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Wang L, Li S, Wang C. Using Pivotal Response Treatment to Improve Language Functions of Autistic Children in Special Schools: A Randomized Controlled Trial. J Autism Dev Disord 2024; 54:2081-2093. [PMID: 37101061 PMCID: PMC10132802 DOI: 10.1007/s10803-023-05988-7] [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] [Accepted: 04/06/2023] [Indexed: 04/28/2023]
Abstract
Language difficulties exert profound negative effects on the cognitive and social development of autistic children. Pivotal Response Treatment (PRT) is a promising intervention for improving social communication in autistic children, but there is a lack of a comprehensive examination of language functions. This study aimed to investigate the effectiveness of PRT in promoting the primary language functions (requesting, labeling, repeating, responding) defined by (Skinner, B. F. (1957). Verbal behavior. Martino Publishing.) theory of verbal behavior in autistic children. Thirty autistic children were randomly divided into the PRT group (Mage = 6.20, SDage = 1.21) and control group (Mage = 6.07, SDage = 1.49). The PRT group were provided with an 8-week training of the PRT motivation component in addition to treatment as usual (TAU) in their schools, whereas the control group only received TAU. Parents of the PRT group were also trained to practice the PRT motivation procedures at home. The PRT group demonstrated greater improvements in all four measured language functions compared to the control group. The improvement in language functions in the PRT group was generalized and maintained at the follow-up assessment. In addition, the PRT intervention enhanced untargeted social and communicative functioning, cognition, motor skills, imitation, and adaptive behaviors in the autistic children. In conclusion, language intervention using the motivation component of PRT is effective in promoting language functions as well as widespread untargeted cognitive and social functions in autistic children.
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Affiliation(s)
- Leilei Wang
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, 38 Tongyan Road, Tianjin, China
- Autism Research Center, Nankai University, Tianjin, China
| | - Shuting Li
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Chongying Wang
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, 38 Tongyan Road, Tianjin, China.
- Autism Research Center, Nankai University, Tianjin, China.
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2
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Berenguer C, Rosa E, De Stasio S, Choque Olsson N. Sleep quality relates to language impairment in children with autism spectrum disorder without intellectual disability. Sleep Med 2024; 117:99-106. [PMID: 38522116 DOI: 10.1016/j.sleep.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVES This study aimed to identify sleep quality profiles of children with autism spectrum disorder (ASD), to compare these profiles with those of typically developing (TD) children, and to verify whether there are differences between them in terms of language skills. METHODS We evaluated the sleep quality and language skills of 47 children with ASD without intellectual disability (ID) and 32 children with TD. Using a hierarchical cluster analysis, we identified two sleep quality ASD profiles (poor and good). We then performed a series of MANCOVAs and ANOVAs to compare the sleep quality and language skills of the two ASD clusters and the TD group. RESULTS A main group effect (TD, "poor" cluster, and "good" cluster) was found in the total sleep quality and all its dimensions. Significant differences were revealed between the "good" and "poor" clusters in the total structural language score (F1,46 = 10.75, p < 0.001) and three of its subscales (speech: F1,46 = 9.19, p < 0.001; syntax, F1,46 = 8.61, p = 0.001; coherence: F1,46 = 11.36, p < 0.001); the total pragmatic language score (F1,46 = 7.00, p = 0.001) and three of its subscales (inappropriate initiation: F1,46 = 8.02, p = 0.001; use of context: F1,46 = 8.07, p = 0.001; nonverbal communication: F1,46 = 7.35, p = 0.001); and the social relations score (F1,46 = 9.97, p = 0.003). CONCLUSIONS Sleep quality in children with ASD (especially a subgroup) is worse than in children with TD. There is an association between sleep quality and language skills, both at the pragmatic and structural levels.
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Affiliation(s)
- Carmen Berenguer
- Department of Developmental and Educational Psychology, ERI-Lectura Faculty of Psychology and Speech Therapy University of Valencia, Blasco Ibanez, 21, 46010, Valencia, Spain.
| | - Eva Rosa
- Department of Basic Psychology, ERI-Lectura, Faculty of Psychology and Speech Therapy, University of Valencia, Blasco Ibanez, 21, 46010, Valencia, Spain.
| | - Simona De Stasio
- Department of Human Studies, LUMSA University, Piazza Delle Vaschette, 101, 00193, Rome, Italy.
| | - Nora Choque Olsson
- Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden.
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3
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Foldager M, Vestergaard M, Lassen J, Petersen LS, Oranje B, Aggernaes B, Simonsen E. Atypical Semantic Fluency and Recall in Children and Adolescents with Autism Spectrum Disorders Associated with Autism Symptoms and Adaptive Functioning. J Autism Dev Disord 2023; 53:4280-4292. [PMID: 36001194 DOI: 10.1007/s10803-022-05677-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 10/15/2022]
Abstract
It is unclear whether children with autism spectrum disorders have atypical semantic fluency and lower memory for the semantics of words. Therefore, we examined semantic typicality, fluency and recall for the categories of fruits and animals in 60 children with autism aged 7-15 years (boys: 48/girls: 12) compared to 60 typically developing controls. Relative to controls, the autism group had reduced animal fluency, fruit typicality and recall for fruits. Notably, these measures were associated with more autistic-like symptoms and/or lower adaptive functioning across the autism and control groups. In conclusion, atypical semantics of fruits in the autism group may reflect development of idiosyncratic semantic networks while their lower semantic fluency and recall suggest impaired executive language functions.
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Affiliation(s)
- Malene Foldager
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Smedegade 16, 4000, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, København, Denmark
| | - Martin Vestergaard
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Smedegade 16, 4000, Roskilde, Denmark.
| | - Jonathan Lassen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Smedegade 16, 4000, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, København, Denmark
| | - Lea S Petersen
- Department of Clinical Medicine, University of Copenhagen, København, Denmark
- Psychiatric Research Unit, Region Zealand, Denmark
| | - Bob Oranje
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Psychiatric Center Glostrup, Copenhagen University Hospital, København, Denmark
| | - Bodil Aggernaes
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Smedegade 16, 4000, Roskilde, Denmark
- PP Clinic Copenhagen, Gentofte, Denmark
| | - Erik Simonsen
- Department of Clinical Medicine, University of Copenhagen, København, Denmark
- Mental Health Services East, Copenhagen University Hospital, Psychiatry Region Zealand, Region Zealand, Denmark
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4
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Jackson E, Levine D, de Villiers J, Iglesias A, Hirsh-Pasek K, Michnick Golinkoff R. Assessing the language of 2 year-olds: From theory to practice. INFANCY 2023; 28:930-957. [PMID: 37350307 DOI: 10.1111/infa.12554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023]
Abstract
Early screening for language problems is a priority given the importance of language for success in school and interpersonal relationships. The paucity of reliable behavioral instruments for this age group prompted the development of a new touchscreen language screener for 2-year-olds that relies on language comprehension. Developmental literature guided selection of age-appropriate markers of language disorder risk that are culturally and dialectally neutral and could be reliably assessed. Items extend beyond products of linguistic knowledge (vocabulary and syntax) and tap the process by which children learn language, also known as fast mapping. After piloting an extensive set of items (139), two phases of testing with over 500 children aged 2; 0-2; 11 were conducted to choose the final 40-item set. Rasch analysis was used to select the best fitting and least redundant items. Norms were created based on 270 children. Sufficient test-retest reliability, Cronbach's alpha, and convergent validity with the MB-CDI and PPVT are reported. This quick behavioral measure of language capabilities could support research studies and facilitate the early detection of language problems.
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Affiliation(s)
| | - Dani Levine
- University of Chicago, Chicago, Illinois, USA
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5
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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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MacFarlane H, Salem AC, Chen L, Asgari M, Fombonne E. Combining voice and language features improves automated autism detection. Autism Res 2022; 15:1288-1300. [PMID: 35460329 DOI: 10.1002/aur.2733] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/30/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022]
Abstract
Variability in expressive and receptive language, difficulty with pragmatic language, and prosodic difficulties are all features of autism spectrum disorder (ASD). Quantifying language and voice characteristics is an important step for measuring outcomes for autistic people, yet clinical measurement is cumbersome and costly. Using natural language processing (NLP) methods and a harmonic model of speech, we analyzed language transcripts and audio recordings to automatically classify individuals as ASD or non-ASD. One-hundred fifty-eight participants (88 ASD, 70 non-ASD) ages 7 to 17 were evaluated with the autism diagnostic observation schedule (ADOS-2), module 3. The ADOS-2 was transcribed following modified SALT guidelines. Seven automated language measures (ALMs) and 10 automated voice measures (AVMs) for each participant were generated from the transcripts and audio of one ADOS-2 task. The measures were analyzed using support vector machine (SVM; a binary classifier) and receiver operating characteristic (ROC). The AVM model resulted in an ROC area under the curve (AUC) of 0.7800, the ALM model an AUC of 0.8748, and the combined model a significantly improved AUC of 0.9205. The ALM model better detected ASD participants who were younger and had lower language skills and shorter activity time. ASD participants detected by the AVM model had better language profiles than those detected by the language model. In combination, automated measurement of language and voice characteristics successfully differentiated children with and without autism. This methodology could help design robust outcome measures for future research. LAY SUMMARY: People with autism often struggle with communication differences which traditional clinical measures and language tests cannot fully capture. Using language transcripts and audio recordings from 158 children ages 7 to 17, we showed that automated, objective language and voice measurements successfully predict the child's diagnosis. This methodology could help design improved outcome measures for research.
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Affiliation(s)
- Heather MacFarlane
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Alexandra C Salem
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Liu Chen
- Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon, USA.,Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - Meysam Asgari
- Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon, USA.,Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA.,Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon, USA.,Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
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7
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Mathée-Scott J, Ellis Weismer S. Naturalistic parent-child reading frequency and language development in toddlers with and without autism. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221136740. [PMID: 36438160 PMCID: PMC9685215 DOI: 10.1177/23969415221136740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIMS The efficacy of parent-child reading for supporting language development has been well-established in the neurotypical (NT) literature. For children with autism spectrum disorder, (ASD) who may be at risk for delays in language development, prior research has shown promise for shared book-reading interventions. Yet there has been limited research on naturalistic parent-child reading with autistic children to date. The present study aimed to fill this missing link in the current literature. METHODS Fifty-seven autistic toddlers participated at two developmental time points: Time 1 (Mage = 30.4 months) and Time 2 (Mage = 43.8 months). An NT control group (N = 31) was matched on age to a subset of the ASD group (N = 33). We assessed group differences in parent-child reading frequency between age-matched NT and autistic groups. Using a one-year follow-up design, we evaluated the relationship between parent-child reading and autistic children's language development. RESULTS Cross-group comparisons revealed that parents of age-matched NT children reported significantly more frequent weekly parent-child reading than parents of autistic toddlers. After a one-year follow-up with the autistic group, within-group analyses revealed that greater frequency of parent-child reading (controlling for maternal education, books in the home, and autism symptom severity) was associated with larger growth in autistic toddlers' receptive and expressive language skills. CONCLUSIONS AND IMPLICATIONS These findings have important clinical implications as they emphasize the potential of parent-child reading for supporting autistic children's language development. Findings demonstrate that frequency of parent-child reading is associated with language development over one year. Findings also demonstrate that parents of autistic children engage in less frequent parent-child reading than parents of age-matched NT peers, suggesting these parents may face more barriers to implementing parent-child reading than parents of NT children.
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Affiliation(s)
- Janine Mathée-Scott
- Janine Mathée-Scott, Waisman Center,
University of Wisconsin–Madison, Room 449, 1500 Highland Ave., Madison, WI
53705, USA.
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8
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Zhao YV, Gibson JL. Solitary symbolic play, object substitution and peer role play skills at age 3 predict different aspects of age 7 structural language abilities in a matched sample of autistic and non-autistic children. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415211063822. [PMID: 36458151 PMCID: PMC9706065 DOI: 10.1177/23969415211063822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUNDS AND AIMS Early symbolic play abilities are closely related to long-term language development for both autistic and non-autistic children, but few studies have explored these relations for different dimensions of pretence and of language. The current study explores carer-reported measures of solitary symbolic play, object substitution and peer role play abilities at age 3, and their respective relations with parent-reported semantics, syntax and narrative abilities at age 7 for both autistic and non-autistic children. METHODS We conducted secondary data analyses exploring links between different aspects of pretence and of language on the Longitudinal Study of Australian Children population cohort. We identified 92 autistic children and used propensity score matching to match them with 92 non-autistic children based on demographic and developmental information such as non-verbal IQ and socioeconomic status. We explored concurrent and longitudinal relations using correlation and regression models. Results: Both correlational and hierarchical regression analyses confirmed the significant effects of age 3 symbolic play abilities in facilitating age 7 semantics, syntax and narrative abilities for autistic children. We found that object substitution held most prominent influence, followed by peer role play and solitary symbolic play. In contrast, for non-autistic children, none of the age 3 symbolic play abilities were significant predictors, whereas socioeconomic status at birth and age 3 language abilities held significant influences on their age 7 semantics, syntax and narrative abilities. Conclusion: We discuss the implications of our findings for play interventions targeting language outcomes.
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Affiliation(s)
| | - Jenny Louise Gibson
- Jenny L. Gibson, Faculty of Education, 184
Hills Road, Cambridge, CB2 8PQ, UK.
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9
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Wong KHY, Lee KYS, Tsze SCY, Yu WS, Ng IHY, Tong MCF, Law T. Comparing Early Pragmatics in Typically Developing Children and Children with Neurodevelopmental Disorders. J Autism Dev Disord 2021; 52:3825-3839. [PMID: 34480668 PMCID: PMC8418285 DOI: 10.1007/s10803-021-05261-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 12/02/2022]
Abstract
This study examined the early pragmatic language skills in typically developing (TD) preschool-age children, children with language impairment (LI) and children with autism spectrum disorder (ASD). Two hundred and sixty-two TD children, 73 children with LI, and 16 children with ASD were compared on early pragmatics through direct assessment (DA). Post hoc analysis revealed that children in two clinical groups displayed significant pragmatic language deficits. Children in the ASD group who were older exhibited comparable degree of impairments as their LI peers, suggesting a relatively stagnant development of pragmatic language skills in children with ASD. Findings also supported the use of DA in identifying pragmatic language deficits, which have implications for the adoption of this assessment approach in clinical settings.
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Affiliation(s)
- Kay H Y Wong
- Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China. .,Institute of Human Communicative Research, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
| | - Kathy Y S Lee
- Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.,Institute of Human Communicative Research, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Sharon C Y Tsze
- Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Wilson S Yu
- Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Iris H-Y Ng
- Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.,Institute of Human Communicative Research, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Michael C F Tong
- Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.,Institute of Human Communicative Research, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Thomas Law
- Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.,Institute of Human Communicative Research, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Sturrock A, Adams C, Freed J. A Subtle Profile With a Significant Impact: Language and Communication Difficulties for Autistic Females Without Intellectual Disability. Front Psychol 2021; 12:621742. [PMID: 34434133 PMCID: PMC8380773 DOI: 10.3389/fpsyg.2021.621742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 07/19/2021] [Indexed: 11/21/2022] Open
Abstract
The presentation of autism in females is poorly understood, which is thought to contribute to missed or later- age diagnosis, especially for those without intellectual disability. Dedicated research into social and behavioral differences has indicated a specific female phenotype of autism. However, less has been done to explore language and communication profiles, despite known sex/gender differences in typically developing populations. This article provides a synthesis of recent work from this small but emerging field. It focuses on a series of four preliminary and explorative studies conducted by the authors and embeds this within the wider literature. Findings suggest a specific profile of language and communication strengths and weaknesses for autistic females without intellectual disability (compared to autistic males and typically developing females). Furthermore, despite the relatively subtle presentation of difficulties (compared to autistic males), the impact on functionality, social inter-relations and emotional well-being, appears to be equitable and significant. The discussion highlights the need for further empirical research and proposes areas for investigation. Implications for clinical practice include the need for better recognition, testing and provision of interventions dedicated to the language and communication difficulties for autistic females. This has relevance for diagnostic, mental health and speech and language therapy services.
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Affiliation(s)
- Alexandra Sturrock
- Department of Human Communication Hearing and Development, The University of Manchester, Manchester, United Kingdom
| | - Catherine Adams
- Department of Human Communication Hearing and Development, The University of Manchester, Manchester, United Kingdom
| | - Jenny Freed
- Department of Human Communication Hearing and Development, The University of Manchester, Manchester, United Kingdom
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11
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McKernan EP, Kim SH. School-entry language skills as predictors of concurrent and future academic, social, and adaptive skills in kindergarteners with ASD. Clin Neuropsychol 2021; 36:899-920. [PMID: 34315330 DOI: 10.1080/13854046.2021.1950211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study compared language profiles of children with autism spectrum disorder (ASD) and typically developing (TD) children at kindergarten-entry and investigated whether kindergarten-entry language scores were predictive of concurrent and future academic achievement, peer interactions, and adaptive skills in children with ASD. METHOD Participants included 97 children (62 children with ASD; 35 TD children) assessed at kindergarten-entry and -exit. Language abilities were assessed using the Children's Communication Checklist-2 (CCC-2). Children with ASD and TD children's language scores were compared at baseline, and the ASD group was followed longitudinally. Regression analyses were performed to compare language scores between ASD and TD groups and to predict concurrent and future functional skills from kindergarten-entry language scores for children with ASD. RESULTS Children with ASD demonstrated significantly more impairments across all scales of the CCC-2 at kindergarten-entry compared to TD children. Within the ASD group, kindergarten-entry pragmatic language significantly predicted concurrent math and reading achievement. Both syntactic/semantic and pragmatic domains significantly predicted kindergarten-exit reading performance; pragmatics significantly predicted kindergarten-exit math performance. Pragmatics also predicted concurrent and kindergarten-exit peer play. Syntax/semantics significantly predicted concurrent adaptive communication skills, whereas pragmatics significantly predicted concurrent adaptive daily living and socialization skills, as well as kindergarten-exit socialization skills. CONCLUSIONS School-entry language abilities can serve as a valuable predictor of functional outcomes across the kindergarten year for cognitively-able children with ASD. Results highlight the need to target early language abilities to maximize academic, social, and adaptive skills.
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Affiliation(s)
| | - So Hyun Kim
- Department of Psychiatry, Weill Cornell Medical College, White Plains, NY, USA
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12
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Sturrock A, Chilton H, Foy K, Freed J, Adams C. In their own words: The impact of subtle language and communication difficulties as described by autistic girls and boys without intellectual disability. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:332-345. [PMID: 34291667 PMCID: PMC8814951 DOI: 10.1177/13623613211002047] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Subtle language and communication difficulties are experienced by many autistic individuals even when they do not have additional learning disabilities. These difficulties may affect a person's day-to-day living, social relationships and emotional well-being. However, currently, there is not much research into this topic. To date, no one has asked autistic children about their own language and communication difficulties or how they feel it affects them. Asking the children could provide valuable new insights. In this study, 12 autistic children (9-14 years), without learning disability, were interviewed on this topic. We developed interview questions, resources and interview procedures with the support of the autistic community. We also worked with an autistic researcher to analyse our results. We aimed to get the most genuine report of the autistic child's experiences. Our results showed that the children could give detailed insight into their language and communication difficulties if they were given the right support. They told us about how subtle language and communication difficulties affected their ability to learn, take part in certain activities and seek help. They talked about how subtle difficulties affect their ability to talk to new people, talk in groups and ultimately make friends. They also told us about the emotional upset that these subtle difficulties could have. They suggest that communication breakdown leads to negative feelings, but also that negative feelings can lead to more difficulties explaining themselves. The results of this study suggest that we should do more research on the effects of subtle language and communication difficulties. There are also implications for clinical practice. We should identify subtle language and communication difficulties through thorough assessment because these are often missed. We should also develop therapy and strategies that are aimed at individuals with subtle language and communication difficulties because this could help prevent additional difficulties with learning, help-seeking, friendship-making and emotional well-being.
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13
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Salem AC, MacFarlane H, Adams JR, Lawley GO, Dolata JK, Bedrick S, Fombonne E. Evaluating atypical language in autism using automated language measures. Sci Rep 2021; 11:10968. [PMID: 34040042 PMCID: PMC8155086 DOI: 10.1038/s41598-021-90304-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/06/2021] [Indexed: 11/09/2022] Open
Abstract
Measurement of language atypicalities in Autism Spectrum Disorder (ASD) is cumbersome and costly. Better language outcome measures are needed. Using language transcripts, we generated Automated Language Measures (ALMs) and tested their validity. 169 participants (96 ASD, 28 TD, 45 ADHD) ages 7 to 17 were evaluated with the Autism Diagnostic Observation Schedule. Transcripts of one task were analyzed to generate seven ALMs: mean length of utterance in morphemes, number of different word roots (NDWR), um proportion, content maze proportion, unintelligible proportion, c-units per minute, and repetition proportion. With the exception of repetition proportion (p [Formula: see text]), nonparametric ANOVAs showed significant group differences (p[Formula: see text]). The TD and ADHD groups did not differ from each other in post-hoc analyses. With the exception of NDWR, the ASD group showed significantly (p[Formula: see text]) lower scores than both comparison groups. The ALMs were correlated with standardized clinical and language evaluations of ASD. In age- and IQ-adjusted logistic regression analyses, four ALMs significantly predicted ASD status with satisfactory accuracy (67.9-75.5%). When ALMs were combined together, accuracy improved to 82.4%. These ALMs offer a promising approach for generating novel outcome measures.
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Affiliation(s)
- Alexandra C Salem
- Department of Psychiatry, Oregon Health and Science University, Portland, 97239, USA.
| | - Heather MacFarlane
- Department of Psychiatry, Oregon Health and Science University, Portland, 97239, USA
| | - Joel R Adams
- Computer Science and Electrical Engineering, Oregon Health and Science University, Portland, 97239, USA
| | - Grace O Lawley
- Computer Science and Electrical Engineering, Oregon Health and Science University, Portland, 97239, USA
| | - Jill K Dolata
- Department of Pediatrics, Oregon Health and Science University, Portland, 97239, USA
| | - Steven Bedrick
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, 97239, USA
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health and Science University, Portland, 97239, USA
- Department of Pediatrics, Oregon Health and Science University, Portland, 97239, USA
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14
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Cermak CA, Arshinoff S, Ribeiro de Oliveira L, Tendera A, Beal DS, Brian J, Anagnostou E, Sanjeevan T. Brain and Language Associations in Autism Spectrum Disorder: A Scoping Review. J Autism Dev Disord 2021; 52:725-737. [PMID: 33765302 DOI: 10.1007/s10803-021-04975-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
Examining brain and behaviour associations for language in autism spectrum disorder (ASD) may bring us closer to identifying neural profiles that are unique to a subgroup of individuals with ASD identified as language impaired (e.g. ASD LI+). We conducted a scoping review to examine brain regions that are associated with language performance in ASD. Further, we examined methodological differences across studies in how language ability was characterized and what neuroimaging methods were used to explore brain regions. Seventeen studies met inclusion criteria. Brain regions specific to ASD LI+ groups were found, however inconsistencies in brain and language associations were evident across study findings. Participant age, age-appropriate language scores, and neuroimaging methods likely contributed to differences in associations found.
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Affiliation(s)
- Carly A Cermak
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada. .,Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada. .,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.
| | - Spencer Arshinoff
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Leticia Ribeiro de Oliveira
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.,Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Anna Tendera
- Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Deryk S Beal
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.,Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Jessica Brian
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.,Department of Paediatrics, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.,Department of Paediatrics, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Teenu Sanjeevan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
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