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Williams TI, Loucas T, Sin J, Jeremic M, Meyer S, Boseley S, Fincham-Majumdar S, Aslett G, Renshaw R, Liu F. Using music to assist language learning in autistic children with minimal verbal language: The MAP feasibility RCT. Autism 2024:13623613241233804. [PMID: 38433533 DOI: 10.1177/13623613241233804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
LAY ABSTRACT Research has shown that autistic individuals often have unusually good musical skills and that combining words and music helps autistic individuals to focus on spoken words. This study tests the idea that music will help with early language learning of preschool autistic children. The results show that when caregivers sing words to autistic children, the children pay more attention to the caregiver than when the words are spoken and that they learn word combinations more easily.
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Williams TI, Loucas T, Sin J, Jeremic M, Aslett G, Knight M, Fincham-Majumdar S, Liu F. A randomised controlled feasibility trial of music-assisted language telehealth intervention for minimally verbal autistic children-the MAP study protocol. Pilot Feasibility Stud 2021; 7:182. [PMID: 34598714 PMCID: PMC8485102 DOI: 10.1186/s40814-021-00918-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/17/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND About 30% of children with autism spectrum disorder (ASD) do not develop functional speech and remain non-verbal or minimally verbal even after years of speech, language and educational interventions. A wide range of interventions have been developed for improving communication in ASD, but none have proved effective in eliciting functional language in ASD children. Research has found that people with ASD are more likely to have perfect pitch and prefer music to language. Further, it seems that language delay tends to co-occur with better musical skills. Brain imaging research has found that music alongside words increases the attention that people with ASD pay to spoken words. METHODS In this protocol, we describe our music-assisted programmes (MAP) that will use music to attract the attention of people with ASD to speech. MAP may open the brain pathways to language and therefore help improve communication skills for people with ASD more than standard communication protocols. In particular, we aim to develop and test whether individualised, easily used MAP would increase spoken language in 24-60-month-old, nonverbal or minimally verbal children with ASD. We will develop a structured training method, delivered through naturalistic, interactive activities (e.g. songs) to teach language to ASD children. We will test this by comparing two groups: one undertaking music-assisted programmes, and the other receiving speech and language therapy in the way that is recommended in NHS clinics. Participants will be allocated to groups randomly. The feasibility of MAP will be assessed through estimations of recruitment and retention rates, the sensitivity and reliability of the outcome measures, the intensity and frequency of the trial, the usability of the MAP app (beta version), and the burden of the assessments for the children and parents. DISCUSSION This feasibility randomised controlled trial will establish the acceptability and estimate the power of the MAP intervention to improve early word learning in children with ASD. In the longer term, this research will help us develop an app for parents or carers of children with ASD to design their own songs and implement their own individualised MAP. TRIAL REGISTRATION ISRCTN, ISRCTN12536062 . Registered on 26 June 2019.
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Affiliation(s)
- Tim I Williams
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Tom Loucas
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Jacqueline Sin
- School of Health Sciences, City University of London, London, UK
| | - Mirjana Jeremic
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Georgia Aslett
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Sara Fincham-Majumdar
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Fang Liu
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
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Cilibrasi L, Stojanovik V, Loucas T, Riddell P. The role of noninitial clusters in the Children's Test of Nonword Repetition: Evidence from children with language impairment and typically developing children. Dyslexia 2018; 24:322-335. [PMID: 30338595 DOI: 10.1002/dys.1599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 09/02/2018] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
The Children's Test of Nonword Repetition (CNRep) is one of the most popular tests of nonword repetition. The test is composed of nonwords of different length, and normative data suggest that children experience more difficulties in repeating long nonwords. An analysis of the distribution of phonological clusters in the test shows that noninitial clusters are unequally distributed in the test: They only appear in long nonwords (four and five syllables). For this reason, we hypothesized that the difficulties children encounter with long nonwords may be influenced by the phonological complexity of the clusters and not just by the challenge for working memory associated with length. To test the hypothesis, we compared repetition performance in long nonwords with and without a noninitial cluster in 18 children with language impairment and 18 typically developing children. The analysis shows that long nonwords with noninitial clusters are repeated less accurately by both groups. In addition, there was an interaction between cluster and age: The effect of cluster is absent in younger children and gradually increases with age. These findings suggest that phonological complexity may be having an impact on the length effect normally observed in the CNRep, and this impact may be particularly evident in older children.
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Affiliation(s)
- Luca Cilibrasi
- Department of English-ELT and Department of Linguistics, Charles University, Prague, Czech Republic
- Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge, UK
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Vesna Stojanovik
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Tom Loucas
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Patricia Riddell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Rudra A, Ram JR, Loucas T, Belmonte MK, Chakrabarti B. Bengali translation and characterisation of four cognitive and trait measures for autism spectrum conditions in India. Mol Autism 2016; 7:50. [PMID: 27980709 PMCID: PMC5135772 DOI: 10.1186/s13229-016-0111-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 11/08/2016] [Indexed: 12/21/2022] Open
Abstract
Background Autism is characterised by atypical social-communicative behaviour and restricted range of interests and repetitive behaviours. These features exist in a continuum in the general population. Behavioural measures validated across cultures and languages are required to quantify the dimensional traits of autism in these social and non-social domains. Bengali is the seventh most spoken language in the world. However, there is a serious dearth of data on standard measures of autism-related social and visual cognition in Bengali. Methods Bengali translations of two measures related to social-communicative functioning (the Children’s Reading the Mind in the Eyes Test (RMET) and a facial emotion recognition test with stimuli taken from the Karolinska Directed Emotional Faces database), one measure of visual perceptual disembedding (the Embedded Figures Test), and a questionnaire measure (the Children’s Empathy Quotient) were tested in 25 children with autism spectrum conditions (ASC) and 26 control children (mean age = 10.7 years) in Kolkata, India. Group differences were analysed by t test and multiple regression (after accounting for potential effects of gender, IQ, and age). Results Behavioural and trait measures were associated with group differences in the expected directions: ASC children scored lower on the Children’s Empathy Quotient and the RMET, as well as on facial emotion recognition, but were faster and more accurate on the Embedded Figures Test. Distributional properties of these measures within groups are similar to those reported in Western countries. Conclusions These results provide an empirical demonstration of cross-cultural generalisability and applicability of these standard behavioural and trait measures related to autism, in a major world language.
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Affiliation(s)
- Alokananda Rudra
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK ; Ben Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Tom Loucas
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Matthew K Belmonte
- The Com DEALL Trust, Bangalore, India ; Nottingham Trent University, Nottingham, UK
| | - Bhismadev Chakrabarti
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Loucas T, Baird G, Simonoff E, Slonims V. Phonological processing in children with specific language impairment with and without reading difficulties. Int J Lang Commun Disord 2016; 51:581-588. [PMID: 26992032 DOI: 10.1111/1460-6984.12225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 10/10/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Specific language impairment (SLI) is heterogeneous and identifying subgroups within it may help explain the aetiology of the condition. Phonological processing abilities distinguish between children with SLI who do and do not have reading decoding impairments (RDIs). AIMS To probe different levels of phonological processing in children with SLI with and without RDI to investigate the cognitive basis of these differences. METHODS & PROCEDURES A total of 64 children aged 5-17 years were classified using the results of standardized language and single-word reading tests into those with no SLI and no RDI (No SLI/No RDI) (N = 18), no SLI but with RDI (No SLI/RDI) (N = 4, not included in analyses because of the small number), SLI/No RDI (N = 20), and SLI/RDI (N = 22). The groups were compared on a range of tasks engaging different levels of phonological processing (input and output processing and phonological awareness). OUTCOMES & RESULTS The SLI/RDI group was distinguished from the SLI/No RDI and No SLI/No RDI groups by more errors in the longer items in non-word repetition and by poorer phonological awareness. Non-word discrimination scores indicated a gradient of performance across groups that was not associated with a qualitatively different pattern of performance. CONCLUSIONS & IMPLICATIONS This is the first study contrasting input and output processes associated with phonological processing. The results suggest that deficits in SLI plus RDI may be associated with impairment in actively maintaining phonological representations for phonological processing, which is not present in those without RDI and which leads to reading decoding difficulties.
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Affiliation(s)
- Tom Loucas
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Gillian Baird
- Children's Neurosciences Centre, Evelina London Children's Hospital, St Thomas' Hospital, London, UK
| | - Emily Simonoff
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Vicky Slonims
- Children's Neurosciences Centre, Evelina London Children's Hospital, St Thomas' Hospital, London, UK
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Riches NG, Loucas T, Baird G, Charman T, Simonoff E. Elephants in Pyjamas: Testing the Weak Central Coherence Account of Autism Spectrum Disorders Using a Syntactic Disambiguation Task. J Autism Dev Disord 2015; 46:155-163. [DOI: 10.1007/s10803-015-2560-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dalton N, Chandler S, Turner C, Charman T, Pickles A, Loucas T, Simonoff E, Sullivan P, Baird G. Gut permeability in autism spectrum disorders. Autism Res 2013; 7:305-13. [PMID: 24339339 DOI: 10.1002/aur.1350] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 10/22/2013] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To test whether gut permeability is increased in autism spectrum disorders (ASD) by evaluating gut permeability in a population-derived cohort of children with ASD compared with age- and intelligence quotient-matched controls without ASD but with special educational needs (SEN). PATIENTS AND METHODS One hundred thirty-three children aged 10-14 years, 103 with ASD and 30 with SEN, were given an oral test dose of mannitol and lactulose and urine collected for 6 hr. Gut permeability was assessed by measuring the urine lactulose/mannitol (L/M) recovery ratio by electrospray mass spectrometry-mass spectrometry. The ASD group was subcategorized for comparison into those without (n = 83) and with (n = 20) regression. RESULTS There was no significant difference in L/M recovery ratio (mean (95% confidence interval)) between the groups with ASD: 0.015 (0.013-0.018), and SEN: 0.014 (0.009-0.019), nor in lactulose, mannitol, or creatinine recovery. No significant differences were observed in any parameter for the regressed versus non-regressed ASD groups. Results were consistent with previously published normal ranges. Eleven children (9/103 = 8.7% ASD and 2/30 = 6.7% SEN) had L/M recovery ratio > 0.03 (the accepted normal range cut-off), of whom two (one ASD and one SEN) had more definitely pathological L/M recovery ratios > 0.04. CONCLUSION There is no statistically significant group difference in small intestine permeability in a population cohort-derived group of children with ASD compared with a control group with SEN. Of the two children (one ASD and one SEN) with an L/M recovery ratio of > 0.04, one had undiagnosed asymptomatic celiac disease (ASD) and the other (SEN) past extensive surgery for gastroschisis.
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Affiliation(s)
- Neil Dalton
- WellChild Laboratory, Evelina Children's Hospital & King's College London, London
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Riches NG, Loucas T, Baird G, Charman T, Simonoff E. Interpretation of compound nouns by adolescents with specific language impairment and autism spectrum disorders: an investigation of phenotypic overlap. Int J Speech Lang Pathol 2012; 14:307-317. [PMID: 22762205 DOI: 10.3109/17549507.2012.679313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The study aimed to investigate (i) whether adolescents with Specific Language Impairment (SLI) and Autism plus Language Impairment (ALI) experience word-formation difficulties, and (ii) whether these two groups present with a similar language phenotype. The study investigated four groups using a 2 (language status) ×2 (autism status) design; adolescents with SLI (n = 14), ALI (n = 16), Autism Language-Typical (ALT; n = 14), and language matched controls (n = 17), with all groups presenting with typical non-verbal skills. Mean age was 14;10. Comprehension of conventional Noun-Noun lexical compounds (e.g., snowman), synthetic compounds (SCs, e.g., cat chaser), and novel root compounds (RCs, e.g., sheep socks), was assessed using a forced-choice picture selection task. The SLI and ALI participants frequently mis-parsed the SCs, interpreting the first noun as the agent. Those with poorer vocabularies and non-word repetition had greater difficulties. Reaction time (RT) profiles were flatter in the ASD groups, with similar RTs across different compounds. Language difficulties in the SLI and ALI groups extend to word-formation processes; for example, comprehension of SCs. This may reflect difficulties making analogies with stored lexical items. Overall the results support the hypothesis of a phenotypic overlap between SLI and ALI.
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Abstract
BACKGROUND Autism spectrum disorder (ASD) was once considered to be highly associated with intellectual disability and to show a characteristic IQ profile, with strengths in performance over verbal abilities and a distinctive pattern of 'peaks' and 'troughs' at the subtest level. However, there are few data from epidemiological studies. METHOD Comprehensive clinical assessments were conducted with 156 children aged 10-14 years [mean (s.d.)=11.7 (0.9)], seen as part of an epidemiological study (81 childhood autism, 75 other ASD). A sample weighting procedure enabled us to estimate characteristics of the total ASD population. RESULTS Of the 75 children with ASD, 55% had an intellectual disability (IQ<70) but only 16% had moderate to severe intellectual disability (IQ<50); 28% had average intelligence (115>IQ>85) but only 3% were of above average intelligence (IQ>115). There was some evidence for a clinically significant Performance/Verbal IQ (PIQ/VIQ) discrepancy but discrepant verbal versus performance skills were not associated with a particular pattern of symptoms, as has been reported previously. There was mixed evidence of a characteristic subtest profile: whereas some previously reported patterns were supported (e.g. poor Comprehension), others were not (e.g. no 'peak' in Block Design). Adaptive skills were significantly lower than IQ and were associated with severity of early social impairment and also IQ. CONCLUSIONS In this epidemiological sample, ASD was less strongly associated with intellectual disability than traditionally held and there was only limited evidence of a distinctive IQ profile. Adaptive outcome was significantly impaired even for those children of average intelligence.
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Affiliation(s)
- T Charman
- Centre for Research in Autism and Education, Department of Psychology and Human Development, Institute of Education, London, UK.
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Riches NG, Loucas T, Baird G, Charman T, Simonoff E. Non-word repetition in adolescents with specific language impairment and autism plus language impairments: a qualitative analysis. J Commun Disord 2011; 44:23-36. [PMID: 20673911 DOI: 10.1016/j.jcomdis.2010.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 06/22/2010] [Accepted: 06/27/2010] [Indexed: 05/28/2023]
Abstract
UNLABELLED Non-word repetition (NWR) was investigated in adolescents with typical development, Specific Language Impairment (SLI) and Autism Plus language Impairment (ALI) (n=17, 13, 16, and mean age 14;4, 15;4, 14;8 respectively). The study evaluated the hypothesis that poor NWR performance in both groups indicates an overlapping language phenotype (Kjelgaard & Tager-Flusberg, 2001). Performance was investigated both quantitatively, e.g. overall error rates, and qualitatively, e.g. effect of length on repetition, proportion of errors affecting phonological structure, and proportion of consonant substitutions involving manner changes. Findings were consistent with previous research (Whitehouse, Barry, & Bishop, 2008) demonstrating a greater effect of length in the SLI group than the ALI group, which may be due to greater short-term memory limitations. In addition, an automated count of phoneme errors identified poorer performance in the SLI group than the ALI group. These findings indicate differences in the language profiles of individuals with SLI and ALI, but do not rule out a partial overlap. Errors affecting phonological structure were relatively frequent, accounting for around 40% of phonemic errors, but less frequent than straight Consonant-for-Consonant or vowel-for-vowel substitutions. It is proposed that these two different types of errors may reflect separate contributory mechanisms. Around 50% of consonant substitutions in the clinical groups involved manner changes, suggesting poor auditory-perceptual encoding. From a clinical perspective algorithms which automatically count phoneme errors may enhance sensitivity of NWR as a diagnostic marker of language impairment. LEARNING OUTCOMES Readers will be able to (1) describe and evaluate the hypothesis that there is a phenotypic overlap between SLI and Autism Spectrum Disorders (2) describe differences in the NWR performance of adolescents with SLI and ALI, and discuss whether these differences support or refute the phenotypic overlap hypothesis, and (3) understand how computational algorithms such as the Levenshtein Distance may be used to analyse NWR data.
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Affiliation(s)
- N G Riches
- Guy's and St Thomas' NHS Hospital Trust, Newcomen Centre, Guy's Hospital, London, SE1 9RT, UK.
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Loucas T, Riches NG, Charman T, Pickles A, Simonoff E, Chandler S, Baird G. Speech perception and phonological short-term memory capacity in language impairment: preliminary evidence from adolescents with specific language impairment (SLI) and autism spectrum disorders (ASD). Int J Lang Commun Disord 2010; 45:275-286. [PMID: 20131963 DOI: 10.3109/13682820902936433] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND The cognitive bases of language impairment in specific language impairment (SLI) and autism spectrum disorders (ASD) were investigated in a novel non-word comparison task which manipulated phonological short-term memory (PSTM) and speech perception, both implicated in poor non-word repetition. AIMS This study aimed to investigate the contributions of PSTM and speech perception in non-word processing and whether individuals with SLI and ASD plus language impairment (ALI) show similar or different patterns of deficit in these cognitive processes. METHOD & PROCEDURES Three groups of adolescents (aged 14-17 years), 14 with SLI, 16 with ALI, and 17 age and non-verbal IQ matched typically developing (TD) controls, made speeded discriminations between non-word pairs. Stimuli varied in PSTM load (two- or four-syllables) and speech perception load (mismatches on a word-initial or word-medial segment). OUTCOMES & RESULTS Reaction times showed effects of both non-word length and mismatch position and these factors interacted: four-syllable and word-initial mismatch stimuli resulted in the slowest decisions. Individuals with language impairment showed the same pattern of performance as those with typical development in the reaction time data. A marginal interaction between group and item length was driven by the SLI and ALI groups being less accurate with long items than short ones, a difference not found in the TD group. CONCLUSIONS & IMPLICATIONS Non-word discrimination suggests that there are similarities and differences between adolescents with SLI and ALI and their TD peers. Reaction times appear to be affected by increasing PSTM and speech perception loads in a similar way. However, there was some, albeit weaker, evidence that adolescents with SLI and ALI are less accurate than TD individuals, with both showing an effect of PSTM load. This may indicate, at some level, the processing substrate supporting both PSTM and speech perception is intact in adolescents with SLI and ALI, but also in both there may be impaired access to PSTM resources.
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Affiliation(s)
- Tom Loucas
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
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Riches NG, Loucas T, Baird G, Charman T, Simonoff E. Sentence repetition in adolescents with specific language impairments and autism: an investigation of complex syntax. Int J Lang Commun Disord 2010; 45:47-60. [PMID: 19343567 DOI: 10.3109/13682820802647676] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Recent studies have indicated that many children with autism spectrum disorders present with language difficulties that are similar to those of children with specific language impairments, leading some to argue for similar structural deficits in these two disorders. AIMS Repetition of sentences involving long-distance dependencies was used to investigate complex syntax in these groups. METHODS & PROCEDURES Adolescents with specific language impairments (mean age = 15;3, n = 14) and autism spectrum disorders plus language impairment (autism plus language impairment; mean age = 14;8, n = 16) were recruited alongside typically developing adolescents (mean age = 14;4, n = 17). They were required to repeat sentences containing relative clauses that varied in syntactic complexity. OUTCOMES & RESULTS The adolescents with specific language impairments presented with greater syntactic difficulties than the adolescents with autism plus language impairment, as manifested by higher error rates on the more complex object relative clauses, and a greater tendency to make syntactic changes during repetition. CONCLUSIONS & IMPLICATIONS Adolescents with specific language impairments may have more severe syntactic difficulties than adolescents with autism plus language impairment, possibly due to their short-term memory limitations.
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Affiliation(s)
- N G Riches
- Clinical Language Sciences, University of Reading, Reading, UK.
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Loucas T. Book review: Assessment of Autism Spectrum Disorders by S. Goldstein, J.A. Naglieri and S. Ozonoff (Eds). London: Guildford Press, 2009. ISBN 978—1—59385 —983—1. £27.45 hdk. 384 pp. Autism 2009. [DOI: 10.1177/1362361309346113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Charman T, Pickles A, Chandler S, Wing L, Bryson S, Simonoff E, Loucas T, Baird G. Commentary: Effects of diagnostic thresholds and research vs service and administrative diagnosis on autism prevalence. Int J Epidemiol 2009; 38:1234-8; author reply 1243-4. [DOI: 10.1093/ije/dyp256] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pickles A, Simonoff E, Conti-Ramsden G, Falcaro M, Simkin Z, Charman T, Chandler S, Loucas T, Baird G. Loss of language in early development of autism and specific language impairment. J Child Psychol Psychiatry 2009; 50:843-52. [PMID: 19527315 DOI: 10.1111/j.1469-7610.2008.02032.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Several authors have highlighted areas of overlap in symptoms and impairment among children with autism spectrum disorder (ASD) and children with specific language impairment (SLI). By contrast, loss of language and broadly defined regression have been reported as relatively specific to autism. We compare the incidence of language loss and language progression of children with autism and SLI. METHODS We used two complementary studies: the Special Needs and Autism Project (SNAP) and the Manchester Language Study (MLS) involving children with SLI. This yielded a combined sample of 368 children (305 males and 63 females) assessed in late childhood for autism, history of language loss, epilepsy, language abilities and nonverbal IQ. RESULTS language loss occurred in just 1% of children with SLI but in 15% of children classified as having autism or autism spectrum disorder. Loss was more common among children with autism rather than milder ASD and is much less frequently reported when language development is delayed. For children who lost language skills before their first phrases, the phrased speech milestone was postponed but long-term language skills were not significantly lower than children with autism but without loss. For the few who experienced language loss after acquiring phrased speech, subsequent cognitive performance is more uncertain. CONCLUSIONS Language loss is highly specific to ASD. The underlying developmental abnormality may be more prevalent than raw data might suggest, its possible presence being hidden for children whose language development is delayed.
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Affiliation(s)
- Andrew Pickles
- Biostatistics, Health Methodology Research Group, The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom.
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Abstract
AIM We undertook this study to explore the degree of impairment in movement skills in children with autistic spectrum disorders (ASD) and a wide IQ range. METHOD Movement skills were measured using the Movement Assessment Battery for Children (M-ABC) in a large, well defined, population-derived group of children (n=101: 89 males,12 females; mean age 11y 4mo, SD 10mo; range 10y-14y 3mo) with childhood autism and broader ASD and a wide range of IQ scores. Additionally, we tested whether a parent-completed questionnaire, the Developmental Coordination Disorder Questionnaire (DCDQ), was useful in identifying children who met criteria for movement impairments after assessment (n=97 with complete M-ABCs and DCDQs). RESULTS Of the children with ASD, 79% had definite movement impairments on the M-ABC; a further 10% had borderline problems. Children with childhood autism were more impaired than children with broader ASD, and children with an IQ less than 70 were more impaired than those with IQ more than 70. This is consistent with the view that movement impairments may arise from a more severe neurological impairment that also contributes to intellectual disability and more severe autism. Movement impairment was not associated with everyday adaptive behaviour once the effect of IQ was controlled for. The DCDQ performed moderately well as a screen for possible motor difficulties. INTERPRETATION Movement impairments are common in children with ASD. Systematic assessment of movement abilities should be considered a routine investigation.
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Affiliation(s)
- Dido Green
- Newcomen Centre, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, London, UK.
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Loucas T, Charman T, Pickles A, Simonoff E, Chandler S, Meldrum D, Baird G. Autistic symptomatology and language ability in autism spectrum disorder and specific language impairment. J Child Psychol Psychiatry 2008; 49:1184-92. [PMID: 19017030 DOI: 10.1111/j.1469-7610.2008.01951.x] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Autism spectrum disorders (ASD) and specific language impairment (SLI) are common developmental disorders characterised by deficits in language and communication. The nature of the relationship between them continues to be a matter of debate. This study investigates whether the co-occurrence of ASD and language impairment is associated with differences in severity or pattern of autistic symptomatology or language profile. METHODS Participants (N = 97) were drawn from a total population cohort of 56,946 screened as part of study to ascertain the prevalence of ASD, aged 9 to 14 years. All children received an ICD-10 clinical diagnosis of ASD or No ASD. Children with nonverbal IQ > or =80 were divided into those with a language impairment (language score of 77 or less) and those without, creating three groups: children with ASD and a language impairment (ALI; N = 41), those with ASD and but no language impairment (ANL; N = 31) and those with language impairment but no ASD (SLI; N = 25). RESULTS Children with ALI did not show more current autistic symptoms than those with ANL. Children with SLI were well below the threshold for ASD. Their social adaptation was higher than the ASD groups, but still nearly 2 SD below average. In ALI the combination of ASD and language impairment was associated with weaker functional communication and more severe receptive language difficulties than those found in SLI. Receptive and expressive language were equally impaired in ALI, whereas in SLI receptive language was stronger than expressive. CONCLUSIONS Co-occurrence of ASD and language impairment is not associated with increased current autistic symptomatology but appears to be associated with greater impairment in receptive language and functional communication.
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Affiliation(s)
- Tom Loucas
- School of Psychology and Clinical Language Sciences, University of Reading, UK.
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Baird G, Pickles A, Simonoff E, Charman T, Sullivan P, Chandler S, Loucas T, Meldrum D, Afzal M, Thomas B, Jin L, Brown D. Measles vaccination and antibody response in autism spectrum disorders. Arch Dis Child 2008; 93:832-7. [PMID: 18252754 DOI: 10.1136/adc.2007.122937] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To test the hypothesis that measles vaccination was involved in the pathogenesis of autism spectrum disorders (ASD) as evidenced by signs of a persistent measles infection or abnormally persistent immune response shown by circulating measles virus or raised antibody titres in children with ASD who had been vaccinated against measles, mumps and rubella (MMR) compared with controls. DESIGN Case-control study, community based. METHODS A community sample of vaccinated children aged 10-12 years in the UK with ASD (n = 98) and two control groups of similar age, one with special educational needs but no ASD (n = 52) and one typically developing group (n = 90), were tested for measles virus and antibody response to measles in the serum. RESULTS No difference was found between cases and controls for measles antibody response. There was no dose-response relationship between autism symptoms and antibody concentrations. Measles virus nucleic acid was amplified by reverse transcriptase-PCR in peripheral blood mononuclear cells from one patient with autism and two typically developing children. There was no evidence of a differential response to measles virus or the measles component of the MMR in children with ASD, with or without regression, and controls who had either one or two doses of MMR. Only one child from the control group had clinical symptoms of possible enterocolitis. CONCLUSION No association between measles vaccination and ASD was shown.
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Affiliation(s)
- G Baird
- Newcomen Centre for Child Development, Guy's & St Thomas' NHS Foundation Trust, London, UK.
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Baird G, Charman T, Pickles A, Chandler S, Loucas T, Meldrum D, Carcani-Rathwell I, Serkana D, Simonoff E. Regression, Developmental Trajectory and Associated Problems in Disorders in the Autism Spectrum: The SNAP Study. J Autism Dev Disord 2008; 38:1827-36. [DOI: 10.1007/s10803-008-0571-9] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 04/02/2008] [Indexed: 10/22/2022]
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Charman T, Baird G, Simonoff E, Loucas T, Chandler S, Meldrum D, Pickles A. Efficacy of three screening instruments in the identification of autistic-spectrum disorders. Br J Psychiatry 2007; 191:554-9. [PMID: 18055961 DOI: 10.1192/bjp.bp.107.040196] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Screening instruments for autistic-spectrum disorders have not been compared in the same sample. AIMS To compare the Social Communication Questionnaire (SCQ), the Social Responsiveness Scale (SRS) and the Children's Communication Checklist (CCC). METHOD Screen and diagnostic assessments on 119 children between 9 and 13 years of age with special educational needs with and without autistic-spectrum disorders were weighted to estimate screen characteristics for a realistic target population. RESULTS The SCQ performed best (area under receiver operating characteristic curve (AUC)=0.90; sensitivity 0.86; specificity 0.78). The SRS had a lower AUC (0.77) with high sensitivity (0.78) and moderate specificity (0.67). The CCC had a high sensitivity but lower specificity (AUC=0.79; sensitivity 0.93; specificity 0.46). The AUC of the SRS and CCC was lower for children with IQ < 70. Behaviour problems reduced specificity for all three instruments. CONCLUSIONS The SCQ, SRS and CCC showed strong to moderate ability to identify autistic-spectrum disorder in this at-risk sample of school-age children with special educational needs.
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Affiliation(s)
- Tony Charman
- Behavioural and Brain Sciences Unit, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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Chandler S, Charman T, Baird G, Simonoff E, Loucas T, Meldrum D, Scott M, Pickles A. Validation of the social communication questionnaire in a population cohort of children with autism spectrum disorders. J Am Acad Child Adolesc Psychiatry 2007; 46:1324-1332. [PMID: 17885574 DOI: 10.1097/chi.0b013e31812f7d8d] [Citation(s) in RCA: 250] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the properties of the Social Communication Questionnaire (SCQ) in a population cohort of children with autism spectrum disorders (ASDs) and in the general population. METHOD SCQ data were collected from three samples: the Special Needs and Autism Project (SNAP) cohort of 9- to 10-year-old children with special educational needs with and without ASD and two similar but separate age groups of children from the general population (n = 411 and n= 247). Diagnostic assessments were completed on a stratified subsample (n = 255) of the special educational needs group. A sample-weighting procedure enabled us to estimate characteristics of the SCQ in the total ASD population. Diagnostic status of cases in the general population samples were extracted from child health records. RESULTS The SCQ showed strong discrimination between ASD and non-ASD cases (sensitivity 0.88, specificity 0.72) and between autism and nonautism cases (sensitivity 0.90, specificity 0.86). Findings were not affected by child IQ or parental education. In the general population samples between 4% and 5% of children scored above the ASD cutoff including 1.5% who scored above the autism cutoff. Although many of these high-scoring children had an ASD diagnosis, almost all(approximately 90%) of them had a diagnosed neurodevelopmental disorder. CONCLUSIONS This study confirms the utility of the SCQ as a first-level screen for ASD in at-risk samples of school-age children.
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Affiliation(s)
- Susie Chandler
- Profs. Chandler and Baird are with Guy's and Thomas' NHS Foundation Trust, London; Prof. Charman is with UCL Institute of Child Health, London; Prof. Simonoff is with the Institute of Psychiatry, Kings College London; Dr. Loucas is with School of Psychology and Clinical Language Sciences, University of Reading, UK; Dr. Meldrum is with Chatswood Assessment Centre, Sydney; Ms. Scott is with East Sussex Hospitals NHS Trust, UK; and Prof. Pickles is with Division of Epidemiology & Health Sciences, University of Manchester, UK.
| | - Tony Charman
- Profs. Chandler and Baird are with Guy's and Thomas' NHS Foundation Trust, London; Prof. Charman is with UCL Institute of Child Health, London; Prof. Simonoff is with the Institute of Psychiatry, Kings College London; Dr. Loucas is with School of Psychology and Clinical Language Sciences, University of Reading, UK; Dr. Meldrum is with Chatswood Assessment Centre, Sydney; Ms. Scott is with East Sussex Hospitals NHS Trust, UK; and Prof. Pickles is with Division of Epidemiology & Health Sciences, University of Manchester, UK
| | - Gillian Baird
- Profs. Chandler and Baird are with Guy's and Thomas' NHS Foundation Trust, London; Prof. Charman is with UCL Institute of Child Health, London; Prof. Simonoff is with the Institute of Psychiatry, Kings College London; Dr. Loucas is with School of Psychology and Clinical Language Sciences, University of Reading, UK; Dr. Meldrum is with Chatswood Assessment Centre, Sydney; Ms. Scott is with East Sussex Hospitals NHS Trust, UK; and Prof. Pickles is with Division of Epidemiology & Health Sciences, University of Manchester, UK
| | - Emily Simonoff
- Profs. Chandler and Baird are with Guy's and Thomas' NHS Foundation Trust, London; Prof. Charman is with UCL Institute of Child Health, London; Prof. Simonoff is with the Institute of Psychiatry, Kings College London; Dr. Loucas is with School of Psychology and Clinical Language Sciences, University of Reading, UK; Dr. Meldrum is with Chatswood Assessment Centre, Sydney; Ms. Scott is with East Sussex Hospitals NHS Trust, UK; and Prof. Pickles is with Division of Epidemiology & Health Sciences, University of Manchester, UK
| | - Tom Loucas
- Profs. Chandler and Baird are with Guy's and Thomas' NHS Foundation Trust, London; Prof. Charman is with UCL Institute of Child Health, London; Prof. Simonoff is with the Institute of Psychiatry, Kings College London; Dr. Loucas is with School of Psychology and Clinical Language Sciences, University of Reading, UK; Dr. Meldrum is with Chatswood Assessment Centre, Sydney; Ms. Scott is with East Sussex Hospitals NHS Trust, UK; and Prof. Pickles is with Division of Epidemiology & Health Sciences, University of Manchester, UK
| | - David Meldrum
- Profs. Chandler and Baird are with Guy's and Thomas' NHS Foundation Trust, London; Prof. Charman is with UCL Institute of Child Health, London; Prof. Simonoff is with the Institute of Psychiatry, Kings College London; Dr. Loucas is with School of Psychology and Clinical Language Sciences, University of Reading, UK; Dr. Meldrum is with Chatswood Assessment Centre, Sydney; Ms. Scott is with East Sussex Hospitals NHS Trust, UK; and Prof. Pickles is with Division of Epidemiology & Health Sciences, University of Manchester, UK
| | - Mimi Scott
- Profs. Chandler and Baird are with Guy's and Thomas' NHS Foundation Trust, London; Prof. Charman is with UCL Institute of Child Health, London; Prof. Simonoff is with the Institute of Psychiatry, Kings College London; Dr. Loucas is with School of Psychology and Clinical Language Sciences, University of Reading, UK; Dr. Meldrum is with Chatswood Assessment Centre, Sydney; Ms. Scott is with East Sussex Hospitals NHS Trust, UK; and Prof. Pickles is with Division of Epidemiology & Health Sciences, University of Manchester, UK
| | - Andrew Pickles
- Profs. Chandler and Baird are with Guy's and Thomas' NHS Foundation Trust, London; Prof. Charman is with UCL Institute of Child Health, London; Prof. Simonoff is with the Institute of Psychiatry, Kings College London; Dr. Loucas is with School of Psychology and Clinical Language Sciences, University of Reading, UK; Dr. Meldrum is with Chatswood Assessment Centre, Sydney; Ms. Scott is with East Sussex Hospitals NHS Trust, UK; and Prof. Pickles is with Division of Epidemiology & Health Sciences, University of Manchester, UK
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Baird G, Simonoff E, Pickles A, Chandler S, Loucas T, Meldrum D, Charman T. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet 2006; 368:210-5. [PMID: 16844490 DOI: 10.1016/s0140-6736(06)69041-7] [Citation(s) in RCA: 1112] [Impact Index Per Article: 61.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recent reports have suggested that the prevalence of autism and related spectrum disorders (ASDs) is substantially higher than previously recognised. We sought to quantify prevalence of ASDs in children in South Thames, UK. METHODS Within a total population cohort of 56 946 children aged 9-10 years, we screened all those with a current clinical diagnosis of ASD (n=255) or those judged to be at risk for being an undetected case (n=1515). A stratified subsample (n=255) received a comprehensive diagnostic assessment, including standardised clinical observation, and parent interview assessments of autistic symptoms, language, and intelligence quotient (IQ). Clinical consensus diagnoses of childhood autism and other ASDs were derived. We used a sample weighting procedure to estimate prevalence. FINDINGS The prevalence of childhood autism was 38.9 per 10,000 (95% CI 29.9-47.8) and that of other ASDs was 77.2 per 10,000 (52.1-102.3), making the total prevalence of all ASDs 116.1 per 10,000 (90.4-141.8). A narrower definition of childhood autism, which combined clinical consensus with instrument criteria for past and current presentation, provided a prevalence of 24.8 per 10,000 (17.6-32.0). The rate of previous local identification was lowest for children of less educated parents. INTERPRETATION Prevalence of autism and related ASDs is substantially greater than previously recognised. Whether the increase is due to better ascertainment, broadening diagnostic criteria, or increased incidence is unclear. Services in health, education, and social care will need to recognise the needs of children with some form of ASD, who constitute 1% of the child population.
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Affiliation(s)
- Gillian Baird
- Newcomen Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
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