How does speech and language therapy support understanding of non-literal language in autism?
According to the NHS, autistic people can find indirect or implied meaning harder to interpret, especially when language is unclear. NHS guidance also notes that a GP or autism assessment team can refer someone to a speech and language therapist when communication affects everyday life.
Understanding the concept
Non literal language includes idioms, metaphors, sarcasm, jokes, hints and “reading between the lines”. The National Autistic Society explains that many autistic people prefer clear, direct language and may take longer to process what is said, which can make figurative phrases or implied messages harder to decode quickly.
It can help to remember the National Autistic Society point that misunderstandings are often about a mismatch in communication styles, not lack of intelligence or effort.
Evidence and impact
Guidance from NICE describes autism as involving persistent social communication differences and recommends communication focused, structured approaches that are adapted to the person. NICE also emphasises reasonable adjustments like avoiding jargon, checking understanding, and using written or visual information, all of which matter when conversations include humour, indirect requests, or implied expectations.
Research also supports the idea that figurative language can be specifically challenging. A review on figurative language processing in autism reports that autistic groups often show lower accuracy and slower responses for tasks involving idioms, metaphors and irony, while also highlighting wide differences between individuals.
Practical support and approaches
The RCSLT explains that speech and language therapists work on understanding and using language in real life contexts. When non literal language is a priority for the autistic person, therapy often focuses on practical comprehension, not “acting neurotypical”.
Common SLT strategies include:
- Explicit teaching of common idioms or sarcasm patterns, using clear definitions and real examples, supported by evidence synthesised in a recent scoping review on PMC
- Visual supports to map “what was said” versus “what was meant”, as recommended by Newcastle Hospitals
- Practising clarification scripts, such as “Do you mean X or Y?”, which aligns with National Autistic Society advice to make meanings explicit and check understanding in relationships
- Coaching families, teachers and employers to use more direct language, as suggested by the National Autistic Society
Challenges and considerations
The evidence base for specific non literal language interventions is still developing. The scoping review on PMC notes that studies are often small and varied, with limited long term follow up. It is also important that goals do not pressure masking. Guidance from Newcastle Hospitals and the National Autistic Society supports a respectful approach that improves mutual understanding rather than blaming autistic people for missing hints.
How services can help
The NHS explains that autistic people can be referred to speech and language therapy when communication support is needed. In adult services, NICE recommends communication adjustments and structured support, while the RCSLT highlights co produced goals that matter to the person, such as understanding workplace humour, classroom language, or relationship communication.
Takeaway
Speech and language therapy can help autistic people understand non literal language by making meaning clearer, practising in real contexts, and changing environments so communication is easier for everyone. If indirect language is causing stress at school, work or home, it may help to discuss support options through your NHS pathway.
If you or someone you support would benefit from early identification or structured autism guidance, visit Autism Detect, a UK-based platform offering professional assessment tools and evidence-informed support for autistic individuals and families.
