This article examines the question of prayer in relation to the diagnosis of autism. Prayer is understood as speech addressed to God. Procedures for diagnosing autism use different standard instruments for measuring the linguistic and social deficits associated with autism. All procedures refer either to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition {(DSM-IV)}, or to the International Classification of Diseases, tenth revision {(ICD-10)}, and implicitly to the limited, syntactic perspective on language therein. This conceptualization of language does not effectively identify the reality of prayer as a speech act. Some research has attempted to broaden the conception of language beyond that found in {DSM-IV} and {ICD-10}, particularly in the direction of a socio-linguistic model. The present paper speculates on the potential for doing the same in respect of prayer. This task has unique characteristics. Three directions are suggested, each more theologically engaged than the last, and, in inverse proportion, adaptable to clinical practice.