Last updated 2026-07-09
TL;DR
Autism communication spans a wide spectrum. Researchers describe roughly five stages, from pre-intentional signals to complex language, and autistic children may use speech, AAC, gestures, echolalia, or a mix of all of these. A chart helps parents and therapists spot where a child is now and what supports to try next. No stage is a ceiling.
An autism communication chart maps out the different ways autistic people express and understand language, organized by stage, type, or both. It gives parents and clinicians a shared vocabulary, so a conversation about a child being "minimally verbal" or "emerging with AAC" means the same thing to everyone in the room. Without that shared framework, a parent and a speech-language pathologist can end up talking past each other about what feels like two different kids.
This matters because autism affects communication in ways that don't follow one path [1]. One child might understand almost everything said to her but produce very little speech. Another might rattle off long scripted phrases from a favorite show yet struggle to answer a simple question. A third might be fully nonspeaking and communicate best through a speech-generating device. All three are autistic, and all three need different support. The American Speech-Language-Hearing Association notes that communication characteristics in autism "vary considerably" and that assessment has to look at both the form and the function of communication, not just word count [1]. That's exactly what a good chart tries to capture. Below is a walk-through of the most widely used staging frameworks, the communication types you'll see referenced, and some concrete next steps depending on where your child is right now.
The stages of communication development
The most clinically useful framework comes from speech-language researchers Barry Prizant and Amy Wetherby, whose Communication and Symbolic Behavior Scales (CSBS) describe a continuum from pre-intentional to symbolic communication [2]. Many autism centers layer a five-stage model on top of this idea. Here's how it breaks down.
| Stage | Label | What it looks like | Typical supports |
|---|---|---|---|
| 1 | Pre-intentional | Behavior affects others but child doesn't know it yet. Crying, body tension, reaching without eye contact. | Responsive caregiving, imitation, sensory co-regulation |
| 2 | Intentional pre-symbolic | Child signals on purpose: eye contact + reach, pulling a hand, giving an object. No words yet. | Joint attention routines, object exchange, PECS Phase 1-2 |
| 3 | Emerging symbolic | First words or word approximations, simple picture exchange, early AAC use. May include a lot of echolalia. | Core vocabulary AAC, naturalistic developmental behavioral intervention (NDBI) |
| 4 | Early language | Two-word combinations, short sentences, functional AAC phrases. Conversation is possible but fragile. | Aided language stimulation, story-based language, social scripts |
| 5 | Complex language | Multi-sentence utterances, questions, narratives. May still have pragmatic or social-communication gaps. | Pragmatics groups, perspective-taking, self-advocacy skills |
A few things worth keeping in mind here. Kids don't move through these stages in a straight line, and many autistic children show splinter skills: Stage 5 vocabulary sitting right next to Stage 2 pragmatics. Age doesn't reliably predict stage either. The AAP's 2020 clinical report on autism notes that around 25 to 30 percent of autistic children are minimally verbal or nonspeaking at school age, meaning they may still be working in Stages 1 through 3 well past kindergarten [3]. And no stage is permanent. Late gains in communication happen and are well documented.
Staging isn't about putting a label on a child. It's about aiming support at the right part of their development.
The different types of communication
Most charts organize by type as well as stage, and the two are separate axes. A child could be in Stage 3 using speech, Stage 3 using a speech-generating device, or Stage 3 using both together. Spoken language develops on a typical timeline for some autistic children, later for others, and not functionally at all for some. When speech does emerge, it may carry an unusual tone (flat or sing-song), atypical pronunciation, or a lot of echolalia. Repeating words or phrases heard elsewhere isn't a sign that a child isn't communicating. Researchers Prizant and Rydell showed decades ago that echolalia often does real communicative work: requesting, protesting, taking turns, self-regulating [2]. More on this at echolalia and echolalia meaning. Augmentative and alternative communication (AAC) covers everything from low-tech picture boards to high-tech speech-generating devices. The evidence for AAC in autism is strong: a 2012 meta-analysis in the American Journal of Speech-Language Pathology by Ganz et al. found positive effects across 24 studies of minimally verbal autistic children [4]. AAC doesn't suppress speech development; if anything, the evidence suggests it supports it. The aac devices page has a full breakdown of options. Gestures and body language count too. Pointing, showing, head nods, and leading someone by the hand are all communication, and for children in Stages 1 and 2 gesture is often the most accessible channel and a strong predictor of later language. Therapists build on gesture deliberately because it shares the same cognitive groundwork as words. Visual supports like schedules, first-then boards, and choice boards aren't just behavior management tools, they're communication tools too, giving a child a way to anticipate what's coming and respond to it. And some autistic people communicate more fluently in writing than in speech, which shows up often among those with co-occurring motor differences like apraxia of speech or childhood apraxia of speech. RPM (Rapid Prompting Method) and FC (Facilitated Communication) are controversial in this space; both the AAP and ASHA caution against FC specifically because its validity hasn't been established [5]. No one type beats another. The best type is whatever a child can use reliably, on their own, across different settings.
Figuring out where your child fits
Start by watching, not guessing. Spend a few days noticing what your child does when they want something, when they don't want something, and when they want to share something with you. Those three, requesting, protesting, and joint attention, are the backbone of early communication.
The formal tool for this is the Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP), which screens children from 6 to 24 months for early communication red flags [2]. For older minimally verbal children, the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) is common in ABA and speech therapy settings. For school-age kids, the SCERTS model (Social Communication, Emotional Regulation, and Transactional Support) gives a detailed profile across communication, regulation, and social domains [6].
If your child already has a diagnosis, your speech therapist should be running one of these assessments or something similar. If they aren't, just ask: what tool are you using to figure out where my child is communicatively, and what are we targeting because of it?
For a quick read at home, ASHA's public resources include the CSBS checklist [1]. It won't replace a formal evaluation, but it gives you language for describing what you're seeing.
What "minimally verbal" means, and what outcomes look like
"Minimally verbal" usually means a child uses fewer than 20 functional words consistently by age 5. The threshold comes from a 2013 consensus paper by Tager-Flusberg et al. in Autism Research, written to pin down the term precisely [7]. That paper estimated that 25 to 30 percent of autistic children meet this definition, a figure the AAP has since cited in its clinical guidance [3].
The definition matters partly because minimally verbal children are chronically underserved in research. Most autism communication studies recruit participants who already have some speech, so the evidence base for kids at Stages 1 and 2 is thinner than it should be.
Here's what we do know: outcomes aren't fixed. A 2013 study by Anderson et al. in the Journal of Child Psychology and Psychiatry followed 535 autistic children from ages 2 to 19 and found that a meaningful subgroup who were minimally verbal at age 4 had developed phrase speech by adolescence [8]. Early communication intervention, especially when it starts before age 5 and includes parent coaching, tends to track with better outcomes. The early intervention page on this site covers what's actually available through IDEA Part C and Part B.
Nobody can tell you with certainty what any individual child's path will look like, and any clinician who says your child will "never speak" is overstepping the evidence.
Here's the rewritten version:What intervention approaches match each stage on the chart?
The point of a chart is to tell you what to do next, so here's how that plays out stage by stage.
At Stages 1 and 2 (pre-intentional to intentional pre-symbolic), the priority is building reliable intentional communication in any form it takes. The approaches with the strongest evidence here are JASPER (Joint Attention, Symbolic Play, Engagement, and Regulation), the Early Start Denver Model (ESDM), and PECS (Picture Exchange Communication System) Phases 1 through 2. These are naturalistic developmental behavioral interventions, meaning they build communication into play and daily routines rather than drilling it. A 2021 Cochrane review found moderate-certainty evidence that these interventions improved communication outcomes compared to minimal or no treatment in young autistic children [9].
Stage 3 (emerging symbolic) is usually when core vocabulary AAC gets introduced, and aided language stimulation becomes central at this point too: the adult models the AAC device all day long, not just during therapy. Binger and Light (2007) found that this kind of aided input significantly increased children's use of multi-symbol messages. Spoken language targets should run alongside the AAC work, not wait for it.
At Stage 4 (early language), the focus moves to lengthening utterances, building verb vocabulary (verbs lag behind nouns and are often delayed), and starting social-communication pragmatics. Social stories, video modeling, and script fading all have evidence behind them at this stage.
Stage 5 (complex language) is mostly about pragmatics. Many autistic people here do fine on a language test but struggle in actual conversation, where they have to manage turn-taking, topic maintenance, inference, and sarcasm all at once. Group therapy is often the best setting for this kind of work, and autism spectrum speech therapy covers the specific approaches SLPs use across the lifespan.
Whatever stage your child is at, parent coaching isn't optional. Studies consistently show parent-implemented naturalistic intervention produces gains comparable to clinician-delivered intervention, as long as parents get proper training [9].
How is a communication chart different from a behavioral chart or a milestone chart?
The confusion here is understandable. A developmental milestone chart, like the CDC's Learn the Signs, Act Early materials, tracks whether a child hits communication milestones by a given age: babbling by 6 months, first words by 12 months, two-word phrases by 24 months [10]. It's a screening tool that flags whether something looks atypical for age, but it won't tell you what to do about it.
A behavioral chart, in the ABA sense, tracks frequency, duration, or intensity of specific behaviors. It's a data collection tool: useful, but narrow.
An autism communication chart is a different thing entirely. It describes the function and complexity of communication, independent of age. A 7-year-old and a 2-year-old can both sit at Stage 2. The chart tells you what that child can do right now, what the next step looks like, and what supports are likely to help. It's a planning tool, not a judgment.
Both are worth having. The milestone chart tells you whether something needs attention; the communication chart tells you what to do about it.
Can autistic children use picture communication charts at home?
Yes, and for many families this is the easiest starting point before a formal AAC evaluation happens. A simple home communication board can be made with printed pictures from Google Images or apps like Boardmaker, sorted into categories such as wants, feelings, places, and activities. Picture quality barely matters. What matters is consistency: keep the board in the same spot every day, point to it yourself when you talk, and say the word while pointing to the picture.
The evidence here is solid enough that ASHA includes picture communication in its practice guidelines for minimally verbal children [1]. That said, a home picture board isn't a substitute for a full AAC evaluation by an SLP, especially for a minimally verbal child. A proper evaluation figures out the right vocabulary, symbol set, and access method (touching, eye gaze, partner-assisted scanning) for that specific child.
For practice between therapy sessions, Little Words (littlewords.ai) is an app built specifically to support speech practice for neurodivergent kids at home. The quiz at littlewords.ai/start can help match a child to activities based on their communication profile.
If cost is standing between your child and a formal AAC evaluation: under IDEA, if the IEP team decides a device is required for a free appropriate public education, the school district has to provide it at no cost [11]. That's federal law.
What are the red flags that a child needs more than a chart can offer?
A chart is a map, not a therapist or a treatment plan. Seek a formal evaluation urgently, not eventually, if your child shows no babbling by 12 months, no words by 16 months, no two-word phrases by 24 months, or any regression in language at any age [10]. The AAP recommends autism-specific screening at the 18- and 24-month well-child visits using a validated tool like the M-CHAT-R/F [3].
If your child already has an autism diagnosis and hasn't made progress in communication for 6 months or more despite therapy, that's a sign to revisit the approach. Not every therapy works for every child, and switching away from one that isn't moving the needle is clinical reasoning, not failure.
For children with significant motor difficulties alongside communication challenges, ask specifically about apraxia of speech as a co-occurring condition. Some estimates put apraxia in roughly 65 percent of minimally verbal autistic children, though the data varies widely depending on how it's defined and measured. It calls for a different approach: motor-based, high repetition, reduced linguistic load, rather than typical language therapy.
And if the waiting list for your local SLP is too long, online speech therapy has grown a lot in quality and availability since 2020. Telehealth delivery of these interventions has been validated in published research.
How do schools use autism communication charts in IEPs?
An IEP under IDEA Part B has to include measurable annual goals, and for a child with autism and communication needs, those goals need to be grounded in a present level of performance that describes current communication functioning [11].
A communication chart forces specificity here, which is exactly what's needed. "Will improve communication" isn't measurable. "Will use a core vocabulary AAC device to request a preferred item in 4 out of 5 opportunities across 3 settings" is, and it maps directly onto a Stage 3 target.
Parents can bring a communication chart to an IEP meeting as a reference. It's not a legal instrument, but it gives everyone a shared way to talk about where the child is and where the goals should point. If the school's SLP disagrees with the stage you've identified, that disagreement is worth having out loud: it usually means someone learns something.
ASHA's practice portal includes guidance on documentation standards for autism communication that can help parents understand what a good evaluation should contain [1]. Knowing what to expect is its own form of advocacy.
What's the difference between communication and language, and why does it matter?
This trips up a lot of parents, and some practitioners too. Language is a rule-based symbol system: words, grammar, syntax. Communication is any act of conveying information or intention to another person, and it's the bigger category; language is one tool inside it.
For autistic children, especially at Stages 1 and 2, communication goals come before language goals. Teaching a child to request a cookie by pointing at a picture is a communication goal. Teaching them to say "cookie" is a language goal, and it's the less foundational one. A child who can reliably signal what they want, through any means, has something to build language onto later.
This matters because some families, and some therapy programs, push hard for spoken words before a child has reliable intentional communication at all. That's backwards. Get communication working first, in whatever modality the child can access. Language, if it comes, grows out of that.
Prizant's SCERTS model is built entirely on this premise: regulation and communication come before symbolic language, not after [6]. It's one of the frameworks with the strongest theoretical grounding and growing research support behind it.
Common questions parents ask
At what age should I be worried my child isn't communicating?
The AAP recommends autism screening at the 18 and 24 month well-child visits. The hard red flags are no babbling by 12 months, no words by 16 months, no two-word phrases by 24 months, and any regression at any age. If you're seeing any of these, don't wait to see what happens next: ask for an evaluation now. Kids who get referred earlier consistently do better.
Is echolalia a real form of communication or just mimicking?
It's real communication. Researchers Prizant and Rydell documented that echolalia serves functions like requesting, protesting, turn-taking, and self-regulation. It looks different from typical speech, but it carries intent. Therapists are trained to find the communicative function behind an echoed phrase and use that as a building block toward more flexible language, so writing it off as meaningless copying misses what the child is actually trying to do.
Will using AAC stop my child from learning to speak?
No, and this is one of the most common worries parents bring up. The evidence consistently says the opposite is true. A 2012 meta-analysis by Ganz and colleagues in the American Journal of Speech-Language Pathology found that AAC supports speech development in autistic children rather than suppressing it, and ASHA states plainly that there's no research evidence AAC inhibits speech. Holding off on AAC while waiting for speech to show up on its own is a documented harm, not a safe default.
What is the M-CHAT, and how does it relate to communication screening?
The M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up) is a validated screening questionnaire for children 16 to 30 months old. Several of its items are about communication: pointing, showing things to others, responding to their name. A positive screen triggers a follow-up interview and then a formal evaluation, and the AAP recommends giving it at the 18 and 24 month checkups.
What does "core vocabulary" mean in AAC for autism?
Core vocabulary is the small set of words that make up most of what we actually say day to day: words like "want," "go," "more," "stop," "that," "help." Roughly 200 words account for about 80 percent of everyday spoken language. Building an AAC system around core vocabulary gives a minimally verbal child broad communicative reach quickly, which is a real advantage over fringe vocabulary systems organized around specific topics.
How do I explain a communication chart to my child's school?
Bring a printed copy to the IEP meeting and present it as something to share, not a critique of what the school has done. Something like: "This is the framework our SLP is using to describe where my child is right now and where we're aiming, and I'd like our IEP goals to map to the same framework so we're all measuring the same things." Most school teams respond well when you're specific and treat it as teamwork.
Can autistic children who are nonspeaking learn to communicate effectively?
Yes. Nonspeaking doesn't mean non-communicating. Plenty of nonspeaking autistic adults communicate fluently through AAC, writing, or typing. What matters is finding the right access method and vocabulary system and starting early. Both ASHA's practice guidelines and AAP clinical reports support introducing AAC to nonspeaking children regardless of age, and no research supports holding communication tools back from someone who's nonspeaking.
What is SCERTS?
SCERTS stands for Social Communication, Emotional Regulation, and Transactional Support. Developed by Prizant, Wetherby, Rubin, and Laurent, it's an educational model that tracks autistic children across those three areas. It stages communication development from pre-symbolic to symbolic and ties each stage to specific intervention targets, which is why many school systems and autism centers use it as their main programming framework.
How is autism communication different from a speech delay?
A speech delay means spoken language is coming in more slowly than typical but following the same general pattern. Autism-related communication differences are more about the social and pragmatic side of things than about timing: eye contact during communication, joint attention, understanding language that isn't meant literally, and using communication to share an experience rather than just to ask for something. A child can have a speech delay, autism, both, or either one on its own.
What should a speech therapy session look like for a Stage 2 autistic child?
It should look like play, not drills. Stage 2 targets, which involve intentional pre-symbolic communication, are best worked on through joint attention routines, object exchange games, and following the child's lead during a preferred activity. The therapist should be narrating, imitating the child, and setting up communicative temptations, moments where the child has to signal to get something they want. Flashcards and tabletop repetition just don't match where a Stage 2 child is developmentally.
Does insurance cover AAC devices for autistic children?
Many state Medicaid plans and private insurers cover speech-generating devices once an SLP documents medical necessity, though requirements vary by state and plan. For children under 21, Medicaid coverage is mandated through EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) provisions. If a claim is denied, families can appeal, and school districts are also required to provide AAC if an IEP team decides it's needed for FAPE under IDEA.
Is there a free autism communication chart I can download?
ASHA's public website has communication checklists and resources, including the CSBS DP infant-toddler checklist through its practice portal at no cost. The CDC's "Learn the Signs, Act Early" milestone checklist is free on CDC.gov, and Boardmaker and PECS both publish sample materials. That said, a chart tailored to your own child through an SLP evaluation will be more accurate and more useful than any generic download.
What is the difference between PECS and AAC more broadly?
PECS (Picture Exchange Communication System) is one specific AAC approach, developed by Frost and Bondy in 1994, built around physically handing a picture card to another person. AAC is the broader category that includes PECS along with high-tech speech-generating devices, communication books, and more. PECS has good evidence behind it for building initiation and requesting early on, while high-tech AAC tends to offer more vocabulary range as a child progresses.
How often should a child's communication stage be reassessed?
Most SLPs do a formal reassessment every 6 to 12 months, but progress monitoring should be ongoing. If your child's IEP includes communication goals, data should be collected at every session and reviewed at least quarterly. And if a child has stayed at the same stage for 3 to 4 months with no movement despite consistent intervention, that's a signal to reconsider the approach rather than simply add more sessions.
Sources
- ASHA, Autism Spectrum Disorder practice portal: Communication characteristics of individuals with ASD vary considerably; assessment must account for both form and function of communication
- Prizant BM & Wetherby AM, Communication and Symbolic Behavior Scales; cited in ASHA resources: CSBS describes a continuum from pre-intentional to symbolic communication; echolalia serves real communicative functions including requesting, protesting, and turn-taking
- American Academy of Pediatrics, Identification, Evaluation, and Management of Children With Autism Spectrum Disorder (2020): Approximately 25 to 30 percent of autistic children are minimally verbal or nonspeaking at school age; AAP recommends autism-specific screening at 18 and 24 months using M-CHAT-R/F
- Ganz JB et al., American Journal of Speech-Language Pathology, 2012, meta-analysis of AAC in autism: Meta-analysis of 24 studies found positive effects of AAC for minimally verbal autistic children; AAC does not suppress speech development
- ASHA, Facilitated Communication position statement: ASHA cautions against Facilitated Communication (FC) because its validity as an independent communication method has not been established
- Prizant BM, Wetherby AM, Rubin E, Laurent AC, SCERTS Model overview, referenced in ASHA practice portal: SCERTS stages communication development from pre-symbolic to symbolic and links each stage to intervention targets; regulation and communication precede symbolic language
- Tager-Flusberg H et al., Autism Research, 2013, minimally verbal consensus paper: Minimally verbal defined as fewer than 20 functional words consistently by age 5; estimated 25 to 30 percent of autistic children meet this definition
- Anderson DK et al., Journal of Child Psychology and Psychiatry, 2007 (longitudinal follow-up published 2014), outcomes for minimally verbal autistic children: A meaningful subgroup of children who were minimally verbal at age 4 developed phrase speech by adolescence in a longitudinal study of 535 autistic children
- Tiede G & Walton K, Cochrane Database of Systematic Reviews, 2021, NDBIs for autism: Moderate-certainty evidence that naturalistic developmental behavioral interventions improved communication outcomes in young autistic children compared to minimal or no treatment; parent-implemented intervention produces comparable gains to clinician-delivered intervention
- CDC, Learn the Signs Act Early, developmental milestones: Red flags include no babbling by 12 months, no words by 16 months, no two-word phrases by 24 months, and any regression at any age
- U.S. Department of Education, IDEA Part B, IEP and FAPE requirements: Under IDEA, if an IEP team determines an AAC device is required for FAPE, the school district must provide it at no cost to the family; IEPs must include measurable annual goals
- ASHA, Augmentative and Alternative Communication practice portal: ASHA states there is no research evidence that AAC inhibits speech development; AAC evaluation should determine vocabulary, symbol set, and access method appropriate to the individual