Expressive language abilities of boys with idiopathic autism spectrum disorder and boys with fragile X syndrome + autism spectrum disorder: Cross-context comparisons

Language competency in autism: a scientometric review

The study of atypical language acquisition in children with, autism spectrum disorder (ASD) is crucial for both practical and theoretical reasons. Understanding the course of language development in ASD can inform potential interventions and treatments while shedding light on the necessary conditions for language development in typically developing children. This scientometric review aims to provide a comprehensive overview of the research landscape in this field, identifying trends, patterns, and knowledge gaps. The methods employed in this review comprise a systematic search of three major databases: Scopus (5,026 documents), Web of Science (WoS; 4,570 documents), and Lens (3,235 documents). The analysis includes bibliometric indicators such as knowledge production size by year, country, university, source, subject area, author, and citation. Scientometric indicators consist of burst detection, silhouette, clusters, citation, and co-occurrence of keywords. The analysis reveals clusters focusing on various aspects of language development in ASD, such as motor skills, parental communication strategies, cognitive processes, and genetics. Key clusters include the relationship between fine motor gestures and language usage patterns, the role of expressive language skills and maternal gesture use, and the effectiveness of online parent training modules for improving prelinguistic predictors. Other noteworthy clusters explore the importance of core language skills, the role of natural language input and syntactic complexity, and the genetic underpinnings of language abilities in high-functioning adults with ASD. In conclusion, this scientometric review highlights the top 10 clusters and their respective Silhouette values, providing valuable insights into language acquisition in ASD. These findings have important implications for guiding future research directions and informing the creation of targeted and effective interventions to support language acquisition in this population.

A thematic review of autism spectrum disorder research in Saudi Arabia: Insights into diagnosis, assessment, and language considerations

This study reviews the crucial role of language in Autism Spectrum Disorder (ASD) diagnosis and assessment in Saudi Arabia. Using tailored search strings, 206 relevant documents were retrieved from the Web of Science and Scopus databases. An increasing trend in ASD research in Saudi Arabia was observed through temporal analysis. Keyword analysis identified key themes including "autism," "language," "assessment," "diagnosis," "Saudi Arabia," and "children." The focus of research has shifted over the years, from pure clinical and diagnostic aspects to a more comprehensive approach that includes language and cultural factors in ASD evaluation. The findings underscore the need for culturally and linguistically sensitive assessment tools, acknowledging the impact of bilingualism on language development, and the importance of language difficulties in diagnostic decision-making. The study highlights the necessity for further research, especially longitudinal studies examining the influence of language and cultural factors on ASD outcomes. The findings are significant for clinical practice, emphasizing the need for linguistically sensitive approaches in ASD diagnosis and assessment. This research serves as a guide for future studies by identifying the gaps in existing literature and areas of focus. The study identifies crucial gaps in existing literature, particularly the need for longitudinal studies examining the influence of language and cultural factors on ASD outcomes. The findings underscore the importance of culturally and linguistically sensitive approaches in ASD diagnosis and assessment, providing a novel insight for future research and clinical practice in Saudi Arabia.

An Exploratory Study of Pragmatic Language Use Across Contexts With the Pragmatic Rating Scale-School Age Among Autistic Boys and Boys With Fragile X Syndrome Plus Autism

PURPOSE

Autistic boys and boys with co-occurring fragile X syndrome and autism spectrum disorder (FXS + ASD) demonstrate similar pragmatic language difficulties. The Pragmatic Rating Scale-School Age (PRS-SA) captures ecologically valid metrics of pragmatic language impairments in these populations. It is traditionally scored based on the Autism Diagnostic Observation Schedule (ADOS), which may limit the use of the PRS-SA more broadly in research and clinical contexts.

METHOD

This study evaluated the feasibility of the PRS-SA based on a shorter, semistructured conversational context compared to the ADOS in school-age autistic boys (n = 16) and boys with FXS + ASD (n = 16), matched on ASD traits. Differences across ADOS and conversational contexts and associations with ASD-related social difficulties were evaluated.

RESULTS

Findings revealed differences in PRS-SA scores between ADOS and conversational contexts, but only for the FXS + ASD group. Limited associations were observed between PRS-SA scores and ASD traits.

CONCLUSIONS

Results from this study indicate the feasibility of using the PRS-SA in a shorter conversational context than the ADOS to assess pragmatic language among autistic boys. For boys with FXS + ASD, contextual differences warrant careful consideration in future work.

Parent Certainty and Consistency When Completing Vocabulary Checklists in Young Autistic Children

PURPOSE

Using a novel parent report measure, this study investigated whether asking parents to rate their certainty when reporting on child vocabulary skills provided additional insight into parent report and emerging language abilities in young autistic children. Specifically, we investigated whether parent certainty varied based on whether the child was reported to understand, understand and say, or neither understand nor say the word and whether standardized measures of expressive and receptive language abilities and/or autistic traits predicted parent certainty. Lastly, we investigated whether certainty was associated with inconsistency in parent report of child word knowledge.

METHOD

Twenty-one parents and their autistic children ages 2-5 years participated. One parent per child completed the MacArthur-Bates Communicative Development Inventories (MCDI) Words and Gestures form and a custom vocabulary checklist including 24 object nouns from the MCDI. Within the custom form, parents indicated whether their child understood, understood and said, or neither understood nor said 24 target nouns and reported how certain they were about their responses using a 5-point scale. Expressive language, receptive language, and autistic traits were measured via direct assessment using standardized measures.

RESULTS

Parent certainty varied widely and was higher for words the parents reported the children understood and said compared to that for words children either understood or neither understood nor said. Certainty ratings were higher when a child had higher standardized receptive and expressive language scores. Lastly, parent certainty was associated with reporting consistency, clarifying previous findings of inconsistencies in parent report of child vocabulary.

CONCLUSION

Findings from this study indicate that measuring parent certainty provides critical information when assessing early vocabulary skills in autistic children.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23671497.

Consistency and reliability of automated language measures across expressive language samples in autism

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with substantial clinical heterogeneity, especially in language and communication ability. There is a need for validated language outcome measures that show sensitivity to true change for this population. We used Natural Language Processing to analyze expressive language transcripts of 64 highly-verbal children and young adults (age: 6-23 years, mean 12.8 years; 78.1% male) with ASD to examine the validity across language sampling context and test-retest reliability of six previously validated Automated Language Measures (ALMs), including Mean Length of Utterance in Morphemes, Number of Distinct Word Roots, C-units per minute, unintelligible proportion, um rate, and repetition proportion. Three expressive language samples were collected at baseline and again 4 weeks later. These samples comprised interview tasks from the Autism Diagnostic Observation Schedule (ADOS-2) Modules 3 and 4, a conversation task, and a narration task. The influence of language sampling context on each ALM was estimated using either generalized linear mixed-effects models or generalized linear models, adjusted for age, sex, and IQ. The 4 weeks test-retest reliability was evaluated using Lin's Concordance Correlation Coefficient (CCC). The three different sampling contexts were associated with significantly (P < 0.001) different distributions for each ALM. With one exception (repetition proportion), ALMs also showed good test-retest reliability (median CCC: 0.73-0.88) when measured within the same context. Taken in conjunction with our previous work establishing their construct validity, this study demonstrates further critical psychometric properties of ALMs and their promising potential as language outcome measures for ASD research.

Comparison of Linguistic Error Production in Conversational Language Among Boys With Fragile X Syndrome + Autism Spectrum Disorder and Autistic Boys

PURPOSE

Expressive language impairments are common among school-age boys with fragile X syndrome (FXS) and autistic boys. Given the high co-occurrence of autism spectrum disorder (ASD) among individuals with FXS, cross-condition comparisons can elucidate the specificity of such impairments as they relate to ASD. Language samples can provide fruitful information regarding individuals' grammatical skills in less structured formats relative to standardized measures. This study examined grammatical errors produced during a conversational language sample among 20 boys with FXS and co-occurring ASD (FXS + ASD) and 19 autistic boys matched on ASD severity.

METHOD

Language samples were coded for omissions and errors at the word and utterance levels. Participants' grammatical errors were also compared to separate mental age-matched and mean length of utterance-matched boys from a reference database.

RESULTS

Boys with FXS + ASD and autistic boys produced similar rates of errors across all categories. Relative to their matched comparison groups, boys with FXS + ASD and autistic boys produced significantly more omissions during conversation.

CONCLUSIONS

These findings suggest that omissions may be a unique grammatical marker associated with the ASD phenotype. Further examination of omissions across diagnostic groups would aid in clarifying the specificity of omissions in the language phenotype of ASD.

Communication in fragile X syndrome: Patterns and implications for assessment and intervention

Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and is associated with a high rate of autism diagnosis. Language delays have been noted in the areas of overall communication and the specific areas of receptive, expressive, and pragmatic language, as well as in development of speech sounds and literacy. It has been widely noted that those individuals with a diagnosis of both FXS and autism tend to have more significant intellectual disability and language disorder. In this study, the research exploring the FXS language phenotype is presented, and the roles of cognition, autistic symptomatology, and gender are highlighted as possible. Implications for assessment and intervention approaches based on the strengths and weaknesses of the FXS language phenotype are provided.

Conversational adaptation in children and teens with autism: Differences in talkativeness across contexts

Successful social communication is complex; it relies on effectively deploying and continuously revising one's behavior to fit the needs of a given conversation, partner, and context. For example, a skilled conversationalist may instinctively become less talkative with a quiet partner and more talkative with a chattier one. Prior research suggests that behavioral flexibility across social contexts can be a particular challenge for individuals with autism spectrum condition (ASC), and that difficulty adapting to the changing needs of a conversation contributes to communicative breakdowns and poor social outcomes. In this study, we examine whether reduced conversational adaptation, as measured by talkativeness, differentiates 48 verbally fluent children and teens with ASC from 50 neurotypical (NT) peers matched on age, intelligence quotient, and sex ratio. Participants completed the Contextual Assessment of Social Skills with two novel conversation partners. The first acted interested in the conversation and talked more (Interested condition), while the second acted bored and talked less (Bored condition). Results revealed that NT participants emulated their conversation partner's behavior by being more talkative in the Interested condition as compared to the Bored condition (z = 9.92, p < 0.001). In contrast, the ASC group did not differentially adapt their behavior to the Bored versus Interested context, instead remaining consistently talkative in both (p = 0.88). The results of this study have implications for understanding social communication and behavioral adaptation in ASC, and may be valuable for clinicians interested in improving conversational competence in verbally fluent individuals with autism. LAY SUMMARY: Social communication-including everyday conversations-can be challenging for individuals on the autism spectrum. In successful conversations, people tend to adjust aspects of their language to be more similar to their partners'. In this study, we found that children and teens with autism did not change their own talkativeness in response to a social partner who was more or less talkative, whereas neurotypical peers did. These findings have clinical implications for improving conversational competence in verbally fluent individuals with autism.

Brief Report: Linguistic Mazes and Perseverations in School-Age Boys with Fragile X Syndrome and Autism Spectrum Disorder and Relationships with Maternal Maze Use

Autism spectrum disorder (ASD) and fragile X syndrome (FXS) are neurodevelopmental disorders with overlapping pragmatic language impairments. Prior work suggests pragmatic language differences may run in families. This study examined specific pragmatic difficulties (i.e., linguistic mazes and perseverations) in boys (9-18 years) with idiopathic ASD (n = 26) and FXS+ASD (n = 29), and relationships with maternal maze use. Language samples were obtained separately for boys and mothers. Nonparametric analyses suggested that boys largely did not differ in their rates of mazes, but that boys with FXS+ASD exhibited more perseverations. Mazes were correlated between fragile X dyads. Maternal mazes were correlated with child perseverations among idiopathic ASD dyads. These findings have implications for the etiological significance of ASD-related language phenotypes.