Does being unable to talk at all mean the inability to think out actual words inside one’s head?
Can nonverbal autistics who clearly understand many things that go on around them and who follow instructions have the ability to “talk inside their heads”?
Have you ever met or interacted with an autistic adult or teen for whom speech is completely absent?
Have you wondered how an adult can’t even say “Hi” or their one-syllable name?
Well, that’s a whole nother article, but the topic here is how very fascinating it is to wonder if nonverbal autistic individuals can sound out words in their mind.
At first, you might think, “Well, why don’t we ask one? They can nod their head for yes or shake their head for no.”
The problem with that is some won’t respond to this question.
And if they do with a head shake or nod, you may not know if it’s an accurate response. More on that shortly.
Understanding What “Nonverbal” Actually Means
The term nonverbal autism describes people who use little or no spoken (expressive) language.
However, receptive language (comprehension of speech) can be far greater than that of expressive.
If a nonspeaking autistic woman can independently remove her clothes, put on a bathing suit, then after being in the water, can remove it, efficiently dry herself with a towel and put her clothes back on, follow many instructions, and get uptight when people nearby are talking about her — it might seem logical that certainly, she can say words inside her head.
She’s an example of how some nonverbal autistics understand spoken language well.
Sometimes, they can learn how to use an AAC (augmentative and alternative communication) device, knowing how to navigate it to express wants and even feelings by tapping screen icons that make the device talk in its computer voice.
Others have very limited language comprehension, as evidenced in their inability to follow anything more than a handful of simple directives.
Because of this variation, the ability to sound out words internally would not be uniform across all nonverbal autistic people.
What is internal speech?
Well, the definition seems obvious. It’s literally the voice inside our heads.
This is most evident when we “read to ourselves.”
It also frequently occurs when we replay words that someone spoke, either because we enjoyed them, were angered by them or need the replay for clarification.
Then there’s rehearsing. Many autistics with full spoken language will often rehearse conversations they’re planning on having, or play back past conversations, sometimes responding with their inner voice in a way that they wished they’d had for real.
Psychologist Lev Vygotsky proposed that internal speech develops from external speech during childhood, gradually becoming internalized.
Later research has supported the idea that inner speech relies on similar brain networks as does spoken language.
But internal speech is not the only way we think.
Internal Language Without Spoken Words
A landmark study by Kjelgaard and Tager-Flusberg (Journal of Autism and Developmental Disorders, 2001) showed that some autistic kids with severe expressive language impairment still demonstrated far better receptive language abilities than what would be expected for their expressive limitations.
For example, the comprehension level of kids with little to no functional speech was verified with nonverbal responses to directives such as pointing, selecting correct items and following commands.
So if a nonverbal autistic person understands language, they may also be able to manipulate language internally, including sounding out words.
However, if language comprehension itself is limited, internal sounding-out may not occur in the same way, or at all.
Evidence from Literacy Studies
Studies of literacy in nonverbal or minimally verbal autistic individuals provide some of the clearest evidence that internal word processing can occur without speech.
A study (Erickson et al, Research and Practice for Persons with Severe Disabilities, 2007), found that some nonverbal individuals demonstrated decoding skills, including phonological awareness, despite not using spoken language.
For example, participants might be asked to identify which written word matched a spoken prompt or to select letters associated with specific sounds.
In some cases, participants were able to spell words accurately or select correct written answers, even though they could not say the words aloud.
Brain Imaging and Silent Language Processing
Neuroimaging studies help explain how this is possible.
Research by Martin and colleagues (Brain and Language, 2013) showed that silent reading activates many of the same language regions as spoken speech, including frontal and temporal language areas.
However, motor speech regions are not always engaged to the same degree.
In autism, studies have shown that language networks can be organized differently.
A study by Kana et al (NeuroImage, 2006) found that autistic people often show reduced connectivity between language regions — but preserved activation in some areas during language tasks.
This means that a nonverbal autistic person might activate language networks internally without producing speech externally.
Why not just ask a nonverbal autistic, “Can you say words in your head?”
There’ve been no studies on how well this works. However, remember the woman I described at the beginning who had good receptive language but couldn’t talk?
She’s real. I’ve worked with “Payzley” as a community connector.
One day I asked if she’d like to see puppies. She quickly nodded, smiling.
At the puppy store, she wanted nothing to do with the puppies and was clearly uncomfortable.
I later learned she has a fear of dogs.
Payzley had nodded when she should’ve shaken her head.
If a nonverbal autistic nods upon being asked if they ever sound out words in their head — well, we still wouldn’t know for sure.
In a Nutshell
Whether a nonverbal autistic individual can sound out words internally depends on several factors.
These include early language exposure, receptive language ability, literacy instruction, sensory processing differences and how their brain organizes language networks.
