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Autism and social communication

  • Behaviour, emotions and mental health
  • Child development and growing up
  • Speech, language and communication
Young boy and teacher playing with a sand pit

Children with social communication difficulties struggle to understand the meaning behind spoken and nonverbal communication, such as body language, facial expressions, and tone of voice. They may also have trouble with concepts like eye contact and understanding others' thoughts and feelings.

Throughout this website the terms autism, autistic spectrum disorders and the abbreviation ASD are used to cover the whole range of developmental presentations and terms, which include Kanner’s autism, autistic spectrum conditions (ASC) and Asperger's syndrome.

What are social communication difficulties

Children with social communication difficulties have problems understanding what other people mean. Communication is not just the words we use; but how we use our body language, facial expression and tone of voice to communicate with someone else. Children with social communication difficulties may find it hard to understand the messages we give to each other without speaking. This includes the meaning we put into our voice, the expressions on our faces, and gestures such as waving, pointing or shrugging.

Eye contact is another important part of non-verbal communication. Most of us do this without thinking about it. Children with social communication difficulties may not know instinctively how and when to give eye contact.

They may also find it hard to understand what other people are thinking or feeling. This means they can find it difficult to see things from someone else’s point of view. They may do things which seem out of place, such as:

  • talking in a very loud voice to a person standing next to them
  • talking intensely at length about things that interest them to someone they have never met before
  • finding it challenging to take turns 

This can often make it hard to make or keep friends and join in games.

Differences between social communication difficulties and autism

Social communication difficulties are a core characteristic of autism. These difficulties can lead to developmental differences in the following areas:

  • development of and the use of communication and language
  • social and emotional understanding
  • flexibility of thought, behaviour and play
  • sensory differences

Children have individual strengths and difficulties and the way in which these are presented can vary widely. For a diagnosis of autism spectrum disorder (ASD) it is necessary to have significant difficulties in most or all of these areas. Some children may have some difficulties in one or more of these areas, but not all of them, and so don’t have a full diagnosis of autism. However, understanding your child's difficulties can still be helpful. 

Some children can be diagnosed with an ASD when they are young. In some cases this may be from the age of about 2 years old. But, not everyone is diagnosed early in life. It is common for older children and adults to be diagnosed with an ASD, particularly those children who have fewer problems with speaking and learning. 

What to do if you think your child might have autism

To begin with, if you have worries about your child’s development speak to your health visitor, nursery worker, family worker, school teacher or SENCO about your concerns. If they share your concerns they will be able to plan the next steps with you. You can also take a look at our online learning.

Autism and social communication difficulties online learning

How we can help

Following a referral by a health visitor, nursery or school, community paediatrics assesses children who have developmental conditions including social communication difficulties and autism.

All referrals are considered carefully by senior clinicians. We aim to gather information about your child from all the places that they spend time at and are cared for. This is vital to get a rounded picture of them. 

If your child has recently been assessed and you have learnt that they have social communication difficulties or autism, we have lots of information and guidance to help. 

After assessment for autism spectrum disorder

Last reviewed: 1 November, 2023


Who can help

If you have any questions or concerns about your child's autism and social communication, a health professional in our team will be able to offer advice and support. You can call us on 0300 029 50 50.

Open Monday to Friday 8:30am to 4:30pm (excluding bank holidays).

In this section some information has been adapted from existing online content with the kind permission and support of Autism Wales.

Autism is a spectrum condition and affects people in different ways. Like everyone, people with autism have their own strengths and challenges. The information on this website will be continuously reviewed and developed with families to ensure it meets their needs.

Have your say

Please tell us about your recent experience with any of our services by answering a few simple questions. We want to hear about what you felt went well and what you think we could do differently. 

Your voice makes a difference and helps us improve our services for you and other families.

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