Autistic Children's Irritability During Social Communication Assessments

PURPOSE

Accurate measurement of autistic children's social communication is critical for assessing skills, setting intervention goals, evaluating change over time, determining service eligibility, and determining classroom placement. There are various types of assessments, some of which use specific tasks to elicit social communication. Structured tasks may frustrate children, inadvertently elicit irritability, and have a cascading effect on their ability to communicate. To date, no studies have evaluated how differing types of social communication assessments may exacerbate children's irritability and impact assessment scores. We examined the extent to which (a) social communication assessment type (structured vs. naturalistic) impacts autistic children's irritability and (b) child irritability is associated with social communication scores.

METHOD

Autistic toddlers (n = 114, Mage = 33.09 months, SD = 6.15) completed the Communication and Symbolic Behavior Scales (CSBS; structured) and a 10-min play-based mother-child interaction (MCX; naturalistic). Child irritability was scored on both assessments using a global rating scale of 0-15.

RESULTS

Child irritability during the CSBS was significantly higher than during the MCX (V = 4892, p < .001, r = .68). Higher irritability was associated with lower CSBS social communication scores (B = -0.05, p = .03), but not MCX scores (B = 0.04, p = .13; Theil's F = 6.92, p = .009).

CONCLUSIONS

Our findings suggest that the CSBS may pose unique challenges for autistic children, as it led to higher rates of irritability and negatively affected children's social communication scores. Evaluating the association between assessment type and irritability supports the complete characterization of autistic children's experience during assessments and clinicians in obtaining a more representative measure of social communication.

Assessing pragmatics in early childhood with the Language Use Inventory across seven languages

The Language Use Inventory (LUI) is a parent-report measure of the pragmatic functions of young children's language, standardized and norm-referenced in English (Canada) for children aged 18-47 months. The unique focus of the LUI, along with its appeal to parents, reliability and validity, and usefulness in both research and clinical contexts has prompted research teams globally to translate and adapt it to other languages. In this review, we describe the original LUI's key features and report on processes used by seven different research teams to translate and adapt it to Arabic, French, Italian, Mandarin, Norwegian, Polish, and Portuguese. We also review data from the studies of the seven translated versions, which indicate that all the LUI versions were reliable and sensitive to developmental changes. The review demonstrates that the LUI, informed by a social-cognitive and functional approach to language development, captures growth in children's language use across a range of linguistic and cultural contexts, and as such, can serve as a valuable tool for clinical and research purposes.

The Assessment of Early Pragmatic Development: A Study of the Reliability and Validity of the Language Use Inventory-Italian

Purpose Pragmatics is receiving much attention in both the fields of developmental and clinical psychology; however, there is a dearth of instruments to assess pragmatic abilities specifically among young toddler-age children. The aim of the current study was to test the psychometric properties of the Italian version of the Language Use Inventory (LUI), named the LUI-Italian, a parent report measure assessing pragmatic language development in children 18-47 months of age. Method Parents of Italian-speaking children who ranged in age between 18 and 47 months completed the LUI-Italian at T1 (N = 389) and 1 week later (N = 53). At T1, children were also administered the First Language Test (Test del Primo Linguaggio [TPL]), a direct measure of pragmatics, vocabulary, and syntax. Results Cronbach's alpha values were at or above acceptable levels. Factor analysis and test-retest confirmed the strong structure and reliability of the LUI-Italian. Some evidence for concurrent validity was found, as shown by associations between the LUI-Italian and the TPL. Conclusions The LUI-Italian demonstrated good psychometric properties relating to reliability, thus providing a sound basis for proceeding to a standardization study, and supporting cross-cultural comparison of pragmatic development and further exploration of profiles of pragmatic competence for children displaying language impairments or delay. Future studies need to further test concurrent, divergent, and predictive validity of the LUI-Italian.

Measuring the Diagnostic Features of Social (Pragmatic) Communication Disorder: An Exploratory Study

PURPOSE

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition introduced a new neurodevelopmental disorder, social (pragmatic) communication disorder (SPCD), that is characterized by deficits in 4 areas of communication. Although descriptions of these areas are provided, no assessment tools for SPCD are recommended. The purpose of this study was to examine the extent to which items from measurement tools commonly used in assessing pragmatic language impairment and related disorders might be useful in assessing the characteristics of social communication that define SPCD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

METHOD

Based on a literature search, 594 items from assessment tools commonly used to measure social communication abilities in people with pragmatic language impairment were identified. The first author judged whether each item reflected 1, more than 1, or none of the 4 SPCD diagnostic characteristics. After a brief training process, 5 second raters independently mapped subsets of items to the 6 categories. We calculated the percentage of agreement and Cohen's kappa for each pair of raters in assigning items to categories.

RESULTS

Percentages of agreement ranged from 76% to 82%, and Cohen's kappa values ranged from .69 to .76, indicating substantial agreement. Sources and item numbers for the 206 items that both raters assigned to the same SPCD feature are provided.

CONCLUSIONS

These items may provide guidance in assessing SPCD and in designing standardized screening and diagnostic measures for SPCD.

Using the Delphi Technique to Explore Complex Concepts in Speech-Language Pathology: An Illustrative Example From Children's Social Communication

PURPOSE

In recent years, there has been an increasing interest in expanding the research approaches that speech-language pathologists utilize, particularly for addressing complex questions. Consensus-building techniques can be useful for addressing such questions. The Delphi technique is a consensus-building process involving structured communication among members of an expert panel via independent responses to iterative rounds of questionnaires. The purpose of this research note is to describe and demonstrate the Delphi technique using an application to a complex problem in speech-language pathology, that is, the bases of social communication and pragmatics.

METHOD

The Delphi technique was described and illustrated via the following study: 10 expert speech-language pathologists participated in a 3-round Delphi study. Participants were asked to list the key features of social communication and pragmatics in Round 1. Questions for Rounds 2 and 3 were developed on the basis of the participants' responses to previous rounds.

RESULTS

The Delphi technique was useful in bringing participants to consensus on the key features of social communication and pragmatics and offered a starting point for the continued exploration of this complex problem.

CONCLUSION

A discussion of the benefits and limitations of the technique is included, highlighting the utility of the technique to the field of speech-language pathology.

Pragmatics of language and theory of mind in children with dyslexia with associated language difficulties or nonverbal learning disabilities

The present study aims to find empirical evidence of deficits in linguistic pragmatic skills and theory of mind (ToM) in children with dyslexia with associated language difficulties or nonverbal learning disabilities (NLD), when compared with a group of typically developing (TD) children matched for age and gender. Our results indicate that children with dyslexia perform less well than TD children in most of the tasks measuring pragmatics of language, and in one of the tasks measuring ToM. In contrast, children with NLD generally performed better than the dyslexia group, and performed significantly worse than the TD children only in a metaphors task based on visual stimuli. A discriminant function analysis confirmed the crucial role of the metaphors subtest and the verbal ToM task in distinguishing between the groups. We concluded that, contrary to a generally-held assumption, children with dyslexia and associated language difficulties may be weaker than children with NLD in linguistic pragmatics and ToM, especially when language is crucially involved. The educational and clinical implications of these findings are discussed.