We know that children with ASD have difficulty with gestures. If a child comes to us who doesn’t point to share attention, we have red flags waving in our heads. Children with ASD are delayed in their use of gestures, use them less frequently, and have a smaller repertoire. We also know that in typically developing children, gestures come before speech and predict later language abilities. Little research, however, has actually delved into what gesture development looks like in toddlers with ASD and how it relates to their overall language development. Does their gesture development follow a predictable sequence, and does that sequence match that of their TD peers? How are gestures and verbal language linked for toddlers with ASD?
These researchers examined the gesture development of 42 toddlers with ASD and found:
Toddlers with ASD’s gesture and language development followed a predictable path that mirrors typically developing peers. This path differed in one interesting and important way, though: typically developing children use pointing as a pre-verbal means of communication, but for many toddlers with ASD, pointing emerged after they began to use words.
For toddlers with ASD, as well as their TD peers, combining gestures with single words precedes and predicts when they will begin to use word combinations.
So what does this mean for us?
First, a point of caution: this study looked at the development of gesture use in toddlers with ASD, but this study design can’t tell us what causes what. Simply because combining words and gestures comes before phrase speech does not necessarily mean that teaching a child to combine words and gestures will result in a child using phrase speech. In order to make that claim, we will need a randomized controlled trial of an intervention that attempts to teach toddlers with ASD phrase speech through targeting gesture and word combinations.
Nonetheless, these findings lend some support to intervention approaches that follow typical development. If a child is not yet using words, targeting early gesture use may support intentional communication and first words. If a child is speaking but not combining his words and gestures together, targeting combining words and gestures may support the development of phrase speech.
Talbott, M. R., Young, G. S., Munson, J., Estes, A., Vismara, L. A., & Rogers, S. J. (2018). The Developmental Sequence and Relations Between Gesture and Spoken Language in Toddlers With Autism Spectrum Disorder. Child Development. Advance online publication. doi: 10.1111/cdev.13203.