Speech delay or autism? A parent’s guide to next steps

By NeuroVillage · Updated 26 October 2026 · General information for parents and carers

When your child is not talking as you expected, it can be hard to know which question to ask first. Speech delay alone cannot tell you whether a child is autistic. An online score cannot settle that question either.

Start with support, rather than a score. Speak to your GP or health visitor about your concerns. Bring examples of how your child communicates, understands and plays in everyday situations.

Look at the whole communication picture

Autism assessment considers development and behaviour more widely than speech alone. A child may use few spoken words, speak fluently, or communicate in other ways. NICE advises against ruling out autism simply because a child smiles, makes eye contact or reached language milestones as expected. There can also be other explanations for communication differences.

Read the NHS information on signs of autism in children for an overview. Recognising a trait is a reason to discuss a concern, not proof of a diagnosis.

Ask about speech and language support

A speech and language therapist can assess communication needs and work with a child, their family and other professionals. Ask your GP, health visitor or local children’s therapy service how referrals work in your area. Ask about hearing concerns too.

The Royal College of Speech and Language Therapists explains what therapy involves. If considering an independent therapist, check their registration with the HCPC, the UK regulator; RCSLT membership is not the same as regulatory registration.

If your child has lost language, social or movement skills they previously used, tell a healthcare professional promptly. NICE recommends assessment pathways for developmental regression; do not rely on an online questionnaire to explain it.

A simple note to take to an appointment

You do not need to test your child at home. A few ordinary examples can help explain what you mean:

  • What your child does to ask for something, share an interest or say no.
  • What they seem to understand, including familiar routines and instructions.
  • When communication feels easier or harder, and what support helps.
  • Any change in skills, hearing concerns or observations from nursery or school.
  • Your main question: “What support can we begin, and what assessment would you recommend?”

What about autism questionnaires?

Established screening tools have specific age ranges and instructions. They do not diagnose autism or replace a professional assessment. Our autism screening questionnaire guide explains where to find official tools and how to prepare for a discussion.

For everyday education support, see how to ask nursery or school for SEND support. Families in England can also read about NHS Right to Choose autism assessments.

Sources and further reading

Compiled by NeuroVillage using the sources above. This is general information, not a clinical assessment or individual medical advice. We do not provide an autism likelihood score.