/start-modeling), AssistiveWare
29. [Practitioner review: multilingualism and neurodevelopmental disorders: an overview of recent research and discussion of clinical implications](https://doi.org/10.1111/jcpp.12596), Journal of Child Psychology and Psychiatry (Uljarević et al.), 2016
30. [Language and communication skills in multilingual children on the autism spectrum: a systematic review](https://doi.org/10.1177/13623613221147780), Autism (Gilhuber, Raulston and Galley), 2023
31. [Role of the speech and language therapist with bilingual children](https://www.rcslt.org/wp-content/uploads/media/Project/RCSLT/5-impact-of-bilingualism-slcd.pdf), Royal College of Speech and Language Therapists
32. [Can autistic children learn two languages?](https://www.hanen.org/information-tips/can-children-on-the-autism-spectrum-learn-two-languages), The Hanen Centre, January 2023
33. [Autism spectrum disorder in under 19s: support and management (CG170)](https://www.nice.org.uk/guidance/cg170/chapter/Recommendations), NICE, 2021
34. [Assessment](https://www.communicationmatters.org.uk/what-is-aac/assessment/), Communication Matters
35. [Speech and language therapy referrals](https://www.cpft.nhs.uk/speech-and-language-therapy-referrals/), Cambridgeshire and Peterborough NHS Foundation Trust
36. [Supporting an autistic child](https://www.nhs.uk/conditions/autism/supporting-a-child/), NHS, 6 May 2026
37. [Written question 11799: speech and language therapy waiting lists](https://questions-statements.parliament.uk/written-questions/detail/2026-06-22/11799), UK Parliament, 1 July 2026
38. [Autism: clinical information](https://www.rcslt.org/speech-and-language-therapy/clinical-information/autism/), Royal College of Speech and Language Therapists, October 2023
39. [Speech and language therapist registration](https://www.gov.uk/find-licences/speech-and-language-therapist-registration), GOV.UK
40. [Check the register](https://www.hcpc-uk.org/check-the-register/), Health and Care Professions Council
41. [Find a speech therapist](https://asltip.com/find-a-speech-therapist/), ASLTIP
42. [FAQs](https://asltip.com/faqs/), ASLTIP
43. [Hearing tests for children](https://www.nhs.uk/conditions/hearing-tests-children/), NHS
44. [Autism and peripheral hearing loss: a systematic review](https://europepmc.org/article/MED/24300947), International Journal of Pediatric Otorhinolaryngology (Beers et al.), 2014
45. [Autism spectrum disorder in under 19s: recognition, referral and diagnosis (CG128)](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations), NICE
46. [Epilepsy](https://www.nhs.uk/conditions/epilepsy/), NHS
47. [Communication Matters (ISAAC UK)](https://www.communicationmatters.org.uk/), Communication Matters
48. [Contact us](https://contact.org.uk/about-contact/contact-us/), Contact

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General information for families in the UK, not medical, legal or financial advice. If you are worried about your child's health, contact your GP or call NHS 111 (in Northern Ireland, your GP out of hours service). In an emergency, call 999.