Examples of low- and high-tech AAC displays. Credit: Current Psychiatry Reports (2025). DOI: 10.1007/s11920-025-01616-6

Communication is vital to expressing and getting what we want and need, bonding with other people and navigating the world in which we live. But, by definition, autistic people often deal with difficulties communicating, which impacts their quality of life. To better understand the communication difficulties experienced by autistic adults and help the clinicians and researchers who have autistic people in their lives, researchers from Drexel University's A.J. Drexel Autism Institute reviewed recent research on the subject and crafted a set of recommendations.

It is important that clinicians, researchers, family members, friends and other allies to autistic people develop a strong understanding of autistic communication to strengthen interactions with and improve quality of life for autistic people.

Recently published in Current Psychiatry Reports, the research team reviewed scientific literature (primarily published between 2020–2024) on communication skills and experiences of autistic adults over the past five years. The researchers focused on general communication outcomes in adulthood, literal and non-literal language, augmentative and alternative communication, nonverbal communication and "double empathy"—a theory developed by autistic scholars about the two-way nature of misunderstandings between autistic and non-autistic people.

Led by Ashley de Marchena, Ph.D., an associate research professor in the Autism Institute, the review of research indicates that a substantial proportion of autistic adults do not develop fluent language by adulthood. Even among those who do develop fluent language, challenges are pervasive.

"Autistic adults frequently experience communication barriers impacting relationships, employment and health, " said de Marchena. "These barriers arise from multiple sources, such as language, nonverbal communication and unaccommodating environments and communication partners. Thus, it is essential to take a multifaceted approach to supporting autistic adults to ensure their communication success."

The researchers add that autistic people are frequently misunderstood, and because of their differences, they are too often blamed for miscommunication when it happens. In reality, communication is always a two-way street. Over time, miscommunication after miscommunication can lead some autistic people to stop trying and withdraw from society, because it feels bad to be constantly misunderstood, especially when it feels like others are blaming you for misunderstandings or not trying hard enough to understand you.

"Simple adaptations that non-autistic people can make to accommodate communication differences can go a long way toward reducing misunderstandings and including autistic people more fully in the community, " said de Marchena.

The researchers concluded that it is vital for clinicians and researchers to understand how autistic traits commonly manifest in adults and to accept and accommodate communication differences as they arise. They also offered specific recommendations to help clinicians and researchers strengthen their interactions with the autistic people in their lives:

"It's very important that we continue to support research and clinical interventions related to communication in autism—especially for those who are non-speaking or minimally speaking, who are most in need of innovations, but least likely to be included in research, especially as adults, " said de Marchena.

She added that it is also important for allies—including those in the lab, clinic and the broader community—to learn how to recognize and accommodate common autistic communication differences for those who do speak fluently, but may struggle in less visible ways.

More information: Ashley de Marchena et al, Communication in Autistic Adults: An Action-Focused Review, Current Psychiatry Reports (2025). DOI: 10.1007/s11920-025-01616-6