When communication needs are not met
When autistic people struggle to have their communication needs understood or supported, this can affect many areas of their lives. They may be misjudged or treated unfairly. For example, someone might be seen as rude, awkward, or uninterested when they are feeling overwhelmed, anxious, or misunderstood.
This can lead to experiences such as:
- Being teased, bullied, or left out
- Difficulty making or keeping friendships
- Feeling extremely tired after social interaction
- Anxiety before, during, or after social situations
- Feeling embarrassed, frustrated, or blamed
- Low self‑esteem and feeling “not good enough”
- Feeling lonely or isolated
These experiences can make things harder in education, at work, and in the wider community. Over time, they can increase the risk of mental health difficulties such as anxiety or depression.
Many autistic people develop masking as a way to cope. Masking means hiding autistic differences and trying to act more like non‑autistic people in order to fit in. For example, someone might force eye contact, copy other people’s behaviour, or push themselves to speak when it feels extremely hard. While masking can help in the short term, it often leads to exhaustion, stress, burnout, and autistic needs being missed or ignored.
How autistic communication needs can be met
Many everyday environments – such as schools, workplaces, healthcare settings, and social spaces – are not designed with autistic communication needs in mind. The good news is that small changes can make a big difference.
Helpful adjustments include:
- Making the environment more comfortable (for example, reducing noise or bright lighting)
- Accepting the person’s preferred way of communicating (for example typing, using AAC, or having their camera off in video calls)
- Saying exactly what you mean, using clear and direct language
- Avoiding sarcasm and idioms, or explaining them
- Not giving too much information at once
- Breaking instructions into small, clear steps
- Summarising key points
- Checking what the person has understood, without putting them under pressure
- Offering written information, pictures, or visual supports
- Allowing extra thinking and processing time
- Showing patience and respect for the person’s preferences
It is also important to:
- Accept all forms of communication as valid, not just speech
- Remember that behaviour is a form of communication (for example withdrawing, becoming distressed, or shutting down may be a sign that something is too much)
Some people find it helpful to use a communication passport. (Alice from SAT will send a link or pdf to include here). This is a simple document that explains how someone communicates, what helps, what doesn’t help, and how others can support them. Planning and practising for situations like appointments, phone calls, or meetings can also reduce stress.
Autistic communication is different, not wrong
It is important to always remember:
- Every autistic person has a unique mix of communication strengths, differences, and needs
- What works well for one person may not work for another
- Communication abilities can change depending on tiredness, stress, health, or sensory overload
If communication breaks down, this should not be seen as the autistic person’s fault. Communication is shared, and responsibility lies with everyone involved.
Adapting communication helps autistic people to:
- Have equal opportunities
- Build positive relationships with family and friends
- Take part more fully with family and friends and in education, work, and community life
Therapy and other support
Some autistic people may have therapy or other support to help with communication and everyday life. This support should be based on what the person wants and needs. There are different ways people might access support. Some people may be able to get support through NHS services if they meet certain criteria for that service. This is not automatic just because someone is autistic, as NHS support is often limited. Some children and young people may get support through education, or through funding such as an Education, Health and Care Plan (EHCP). In all cases, the autistic person should be listened to and involved in decisions about support, no matter their age.
Professionals offering support should:
- Have a good understanding of autism
- Take time to get to know the individual
- Focus on strengths as well as differences
- Respect what the person wants and does not want
Support may include:
- Reasonable adjustments. These are changes that help people access services. Without these changes, some people may find it hard or not possible to use education, healthcare, work or leisure services. People can ask for reasonable adjustments when they need them. Some people may need support to ask, or may want to practise what to say. It can also help to ask for adjustments in writing, or to use a communication passport to explain needs. For example, someone might ask to book a GP appointment by email instead of by phone.
For more information about reasonable adjustments in health care, click the following link:
Preparing for health care appointments and hospital stays – information for autistic people
- Support with anxiety and self‑advocacy. This may include learning strategies such as breathing or mindfulness, reflecting on situations that felt easier and why, practising self‑advocacy through role play, or making prompt notes for phone calls or meetings.
- AAC (Augmentative and Alternative Communication). This can include symbols, apps, communication devices, typing, writing, or drawing, and may support people who do not use speech or whose speech is limited or variable.
- Speech and language therapy. A neuroaffirmative speech and language therapist supports communication in ways that respect autism as a natural difference. They follow the person’s lead, support all forms of communication, and take sensory needs into account. They do not try to stop autistic behaviours such as stimming or avoiding eye contact, and they do not train the person to communicate or behave more neurotypically.
- Play‑based approaches to help families, carers, or teachers understand an autistic child’s communication style. These approaches usually follow the autistic child’s lead and support joint attention, such as sharing focus on an activity or object together.
- Intensive Interaction. This is a way of building connection by slowing down, watching carefully, and responding to the person’s sounds, actions, or movements in a warm and respectful way. It focuses on shared attention, enjoyment, and understanding, rather than on teaching specific skills or using spoken language. Intensive Interaction can be used with autistic people who cannot speak or communicate in another way – such as with signing, writing or AAC.
What autistic people might find helpful to try
Some autistic people find it helpful to use strategies to protect their energy and support communication. These might include:
- Finding out what to expect before social situations and practising if helpful
- Getting support from a trusted friend or family member before, during, or after events
- Choosing which social events to attend – and feeling okay about saying no
- Planning quiet time before or after social situations to prepare or recover
- Having a plan for what to do if things become overwhelming
- Socialising online, where communication may feel easier
- Connecting with people who share similar interests or with other autistic people
What matters most is that autistic people are supported to communicate in ways that feel safe, respectful, and true to who they are.
Key points
- When communication needs are not met, autistic people can be misunderstood, excluded, or harmed
- Masking may help short‑term, but often has serious long‑term costs
- Small, practical changes can make communication easier, fairer, less stressful and less tiring
- Responsibility for good communication is shared
- Autistic communication is different, not wrong
Resources
For a list of resources to support autistic people with communication, click the following link:
https://www.leicspart.nhs.uk/autism-space/general-resources/other-resources/
References
National Autistic Society – click this link for more information:
www.autism.org.uk/advice-and-guidance/about-autism/autism-and-communication
Royal College of Speech and Language Therapists – for more information, click the following links:
www.rcslt.org/members/clinical-guidance/autism/autism-guidance/
