Which Communication Milestones Signal Concern for Autism When Speech is Absent?

PostedNovember 5, 2025

UpdatedNovember 5, 2025

ByMy Patient Advice

Author: Lucia Alvarez, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

When speech is absent or significantly delayed, communication milestones in autism can provide critical clues about a child’s development. Children typically reach key communication milestones at specific ages, such as responding to their name, making eye contact, and using gestures to express needs. However, when these milestones are missing or delayed, it may indicate a need for further evaluation of autism.

In the absence of speech, communication milestones in autism such as nonverbal cues, social engagement, and early gestures can be the first signs to watch for. A lack of these signs, such as not responding to social cues or failing to make eye contact, may be concerning, particularly when other early signs of autism are present.

Key Communication Milestones to Monitor

Here are some communication milestones in autism that can signal concern when speech is absent:

Nonverbal Communication:

Babies typically start using gestures, like pointing or waving, by the age of one. If these early gestures are missing or significantly delayed, it could signal a speech delay and a potential developmental concern.

Social Engagement:

By 6 months, most babies engage with their caregivers through smiles, eye contact, or cooing. A child who avoids eye contact or shows no interest in social interaction may be showing early signs of autism, even in the absence of speech.

Response to Name:

By 9 months, infants generally begin to respond to their name. A lack of response to name, combined with other social communication delays, can raise concerns about autism and should be evaluated further, potentially leading to an autism diagnosis.

When speech delay is accompanied by other communication milestones in autism being missed, it’s important to seek an autism diagnosis. Early identification can help you access therapies and interventions that support language development and social skills.

For tailored advice and expert guidance, visit providers like Autism Detect for personalised consultations.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Early Signs & Symptoms of Autism.

Lucia Alvarez, MSc

Author

Lucia Alvarez is a clinical psychologist with a Master’s in Clinical Psychology and extensive experience providing evidence-based therapy and psychological assessment to children, adolescents, and adults. Skilled in CBT, DBT, and other therapeutic interventions, she has worked in hospital, community, and residential care settings. Her expertise includes grief counseling, anxiety management, and resilience-building, with a strong focus on creating safe, supportive environments to improve mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.