Late-talking kids and "Einstein syndrome"
post by Steven Byrnes (steve2152)
Autism, ASD, and misdiagnoses thereof
What causes "Einstein syndrome"?
I talked late—no words at age 2, ten words at 2¼, lots and lots of words at 2½. Or so I've been told! :-P
My younger kid is also a late talker—maybe 7 words at age like 1½, and still ~7 words now well into age 2. (And not all the same words! He added a couple and dropped a couple.) When my older kid was the age that my younger kid is now, he was chatting away in 10-word sentences. So anyway, as a Responsible Parent, I'm doing some homework about late talking. Here are some of my notes, not in any particular order.
(If you like my speculative neuroscience writing, there's a bit of it in the last section.)
Update later: Yay! Without any interventions, he finally started rapidly increasing his spoken vocabulary just a few months after I wrote this. :-)
I read the 2014 book Late-Talking Children: A Symptom or a Stage? by Stephen M. Camarata. It's excellent, I really trust the guy. I also read the 2002 book The Einstein Syndrome: Bright Children Who Talk Late by Thomas Sowell. Sowell is an economist (!) while Camarata is a professor of speech and language disorders, so predictably Camarata is much more knowledgeable. My understanding is that Sowell's books were valuable at the time for kick-starting public awareness of the existence of bright late-talking kids (more on which below), but now that Camarata's book is out, that's the best resource.
Sowell was not a late talker himself, but Camarata was, and Sowell and Camarata each have a late-talking child.
Camarata has a comprehensive discussion of the full range of conditions that lead to late talking, from autism to apraxia to "nothing in particular, just a passing phase". Speaking of which...
There's a subgroup of late talkers who are smart (when tested non-verbally), often understand spoken language despite not talking, don't have autism or hearing loss or other conditions, and whose speech delay resolves on its own and they wind up settling into the normal range for adult language skills. This turns out to be an interesting bunch—this is what Sowell dubbed "Einstein Syndrome".
I find the term "Einstein Syndrome" super-obnoxious—it sounds like bragging. If we prefer a self-deprecating title, maybe it could have been called "Ed Teller Syndrome", named after one of the worst and most destructive humans in history, afaict. ... or "Lots Of Unremarkable People You've Never Heard Of Syndrome" for that matter. Oh well. Sowell called it "Einstein Syndrome" and the term seems to have stuck.
Anyway, this group turns out to be disproportionately likely to be highly analytical, and to be part of highly analytical families, including unusual numbers of parents who are engineers, physicists, mathematicians, accountants, etc. (Also, professional musicians!) (For my part, I'm a physicist.)
Famous people with Einstein Syndrome include: physicists Albert Einstein, Richard Feynman, and Ed Teller; economists Gary Becker and Richard Rosett; mathematicians Julia Robinson and Srinivasa Ramanujan; concert pianists Clara Schumann and Arthur Rubinstein; and politicians Dick Armey and, um, Benito Mussolini.
Autism, ASD, and misdiagnoses thereof
Camarata gives the impression that these days, non-autistic late-talking kids are at very high risk of being misdiagnosed as autistic by incompetent or careless professionals. This especially applies to school screenings; school screening people may be mainly thinking about classroom placement and funding and following the bureaucratic rules and so on, instead of thinking about doing a correct differential diagnosis of the child. He goes through example after example after example drawn from the children he's worked with at his lab for late-talking children.
He says that giving a non-autistic child an autism-specific early intervention can be quite damaging and traumatic to the child. (Well, he also says that a lot of autism-specific early interventions in use today are just bad period, even for kids with autism! And even beyond autism, that there are a lot of early interventions that are universally counterproductive but still in use. It's a jungle out there!) Likewise, he says that a false autism diagnosis (or false diagnosis of Global Developmental Delay, etc.) on a school record can follow a kid for years and cause endless problems.
Incidentally, Camarata seems a bit annoyed about the whole idea of "autism spectrum"; his perspective seems to be that "classic autism" is very much more serious than the edge case kids who barely qualify as ASD (as judged by a careless person mindlessly following a checklist), and that lumping all these kids together under the banner of "autism" is causing parents, teachers, and others to have mistaken expectations, to do wrong interventions, and to misallocate resources. I have no opinion here, I just thought that was an interesting take. I think he's mostly talking about how the diagnostic criteria get translated into practice in wider society, and not about the fundamental science of autism.
For my part, it's blindingly obvious that my kid does not have classic autism—he's super into elaborate pretend play with his teddy bears (as I was at that age), etc. etc. It's still possible that he has a different condition that needs early treatment, but given the family history of non-problematic speech delay, and other factors I won't get into, I think on balance that it's fine for us to wait another few months and see if he starts talking on his own, before bringing him to a specialist. Maybe this spring or summer. On a gut level, the book definitely got me feeling more worried about my kid being mishandled and mistreated by The System than worried about his healthy development per se. Anyway, I feel ready to venture forth into that world armed with information, having read the book.
(When I was a late-talking kid, my parents got a free town-government-provided child speech pathologist (not sure her exact job title), and she came over once a week, and we played games, and my parents say it was lovely and I had a lot of fun. I figure, in all likelihood, I would have started talking at the same time with or without her. But whatever, no harm done.)
What causes "Einstein syndrome"?
No one knows, but hey, I know a bit of neuroscience, it's fun to speculate. Consider some observations about my kid:
- He has a great understanding of spoken language.
- He can sing recognizable songs (like "da-da-da" in the tune of Twinkle Twinkle Little Star)
- He can imitate non-word sounds, and animal sounds, and he babbles a lot. (Note: non-word sounds and speech are two different parts of the brain! Well, at least for listening; probably for speaking too but I haven't checked the literature, see comment [LW(p) · GW(p)].)
- I think it's quite clear that he wants to talk and is trying to talk, but he really just can't.
- He is excellent at communicating non-verbally, in all sorts of creative ways, including making up a large vocabulary of sign-language-type gestures (with sound effects!) for particular foods and activities.
OK, now we turn for inspiration to Randall O'Reilly et al.'s excellent 2017 paper Deep Predictive Learning: A Comprehensive Model of Three Visual Streams.
To oversimplify, the neocortex is a huge and important part of the brain, and every part of the neocortex is a little learning machine that finds patterns relating the inputs going into that part of the neocortex to each other and to the outputs exiting that part of the neocortex. One of the very interesting aspects of this paper is that they found (in the case of vision processing) that when they hooked all the information streams together at the same time into their final configuration, the learning algorithm just flails around, it doesn't make any progress. Instead, what they had to do was turn on the region-to-region connections in the right order.
First, they turn on one region-to-region connection, then they let the learning algorithm run until it settles down, having learned a vocabulary of patterns that relate those two information streams. Only then do they turn on a second region-to-region connection, to build higher-level patterns out of the lower-level patterns, and so on. In their words: "In the case of vision, the spatial (Where) aspect of prediction can be learned first, independent of the What aspect, and having systematic and accurate high-level spatial predictions … then partitions away that aspect of the prediction error, leaving a residual that is more about object identity (What)."
According to the paper, developmental neuroscience data indeed supports the idea that different region-to-region brain connections appear at different times in development.
I would also speculate: Maybe these region-to-region connections are not triggered by age, or not entirely by age. Maybe the brain just monitors how frequently the synapses in some region are getting edited, and if the rate gets sufficiently low, it implies that the patterns have been learned, and that's what triggers some new region-to-region connection to come online. (I didn't just make that up entirely, I think I read someone hypothesizing this kind of mechanism in a slightly different context, namely the "sensitive periods" after which learning more-or-less stops in certain brain regions like V1.)
So anyway, I wind up with the idea that there's a region of my kid's brain already building the low-level patterns that will correspond to composing and speaking language, but that this region of my kid's brain is currently disconnected from the mouth/tongue/throat motor control area of his brain. Sooner or later, his brain will decide it's ready, that connection will finally form, and then he'll start talking! Don't know if it's true, but I kinda like that idea. Knock on wood!
Incidentally, Camarata cites this study that says that people who had specific language impairment as kids (delayed speech for no obvious reason) are 55% likely to process language mainly in the right hemisphere, 27% in both hemispheres, and just 18% mainly in the left hemisphere; whereas 90% of the control group processed language mainly in the left hemisphere. He also cites this other study along the same lines . Pretty wild, if true! Score one for cortical uniformity [LW · GW] ! Not sure how / if that relates to the previous paragraphs :-P UPDATE: Oops, on closer examination, the first study I mentioned says that adults who were speaking normally now, but had had specific language impairment as kids, had 100% left-hemisphere-lateralized speech (i.e. the typical pattern). The numbers I quoted above were for the kids with specific language impairment, i.e. who were not yet talking, or just starting to talk, or something. For the second paper, I'm not sure, but it seems likely that the kids in the experiment were not yet talking (or not much?) at the time of the experiment. So that's not as interesting as a result as I thought at first.
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comment by Bazza ·
2021-02-03T20:04:54.688Z · LW(p) · GW(p)
Just chanced on your post and am moved to comment as I was a 'late talker'. My parents tell me I had few words (I was a 3rd child so they had prior experience) until sometime after I was three and instead mostly relied on nonverbal communication (gesture, pointing, facial expressions etc). Then over the course of maybe a month or two developed normal speech and began asking incessant questions. I also followed this pattern with reading and other intellectual skills as an older child and adult, though this may be coincidental.
Now, 60 years later I have been married for decades, have grown kids and live comfortably because I am paid well to exercise judgement (not law). However, my wife also differs from the norm and my kids certainly do (Two have had 'diagnoses' tossed their way). That may be a consequence of assortative mating but it has also meant that two of them have got themselves a great deal of scholarship money at Uni.
comment by Bucky ·
2021-02-03T16:06:25.836Z · LW(p) · GW(p)
Great, informative post - my youngest is fairly late at talking so this was helpful.
Note: animal sounds and speech are two different parts of the brain!
This was surprising to me - do you have a reference?Replies from: steve2152
↑ comment by Steven Byrnes (steve2152) ·
2021-02-03T21:30:35.179Z · LW(p) · GW(p)
I was going to say Myth of Mirror Neurons by Hickok (excellent book by the way—maybe the only neuroscience book I've ever read where I feel like I can treat every word as gospel truth). But I just went back and double-checked, and he actually only said this about receptive language, not production.
Specifically, Hickok cites evidence that the task of distinguishing nonword sounds from each other (e.g. "ba" vs "da") is "double dissociated" from the task of distinguishing different words (e.g. "bad" vs "dad"). In simpler terms, some people get brain damage that causes them to be able to distinguish ba-vs-da but not bad-vs-dad, and other people get brain damage that causes them to be able to distinguish bad-vs-dad but not ba-vs-da. This proves that they're at least partly processed in different brain regions.
I still think what I wrote is probably correct (i.e. that production of animal sounds or other "sound effects" involves different brain regions than production of speech, although of course they'll overlap by both passing through low-level motor control on the way out). But until I find direct evidence, I better fix the wording! Thanks for calling me out on that :-)Replies from: Bucky
↑ comment by Bucky ·
2021-02-04T15:55:33.797Z · LW(p) · GW(p)
One thing I've been thinking about regarding animal noises is the actual animal noise and the not-quite-phonetic spelling of the noise. My slightly late talking youngest son makes realistic animal noises rather than saying "moo" (which I think most children would say). Even now when I think of what noise a cow makes I initially think "moo", rather than of the actual noise itself.
I'm not sure that actually means anything - just an observation!Replies from: steve2152
comment by G Gordon Worley III (gworley) ·
2021-02-03T21:15:46.540Z · LW(p) · GW(p)
So anyway, I wind up with the idea that there's a region of my kid's brain already building the low-level patterns that will correspond to composing and speaking language, but that this region of my kid's brain is currently disconnected from the mouth/tongue/throat motor control area of his brain. Sooner or later, his brain will decide it's ready, that connection will finally form, and then he'll start talking!
To offer anecdata about this, I was, too, a late talker. I didn't start seriously talking until I was about 3.5 years old!
My parents tell me that it was very sudden. Basically one day I was not really talking, using very few words, and the next I was suddenly speaking in full, complex sentences.
I've never been diagnosed as being on the autism spectrum. I did continue to be developmentally behind, but I was smart enough that this balanced out and no one really noticed but me after the fact when I learned enough developmental psychology to realize what had been going on.Replies from: steve2152
↑ comment by Steven Byrnes (steve2152) ·
2021-02-04T16:26:23.472Z · LW(p) · GW(p)
Yeah Sowell's books says that immediately speaking full sentences is a pretty common pattern, or at least not unheard of. I think Teller was in that category.
In fact this is one reason I've long been skeptical of the people who say you need "embodied cognition" to get AGI. Passive predictive ("self-supervised") learning gets you pretty far by itself, such that you learned to speak complete sentences purely from predictive learning, not trial-and-error (or at least minimal trial-and-error).
comment by Jonathan_Graehl ·
2021-02-03T18:53:43.239Z · LW(p) · GW(p)
I just want to offer: feeling uncertain or insecure about your kid's prospects is normal and healthy. Be curious but also explore the idea that a delayed kid is happy+great too. Also, pretty much everyone learns to speak normally eventually. Irrelevant personal anecdote (my speech-delayed kid is not really an 'einstein') follows:
My 1st was mildly precocious in signing, speaking, singing; I felt uncertain about my 2nd, who was many months slower on his first words yet did have ~80 words by 2 (below avg, though his understanding seemed fine) and now at almost 3 years is normally competent+chatty. It's apparently more common for boys to have this sort of delay. I wondered if some chipped teeth (avoided dentist during covid) might have contributed. I read into him a low desire to verbally communicate (insecurity of some sort? preference for physical grabbing/pointing/showing?) yet he loves to narrate + interact now. He only rarely tries to hum/sing - some people are musical, seems mostly unrelated to speech. He got started trying to speak mostly in the context of peekaboo type 1.4 year old game playing ("oh no! you're stuck" "the ball is stuck!" repeatedly wedging self or toy behind couch). Sounds like a completely different trajectory/mechanism from your son's speech delay. (My 3rd is 4 mo old but far more expressive w/ babble+eye contact than her sibs - perhaps competing for limited attn or fed by more toddler stimulus?).
I'm very confident that a follow-up to this post in 2 years would be "well, totally normal speech now".Replies from: steve2152
↑ comment by Steven Byrnes (steve2152) ·
2021-02-03T20:06:20.588Z · LW(p) · GW(p)
pretty much everyone learns to speak normally eventually
Well, Camarata says that 60% of late talkers catch up within a year or two.
In my kid's particular case, the odds are much higher than 60% because I have a lot more information about him than just the one datapoint that he's a late talker. I'm not worried.
It's apparently more common for boys to have this sort of delay.
Yes, I forget the ratio, maybe 80/20 or 85/15? I don't know why it's so lopsided.
comment by Rebecca ·
2022-01-05T11:05:53.567Z · LW(p) · GW(p)
Thank you, great piece.
I have a later-talking son, now 8, who began speaking in sentences – from a 6-word vocab – at around 2.5 years. Suffice to say, we were relieved. Our daughter, now 21 months, has about the same range as son for same age. We're hoping for a similar outcome, i.e., she starts talking at some point! While no Einstein (!), our boy has great visual-spatial abilities and memory as well as incredible dexterity – think elaborate origami and detailed, three-dimensional drawing. Our girl has very good balance and bodily spatial awareness. Our son was a wonderful pre-verbal communicator as an infant and toddler – all gesture, sound effects, eye contact, expression, and emotion! – and his receptive language was just fine. Our daughter is the same. I don't think our son could talk until he did talk. Our girl doesn't imitate or repeat words we say to her, although today I think she tried to say 'bubble', which came out like 'booba', which is her word for breastmilk, the most spoken of her very few words! Ha!
I am very interested in your comment about right-hemisphere dominance for language in late talkers! What is that about?? I've read that left-handers are often right-lateralised for language (like their handedness), while a tiny minority of right-handers are naturally right-lateralised for language (unlike their handedness). So what are the brains of these kids doing while other kids are broadcasting from their first birthday or sometimes well before?? Psychiatrist/author Iain McGilchrist writes brilliantly on the importance of the right hemisphere for picking up and signalling deeper layers of communication – metaphor, implicit meaning, prosody, humour, etc. – rather than literal meaning, which is normally the purview of the left hemisphere. Seems like these kids are doing it all on the right!
I wonder if this imparts advantages or disadvantages in different ways?? Any ideas?Replies from: steve2152
comment by Kunal Bhatia (kunal-bhatia) ·
2021-12-15T18:58:48.660Z · LW(p) · GW(p)
I was too a late talker and didn’t start talking until I was 2.5 years old but later I turned out to be okay. I have 8 doctors in my family. It’s interesting how the role of family plays out. I have an impeccable memory and a way with computers. I want to be an astrophysicist and just completed my undergrad in physics and astronomy. I think I have Einstein Syndrome
comment by Slider ·
2021-02-03T19:19:10.340Z · LW(p) · GW(p)
I was a late talker and I was after admission to university diagnosed with aspergers. The word autism can trigger very inappropriate and ablist attitudes. Even if the kid is bona fide autistic it might make sense to mask as neurotypical. The up and downs can be a coin toss whether it is a good idea.
You wouldn't try to pray away your kids gayness but unfortunately stuff like applied behaviounal analysis can effectively try to punish a neurodivergence out (howeer raising a gay child in a strict closet also sounds like a recipe for disaster). Like gayness could sound like sickness to some, there is also a direction where neurodivergence is a developmental trait rather than all deficiency. Unfortunatatedly society isn't really on the ball to sort out effective treatments and humane treatments. As a parent it would be prudent to be aware if your child has needs outside of the distribution. One doesn't need strict labels in order to address those.Replies from: steve2152
↑ comment by Steven Byrnes (steve2152) ·
2021-02-03T19:50:35.587Z · LW(p) · GW(p)
Yeah I haven't thought about it much, but it does seem like there's a fine line between "you get this early intervention because Society doesn't like the way your brain is functioning and wants to change it" (=bad) vs "you get this early intervention because different kids have different needs and you'll do best with an education tailored to your own needs" (=good). Like, other things equal, we want kids to grow into adults who can live independently, right? So if a kid is on a trajectory towards not being able to live independently as an adult, then in a sense, we do want to change that trajectory, and that might implicitly mean changing the kind of adult they grow up into, at least to some extent. Not that there would be anything wrong with the person if they followed the default trajectory. I dunno. I know nothing about ABA by the way.
As for "society isn't on the ball", you can say that again! Like for example, Camarata's book says over and over, in chapter after chapter, "Do not let anyone strap your kid into a chair unless it's for orthopedic support." "Always ask explicitly if they strap kids into Rifton chairs." "Write into the education plan that they will not strap your child into a Rifton chair under any circumstances", Over and over. He says it so many times that I really get the idea that people are doing this everywhere! He says there isn't a shred of evidence that strapping a kid into a chair is helpful for teaching anyone, with or without autism, in any circumstance (and lots of evidence that it isn't helpful). It's just awful.Replies from: Slider
↑ comment by Slider ·
2021-02-03T21:00:30.406Z · LW(p) · GW(p)
Sometimes it is inconvenient to be different and there are tradeoffs whether environment should adapt to the indiviudal or individual to the environment. If you are blind and want access to text culture it makes sense to learn braille. Learning a visual language would not make sense, even if a for a seeing person that is key to study ability. A sensory sensitivity difference might mean a normal class room might feel like a disco. Does that mean the child should learn how to be in a constant disco (because that is what everybody else has to deal with) or does providing study peace mean ear protection, small group size or a non-group setting.
The example with the chair seems like I should be surprised but sadly I am not. It is the kind of error of providing eye-glasses to a deaf person (because they are both "disabilities") or chemically tranqualising elderly people so that caretaking for them is eased because they just lie in bed all the time. As a parent making sure procedures are actually in the childs interest and not for example the convenience of the care provider is paramount.
comment by Cobalt ·
2021-02-03T15:47:06.941Z · LW(p) · GW(p)
In the literature you reviewed, was there mention of late-talking as a result of trauma in early childhood/infancy occurring before speech development? If so, would you be willing to share the references? (Very late talker here, no word or babbling before the age of 4.)Replies from: steve2152
↑ comment by Steven Byrnes (steve2152) ·
2021-02-03T16:01:47.690Z · LW(p) · GW(p)
Cool! Oh wow, yeah I'm not nearly as much of a late talker as some kids, just compared to typical kids.
To answer your question: I don't think so. Obviously in horrific cases (like those Romanian orphanages) where the kid is never exposed to language, they won't learn to talk. He says a bit about how a child in an early intervention program will do better if they feel safe around adults, but I don't recall him saying anything about that kind of thing as an underlying cause.