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Keating J, Uljarević M, van Goozen SHM, Abbot-Smith K, Hay DF, Leekam SR. Assessing pragmatic language difficulties using the Revised Children's Communication Checklist-2. Exploratory structural equation modeling and associations with restricted and repetitive behaviors. Autism Res 2024; 17:584-595. [PMID: 38311962 DOI: 10.1002/aur.3100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
In this paper, we investigated the psychometric properties of the Child Communication Checklist-Revised (CCC-R) for the first time with an English-speaking sample. We used a confirmatory application of exploratory structural equation modeling (ESEM) to re-evaluate the CCC-R's psychometric properties. We found strong support for its use as an assessment for pragmatic and structural language. Our second main aim was to explore associations between pragmatic and structural language and restricted and repetitive behaviors (RRBs), two hallmark characteristics of autism. We used the CCC-R and Repetitive Behavior Questionnaire (RBQ-2) to investigate these associations in a diverse non-clinical sample of children, taking a transdiagnostic approach. We intentionally excluded autism and other neurodevelopmental diagnoses to test, (1) the CCC-R in a broad sample and (2) the association between pragmatic language and RRB in children not already selected for that association. The sample comprised two groups of children, one was community sampled (n = 123) and the other (n = 143) included children with non-specific behavioral, emotional and/or cognitive difficulties referred to an assessment unit by schools. We found clear associations between pragmatic language difficulties and RRBs in both groups. Regression analysis showed that pragmatic language was the only significant contributor to RRBs even after Grammatical-Semantic score, age, sex, and socioeconomic status were controlled. The pattern was the same for both recruitment groups. However, the effects were stronger for the school-referred group which also had more pragmatic difficulties, grammatical-semantic difficulties and RRBs. A robust link between pragmatic language and RRBs, established in autism, has continuity across the broader non-clinical population.
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Affiliation(s)
- Jennifer Keating
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | - Mirko Uljarević
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
| | - Stephanie H M van Goozen
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | | | - Dale F Hay
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | - Susan R Leekam
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
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Reindal L, Nærland T, Weidle B, Lydersen S, Andreassen OA, Sund AM. Structural and Pragmatic Language Impairments in Children Evaluated for Autism Spectrum Disorder (ASD). J Autism Dev Disord 2023; 53:701-719. [PMID: 33515169 PMCID: PMC9944009 DOI: 10.1007/s10803-020-04853-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/30/2022]
Abstract
Pragmatic language impairments are common in neurodevelopmental disorders, especially in autism spectrum disorder (ASD). The relationship between structural language skills and pragmatic competence in children with autistic symptoms, however, is largely unknown. We investigated this relationship based on the Children's Communication Checklist-2 and early language delay among children (N = 177, 19% females) clinically evaluated for ASD, differentiated into ASD (n = 148) and non-ASD (n = 29). Structural language deficits were common and associated with reduced pragmatic competence in both groups. Pragmatic language impairments were most profound in children with ASD. Early language delay and structural language deficits were less common in females. Our findings suggest that assessment of structural language skills should be included in the evaluation of children with suspected ASD.
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Affiliation(s)
- Lise Reindal
- Department of Child and Adolescent Psychiatry, Møre og Romsdal Hospital Trust, Volda Hospital, Volda, Norway. .,Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Terje Nærland
- NevSom, Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway ,K.G Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Bernhard Weidle
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway ,Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ole A. Andreassen
- K.G Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway ,NORMENT Centre, University of Oslo, Oslo, Norway ,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anne Mari Sund
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway ,Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway
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Wellnitz SAC, Kästel I, Vllasaliu L, Cholemkery H, Freitag CM, Bast N. The Revised Children's Communication Checklist‐2 (
CCC‐R
): Factor Structure and Psychometric Evaluation. Autism Res 2021; 14:759-772. [DOI: 10.1002/aur.2467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Sophia A. C. Wellnitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe‐University Frankfurt am Main Germany
| | - Isabella Kästel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe‐University Frankfurt am Main Germany
| | - Leonora Vllasaliu
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe‐University Frankfurt am Main Germany
| | - Hannah Cholemkery
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe‐University Frankfurt am Main Germany
| | - Christine M. Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe‐University Frankfurt am Main Germany
| | - Nico Bast
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe‐University Frankfurt am Main Germany
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Association between maternal Autism Spectrum Quotient scores and the tendency to see pragmatic impairments as a problem. PLoS One 2018; 13:e0209412. [PMID: 30566425 PMCID: PMC6300330 DOI: 10.1371/journal.pone.0209412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 12/05/2018] [Indexed: 12/02/2022] Open
Abstract
The aim of the present study was to test the hypothesis that individuals with higher Autism Spectrum Quotient (AQ) scores would be more permissive of pragmatic impairments than those with lower AQ scores. We investigated the presence of a correlation between the AQ scores of mothers with children in grades 1 to 6 and their evaluation of assumed pragmatic impairments in children using the Maternal Evaluation of Pragmatic Impairments in Children (MEPC) measure. Mothers were asked to rate how they would feel if their child showed the communication behaviors listed in scales D (coherence), E (inappropriate initiation), F (stereotyped language), G (use of context), and H (nonverbal communication) of the Children’s Communication Checklist-2, which measures pragmatic impairments. All responses were given on a five-point Likert scale. The results indicated that the higher the maternal AQ score, the less the mother tended to evaluate pragmatic impairments as a problem. We also examined whether the age and gender of assumed children influenced the correlation between AQ and MEPC scores, but found no significant correlation. The partial correlation coefficients were calculated for each subscale, none of which was significant. A negative correlation was found between AQ and MEPC scores as a whole.
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