Speech Delay and Autism

 

Dr kondekar

Listening to Speech is 18 months journey, Speech develops only by verbal listening. it doesn't develop by oral motor exercises if listening or understanding or receptive speech is poor. so first focus on listening and learning speech input before you work on output. 90% of your daily time with kid should be spent of language based listening in form of story composition and conversations to start spontaneus speech or relevant speech. Speech is not about reading ro talking, it's more about having depth of verbal understanding. working on only that will help. Dr Kondekar 

https://speechandsenses.blogspot.com/2026/01/speech-develops-only-by-listening-it.html?m

http://pedneuro.weebly.com/ for downloading resources pdf files videos talks and general information related to autism

http://autismdrmumbai.com  For clinic address

http://autismdr.weebly.com for basic protocol 

https://pedneuromumbai.blogspot.com/2020/05/pediatric-learning-disability-autism.html?m=1 for appointment procedure

Preferably watch these 3 short videos before appointment  

https://youtu.be/FVr4f6Tetsw

https://youtu.be/b7Lkwr5HtHk

https://youtu.be/VIJMz9KMP9Y

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Speech is a form of expression that is not just a function or mouth and lips or vocal apparatus. 

Apart from above following are more common causes 

A child who cannot hear.. deafness 

A child who can hear but cannot listen, attention deficit 

A child who gives attention but cannot understand, cognition deficit 

A child who can understand but cannot express, apraxia/aphasia 

Apraxia of speech: non verbal Communication deficit 

Aphasia of speech: verbal communication deficit 

Often if the child has behaviour issues in addition, there is also likely hood or poor understanding and possibility of autism. 

Speech delay lasting more than three months is itself a form of disability 

Other speech issues are speech paucity, echolalia, only need based speech, poor vocabulary issues related to sentence formation, issues of syntax and grammer and speech with poor composition and poor comprehension 

Remember unless child hears, listens, understands...child cannot express Initial expression is by eye contact, facial or body language or pointing 

And then only expressing in words Understanding to expression journey is two years with normal brain, needs active inputs of wide vocabulary through stories, essays and compositions. 

Teaching by music, videos, questions and physical activity doesn't help in improving cognition and vocabulary. 

Teaching by asking is like taking exam before the topic is understood. 

For more speech related tips by Dr Kondekar visit Facebook page 

http://facebook.com/speechandsenses

 Each one will have a different way of approach.

Speech delays are very common among children with autism, but they are also common in children without autism. In autism often hearing is normal, but the child doesnt seem to listen.

Speech delay can often be associated with hearing deficit. Hearing deficit can be commonly due to ear infections like ASOM, CSOM, Otitis Externa, Ear wax, damage to auditory labyrinth or cortex of brain following meningitis or antibiotic use and rarely due to congenital otosclerosis,congenital absence of any crucial part of hearing apparatus. 

Speech delays can also be due to speech understanding, processing, formation and expression of speech. Various disorders of speech expression like cortical dysphasia/ aphasia and speech articulation like dysarthria and also various disorders of brain and disorders of speech apparatus manifesting as specific speech types like scanning speech, stacacto speech, explosive speech, slurred speech are also responsible for speech delay.

Communication is a two way reciprocation of interpersonal relationship. It can be non verbal or body language or expressional and verbal that is with use of language of words/ sounds/voices. 

Communication involves understanding and processing of actions/ words i.e. receptive communication and expressing by actions of various types that is expressive communication.In social and communication disorders both these may be affected.

In autism, often the socialization and social communication is primarily affected but in addition to this autism has other key features which are absent in social communication disorder.

Whatever may be the reason for speech delay; following is the course of evaluation and management for speech delay.

1. Confirm hearing is not affected: It can be confirmed by a BERA test. Although clinically many people will be able to tell hearing is affected or not; the tests will help understand severity and level of hearing affection, whether in ear: outer ear canal or middle ear; or inner year or cochlea or nervous system. Test can at times be false; and may need repeat.

2.If hearing is affected; ear examination; ear cleaning and treatment of ear infection may be needed in cases of ear wax, otitis and adenoiditis. significantly affected /damaged ears with speech delay may need hearing aids. If the hearing is affected at cochlea or at Central nervous system the child may be considered for cochlear implant or devices like hearing aid.

3. Those cases who have no major hearing deficit; and good receptive speech and understanding of speech and have difficulty in talking; these kids will need to be started with speech therapy earliest for modulations of speech apparatus.

4. Children who hear but may not listen; children who may not understand or follow speech or have central speech affection or have difficulty having age appropriate eye contact and response to commands are often likely to be autism; in which only speech therapy may get a very slow or delayed response; unless the prime symptoms of autism are tackled with medicines and occupational therapy.

At our center, most kids establish eye contact and response to commands in 1-3 months

whatsapp 91- 9869405747 for further details. 

Common Genetic Syndromes of AutIsm:

1. Fragile x syndrome FMR1

2. Tuberous sclerosis TSC1 TSC2 

3. Rett syndrome MECP2

4. Prader willi syndrome  deletion of paternal allel at 15q11-q13

5. Angelman Syndrome del/mut in maternal UBE3A

6. WilliamsBeuren Syndro,e 7q11.23 del

7. Smith Magenis syndrome 17 p11.2 del

8. velocardiofacial/ Digeorge syndrome  22q11.2 del

9. PhelanMcDermid Syndrome 22q13.3 del

10. Untreated PKU PAH

for all post links click https://speechandsenses.blogspot.com/p/httpsspeechandsenses.html

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🧠 “मेरा बच्चा उम्र के हिसाब से बोल नहीं रहा… क्या करें?”

👉 सबसे पहले एक बात समझ लो:
Speech delay एक लक्षण है, बीमारी नहीं।

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⚠️ Step 1: घबराना नहीं… पर IGNORE भी नहीं करना

हर late बोलने वाला बच्चा autism नहीं होता
👉 लेकिन हर autism वाले बच्चे में speech delay हो सकता है

👉 इसलिए wait करना सबसे बड़ी गलती है

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🧠 Step 2: फर्क समझो (Dr Kondekar Rule)

🟢 सिर्फ Speech Delay

✔️ बच्चा समझता है
✔️ इशारों से बात करता है
✔️ eye contact करता है
✔️ लोगों में interest है

👉 ये “late talker” हो सकता है

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🔴 Red Flag (Autism का शक)

❌ नाम लेने पर response नहीं
❌ eye contact कम
❌ pointing / दिखाना नहीं
❌ अपनी ही दुनिया में रहता है
❌ बार-बार same activity

👉 ये सिर्फ speech नहीं, communication problem है

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🎯 Step 3: सबसे बड़ी गलती क्या होती है?

❌ “थोड़ा wait करते हैं”
❌ “लड़का है, देर से बोलेगा”
❌ “mobile से सीख जाएगा”

👉 ये सब speech को और delay करते हैं

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🔥 Dr Kondekar Core Concept

👉 “Speech नहीं आ रही… क्योंकि बच्चा LISTEN करना नहीं सीख रहा”

📌 98% learning eyes + ears से होती है
📌 अगर बच्चा connect नहीं कर रहा → बोल नहीं पाएगा

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🧩 Step 4: घर पर क्या शुरू करें?

🎯 1. Listener बनाओ (सबसे important)

• face to face बात करो
• eye contact force मत करो, attract करो
• नाम पुकारो → response लो

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🎯 2. Mobile बंद = Speech चालू

📵 screen = passive brain
👶 interaction = active speech

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🎯 3. छोटे शब्द सिखाओ

• “मम्मा”
• “पानी”
• “दे”

👉 छोटे, clear, बार-बार

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🎯 4. Imitation खेल

• clap करो 👏
• sound copy करवाओ
• action repeat

👉 imitation से speech शुरू होती है

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🎯 5. Demand create करो

❌ सब तुरंत मत दो
✔️ wait करो → बच्चा बोले / इशारा करे

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🚨 Step 5: कब डॉक्टर को दिखाएँ?

👉 तुरंत consult करें अगर:

• 1.5 साल तक शब्द नहीं
• 2 साल तक 2 शब्द नहीं
• eye contact weak
• नाम पर response नहीं

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💡 Golden Line (Dr Kondekar Style)

👉 “Speech सिखानी नहीं पड़ती…
👉 Speech निकलती है connection से”

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📌 Final Take Home

✔️ speech delay को ignore मत करो
✔️ autism का शक हो तो evaluate करो
✔️ जल्दी intervention = बेहतर result
✔️ parents = sabse badi therapy hai parents ki communication  bachche ke sath, trust your experts 

Dr Santosh V Kondekar
Autism doctor India 9869405747
MD DNB DCH FCPS DNB FAIMER
fellowship Pediatric neurology & Epilepsy
Diploma Developmental Neurology
Prof Pediatrics T N Medical College Mumbai 
Director AAKAAR CLINIC Byculla west Mumbai