Gesture, Not Speech, Distinguishes Autistic and Neurotypical Children’s Narratives Across Toy and Human Listener Contexts

PURPOSE: Toy- and play-based interactions are used in developmental, educational, and clinical settings to promote engagement and reduce social demands. Whether autistic and neurotypical children adapt speech and gesture across listener contexts remains unclear. We examined multimodal narratives addressed to toy or human listeners by diagnosis. METHODS: Fifty-two children (28 autistic: Mage = 106.50 months, SD = 30.88; 24 neurotypical: Mage = 85.04 months, SD = 28.25) completed a task based on the ADOS-2 Monkey Story. Speech and gesture amount, diversity, and complexity were analyzed using negative binomial and linear regression with robust standard errors, controlling for age and nonverbal IQ. RESULTS: Neither diagnosis nor listener type predicted speech production. Age was associated with greater lexical diversity but not speech amount or mean utterance length. In the human-listener condition, autistic children produced more complex gesture-speech combinations than neurotypical children. Gesture amount showed a trend-level diagnosis effect (p = 0.053), whereas gesture diversity did not differ reliably. Among autistic children, listener type was unrelated to speech or gesture measures. No Diagnosis × Listener Type interactions were detected. CONCLUSION: Diagnosis-related differences emerged in gesture more than speech, with no reliable effects of listener type. Greater gesture​ complexity among autistic than neurotypical children in the​ human-listener condition underscores variability in autistic gesture use. These findings caution against characterizing autistic multimodal communication solely in terms of reduce​d gesture production. Examining gesture complexity and gesture-speech integration alongside production ​frequency may provide a more comprehensive understanding of autistic communication. Larger studies across communicative contexts are needed before translating findings into practice.