What is considered a speech delay?

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I know some say that you have the dx of AS if there was no speech delay. So first, what is considered speech delay when talking about AS? Does it mean no language for years? Or does it mean trouble with articulation and the use of pronouns and complete sentences at a certain age?

My son was not dx'd with a speech delay. He only had a few words at two (like 5, but he could copy up to 20, but not use them in a meaningful way). At 3, he finally started to put two words together. His articulation was good, using pronouns correctly, when full sentences came, he used them correctly.

My daughter, dx'd with speech delay, had a lot more words than he did. Put two words together a year before he did. She was right about where her peers where (as far as how many words, putting sentences together, etc), but she was hard to understand. Even now, at age 5, she eliminates small words from her sentences, articulation is off and pronouns are misused.

My son was not dx'd with AS, although they do think he does have AS. He was dx'd with ASD. So, do they think he has AS because they consider him as not having a speech delay? He was way behind kids his age, but was that still in the normal range? I would have thought he had the delay.

I guess too, what i am asking is are there two different types of speech delays. One that uses language later than his peers and then a delay where articulation is bad, pronouns misused and small words eliminated from sentences. Or is one of these a language delay? I am confused.

I'm not sure myself but that's a VERY good question!! ! Looking at my own history I spoke at a later age (not sure when) and had issues with r and some words and did speech classes throughout Elementary school which was Kindergarden-5th grade.

"Single words are used by age 2 years, communicative phrases are used by age 3 years."

"Speech delay" is such a fuzzy term. I'm going to act like the SLP-in-training that I am and try to help you out here, but I am just a student, so I may be wrong.

There are five areas of language: phonology, morphology, syntax, semantics and pragmatics.

Phonology basically refers to sound. It's the sounds we use to make up words. This is true "speech", as in a child who cannot say certain sounds due to any number of factors, or a child who uses the wrong sound. This severely affects intelligibility. It sounds that your daughter's problems with articulation fall in here.

Morphology refers to being able to change words (hence the "morph"), say to illustrate the difference between "cat" and "cats"-- a plural marker is one kind of morpheme. So are pronouns. Search "Brown's 14 Grammatical Morphemes" for more information. It also seems as though your daughter would fall in here.

Syntax refers to grammar. It's the vocabulary a person has, and if they put those words together correctly. "Sock blue is" would be an example of poor syntax (sorry, Yoda). Your son's limited vocabulary (by number of words) would fall in here, but his correct usage of those words give him still some good syntax. Your daughter's tendancy to leave out "little words" would fall in here as well.

Semantics refers to meaning-- how we put words together in a way that as meaning to us. A two-year-old saying "Mommy sock" could have multiple meanings ("Mommy's sock", "look, Mommy- a sock", "Mommy I want the sock", etc).

Pragmatics refers to something that many of us on this forum struggle with-- the social use of language. I am not going to approach this with a 10-foot pole. Does that actually mean I will not touch the actual topic of pragmatics with a literal pole? No. Semantically it may look like that (and when I say that phrase, that is what I see), but pragmatically it means that I do not want to approach pragmatics at all, though I just sort of did.

When looking at small children with speech/language impairments, there are a lot of things that clinicians keep in mind. Intelligibility is a big one. Phonological errors (for whatever reason) seriously impact intelligibility. So do morphological errors, and (to a lesser extent, in my opinion) syntactical errors. A small vocabulary is worrisome, but if the child can effectively communicate with that small vocabulary, it's less of a worry than a child who has a disordered sound system or who lacks "little words" (think of how many "little words" we use to convey what we mean).

Your son's more effective use of the language he has is probably why they are thinking he is AS. Though it may be delayed, it sounds like it is following the right course, and it sounds like he uses it well. Boys, as a whole, are also more likely to use less language than girls, as well. And one of the hallmarks of AS is that we do tend to use the language we have well, except pragmatically, where it can break down. But I can write you this post and have it make sense to more than just me. Yes, this is because it is related to something pretty concrete that I have knowledge of, but I am able to express my points in a relatively clear manner. I assume your son is able to communicate (verbally) in a similar fashion. He makes sense to those around him.

This is just my opinion. I hope it helps a little bit.

The speech delay, nicely described by Laney2005, is a controversial part of the AS diagnosis. It's included in the DSM-IV (TR) criteria, but not in the criteria used in other countries. It's also a point of contention amongst clinicians and researchers. How much speech delay? What kind of delay? Are there mitigating circumstances?

This confused my diagnosis, since I did not start speaking until age 4+, then developed severe ear infections that left me with punctured eardrums until age 6. So though I started speaking around age 4+, I wasn't able to interact much until my ear infections resolved, and then my social delays and difficulties became more apparent. In other words, ENT issues clouded the AS issues.

My neurologists and psychiatrists are all skeptical of the significance of speech delay in AS diagnosis. But they are, in general, skeptical of the DSM itself, and prefer other diagnostic criteria. So I was diagnosed with AS (or HFA, take your pick, since my neurologists regard the conditions as essentially identical). I'm waiting to talk to a psychiatrist I know about this, as well as the latest info he has on the revisions forthcoming in the DSM-V, to see what the latest thinking in the psychiatric community is.

I only spoke 4 words (no, mama, dada, sis) until I was 3, then suddenly started speaking in complete sentences

Thanks for the explaination, Laney. Language phonology, language morphology and articulation are her qualifying criteria on her IEP. So, because my son could use his language, even though a little later than others his age, he does not have a speech delay. I always figured he did since he talked a bit later. The drs weren't concerned at all. When he started with the 2 word sentences, that is when his speech really took off. I guess he just wasn't ready to put his thoughts to real words and wanted to do it on his own terms? He also is not the "little professor" that people describe as kids with AS. He does talk about things that kids normally don't, but he does not have a grownup vocabulary (then again, neither do i lol!) So, my daughter has the real speech delay. Got it!

Looks like everyone has their own definition of speech delay. I met a aspie mother at the Autism Speaks walk and she has a son with HFA. He didn't start talking until he was five and the doctor said talking before that is on time but after age five, it's a speech delay. Okay so to him, I would have met the aspie criteria because I was four when I started talking my mom says.
I was also using single words at age two and single sentences like "all done" but I was still considered speech delayed.

Isn't that just an example? That's what "eg." means. Some aspie kids are early talkers.

Yeah, it does mean "for example". A clinically significant speech delay can be other things as well, such as the use of scripts and functional echolalia (even though these words and phrases appear before age two or three, they don't allow the flexible use of self-generated speech that most young children grasp by that age).

I spoke very little until the age of four and needed speech therapy.

Quite simply, a delay in the development of speech (expressive and receptive) compared to age matched peers (an impairment outside of the normal range where people fall); it can range from mild to profound, with the delay improving slowly, fast, or not at all (plus various other iterations).

The full text from the DSM:

Yes and no to that DSM stuff. People with AS often show problems with prosody (intonation and such) and pragmatics. Prosody is suprasegmental (it is effectively superimposed on speech) and though it does convey meaning, problems with prosody do not preclude a diagnosis of AS. Same for pragmatics. As a matter of fact, those can be hallmark signs of AS. Therefore they do not qualify as speech delays. Those impairments listed better fit Kanner's "classic" autism and not AS.

Sorry if I sound pedantic, it's just that speech, language and communication are all very different (though related) entities.

I would consider myself to have had mild-moderate speech delay. Up until the age of 5/6 I could only say a few words at a time and it was very simplistic and not in proper sentences, for example if I was 3, "can I have a glass of milk?" would be "can have milk" or something similar. When I was little if I saw my dad's reflection in the mirror my speech wasn't developed enough to describe what I saw and I used to say "man in the mirror" and my nana thought I was seeing ghosts.
The only time I truly spoke was when repeating things, for example dialogue from "Bambi" or my other favourite which was the theme tune to the old TV programs "goodnight sweet heart" and "heartbeat". What I repeated didn't make sense in the situation often but I didn't care. In playgroup when the children were talking in sentences about things I'd be just repeating "good night sweet heart, I'll see you in the morning!" my mum saw it as a sign of intelligence and would get me to sing another song or quote bambi again.
I was diagnosed with AS but if I used the DSM which I didn't there might have been a chance I would have been HFA because of the speech delay and also other delays like self help, but I didn't use the DSM.

I agree with callista, but normal children can be diagnosed no speech delay and still have no words at 2. My brother didn't say a word until 2ish, idk exact month number but it was after 2 years old, no words at all, then instantly starting speaking in small sentences. He wasnt affected at all by speech delay as he got older. Now i had no words, nothing until 3ish then i started babbling, i had speech delay and then to this day im still considered speech delay cuz i dont speak in full sentences most of the time its one or two words(lately though being doing great verbally hoping this lasts haha). If the child at lets say 5 isnt speaking conversational yet, thats speech delay, i think you should be somewhat fully conversational by 3, if not its usually speech delay, if u say a single word by 2 or before 2, and still are not speaking conversational or in real appropriate sentences by 5, i think you'd be diagnosed with pddnos, becaise it would be pragmatic speech delay meaning, it didnt start out speech delayed however it never caught up to the age appropriately, so now ur consdered speech delayed. So for instance, i know a girl with pddnos started speaking 13months one words and babbling, at 3 she could say 2 word sentence, at 4, she spoke in echolalia, and only at the most 3 word sentences, but could name everything and list everything. at 5, she finally could form full sentences but messed up every subject and noun, like me go out, or him go walk, and then she stuttered and mixed up how she said things. Thats all considered speech delay because its not rendering the msg faithfully and understandably and is developmentally behind. I think i completely confused myself, idk if i did to anybody else, but basically trying to say, ppl can start speaking even one worders at like 1 and still be considered speech delayed because how still developmentally delayed in speech as they get older. Its so hard to explain. I guess in a way im still speech delayed because i cant always get my words out also.

Thanks, everyone, for your input. Much better than googling it, as i have done before and came up with nothing, really, that i could make sense of. Still sketchy, it seems, but i am getting it.

My son has several speech/language issues, but he was never dx'd as having a delay. He talks in monotone (not much anymore), talks with numbers (always throwing numbers or percents in his everyday speech). Some other stuff too i can't think of. He receives speech therapy at school, also for a lisp i didn't even know was there til they told me they decided to add it to the IEP the 2nd year around.

With my daughter, she is progressing. She's been in speech for a year now. The only thing that is taking forever is the correct use of pronouns. We are always correcting her, having her say it again (only if she is in a happy mood, otherwise she will refuse and act out). It is so slow. Been a year and not once has she said one correctly.