Autism and Communication Skills: Addressing Misconceptions With Scientific Facts

Autism is a neurodevelopmental condition that affects development of social and communication behaviors. It has genetic and neurological origins.

There are many widely held misconceptions about autism. Misinformation can be harmful and stigmatizing, contribute to social barriers, reduce access to support, and cause emotional stress. Often, confusion persists because people continue to share outdated theories, and current research may be difficult to understand. All of this can overshadow scientific evidence and the voices of autistic people themselves.

It is critical to have accurate, up-to-date, and practical information to address misconceptions and build understanding. Our approach is grounded in a neurodiversity framework that (a) recognizes autism as a natural variation in human neurological development rather than a deficit to be cured and (b) stems from an evidence-based perspective that draws from current, peer-reviewed research, clinical expertise, and individual and family voices. This combination supports the lived experience of autistic people and ensures that communication about autism reflects the best available scientific knowledge.

Decisions about effective communication services should be based on current research findings. Audiologists and speech-language pathologists (SLPs) can provide information about evidence-based approaches that enhance communication skills and support meaningful relationships, self-advocacy, and overall health and well-being. Neurodiversity-affirming services center an individual’s goals on that person’s evolving interests—respecting their strengths, priorities, and necessary accommodations.

Public awareness of autism has grown—but so have misconceptions about autism and communication skills. Here are several misconceptions that have been refuted, based on published scientific research.

Misconceptions vs. Facts

Misconception	Fact
1. Misconception: Most autistic people do not use speech to communicate.	Fact: Communication skill development in autistic people varies. Some autistic people are nonspeaking or may use little speech, whereas others have strong spoken language abilities. Some autistic people use a combination of speech production and augmentative and alternative communication (AAC) systems. Intervention research supports the development of multimodal communication skills for autistic children. See evidence for Fact 1.
2. Misconception: Hearing loss rarely co-occurs with autism.	Fact: Sensitivity to auditory stimuli in autistic people is complex and multifaceted. Many autistic people experience Decreased Sound Tolerance Disorders (DTSDs)—such as hyperacusis and misophonia. But hearing loss is also prevalent in this population—and is often overlooked. These conditions can occur independently or co-exist. A comprehensive case history is essential—it helps clinicians understand the full scope of auditory challenges. Clinicians should inquire about difficulties understanding speech, following directions, and responding appropriately to sounds—and any discomfort or distress caused by everyday noises. Hyperacusis may be present when sounds that are typically tolerable cause pain or strong negative reactions. Clinicians should consider misophonia when common sounds—like breathing or foot tapping—trigger emotional or behavioral responses. See evidence for Fact 2.
3. Misconception: Autistic people are only at the extremes of intellectual ability. They either have an intellectual disability or demonstrate exceptional intelligence.	Fact: Autism exists across all intellectual levels. There is a wide range of cognitive, language, and behavioral patterns. Some autistic people have intellectual disabilities, whereas others do not. The idea of a “one-size-fits-all” profile is misleading and ignores the broad spectrum of abilities, challenges, and support needs that may be required for full inclusion in society. See evidence for Fact 3.
4. Misconception: Bilingual exposure in the home hinders progress in speech and language development with this population.	Fact: Studies consistently find that raising a child in a bilingual home poses no risk to the language growth or social development of autistic children. Current evidence shows no negative effects of bilingualism on developmental outcomes. See evidence for Fact 4.
5. Misconception: Autistic girls have much better pragmatic and social communication skills than do autistic boys.	Fact: Autistic girls may appear to be more socially engaged than autistic boys; however, autistic girls may be camouflaging difficulties initiating or sustaining reciprocal communication interactions. Autism is often underdiagnosed in girls. Differences in social expectations and activities may make it more difficult to identify autism in girls. Research shows that autistic girls may hide or “mask” their symptoms, thus delaying diagnosis. See evidence for Fact 5.
6. Misconception: The use of augmentative and alternative communication (AAC) prevents a person from developing spoken language.	Fact: AAC can enhance independent communication and often supports the development of speech for autistic people. It’s important to recognize that spoken language is not the sole indicator of intelligence or understanding. Modeling AAC typically is insufficient for autistic people to become effective AAC users. Although they will gain some communication skills with exposure to AAC, most will need direct intervention to achieve their communicative potential. Some autistic people who use spoken language still use AAC. See evidence for Fact 6.
7. Misconception: Echolalia does not serve as a meaningful communication function and should be discouraged.	Fact: Echolalia—which means repeating others’ words or phrases—can be a way for autistic people to communicate, understand language, or manage emotions or stress. See evidence for Fact 7.
8. Misconception: Autism can't be reliably diagnosed before age 4 years.	Fact: Early screening for autism is recommended for children as young as 18 months of age by the American Academy of Pediatrics (AAP). Early diagnosis enables timely support for autistic children and their families. Speech-language pathologists (SLPs) play a key role in identifying young children with communication difficulties—often an early indicator of autism. See evidence for Fact 8.
9. Misconception: Regression in communication skills is a direct result of vaccines.	Fact: Regression in communication skills may be an early indicator of autism and may coincide with the timing of childhood vaccines. However, there is no current scientific evidence linking vaccines to autism. Numerous large-scale studies have shown no causal connection. The original study from 1998 suggesting a link has been thoroughly discredited and retracted. Any concerns of a connection should be discussed with a primary care provider. Audiologists and SLPs can counsel individuals and families about overall health using evidence-based information and resources provided by medical organizations, such as the AAP Statement on Protecting Access to Vaccines. See evidence for Fact 9.

Evidence

Fact 1

Anderson, D. K., Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., Welch, K., & Pickles, A. (2007). Patterns of growth in verbal abilities among children with autism spectrum disorder. Journal of Consulting and Clinical Psychology, 75(4), 594–604. https://doi.org/10.1037/0022-006X.75.4.594

Bottema-Beutel, K., Zisk, A. H., Zimmerman, J., & Yu, B. (2025). Conceptualizing and describing autistic language: Moving on from ‘verbal,’ ‘minimally verbal,’ and ‘nonverbal.’ National Autistic Society, 29(6), 1367–1373. https://doi.org/10.1177/13623613251332573

Guthrie, W., Wetherby, A. M., Woods, J., Schatschneider, C., Holland, R. D., Morgan, L., & Lord, C. E. (2023). The earlier the better: An RCT of treatment timing effects for toddlers on the autism spectrum. Autism, 27(8), 2295‒2309. https://doi.org/10.1177/13623613231159153

Hughes, M. M., Shaw, K. A., DiRienzo, M., Durkin, M. S., Esler, A., Hall-Lande, J., Wiggins, L., Zahorodny, W., Singer, A., & Maenner, M. J. (2023). The prevalence and characteristics of children with profound autism, 15 sites, United States, 2000‒2016. Public Health Reports, 138(6), 971–980. https://doi.org/10.1177/00333549231163551

Rose, V., Trembath, D., Keen, D., & Paynter, J. (2016). The proportion of minimally verbal children with autism spectrum disorder in a community-based early intervention programme. Journal of Intellectual Disability Research, 60(5), 464–477. https://doi.org/10.1111/jir.12284

Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., Bruinsma, Y., McNerney, E., Wetherby, A., & Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2411‒2428. https://doi.org/10.1007/s10803-015-2407-8

Fact 2

Danesh, A. A., Howery, S., Aazh, H., Kaf, W., & Eshraghi, A. A. (2021). Hyperacusis in autism spectrum disorders. Audiology Research, 11, 547–556. https://doi.org/10.3390/audiolres11040049

Do, B., Lynch, P., Macris, E.-M., Smyth, B., Stavrinakis, S., Quinn, S., & Constable, P. A. (2017). Systematic review and meta-analysis of the association of autism spectrum disorder in visually or hearing impaired children. Ophthalmic and Physiological Optics, 37, 212–224. https://doi.org/10.1111/opo.12350

Williams, Z, J., He, J. L., Cascio, C. J., & Woynaroski, T. G. (2021). A review of decreased sound tolerance in autism: Definitions, phenomenology, and potential mechanisms. Neuroscience & Biobehavioral Reviews, 121, 1–17. https://doi:10.1016/j.neubiorev.2020.11.030

Williams, Z. J., Suzman, E., & Woynaroski, T. G. (2021). Prevalence of decreased sound tolerance (hyperacusis) in individuals with autism spectrum disorder: A meta-analysis. Ear and Hearing, 42(5), 1137–1150. http://doi:10.1097/AUD.0000000000001005

Shaw, K. A., Williams, S., Patrick, M. E., et al. (2025). Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years — Autism and Developmental Disabilities Monitoring Network, 16 sites, United States, 2022. MMWR Surveillance Summaries, 74(No. SS-2): 1–22. https://doi.org/10.15585/mmwr.ss7402a1

Shenouda, J., Barrett, E., Davidow, A. L., Sidwell, K., Lescott, C., Halperin, W., Silenzio, V. M. B., & Zahorodny, W. (2023). Prevalence and disparities in the detection of autism without intellectual disability. Pediatrics, 151(2), Article e2022056594. https://doi.org/10.1542/peds.2022-056594

Fact 3

Fact 4

Valicenti-McDermott, M., Tarshis, N., Schouls, M., Galdston, M., Hottinger, K., Seijo, R., Shulman, L., & Shinnar, S. (2013). Language differences between monolingual English and bilingual English‒Spanish young children with autism spectrum disorders. Journal of Child Neurology, 28(7), 945–948. https://doi.org/10.1177/0883073812453204

Wang, M., Jegathesan, T., Young, E., Huber, J., & Minhas, R. (2018). Raising children with autism spectrum disorders in monolingual vs bilingual homes: A scoping review. Journal of Developmental and Behavioral Pediatrics, 39(5), 434–446. https://doi.org/10.1097/DBP.0000000000000574

Zhou, V., Munson, J. A., Greenson, J., Hou, Y., Rogers, S., & Estes, A. M. (2019). An exploratory longitudinal study of social and language outcomes in children with autism in bilingual home environments. Autism: The International Journal of Research and Practice, 23(2), 394–404. https://doi.org/10.1177/1362361317743251

Fact 5

Dean, M., Chang, Y.-C., Shih, W., Orlich, F., & Kasari, C. (2023). Social engagement and loneliness in school-age autistic girls and boys. Women's Health, 19, 1–12. https://doi.org/10.1177/17455057231170973

Grosvenor, L. P., Croen, L. A., Lynch, F. L., Marafino, B. J., Maye, M., Penfold, R. B., Simon, G. E., & Ames, J. L. (2024). Autism diagnosis among U.S. children and adults, 2011‒2022. JAMA Network Open, 7(10), Article e2442218. https://doi.org/10.1001/jamanetJust workopen.2024.42218

Salari, N., Rasoulpoor, S., Rasoulpoor, S., Shohaimi, S., Jafarpour, S., Abdoli, N., Khaledi-Paveh, B., & Mohammadi, M. (2022). The global prevalence of autism spectrum disorder: A comprehensive systematic review and meta-analysis. Italian Journal of Pediatrics, 48(112), 1–16. https://doi.org/10.1186/s13052-022-01310-w

Fact 6

Schlosser, R. W., & Wendt, O. (2008). Effects of augmentative and alternative communication intervention on speech production in children with autism: A systematic review. American Journal of Speech-Language Pathology, 17(3), 212–230. https://doi.org/10.1044/1058-0360(2008/021)

Walters, C., Sevcik, R., & Romski, M. (2021). Spoken vocabulary outcomes of toddlers with developmental delay after parent-implemented augmented language intervention. American Journal of Speech-Language Pathology, 30(2), 1023–1037. https://doi.org/10.1044/2020_AJSLP-20-00093

White, E. N., Ayres, K. M., Snyder, S. K., Cagliani, R. R., & Ledford, J. R. (2021). Augmentative and alternative communication and speech production for individuals with ASD: A systematic review. Journal of Autism and Developmental Disorders, 51(11), 4199–4212. https://doi.org/10.1007/s10803-021-04868-2

Yuan, W., Dunn, M., Kennedy, J., Hsiao, Y.-J., & Poppen, M. (2024). Impact of speech generating device interventions on vocalizations of individuals with autism and severe communication impairment: A systematic review of the research. Education and Training in Autism and Developmental Disabilities, 59(3), 233–256. https://www.jstor.org/journal/eductraiautidev

Fact 7

McAllister, M. L., McFayden, T., & Harrop, C. (2025). Reports of echolalia and related behaviors in autism from parents, teachers, and clinicians: Evidence from the Simon Simplex collection. Autism Research, 18(3), 528–540. https://doi.org/10.1002/aur.3298

Fact 8

Barbaro, J., Sadka, N., Gilbert, M., Beattie, E., Li, X., Ridgway, L., Lawson, L. P., & Dissanayake, C. (2022). Diagnostic accuracy of the social attention and communication surveillance–revised with preschool tool for early autism detection in very young children. JAMA Network Open, 5(3), Article e2146415. https://doi.org/10.1001/jamanetworkopen.2021.46415

Chawarska, K., Klin, A., Paul, R., Macari, S., & Volkmar, F. (2009). A prospective study of toddlers with ASD: Short-term diagnostic and cognitive outcomes. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 50(10), 1235–1245. https://doi.org/10.1111/j.1469-7610.2009.02101.x

Guthrie, W., Swineford, L. B., Nottke, C., & Wetherby, A. M. (2013). Early diagnosis of autism spectrum disorder: Stability and change in clinical diagnosis and symptom presentation. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 54(5), 582–590. https://doi.org/10.1111/jcpp.12008

Ozonoff, S., Young, G. S., Landa, R. J., Brian, J., Bryson, S., Charman, T., Chawarska, K., Macari, S. L., Messinger, D., Stone, W. L., Zwaigenbaum, L., & Iosif, A. M. (2015). Diagnostic stability in young children at risk for autism spectrum disorder: A Baby Siblings Research Consortium study. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 56(9), 988–998. https://doi.org/10.1111/jcpp.12421

Thomas, R. P., de Marchena, A., Wieckowski, A. T., Stahmer, A., Milan, S., Burke, J. D., Barton, M. L., Robins, D. L., & Fein, D. A. (2024). Accuracy of initial diagnostic impressions of autism in toddlers and behaviors that inform these impressions. Autism Research, 17(3), 568–583. https://doi.org/10.1002/aur.3088

Fact 9

DeStefano, F., Price, C. S., & Weintraub, E. S. (2013). Increasing exposure to antibody-stimulating proteins and polysaccharides in vaccines is not associated with risk of autism. The Journal of Pediatrics, 163(2), 561‒567. https://doi.org/10.1016/j.jpeds.2013.02.001

Di Pietrantonj, C., Rivetti, A., Marchione, P., Debalini, M. G., & Demicheli, V. (2021). Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database of Systematic Reviews, 2021(11), Article CD004407. https://doi.org/10.1002/14651858.CD004407.pub5

Hviid, A., Hansen, J. V., Frisch, M., & Melbye, M. (2019). Measles, mumps, rubella vaccination and autism: A nationwide cohort study. Annals of Internal Medicine, 170(8), 513–520. https://doi.org/10.7326/M18-2101

Jain, A., Marshall, J., Buikema, A., Bancroft, T., Kelly, J. P., & Newschaffer, C. J. (2015). Autism occurrence by MMR vaccine status among US children with older siblings with and without autism. JAMA, 313(15), 1534–1540. https://doi.org/10.1001/jama.2015.3077

Richler, J., Luyster, R., Risi, S., Hsu, W. L., Dawson, G., Bernier, R., Dunn, M., Hepburn, S., Hyman, S. L., McMahon, W. M., Goudie-Nice, J., Minshew, N., Rogers, S., Sigman, M., Spence, M. A., Goldberg, W. A., Tager-Flusberg, H., Volkmar, F. R., & Lord, C. (2006). Is there a ‘regressive phenotype’ of autism spectrum disorder associated with the measles-mumps-rubella vaccine? A CPEA study. Journal of Autism and Developmental Disorders, 36(3), 299‒316. https://doi.org/10.1007/s10803-005-0070-1

Taylor, L. E., Swerdfeger, A. L., & Eslick, G. D. (2014). Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine, 32(29), 3623–3629. https://doi.org/10.1016/j.vaccine.2014.04.085

Autism and Communication Skills: Addressing Misconceptions With Scientific Facts

Misconceptions vs. Facts

Misconception

Fact

Evidence

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