Autism and Language: What Every Parent Needs to Know with Laura Bierck, SLP-BCBA

0:00Welcome to Magnificent Minds, where we explore the science of child development with both heart and reason, bringing clarity, compassion and scientific evidence to questions that matter deeply to families. Today, we're diving into one of the most important and often misunderstood topics in autism speech and language development. Because when a child isn't communicating in the way that we expect, it can feel incredibly confusing and at times overwhelming. And parents often find themselves asking, is my child behind? Are we missing something?

0:35Are we doing the right things to help? And what makes us even more complex is that traditional models of language development don't always apply neatly to autistic children. In fact, many autistic individuals process the world differently, often with remarkable visual strengths, powerful memory systems, and unique pathways to language that don't always follow a typical linear progression. So today's conversation is really about expanding the framework and how we think about language and autism.

1:10It's about helping you understand how your child's brain might be approaching language, and how we can meet them there. We're going to talk about why some children learn language in chunks instead of single words, what the term Gestalt language processing actually means and why. It could be helpful to understand why visual supports can be so powerful and also where they can go wrong. We'll talk about the concept of declarative language and why it matters so much, and how to support communication in a way that builds real, flexible language, not just compliance.

1:50And most importantly, we're going to talk about what you can do starting today. I am joined by someone who brings both deep clinical expertise and a really thoughtful, modern perspective to this work. Laura Bierck, speech language pathologist and board certified behavior analyst, and at Cortica she's our senior manager of clinical excellence. So welcome, Laura. So nice to be here. Let's start at a high level. So what do you wish every parent understood about speech and language development in autism?

2:27Yeah, I think one of the most important things is to zoom out from just speech and language and really focus on communication as a whole. It's easy to look at a child who isn't using spoken words and assume they don't have a way to communicate, or that they don't have a way to understand us or that we can't understand them. But that's not often true at all. Communication shows up in so many different forms. It can be actions or gestures or repeated phrases or echolalia, or even behaviors like throwing a toy. So instead of starting from they're not talking. I always encourage parents and professionals to ask, how is this child already communicating?

3:06And what matters enough to them that they're trying to communicate and get this message across? And when we shift our mindset that way, we can really start to see their strengths and build on what's already there and create more meaningful ways for children to connect with the world around them. I love that. How is language development in autism different from what we typically expect in neurotypical children? Yeah, so one of the biggest differences is that language development and autistic children often doesn't follow the typical sequence and timeline that we're used to seeing in neurotypical development.

3:43So in neurotypical kids, we tend to see a fairly typical progression of babbling and then first words and then combining words and then more complex language. And with autism, that path can look a lot more varied. Some children may develop spoken language later. Some may use scripts or echolalia as a part of their language development, and others may rely on more non-verbal forms of communication, like gestures or visuals or AAC. And those are all valid forms of communication. We also sometimes see specific profiles that don't really fit that pattern at all.

4:19For example, some autistic children show hyperlexia where they can have advanced abilities to recognize letter letters or read words early, but still have challenges with understanding or using language meaningfully. And on the other hand, some children may have a co-occurring apraxia of speech, which makes it difficult to plan and coordinate the movements needed for speech. So a child might know exactly what they want to say, but have trouble getting the message or those words out. I imagine from a parent's perspective, it means almost throwing out the old playbook what they thought language development should look like, and coming with a fresh, fresh eyes and really open mind about what particular journey or progression or even like what kind of framework might apply to their child.

5:11So what do you think is a helpful way for parents to think about their own unique child's language development journey? Yeah. I love this question because having a framework can really shift how you see your child's communication. So I'm going to give you a couple of different frameworks because I think they're all really valuable. I know you have a framework that looks at all of neurodevelopment as a tree, but I also encourage parents to think about communication as a tree, maybe a smaller one full neurodevelopmental tree, but at the foundation or its roots of the communication or regulation and connection, can the child engage, feel safe, share attention with another person?

5:51And from there we build into an intentional communication in the trunk, which may be through gestures, through sounds, through words, through repeated phrases, through aac, And then over time, language becomes more flexible and we move into those branches that can can move a little bit more and be social and have some more complexity to them. But if we skip over those foundational pieces, it makes everything else so much harder. Another really helpful lens is to focus on function over form. So in other words, really looking at what your child is trying to communicate and why are they requesting?

6:29Are they protesting? Are they commenting? Are they connecting to share joy with someone and really thinking about the purpose behind their communication? And finally, I always remind parents that progress isn't linear. It's a journey, not a checklist. So instead of asking, are they doing what they're supposed to be doing at this age? Can I check this off? Did I meet this milestone? We really want to ask where they right now and what is the next step that's meaningful for them? I remember early in my in my training as a doctor, a mother saying to me her son was about six at the time and she said to me, she brought me a kind of neurotypical developmental milestones chart and said to me, Dr. Goh Why can't we just go back and fill in all the holes to get him up to where neurotypical six year old would be?

7:27And and that was that was an important moment. I was I was so glad she asked me that, because then we could pause and really have a conversation about how his unique communication trajectory would look so that he could succeed, and that going back and teaching him how to coo and babble and, you know, the very specific kind of milestones would not work. In fact, it would be a source of tremendous frustration for him. Yeah, yeah, yeah, absolutely. It is. It's that piece of it's not that linear progression. And sometimes there are certain holes we need to go back and fill like those building connections.

8:07And sometimes they're just skills that you don't really need and aren't functional. And we can just move past and continue to build on what they have. Exactly. Yeah. I want to talk for a moment about some of the strengths that sometimes we see in autistic children that help them if we lean into those strengths, can really help them with language development and communication. We know many autistic children have strong visual processing skills. How does that shape the way that they learn language? This is such an important piece. Many autistic children are strong visual processors, which means they take in and make sense of information more easily through what they see rather than what they hear.

8:50And that really shapes how they learn language. For a lot of these kids, spoken language is fleeting. It comes and goes really quickly that visual information sticks. So things like written words, pictures, gestures, and even routines can help give language something more predictable and concrete to attach to. And that's why we often see kids respond so well to visual supports or show early strengths and things like letters and reading, which is where hyperlexia comes in. Yeah. Can you? You did mention hyperlexia. Can you explain hyperlexia and why it's important for parents to understand?

9:28Yeah. So hyperlexia is when a child has an early and often very strong ability to recognize letters, numbers, or even read words well before what we would expect, typically and developmentally. So different studies can give you different estimates on this. But generally we see anywhere from 5 to 20% of autistic children with hyperlexia. So for many autistic children, this shows up alongside differences in how they understand or use spoken language. So you might see a child who can read words and label things really well, but still has difficulty with comprehension and conversation or using language in a flexible way.

10:07But when you understand hyperlexia as a part of the child's neurodevelopmental profile, it becomes a huge strength to build on the interest. And letters in written language can actually be a really powerful pathway for teaching, communication and supporting comprehension, expanding vocabulary, and really helping language grow. Yeah. I wonder, how do you think parents can, in a very practical kind of day to day way, use a child's visual strengths to support their communication and language growth? Yeah. Great question. If a child has strong visual processing skills, then the goal is to make language more visible, more concrete and more predictable.

10:48So I'll recommend things like using simple visual supports throughout the day, things like picture schedules, or even just showing an object as you're talking about it. Pairing your words with something the child can see can help language stick and make it easier to understand. Written words can also be incredibly powerful. So labeling items around the house with their written names, or using choice boards with pictures and words, or even typing key words as you say them, can really support both understanding and expression, especially for kids with hyperlexia.

11:23And then it's also helpful to model language alongside actions. So instead of just saying a word, you're showing it. You're doing it. You're saying it all at the same time. And that combination of the visual, plus the action gives the child multiple ways to access and learn the message. I remember this reminds me of one example of a child that I had worked with a few years back, who came to our clinic, and we knew that one of the challenging moments for him was when he would transition away from the bathroom.

12:00So he would go to the bathroom. He'd come back to the to the activity and would say in a repeated way, I have to go to the bathroom, I have to go to the bathroom. Whereas he had just been at the bathroom. And what ended up helping him transition successfully to the back to the activity was for us to write down. You were just in the bathroom and now you are going to. And then we would write out whatever it was, you know, the activity that he was going to do next. I think there was something about us recognizing his visual strength and taking the time to write it down for him.

12:35That built trust and relationship and that helped to regulate him immediately. So just for us to take the time to write something for him to read rather than responding, no, you were just at the bathroom saying something back to him that did not help, but providing him a visual, and then for him to be able to read the transition that was going to occur immediately shifted his brain in a way that allowed him to do it. And so as I hear you talking about some of these strategies that can be used day to day by making language more visible, that just seems so, so powerful and something also that a busy parent could do.

13:14Yeah, that would be the goal. I've had kids even move from single words to whole phrases just by seeing them written out like it's something clicked when they saw multiple words strung together that like, I don't have to just use this one word. I could combine them and use these words. And even just seeing that pattern of multiple words together a couple of times I've seen kids were that really quickly, then leads to phrase and longer sentence development. I have to and I remember very, very early when I was, you know, in my residency training and as, as a physician, when I first saw children who could read, who could not yet speak, it was it blew my mind.

14:02And yet it makes perfect sense neurologically, because those are different, great networks. And for some children, some are stronger than, you know, visual brain networks are stronger than auditory. So I think it's a message. It's something that we understand really well now in our field. But I think it's a message that a lot of parents still haven't heard. So I'm so glad we're talking about it today. Let's shift now a little bit to a topic that's been really of interest to a lot of professionals and parents recently, which is Gestalt language processing. So what is it?

14:38How is it different from the way language is typically thought about? Yeah. So the Gestalt language processing is a term that's very popular right now. And it's used to describe a way some children learn learn language in larger chunks or whole phrases, rather than starting with single words and building up. So our typical way we would think is you might learn juice and then later I want juice. But when we look at Gestalt language processing, a child might learn the full phrase, do you want juice and use that as a full unit?

15:13So in this example, maybe a child who is learn language in chunks might say, do you want juice when communicating that? In fact, they do want juice, but they've heard that said, every time they get juice, what they've heard is do you want juice? So they've associated that phrase with getting juice. You'll often hear that Gestalt language processing is very common in autistic children, largely because echolalia is very common in autism. A large scale study in 2025 found that as many as 90% of autistic individuals use echolalia at some point in their development, but that doesn't mean that 90% of autistic individuals are gestalt language processors.

15:53Research really hasn't definitively given us an answer for this. In fact, research at this time doesn't really support labeling children as Gestalt language processors. But what I think is helpful for us to recognize is that language learning is rarely, one way or another way. All of us learn some language in chunks, and we learn some language in more analytic ways or word by word ways. And I know a lot of parents are familiar with the word echolalia. But just in case, for those who aren't. How would you define echolalia? What does it look like?

16:28Yeah, so echolalia is just the repetition of words or phrases that you've heard, and it can be immediate. It could be. I say, do you want juice? And someone immediately repeats that and says, do you want juice? Or it can show up after time? I say, do you want juice? And again, like next time the juice is out, they repeat. Do you want juice? So it's just the repetition of a phrase either immediately or later on. Yeah. And that the child has heard someone else say or has heard in the video or has heard before some way. And I knowing that echolalia is so common.

17:03And autism, that is a really good reason for us to use language in a flexible way, and to expose a child to lots of different words phrases, to not use language rigidly and repetitively. Absolutely, yeah. One of the things that we've touched on is the importance of using a variety of language flexibly and not rigidly and not repetitively. When we're talking with a child, I want to shift the conversation over to declarative language, because this is what really what we're talking about now, declarative language you and I know is extremely important.

17:47Our listeners may be new to to understanding what this is. So could you explain what it is and why it matters so much? Yeah. So declarative language is language that shares information, experiences or perspectives without placing a demand on the child. As a bit of an over generalization. You can think of it as commenting. So instead of asking for something or directing a behavior, you're commenting, noticing or expressing interest. Imperative language is kind of the opposite of that. It's just it's directive. It tells the child what to do and asks them to respond.

18:23So something that's imperative is something like, say, ball, give me the cup, or what color is that? It makes language almost a demand. The child has to respond to. Declarative language, on the other hand, is more equivalent to an invitation to communicate. There's no pressure to respond. So instead of what color is that? You might say, that's a bright red car. Or you might say something like, you have so many different colors of cars. My favorite is the bright red car. I wonder if you see one you like. One is focused on getting a response, and the other is focused on sharing attention and building language in a more natural way.

19:03That's wonderful. I think of declarative language as creating space. Someone speaking to you using declarative language. It creates space rather than pressure. Absolutely. So if in situations where mostly imperative language is used, what kind of effect does that have on a child's communication development over time? Yeah. You really see this play out over time because when language is mostly imperative, communication starts to feel like a series of tests or a series of demands.

19:38And so some children respond to that by becoming less verbally engaged and relying on compliance based, and wrote answers for using language only when they're absolutely required to use language. It also just really, really limits opportunities for spontaneous communication because, again, the child is spending most of their time reacting rather than learning how to initiate and share ideas. So over the over time, that really impacts confidence and flexibility in language use. Listening today, can you give some examples of how they can shift their language at home?

20:17Absolutely. Instead of what do you want? You might say, I see crackers, cereal and fruit snacks. Or instead of say more, you could say it looks like you want more crackers or during play. Instead of asking a lot of questions, you might just comment on what's going on. That tower is so tall or oh no, it fell. It's really about noticing more and directing less and just trusting that language learning happens through exposure and connection, not just prompting. Honestly, it can be a hard shift to make, but what I would challenge you to do is try to spend a few small chunks of time each day thinking about it.

20:54So maybe five minutes when you're driving in the car or during bath time, or when you are sitting down and playing and really think about it for a couple of minutes and maybe think about it like a ratio for that small chunk of time, and try to make nine statements for every one question or demand you place. I love that we know that in the past, a lot of autism interventions have used simplified or what we call truncated language. Now what is that and why are we moving away from it? Yeah. Truncated language is sometimes referred to as like baby talk or It's essentially when we simplify adult speech to very short or broken down phrases like give ball instead of give me the ball.

21:41And the intention behind that was to make language easier to process or imitate. But we're actually moving away from that because it doesn't reflect natural language use, and it actually can limit exposure to how language is structured and meaningful used in real life. And what does the research or clinical experience tell us about using this kind of more full, more rich language? Instead, both clinical experience and researchers showing us that children learn from language input that's slightly above their current level, which we often call rich natural language.

22:17So when we use full sentences and meaningful contexts, children get access to grammar, vocabulary, tone, and social meaning all at once. And importantly, many autistic children are far more capable of processing that richness than we assume, especially when we support it with visuals context in that connection. Wonderful. Now, a few times you've mentioned aac can you tell our listeners what that stands for and how it can and should be used? Yeah, AAC stands for Augmentative and Alternative Communication, and it's really an umbrella term for any system that supports communication beyond spoken words.

23:00So that can include things like picture systems, sign language or speech generating devices. PECS is the picture exchange communication system, and it's one specific type of arc that uses pictures that a child physically hands to a communication partner. So these tools are helpful anytime a child needs support expressing themselves or understanding language. And that might be a child who isn't speaking yet, or a child who has difficulty being understood, or even a child who benefits from having visual supports alongside spoken language. Most importantly, it's really huge to know that AAC isn't a last resort.

23:40Research shows that AAC often supports spoken language development for autistic individuals. It's often a reliable communication method that's easier to access for the motor system, which can be really important for anyone with the apraxia, and it can be easier to access when dysregulated again because of the reduced motor demands. Yeah. PECS is is a system that I find is often misused. And I've seen a lot of children get stuck when PECS is misused. So what guide guidance can you provide to parents to to avoid that happening?

24:19Yeah. One of the most common places children get stuck. And this can happen with any type of AAC But it does often happen with PECS is when a system becomes very narrow and primarily focused on requesting. So for example, a child learns to ask for snacks or toys, which is great, but that system is not really supporting them. Expanding beyond that into commenting and sharing or connecting socially. Another place we see challenge is when the systems aren't updated as the child grows, so the vocabulary might stay very basic, or the way it's used doesn't really evolve to support more flexible, meaningful communication.

25:00Another tool that we often see use, especially in autism services, are what you might call pictographs. There are these sort of small, simplified drawings. Sometimes they they're often like these kind of little line drawings. They're meant to to depict the meaning of the word that goes with it. But there are a lot of limitations to to pictographs. So tell us a little bit about I see pictographs being used a lot in ABA, a lot in speech language therapy, and for the most part when I've seen them use, they are not helpful and they actually have a lot of limitations.

25:41So can you speak to that a little bit and how if, if they should ever be used and how pictographs can be helpful early on, but they do have some pretty significant limitations. Not everything is easy to represent with a picture, especially more abstract concepts like emotions or time or social ideas. They also require a child to learn what each symbol means, which isn't always as intuitive as we assume. For some children, especially those with strong visual or reading skills, a picture might actually be less clear than the written word.

26:17And generally, generalizing a child's skills is so important, and pictographs don't exist widely in the outside world, whereas words do. Words are everywhere. Absolutely. So I often see people assume that a child, maybe because of their age or because of their spoken language level, won't be able to access and understand written words, but very often they can. So why is it that words are more accessible than we assume for many autistic children? Yeah, this is again, a lot of our autistic children have these really strong visual processing or hyperlexic traits, and words are consistent.

26:58They don't change the way pictures sometimes do. And they map very, very clearly to language. They're everywhere in their environment. They're going to encounter words every time they walk out their door and do anything. So when we can start to incorporate written language earlier through labels, through choice boards, through AAC, and even through typing, it can really open up another pathway for communication that might feel much more natural for a child. Let's talk for a moment about language development at different ages or a different stages of life.

27:35How should parents be thinking about language development based on their child's age, whether a toddler or school age or adolescent? Yeah, I think the most helpful way to think about it is the goals of communication stay the same connection, understanding and expression. But how they show up changes over time. So with toddlers, we're really focused on the foundations, which is connection and shared or joint attention and early intentional communication, which may be through gestures, sound, single words or AAC. But the goal is helping the child learn that communication works, that they can impact the world and they can connect with other people.

28:14And then as children move into school age years, we're building on that foundation. So communication becomes more flexible and social. Things like combining ideas, participating in conversation and understanding others perspectives. And in adolescence, the focus shifts again towards a lot more complex communication. Things like navigating relationships, expressing your identity, advocating for yourself and for others, and handling more abstract language. So across all ages, though, the core question really stays the same how is the child connecting and communicating meaningfully?

28:49Right now? One of the really interesting and exciting areas of autism research today is looking at different subtypes, or different types of autism. Are there different language patterns or needs across different autism subtypes? Yeah, so autism is incredibly diverse. And honestly, the language profiles look so diverse from one individual to another. There may be generalities within a phenotype, but so far we aren't seeing specific patterns and specific checklists that you could have within a phenotype. Some children might have strong verbal skills, but struggle with pragmatic language.

29:26Things like conversation, tone or understanding social context, and others may rely more on AC or have limited spoken language, but communicate very effectively in other ways. It's such a great point, and the research is really supporting what you just said, because there are some kind of developmental behavioral subtypes. We know that there are some of these subtypes come with developmental delay, including language delays, and other subtypes don't come with early language delays. But then maybe do show more of the later social pragmatic difficulties in the use of language.

30:03But across any of these autism subtypes, there can be individuals with tremendous visual strengths, individuals with hyperlexia individuals who are language processors. So. So yes, it really points out how important it is to to look at each unique individual child and really understand their profile and then adapt and individualize the therapy program based on that. Yeah. What's something that gives you the most optimism right now in your field of speech and language therapy? We're starting to value things like echolalia, AAC, visual strengths, and individual learning profiles in a much more meaningful way.

30:44And that opens the door to more respectful, effective, and connected approaches to communication. If a parent is listening and feeling overwhelmed, what would you say are the top three things they can do right now to support their child's language development? Yeah. So my first thing and actually also my second thing is to reduce pressure and first for yourself and second for your child. So for your child try to shift away from asking questions and simply commenting and sharing to reduce that pressure. And for yourself. Remember, progress isn't linear or a checklist. What's important is meeting your child where they are in that moment.

31:22And third, I would say to presume competence and recognize communication in all forms. So give your child access to rich language and visuals and communication tools and trust that they're learning, even if it doesn't look like traditional language learning. What's one mindset shift that can make the biggest difference for families? Yeah, I think again, along with reducing your pressure, the pressure for you, it's understanding that communication isn't something you need to extract from your child. It's something we build with them. So when we move from trying to like, get this language out of them to just creating opportunities for connection, it can really change everything.

32:04Laura, thank you so much for this conversation. That was incredibly valuable. And to everyone listening, thank you for being here, for your curiosity and for the way you show up for your children every single day. If this episode was helpful, please share it with another parent or professional who might benefit. And as always, I'm so grateful you're part of this community. Until next time, take good care of yourself and your magnificent child.