The Developmental Sequence and Relations Between Gesture and Spoken Language in Toddlers With Autism Spectrum Disorder

The Development of Gesture Skills in Chinese Autistic Children: The Predictive Roles of Age and Language Ability

PURPOSE

Gesture delay in autistic infants and toddlers has been widely reported. The developmental trajectory of gesture production during early childhood is understudied. Thus, little is known about the possible changes of gesture production over time. The present study aimed to document the development of gesture production in autistic children and examine whether child-based factors (chronological age and initial language skills) predicted gesture development.

METHOD

A total of 33 Chinese-speaking autistic children (Mage = 56.39 months, SD = 8.54 months) played with their parents at four time points over a 9-month period. Their speech was transcribed, and their gestures were coded from parent-child interaction. Multilevel modeling analysis was used to investigate the development of gesture and its associated factors.

RESULTS

The total number of gestures produced by autistic children decreased over time. Among different factors, children's initial age significantly and negatively predicted children's gesture production, while initial language positively predicted children's gesture production.

CONCLUSIONS

Gesture delay persists in preschool age. The decline in gesture production was associated with children's age and initial language ability. These findings shed light on the difficulties surrounding gesture use in autistic children.

Does Gestural Communication Influence Later Spoken Language Ability in Minimally Verbal Autistic Children?

PURPOSE

The current study examined the predictive role of gestures and gesture-speech combinations on later spoken language outcomes in minimally verbal (MV) autistic children enrolled in a blended naturalistic developmental/behavioral intervention (Joint Attention, Symbolic Play, Engagement, and Regulation [JASPER] + Enhanced Milieu Teaching [EMT]).

METHOD

Participants were 50 MV autistic children (40 boys), ages 54-105 months (M = 75.54, SD = 16.45). MV was defined as producing fewer than 20 spontaneous, unique, and socially communicative words. Autism symptom severity (Autism Diagnostic Observation Schedule-Second Edition) and nonverbal cognitive skills (Leiter-R Brief IQ) were assessed at entry. A natural language sample (NLS), a 20-min examiner-child interaction with specified toys, was collected at entry (Week 1) and exit (Week 18) from JASPER + EMT intervention. The NLS was coded for gestures (deictic, conventional, and representational) and gesture-speech combinations (reinforcing, disambiguating, supplementary, other) at entry and spoken language outcomes: speech quantity (rate of speech utterances) and speech quality (number of different words [NDW] and mean length of utterance in words [MLUw]) at exit using European Distributed Corpora Project Linguistic Annotator and Systematic Analysis of Language Transcripts.

RESULTS

Controlling for nonverbal IQ and autism symptom severity at entry, rate of gesture-speech combinations (but not gestures alone) at entry was a significant predictor of rate of speech utterances and MLUw at exit. The rate of supplementary gesture-speech combinations, in particular, significantly predicted rate of speech utterances and NDW at exit.

CONCLUSION

These findings highlight the critical importance of gestural communication, particularly gesture-speech (supplementary) combinations in supporting spoken language development in MV autistic children.

Task-related differences in the gesture production of young autistic children

BACKGROUND

In typically developing (TD) children, gesture emerges around 9 months of age, allowing children to communicate prior to speech. Due to the important role gesture plays in the early communication of autistic and TD children, various tasks have been used to assess gesture ability. However, few data exist on whether and how tasks differentially elicit gesture, particularly for samples of racially and ethnically diverse autistic children.

AIMS

In this study, we explored if task (a naturalistic parent-child interaction [NPCI]; structured assessment of child communication) differentially elicited rate or type of gesture production for young autistic children.

METHODS AND PROCEDURES

This secondary analysis included baseline data from 80 racially and ethnically diverse autistic children aged 18-59 months who participated in one of two larger studies. Video recordings of NPCIs and an assessment of child communication with standardised administration procedures were collected at baseline. Child gesture rate (number of gestures produced per 10 min) and type were extracted from these recordings and analysed.

OUTCOMES AND RESULTS

The structured assessment elicited more gestures than the NPCI. In terms of gesture type, points, gives, and reaches accounted for 76% of child gestures. Points (which are developmentally more advanced than reaches and gives) were produced at the highest rates within book exploration. Distal points (which are more developmentally advanced than proximal or contact points) were produced at the highest rates when children were tempted to request.

CONCLUSIONS AND IMPLICATIONS

Our findings indicate elicitation tasks differentially elicit type and rate of gesture for young autistic children. To assess the gesture production of young autistic children, a structured task designed to elicit child requests will probe the developmental sophistication of the child's gesture repertoire, eliciting both the most gestures and the most developmentally advanced gestures.

WHAT THIS PAPER ADDS

What is already known on the subject Because of the importance of gesture in early communication for autistic and typically developing children, various tasks have been used to assess it. However, little is known about whether tasks differentially elicit type or rate of gesture for young autistic children from diverse racial and ethnic backgrounds. What this paper adds to existing knowledge Elicitation tasks differentially elicit type and rate of gesture for young autistic children in the early stages of gesture. What are the potential or actual clinical implications of this work? We recommend a structured task designed to elicit child requests to assess the developmental sophistication of a child's gesture repertoire.

Developmental Language Differences in Children with Autism Spectrum Disorders and Possible Sex Difference

Developmental difference is a common characteristic of autism spectrum disorder (ASD) with unclear sex differences. The current study included 610 children with ASD, aged between 2 and 7 years, with completed language profiles. We used a nonparametric item response theory model called Mokken scale analysis to examine the order of acquisition of developmental language milestones in children with ASD. Our results demonstrated the developmental language differences in the expressive and receptive language dimensions in children with ASD compared with typical developmental sequences. Furthermore, The acquisition of gestures and pragmatics was more impaired in the female subgroup than in the male subgroup. The identified developmental language sequence could help provide a more comprehensive ASD developmental profile.

The Role of Gesture in Language Development for Neurotypical Children and Children With or at Increased Likelihood of Autism

For young children, gesture is found to precede and predict language development. However, we are still building a knowledge base about the specific nature of the relationship between gesture and speech. While much of the research on this topic has been conducted with neurotypical children, there is a growing body of work with children who have or are at increased likelihood of autism spectrum disorder (ASD). Here, we summarize the literature on relations between gesture and speech, including the role of child gesture production as well as that of gesture exposure (caregiver gesture). We include literature on both neurotypical children and children with or at likelihood of ASD, highlight the similarities and differences across populations, and offer implications for research as well as early identification and intervention.

Utility of the Language Use Inventory in Young Children at Elevated Likelihood of Autism

PURPOSE

The aims of this study were (a) to evaluate the convergent validity of the Language Use Inventory (LUI) with measures of autism spectrum disorder (ASD) symptoms, language, and social skills and (b) to assess discriminant validity of the LUI with measures of nonlanguage skills, including daily living skills and motor development.

METHOD

This study sample included participants from a longitudinal study (n = 239) of infant siblings with elevated familial likelihood of ASD and lower familial likelihood. Assessment measures completed at 36 months included the LUI, the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), the Mullen Scales of Early Learning, and the Vineland Adaptive Behavior Scales-Second Edition. Bivariate Pearson correlations were estimated between ADOS-2 comparison scores and four language and social skills measures. Additional correlations were estimated between LUI total scores and standard scores from nonlanguage measures. A series of Fisher's Z transformations were applied to evaluate whether bivariate correlations were significantly different.

RESULTS

All four language and social skill measures were moderately to strongly associated with each other and ASD symptom severity scores. The correlation between ADOS-2 comparison scores and LUI total scores was significantly stronger than ADOS-2 correlations with all other measures.

CONCLUSIONS

Our findings provide support for the LUI as a feasible, pragmatic language-targeted instrument for inclusion in early developmental evaluations prompted by language concerns. Administration of the LUI may accelerate earlier referral for a comprehensive assessment of ASD symptoms. Given the high correlation with ADOS-2 scores, an LUI total score in a clinical range of concern may encourage a clinician to refer families for a full diagnostic evaluation of ASD.

Whose Gestures are More Predictive of Expressive Language Abilities among Chinese-Speaking Children with Autism? A Comparison of Caregivers' and Children's Gestures

In spite of the close relationship between gestures and expressive language, little research has examined the roles of the parents' and children's gestures in the development of expressive language abilities in autistic children. Previous findings are also inconclusive. In the present study, we coded the gestures produced by the parents and their autistic children in parent-child interactions and compared the influence of their gestures on the children's expressive language abilities (N = 35; M = 4;10). Autistic children's deictic gestures positively predicted their Mean Length Utterance (MLU), word types, and word tokens whereas parents' deictic gesture inputs negatively predicted MLU and word types. The findings shed light on the importance of the gestures made by autistic children, which may trigger parents' gesture-to-word translation.

Examining Phenotypical Heterogeneity and its Underlying Factors in Gesture Skills of Chinese Autistic Children: Clustering Analysis

PURPOSE

The heterogeneity of autism is well documented, but few studies have studied the heterogeneity of gesture production ability in autistic children. The present study aimed to identify subgroups of autistic children who displayed heterogeneous gesture production abilities and explore the underlying factors, including autism characteristics, intellectual ability, and language ability, that were associated with the heterogeneity.

METHODS

A total of 65 Chinese autistic children (mean age = 5;3) participated. Their autism characteristics and intellectual ability were assessed by standardized measurements. Language output and gesture production were captured from a parent-child interaction task.

RESULTS

We conducted a hierarchical cluster analysis and identified four distinct clusters. Cluster 1 and Cluster 2 both had low gesture production whereas Cluster 3 and Cluster 4 had high gesture production. Both Clusters 1 and 2 had relatively strong autism characteristics, in comparison to Clusters 3 and 4.

CONCLUSIONS

Our findings revealed that children with stronger autism characteristics may gesture less often than those with weaker characteristics. However, the relationship between language ability and intellectual ability and gesture production was not clear. These findings shed light on the directions of intervention on gesture production for autistic children, especially those with stronger autism characteristics.

The cross-racial/ethnic gesture production of young autistic children and their parents

BACKGROUND & AIMS

Early gesture plays an important role in prelinguistic/emerging linguistic communication and may provide insight into a child's social communication skills before the emergence of spoken language. Social interactionist theories suggest children learn to gesture through daily interactions with their social environment (e.g., their parents). As such, it is important to understand how parents gesture within interactions with their children when studying child gesture. Parents of typically developing (TD) children exhibit cross-racial/ethnic differences in gesture rate. Correlations between parent and child gesture rates arise prior to the first birthday, although TD children at this developmental level do not yet consistently exhibit the same cross-racial/ethnic differences as their parents. While these relationships have been explored in TD children, less is known about the gesture production of young autistic children and their parents. Further, studies of autistic children have historically been conducted with predominantly White, English-speaking participants. As a result, there is little data regarding the gesture production of young autistic children and their parents from diverse racial/ethnic backgrounds. In the present study, we examined the gesture rates of racially/ethnically diverse autistic children and their parents. Specifically, we explored (1) cross-racial/ethnic differences in the gesture rate of parents of autistic children, (2) the correlation between parent and child gesture rates, and (3) cross-racial/ethnic differences in the gesture rates of autistic children.

METHODS

Participants were 77 racially/ethnically diverse cognitively and linguistically impaired autistic children (age 18 to 57 months) and a parent who participated in one of two larger intervention studies. Naturalistic parent-child and structured clinician-child interactions were video recorded at baseline. Parent and child gesture rate (number of gestures produced per 10 min) were extracted from these recordings.

RESULTS

(1) Parents exhibited cross-racial/ethnic differences in gesture rate such that Hispanic parents gestured more frequently than Black/African American parents, replicating previous findings in parents of TD children. Further, South Asian parents gestured more than Black/African American parents. (2) The gesture rate of autistic children was not correlated with parent gesture, a finding that differs from TD children of a similar developmental level. (3) Autistic children did not exhibit the same cross-racial/ethnic differences in gesture rate as their parents, a result consistent with findings from TD children.

CONCLUSIONS

Parents of autistic children-like parents of TD children-exhibit cross-racial/ethnic differences in gesture rate. However, parent and child gesture rates were not related in the present study. Thus, while parents of autistic children from different ethnic/racial backgrounds appear to be conveying differences in gestural communication to their children, these differences are not yet evident in child gesture.

IMPLICATIONS

Our findings enhance our understanding of the early gesture production of racially/ethnically diverse autistic children in the prelinguistic/emerging linguistic stage of development, as well as the role of parent gesture. More research is needed with developmentally more advanced autistic children, as these relationships may change with development.

Babies under 1 year with atypical development: Perspectives for preventive individuation and treatment

A baby's first year of life is a time of immense development and cerebral plasticity. Following today's research and clinical observation, the period of the first year of life provides a new challenge inasmuch it is presently clear that it is possible to identify developmental anomalies in this window of time. Effecting early screening procedures could prove very useful, especially where we find genetic vulnerabilities in brothers and sisters of autistic subjects. Interventions of this kind, already practiced by some Public Health systems, can mean taking early action and primary protective measures with significant impacts not only on the subjects (babies and family members) concerned, but also on the public purse. It is, therefore, essential to provide for specific professionalized procedures for psychologists, pediatricians and neuropsychologists to be introduced through personnel highly specialized in interventions during the first year of life.

Gesture Development in Chinese-Speaking Preschool Children With Autism and the Roles of Parental Input and Child-Based Factors

PURPOSE

Children with autism are found to have delayed and heterogeneous gesture abilities. It is important to understand the growth of gesture abilities and the underlying factors affecting its growth. Addressing these issues can help to design effective intervention programs.

METHOD

Thirty-five Chinese-speaking preschoolers with autism spectrum disorder (M _age = 4.89 years, SD = 0.91; four girls) participated in four play sessions with their parents over 9 months. Their child-based factors including autism severity, intellectual functioning, and expressive language abilities were assessed. The gestures (deictic, iconic, and conventional) of the children and their parents were coded. Growth curve analyses were conducted to examine individual growth trajectories and the roles of child-based factors and parental input in shaping the children's gesture development.

RESULTS

Child-based factors and parental input predicted gesture development differently. Parents' gestures positively predicted their children's gestures of the same type. Autism severity negatively predicted iconic and conventional gestures. Overall growth was found in deictic rather than iconic and conventional gestures. Subgroup variation was also found. Specifically, children with better expressive language ability showed a decrease in deictic gestures. An increase in iconic and conventional gestures was found in children with more severe autism and those with poorer expressive language ability and intellectual functioning, respectively.

CONCLUSIONS

Different types of gestures may have different growth trajectories and be predicted by different child-based factors. Particular attention should be given to children who never produced iconic gestures, which is more challenging and may not develop over a short period, and hence require direct instruction.

Coordinated social communication in toddlers with and without autism spectrum disorder during a home observation

BACKGROUND & AIMS

Social communication and language skills have been found to be important predictors of long-term outcomes in individuals with autism spectrum disorder (ASD). However, the development of coordinated social communication (i.e., gestures and sounds or words) remains relatively understudied in young children with ASD and developmental delays (DD). This study used a prospective, longitudinal design and granular observational coding to document the coordination of gestures, sounds, and words in a large, heterogeneous sample of toddlers identified with ASD, DD, or typical development (TD) during a naturalistic home observation. Specific aims were: (1) to compare rates per minute and proportions of coordinated child communicative acts across groups; (2) to examine concurrent relationships between coordinated communication and measures of social communication and autism symptoms; and (3) to examine prospective relationships between coordinated communication, receptive and expressive language skills, and autism symptoms collected at 3 years of age.

METHODS

At a mean age of 20.3 months (SD = 2.0), 211 children (n_ASD = 121; n_DD = 46; n_TD = 44) participated in everyday activities with a parent during an hourlong home observation. Rates per minute and proportions of gestures, sounds and words, as well as temporally overlapping gesture + sound, gesture + word, and gesture + phrase combinations, were compared using one-way ANOVA. Pearson product moment correlations between coordinated communicative acts and measures of social communication, language, and autism symptoms were examined.

RESULTS

On average, children with ASD used sounds and gesture + sounds at significantly lower rates than DD and TD groups, who did not differ. Children with ASD and DD coordinated gesture + single words and gesture + phrases at significantly lower rates than the TD group. Groups did not differ with respect to the rate per minute at which they used gestures alone. Children with TD used a smaller proportion of sounds alone and higher proportions of words and phrases, with and without coordinated gestures, than ASD and DD groups. Children with ASD and DD used a significantly higher proportion of gestures alone than children with TD. Rates per minute and proportions of single words and gesture + words had significant correlations with measures of social communication, language skills, and autism symptoms.

CONCLUSIONS

Results suggest that a significantly lower rate per minute of sounds and gesture + sound combinations was a distinguishing feature of ASD in our sample. Further, limited use of single words and gesture + single words was observed in children ASD and DD. Significant prospective relationships between single words and gesture + words with language skills measured over a year later underscores the importance of acquiring these forms.

IMPLICATIONS

Results support the idea that clinicians should include opportunities to observe and encourage coordinated social communication while screening and assessing young children for DD and ASD in the home environment. The significant associations between rate of single words and gesture + word combinations with language development over a year later have implications for incorporating intervention targets that encourage the use of gesture-speech combinations.

Multimodal Communication in Children with Autism Spectrum Disorder and Different Linguistic Development

This study focuses on the multimodal communication of children with autism spectrum disorders (ASD) compared to typically developing (TD) children. Eleven children with ASD (aged from 28 to 79 months) and 11 TD children (from 12 to 30 months) were matched by their productive vocabulary. We observed their communicative production in a semi-structured play situation. Results showed no differences in the combinations of gestural and vocal elements between children with ASD and TD. By contrast, regarding the production of the three-element multimodal combinations, we found a different pattern between ASD and TD children depending on their lexical development. These results provide clues to understand some controversial findings regarding multimodal production of people with ASD described in the literature.

The Gestures in 2-4-Year-Old Children With Autism Spectrum Disorder

Deficits in gestures act as early signs of impairment in social interaction (SI) and communication in children with autism spectrum disorder (ASD). However, the pieces of literature on atypical gesture patterns in ASD children are contradictory. This investigation aimed to explore the atypical gesture pattern of ASD children from the dimensions of quantity, communicative function, and integration ability; and its relationship with social ability and adaptive behavior. We used a semi-structured interactive play to evaluate gestures of 33 ASD children (24–48 months old) and 24 typically developing (TD) children (12–36 months old). And we evaluated the social ability, adaptive behavior, and productive language of ASD and TD children by using the Adaptive Behavior Assessment System version II (ABAS-II) and Chinese Communication Development Inventory (CCDI). No matter the total score of CCDI was corrected or not, the relative frequency of total gestures, behavior regulation (BR) gestures, SI gestures, and joint attention (JA) gestures of ASD children were lower than that of TD children, as well as the proportion of JA gestures. However, there was no significant group difference in the proportion of BR and SI gestures. Before adjusting for the total score of CCDI, the relative frequency of gestures without vocalization/verbalization integration and vocalization/verbalization-integrated gestures in ASD children was lower than that in TD children. However, after matching the total score of CCDI, only the relative frequency of gestures without vocalization/verbalization integration was lower. Regardless of the fact that the total score of CCDI was corrected or not, the relative frequency and the proportion of eye-gaze-integrated gestures in ASD children were lower than that in TD children. And the proportion of gestures without eye-gaze integration in ASD children was higher than that in TD children. For ASD children, the social skills score in ABAS-II was positively correlated with the relative frequency of SI gesture and eye-gaze-integrated gestures; the total score of ABAS-II was positively correlated with the relative frequency of total gestures and eye-gaze-integrated gestures. In conclusion, ASD children produce fewer gestures and have deficits in JA gestures. The deficiency of integrating eye gaze and gesture is the core deficit of ASD children’s gesture communication. Relatively, ASD children might be capable of integrating vocalization/verbalization into gestures. SI gestures and the ability to integrate gesture and eye gaze are related to social ability. The quantity of gestures and the ability to integrate gesture with eye gaze are related to adaptive behavior.

Clinical Trial Registration:www.ClinicalTrials.gov, identifier ChiCTR1800019679.

A Longitudinal Study of Parent Gestures, Infant Responsiveness, and Vocabulary Development in Infants at Risk for Autism Spectrum Disorder

We investigated gestures that parents used with 12-, 18-, and 24-month-old infants at high or low risk for autism spectrum disorder (ASD; high-risk diagnosed with ASD: n = 21; high-risk classified as no ASD: n = 34; low-risk classified as no ASD: n = 34). We also examined infant responses to parent gestures and assessed the extent to which parent gesture relates to vocabulary development. Parents of three groups gestured in similar frequencies and proportions. Infants, in turn, responded similarly to parent gestures regardless of the infant's ASD risk and later diagnosis. Finally, parents who gestured more at 12 months had children with better vocabulary at 36 months than parents who gestured less. These findings highlight the importance of examining parent gestures when predicting language development.

How do minimally verbal children and adolescents with autism spectrum disorder use communicative gestures to complement their spoken language abilities?

BACKGROUND AND AIMS

Prior work has examined how children and adolescents with autism spectrum disorder who are minimally verbal use their spoken language abilities during interactions with others. However, social communication includes other aspects beyond speech. To our knowledge, no studies have examined how minimally verbal children and adolescents with autism spectrum disorder are using their gestural communication during social interactions. Such work can provide important insights into how gestures may complement their spoken language abilities.

METHODS

Fifty minimally verbal children and adolescents with autism spectrum disorder participated (M _age = 12.41 years; 38 males). Gestural communication was coded from the Autism Diagnostic Observation Schedule. Children (n = 25) and adolescents (n = 25) were compared on their production of gestures, gesture-speech combinations, and communicative functions. Communicative functions were also assessed by the type of communication modality: gesture, speech, and gesture-speech to examine the range of communicative functions across different modalities of communication. To explore the role gestures may play the relation between speech utterances and gestural production was investigated.

RESULTS

Analyses revealed that (1) minimally verbal children and adolescents with autism spectrum disorder did not differ in their total number of gestures. The most frequently produced gesture across children and adolescents was a reach gesture, followed by a point gesture (deictic gesture), and then conventional gestures. However, adolescents produced more gesture-speech combinations (reinforcing gesture-speech combinations) and displayed a wider range of communicative functions. (2) Overlap was found in the types of communicative functions expressed across different communication modalities. However, requests were conveyed via gesture more frequently compared to speech or gesture-speech. In contrast, dis/agree/acknowledging and responding to a question posed by the conversational partner was expressed more frequently via speech compared to gesture or gesture-speech. (3) The total number of gestures was negatively associated with total speech utterances after controlling for chronological age, receptive communication ability, and nonverbal IQ.

CONCLUSIONS

Adolescents may be employing different communication strategies to maintain the conversational exchange and to further clarify the message they want to convey to the conversational partner. Although overlap occurred in communicative functions across gesture, speech, and gesture-speech, nuanced differences emerged in how often they were expressed across different modalities of communication. Given their speech production abilities, gestures may play a compensatory role for some individuals with autism spectrum disorder who are minimally verbal.

IMPLICATIONS

Findings underscore the importance of assessing multiple modalities of communication to provide a fuller picture of their social communication abilities. Our results identified specific communicative strengths and areas for growth that can be targeted and expanded upon within gesture and speech to optimize social communication development.

Gesture Production in Toddlers with Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) demonstrate delayed and atypical communication development. These deficits constitute a core criterion for the diagnosis of ASD, though information regarding gestural communication in toddlers with ASD remains limited. The present investigation implemented a robust gesture classification system in order to obtain quantitative measures of gesture production in a cohort of toddlers with ASD (n = 40) and controls (n = 40) during 10-min, play-based interactions with caregivers. Children with ASD produced fewer overall gestures and gesture subtypes compared to controls. The ASD group also displayed atypical patterns of gesture production. These findings highlight the need for evidence-based screening, assessment, and intervention protocols pertaining to gestural communication in toddlers with ASD.

Language Growth in Young Children with Autism: Interactions Between Language Production and Social Communication

Young children with autism spectrum disorder (ASD) present with a broad range of spoken language abilities, as well as delays in precursor skills such as gesture production and joint attention skills. While standardized assessments describe language strengths, the Communication and Symbolic Behavior Scales (CSBS-DP) is a particularly robust measure as it additionally characterizes precise aspects of social communication. This study provides a unique contribution by assessing the interactional effects of CSBS-DP Social Composite performance with early language samples on later language outcomes. Our results indicate that multiple social communication elements significantly interact with early spoken language to predict later language. Our findings also highlight the transactional relationship between early spoken vocabulary and social communication skills that bolster language development growth.

Profiles of Early Actions and Gestures in Infants With an Older Sibling With Autism Spectrum Disorder

Purpose Infants with autism spectrum disorder (ASD) produce fewer play actions and gestures than neurotypical infants (e.g., Mastrogiuseppe et al., 2015; Veness et al., 2012; Zwaigenbaum et al., 2005). The purpose of this study was to investigate whether different "types" of actions and gestures are more or less likely to develop atypically in ASD. Method We examined eight types of actions and gestures longitudinally from ages 8 to 14 months in 80 infants with a heightened risk for developing ASD by virtue of having an affected older sibling (high risk [HR]; e.g., Ozonoff et al., 2011) and 25 infants with no such familial risk (low risk). Data were collected using the MacArthur-Bates Communicative Development Inventories (Fenson et al., 1994, 1993). Results HR infants later diagnosed with ASD showed less growth across nearly all types of actions and gestures compared to the low-risk comparison group. Importantly, these HR infants who were later diagnosed with ASD also exhibited reduced growth in frequent deictic gestures and in actions that involve object manipulation relative to HR infants with non-ASD language delay. Conclusions During infancy, it is challenging for clinicians to distinguish ASD from other early communicative delays (e.g., Camarata, 2014). Our results indicate that deictic gestures, as well as actions and gestures involving object manipulation, may be useful targets of surveillance strategies for HR infants and could support early detection efforts for ASD.

Age at Onset of Declarative Gestures and 24-Month Expressive Vocabulary Predict Later Language and Intellectual Abilities in Young Children With Williams Syndrome

Background: One of the most consistent findings in the early language acquisition literature regarding children in the general population is that the onset of declarative pointing gestures precedes the onset of expressive referential language. Furthermore, frequency of early use of declarative gestures is a stronger predictor of later lexical development than early vocabulary size. These findings suggest that early declarative gestures may play a critical facilitative role in later language development. To evaluate the universality of these findings, we tested children with Williams syndrome (WS), a genetic disorder associated with both language and communicative gesture delay.

Method: Participants were 47 children with classic-length WS deletions. Age of onset of declarative show and point were determined by parental report on the MacArthur-Bates Communicative Development Inventory (CDI): Words and Gestures. Expressive vocabulary size at onset of these gestures, first referential expressive word, 24 months, and 48 months and grammatical complexity at 48 months were determined by parental report on the CDI: Words and Sentences. Receptive and expressive vocabulary and overall intellectual ability at 48 months were measured using standardized assessments.

Results: In contrast to previous findings for children in the general population, most children with WS began to produce referential language several months before they produced declarative point. A series of multiple regressions indicated that both age at onset of declarative point and expressive vocabulary size at 24 months made significant independent contributions to individual differences in lexical, grammatical, and overall intellectual ability at 48 months. Similarly to the findings for typically developing children and children with other developmental disabilities, individual differences in the declarative gesture measure accounted for considerably more variance in 48-month lexical ability than early expressive vocabulary size.

Discussion: The transition from prelinguistic communication to initial referential language does not depend on the onset of the ability to use declarative point. Nevertheless, the length of time that a child has been producing declarative point was a better predictor than early expressive vocabulary of later lexical abilities. Thus, despite the earlier divergence in their path to language development from the typical one, the path for children with WS re-converges with that for typically developing children and children with other developmental disabilities.