A prospective study of response to name in infants at risk for autism

OBJECTIVE: To assess the sensitivity and specificity of decreased response to name at age 12 months as a screen for autism spectrum disorders (ASD) and other developmental delays. DESIGN: Prospective, longitudinal design studying infants at risk for ASD. SETTING: Research laboratory at university medical center. PARTICIPANTS: Infants at risk for autism (55 six-month-olds, 101 twelve-month-olds) and a control group at no known risk (43 six-month-olds, 46 twelve-month-olds). To date, 46 at-risk infants and 25 control infants have been followed up to 24 months. Intervention Experimental task eliciting response-to-name behavior. MAIN OUTCOME MEASURES: Autism Diagnostic Observation Schedule, Mullen Scales of Early Learning. RESULTS: At age 6 months, there was a nonsignificant trend for control infants to require a fewer number of calls to respond to name than infants at risk for autism. At age 12 months, 100% of infants in the control group "passed," responding on the first or second name call, while 86% in the at-risk group did. Three fourths of children who failed the task were identified with developmental problems at age 24 months. Specificity of failing to respond to name was 0.89 for ASD and 0.94 for any developmental delay. Sensitivity was 0.50 for ASD and 0.39 for any developmental delay. CONCLUSIONS: Failure to respond to name by age 12 months is highly suggestive of developmental abnormality but does not identify all children at risk for developmental problems. Lack of responding to name is not universal among infants later diagnosed with ASD and/or other developmental delays. Poor response to name may be a trait of the broader autism phenotype in infancy.     

Loss of language in early development of autism and specific language impairment

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.     

Variability in outcome for children with an ASD diagnosis at age 2

BACKGROUND: Few studies have examined the variability in outcomes of children diagnosed with autism spectrum disorder (ASD) at age 2. Research is needed to understand the children whose symptoms - or diagnoses - change over time. The objectives of this study were to examine the behavioral and diagnostic outcomes of a carefully defined sample of 2-year-old children with ASD, and to identify child and environmental factors that contribute to variability in outcomes at age 4. METHODS: Forty-eight children diagnosed with autism or pervasive developmental disorder not otherwise specified (PDDNOS) at age 2 were followed to age 4. Diagnostic measures included the Autism Diagnostic Observation Schedule - Generic (ADOS-G) and clinical diagnosis at ages 2 and 4, and the ADI-R at age 4. RESULTS: Diagnostic stability for an ASD diagnosis (autism or PDDNOS) was 63%, and for an autism diagnosis was 68%. Children who failed to meet diagnostic criteria for ASD at follow-up were more likely to: 1) be 30 months or younger at initial evaluation; 2) have milder symptoms of autism, particularly in the social domain; and 3) have higher cognitive scores at age 2. No differences between children with stable and unstable diagnoses were found for amount of intervention services received. Among the children with unstable diagnoses, all but one continued to have developmental disorders, most commonly in the area of language. CONCLUSIONS: The stability of ASD was lower in the present study than has been reported previously, a finding largely attributable to children who were diagnosed at 30 months or younger. Implications for clinical practice are discussed.     

Autism and developmental receptive language disorder--a comparative follow-up in early adult life. I: Cognitive and language outcomes

In this paper we compare adult outcome in a group of young men with autism and a group with developmental receptive language disorders. The two groups were first assessed in early childhood, when aged 7 to 8 years of age. Although matched at that time for nonverbal IQ (mean 92-93) and expressive language ability, the Autism group was significantly more impaired on most measures of social and communication skills and stereotyped behaviours. A later follow-up, in mid-childhood, suggested that although the groups were still quite distinct, social and behavioural problems had become more apparent in the Language group. The current study was completed when the participants were aged, on average, 23 to 24 years. The findings indicated that verbal IQ and receptive language scores had improved significantly more in the Autism group than in the Language group over time. Moreover, although the Language group were less severely impaired in their social use of language, many showed a number of abnormal features in this domain. There were no differences between the groups on tests of reading or spelling. Discriminant function analysis, which had clearly distinguished between the groups as children, now showed much greater overlap between them. Regression analysis indicated that although early language ability appeared to be related to outcome in the Autism group, in the Language group there was little association between measures of childhood functioning and later progress. The implications of these findings for understanding the nature of the underlying deficit in autism and the relationship between the two disorders are discussed.     

Similar developmental trajectories in autism and Asperger syndrome: from early childhood to adolescence

Objective:  The objective of this study was to chart the developmental trajectories of high-functioning children with autism spectrum disorders (ASD) from early childhood to adolescence using the presence and absence of structural language impairment (StrLI) as a way of differentiating autism from Asperger syndrome (AS).
Method:  Sixty-four high-functioning children with ASD were ascertained at 4–6 years of age from several different regional diagnostic and treatment centers. At 6–8 years of age, the ADI-R and the Test of Oral Language Development were used to define an autism group (those with StrLI at 6–8 years of age) and an AS group (those without StrLI). Growth curve analysis was then used to chart the developmental trajectories of these children on measures of autistic symptoms, and adaptive skills in communication, daily living and socialization.
Results:  Differentiating the ASD group in terms of the presence/absence of StrLI provided a better explanation of the variation in growth curves than not differentiating high-functioning ASD children. The two groups had similar developmental trajectories but the group without StrLI (the AS group) was functioning better and had fewer autistic symptoms than the group with StrLI (the autism group) on all measures across time. The differences in outcome could not be explained by non-verbal IQ or change in early language skills.
Conclusion:  Distinguishing between autism and Asperger syndrome based on the presence or absence of StrLI appears to be a clinically useful way of classifying ASD sub-types.     

Factors influencing scores on the social responsiveness scale

Background: The Social Responsiveness Scale (SRS) is a parent‐completed screening questionnaire often used to measure autism spectrum disorders (ASD) severity. Although child characteristics are known to influence scores from other ASD‐symptom measures, as well as parent‐questionnaires more broadly, there has been limited consideration of how non‐ASD‐specific factors may affect interpretation of SRS scores. Previous studies have explored effects of behavior problems on SRS specificity, but have not addressed influences on the use of the SRS as a quantitative measure of ASD‐symptoms. Method: Raw scores (SRS‐Raw) from parent‐completed SRS were analyzed for 2,368 probands with ASD and 1,913 unaffected siblings. Regression analyses were used to assess associations between SRS scores and demographic, language, cognitive, and behavior measures. Results: For probands, higher SRS‐Raw were associated with greater non‐ASD behavior problems, higher age, and more impaired language and cognitive skills, as well as scores from other parent report measures of social development and ASD‐symptoms. For unaffected siblings, having more behavior problems predicted higher SRS‐Raw; male gender, younger age, and poorer adaptive social and expressive communication skills also showed small, but significant effects. Conclusions: When using the SRS as a quantitative phenotype measure, the influence of behavior problems, age, and expressive language or cognitive level on scores must be considered. If effects of non‐ASD‐specific factors are not addressed, SRS scores are more appropriately interpreted as indicating general levels of impairment, than as severity of ASD‐specific symptoms or social impairment. Additional research is needed to consider how these factors influence the SRS’ sensitivity and specificity in large, clinical samples including individuals with disorders other than ASD.     

Characteristics of autism spectrum disorder in Cornelia de Lange syndrome

Background: The prevalence of autism spectrum disorder (ASD) symptomatology is comparatively high in Cornelia de Lange syndrome (CdLS). However, the profile and developmental trajectories of these ASD characteristics are potentially different to those observed in individuals with idiopathic ASD. In this study we examine the ASD profile in CdLS in comparison to a matched group of individuals with ASD. Method: The Autism Diagnostic Observation Schedule (ADOS) was administered to 20 individuals with CdLS (mean age = 11.34; range = 6–13 years) and 20 individuals with idiopathic ASD (mean age = 10.42; range = 8–11 years). Participants were matched according to adaptive behaviour and receptive language skills. Results: Sixty‐five percent (N = 13) of individuals with CdLS met the cut‐off score for autism on the total ADOS score. Further analysis at domain and item level indicated that individuals with CdLS showed significantly less repetitive behaviour, (specifically sensory interests); more eye contact, more gestures and less stereotyped speech than the ASD group. The CdLS group also showed higher levels of anxiety. Conclusions: The comparison between CdLS and idiopathic ASD indicates subtle group differences in the profile of ASD symptomatology that are not accounted for by degree of intellectual disability or receptive language skills. These differences may not be evident when relying solely upon clinical and domain level scores, but may be distinguishing features of the ASD presentations in the two disorders. The findings have implications for the conceptualisation and assessment of ASD in individuals with genetic syndromes.     

Autism spectrum disorder in the second year: stability and change in syndrome expression

OBJECTIVES: Increasing numbers of young children referred for a differential diagnosis of autism spectrum disorders (ASD) necessitates better understanding of the early syndrome expression and the utility of the existing state-of-the art diagnostic methods in this population. METHOD: Out of 31 infants under the age of 2 years referred for a differential diagnosis, 19 were diagnosed with autism, and 9 with pervasive developmental disorder - not otherwise specified (PDD-NOS) when reassessed at 3 years. We examined 1) the symptoms of ASD in the second year and changes in the syndrome expression by the age of three; 2) relationship between expert-assigned clinical diagnosis and diagnostic classification based on Autism Diagnostic Observation Schedule-Generic (ADOS-G) and Autism Diagnostic Interview-Revised (ADI-R) in the second year; 3) the relationship between direct observation and parental report of ASD symptoms. RESULTS: Symptoms of autism and PDD-NOS in the second year were pronounced and stability of the clinical diagnosis was high. The agreement between clinician-assigned autism but not PDD-NOS diagnosis and the ADOS-G was high. However, sensitivity of the ADI-R diagnostic classification of autism was poor. Comparison of concurrent parental report and direct observation revealed discrepancies in severity ratings of key dyadic social behaviors. Changes in communication reflected acquisition of language accompanied by the emergence of unusual language characteristics. Symptoms of social dysfunction were relatively stable over time, and so was the severity of stereotyped behaviors. CONCLUSIONS: The study provides support for stability of clinical diagnosis and syndrome expression in the second year and highlights advantages and limitations of the ADI-R and ADOS-G for diagnosing and documenting symptoms of ASD in infants.     

Latent class analysis of early developmental trajectory in baby siblings of children with autism

Background: Siblings of children with autism (sibs‐A) are at increased genetic risk for autism spectrum disorders (ASD) and milder impairments. To elucidate diversity and contour of early developmental trajectories exhibited by sibs‐A, regardless of diagnostic classification, latent class modeling was used. Methods: Sibs‐A (N = 204) were assessed with the Mullen Scales of Early Learning from age 6 to 36 months. Mullen T scores served as dependent variables. Outcome classifications at age 36 months included: ASD (N = 52); non‐ASD social/communication delay (broader autism phenotype; BAP; N = 31); and unaffected (N = 121). Child‐specific patterns of performance were studied using latent class growth analysis. Latent class membership was then related to diagnostic outcome through estimation of within‐class proportions of children assigned to each diagnostic classification. Results: A 4‐class model was favored. Class 1 represented accelerated development and consisted of 25.7% of the sample, primarily unaffected children. Class 2 (40.0% of the sample), was characterized by normative development with above‐average nonverbal cognitive outcome. Class 3 (22.3% of the sample) was characterized by receptive language, and gross and fine motor delay. Class 4 (12.0% of the sample), was characterized by widespread delayed skill acquisition, reflected by declining trajectories. Children with an outcome diagnosis of ASD were spread across Classes 2, 3, and 4. Conclusions: Results support a category of ASD that involves slowing in early non‐social development. Receptive language and motor development is vulnerable to early delay in sibs‐A with and without ASD outcomes. Non‐ASD sibs‐A are largely distributed across classes depicting average or accelerated development. Developmental trajectories of motor, language, and cognition appear independent of communication and social delays in non‐ASD sibs‐A.     

孤独症筛查量表在早期识别孤独症谱系障碍中的临床价值

目的 探讨孤独症筛查量表早期识别孤独症谱系障碍（ASD）的临床价值。方法 以于重庆医科大学附属儿童医院就诊,并完成ASD筛查及诊断性测试的2 571名儿童为研究对象,最后确诊ASD 2 074例,全面发育迟缓（GDD）261例,发育性语言障碍（DLD）206例,正常发育儿童30例。运用受试者工作特征（ROC）曲线评价改良婴幼儿孤独症筛查量表（M-CHAT）和孤独症行为量表（ABC）筛查ASD的最佳阈值及灵敏度、特异度。结果 M-CHAT量表筛查ASD的灵敏度较高（88.3%）,特异度较低（36.0%）;其灵敏度随着年龄的增长而降低,在16~< 48月龄儿童中,其灵敏度大于80%。ABC量表筛查ASD的特异度较高（87.3%）,灵敏度较低（27.2%）;运用ROC曲线方法得出其最佳截点值为47.5分。联合M-CHAT和ABC量表筛查ASD,并建立多元线性回归模型,其特异度为85.8%,灵敏度为56.6%。结论 M-CHAT量表筛查ASD灵敏度较高,但特异度较低;在16~< 48月龄儿童中的筛查效果相对较好。ABC量表筛查ASD特异度较高,但灵敏度较低。基于联合M-CHAT和ABC量表筛查ASD的多元线性回归模型法识别ASD的效能较好。     

Autism and developmental receptive language disorder--a follow-up comparison in early adult life. II: Social, behavioural, and psychiatric outcomes

This paper focuses on general social functioning in two groups of young men, one with autism and one with developmental receptive language disorders, who were first assessed at the ages of 7-8 years. At that time, although matched for nonverbal IQ (mean 92-93) and expressive language, the Language group showed significantly fewer social and behavioural problems. At follow-up, when aged on average, 23 to 24 years, the Autism group continued to show significantly more impairments in terms of stereotyped behaviour patterns, social relationships, jobs, and independence. However, problems in all these areas were also common in the Language group. Many still lived with their parents, few had close friends or permanent jobs, and ratings of social interaction indicated abnormalities in a number of different areas. On a composite measure of social competence only 10% of the Language group was assessed as having severe social difficulties compared to 74% of the Autism group. Nevertheless, 65% were rated as having moderate social problems and only 25% were rated as being of near/normal social functioning. Two individuals in the Language group, but none in the Autism group, had also developed a florid paranoid psychosis in late adolescence. As in the follow-up of cognitive and linguistic functioning (see Mawhood et al., 2000, this volume, pp. 547-559), discriminant function analysis, which had clearly distinguished between the groups as children, now showed much greater overlap between them. Regression analysis indicated that although early language ability appeared to be related to outcome in the Autism group, there was little association between any measures of childhood functioning and prognosis in the Language group. Theoretically, these findings have implications for our understanding of the nature of autism and other pervasive language disorders, and of the relationship between them. Practically, they demonstrate the very persistent problems experienced by individuals with developmental language disorders, and their need for much greater help and support than is presently available.     

Can family affectedness inform infant sibling outcomes of autism spectrum disorders?

Background: Difficulties in communication and reciprocal social behavior are core features of autism spectrum disorders (ASD) and are often present, to varying degrees, in other family members. This prospective longitudinal infant sibling study examines whether social‐communicative features of family members may inform which infants are at increased risk for ASD and other developmental concerns. Method: Two hundred and seventeen families participated in this study. Infant siblings were recruited from families with at least one older child diagnosed with an ASD (n = 135) or at least one typically developing older child (n = 82). Families completed the Social Responsiveness Scale to assess social and communication features of the broader autism phenotype (BAP), sometimes called quantitative autistic traits (QAT). Family affectedness was assessed in two ways: categorically, based on number of affected older siblings (i.e., typical, simplex, multiplex risk groups) and dimensionally, by assessing varying degrees of QAT in all family members. Infant siblings were assessed at 36 months of age and completed the Autism Diagnostic Observation Schedule and the Mullen Scales of Early Learning. Results: In structural equation models, comparisons between multiplex, simplex and typical groups revealed the highest rates of QAT in the multiplex group followed by the simplex and typical groups. Infant sibling outcomes were predicted by gender, family risk group, proband QAT, and additional sibling QAT. Conclusions: Replicating previous cross‐sectional and family history findings, the present study found elevated social and communication features of the BAP in siblings and fathers of ASD families, but not in mothers. While social and communication features of the BAP in mothers, fathers, and undiagnosed siblings did not predict infant sibling outcomes, having more than one affected older sibling did. Infant siblings from multiplex families were at significantly higher risk for ASD than infant siblings from simplex families in this sample.     

Autistic symptomatology and language ability in autism spectrum disorder and specific language impairment

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 ≥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.     

Cognitive profiles and social-communicative functioning in children with autism spectrum disorder

BACKGROUND: Whether there is an unusual degree of unevenness in the cognitive abilities of children with autism spectrum disorder (ASD) and whether different cognitive profiles among children with ASD might index etiologically significant subgroups are questions of continued debate in autism research. METHOD: The Differential Ability Scales (DAS) and the Autism Diagnostic Observation Schedule (ADOS) were used to examine profiles of verbal and nonverbal abilities and their relationship to autistic symptomatology in 120 relatively high-functioning children with ADI-confirmed diagnoses of autism. RESULTS: Discrepancies between verbal and nonverbal ability scores occurred at a significantly higher rate than in the DAS normative sample (30%) in both a younger group of 73 children (56%) with a mean age of 5;5 and an older group of 47 children (62%) with a mean age of 8;11. Discrepancies were mainly in favor of nonverbal ability in the younger group, but occurred equally in favor of verbal and nonverbal abilities in the older group. Comparison of the two age groups suggested a growing dissociation between verbal and nonverbal (and particularly visual processing) skills with age. In the older group, children with discrepantly higher nonverbal abilities demonstrated significantly greater impairment in social functioning, as measured on the ADOS, independent of absolute level of verbal and overall ability. CONCLUSIONS: These findings demonstrate a high rate of uneven cognitive development in children with ASD. Indications of a dissociation between verbal and visual-perceptual skills among the older children, and the specific association of discrepantly high nonverbal skills with increased social symptoms suggest that the nonverbal > verbal profile may index an etiologically significant subtype of autism.     

孤独症谱系障碍儿童社会技能发展水平及其影响因素

目的 了解孤独症谱系障碍（ASD）儿童社会技能发展状况及其影响因素。方法 选取全国10个城市的889名ASD儿童作为研究对象,采用《孤独症儿童社会技能评定量表》对其进行社会技能评定。结果 ASD儿童社会技能各因子得分均低于理论中值,其中社会沟通水平最低,自我调控水平最高。不同年龄段的ASD儿童社会技能总分以及社会认知、社会参与得分差异有统计学意义（P < 0.05）。不同语言水平ASD儿童社会技能总分以及社会趋向、社会沟通、社会参与、自我调控得分差异有统计学意义（P < 0.01）。结论 ASD儿童社会技能较低,其社会技能与年龄和语言水平有关。     

Comparison of television viewing between children with autism spectrum disorder and controls

Aim: To examine the pattern and extent of television viewing in children with autism spectrum disorder (ASD) compared with typically developing controls and those with delayed language development (DLD). Methods: Fifty‐four individuals with ASD (mean age 2.56 ± 0.66 years) and 84 controls (mean age 2.43 ± 0.81 years) were enrolled. Fifty‐six individuals with DLD, who had language developmental levels similar to those with ASD, were enrolled in our previous study. Main outcome measures included onset and frequency of television viewing, in addition to the type of programme and whether a caregiver cowatched television. Results: Those with ASD began to watch television significantly earlier than controls (6.44 ± 6.35 vs. 12.41 ± 6.00 months of age, p ≤ 0.0001*) and spent more time watching television than those with DLD (4.60 ± 1.91 vs. 3.05 ± 1.90 h/day, p ≤ 0.0001*) and controls (4.60 ± 1.91 vs. 2.06 ± 1.21 h/day, p ≤ 0.0001*). Those with ASD appeared to watch more adult programmes than normal controls, and they were less likely to watch television with caregivers than both control groups. Conclusion: There is an earlier onset and higher frequency of television viewing in autistic children compared with children with typical development.     

Slipped lips: onset asynchrony detection of auditory-visual language in autism

Background:  It has frequently been suggested that individuals with autism spectrum disorder (ASD) have deficits in auditory-visual (AV) sensory integration. Studies of language integration have mostly used non-word syllables presented in congruent and incongruent AV combinations and demonstrated reduced influence of visual speech in individuals with ASD. The aim of our study was to test whether adolescents with high-functioning autism are able to integrate AV information of meaningful, phrase-length language in a task of onset asynchrony detection.
Methods:  Participants were 25 adolescents with ASD and 25 typically developing (TD) controls. The stimuli were video clips of complete phrases using simple, commonly occurring words. The clips were digitally manipulated to have the video precede the corresponding audio by 0, 4, 6, 8, 10, 12, or 14 video frames, a range of 0–500ms. Participants were shown the video clips in random order and asked to indicate whether each clip was in-synch or not.
Results:  There were no differences between adolescents with ASD and their TD peers in accuracy of onset asynchrony detection at any slip rate.
Conclusion:  These data indicate that adolescents with ASD are able to integrate auditory and visual components in a task of onset asynchrony detection using natural, phrase-length language stimuli. We propose that the meaningful nature of the language stimuli in combination with presentation in a non-distracting environment allowed adolescents with autism spectrum disorder to demonstrate preserved accuracy for bi-modal AV integration.     

Response to distress in infants at risk for autism: a prospective longitudinal study

Background: Infants and preschoolers with ASD show impairment in their responses to other people’s distress relative to children with other developmental delays and typically developing children. This deficit is expected to disrupt social interactions, social learning, and the formation of close relationships. Response to distress has not been evaluated previously in infants with ASD earlier than 18 months of age. Methods: Participants were 103 infant siblings of children with autism and 55 low‐risk controls. All children were screened for ASD at 36 months and 14 were diagnosed with ASD. Infants’ responsiveness to distress was evaluated at 12, 18, 24, and 36 months. An examiner pretended to hit her finger with a toy mallet and infants’ responses were video‐recorded. Attention to the examiner and congruent changes in affect were coded on four‐point Likert scales. Results: Cross‐sectional and longitudinal analyses confirm that the ASD group paid less attention and demonstrated less change in affect in response to the examiner’s distress relative to the high‐risk and low‐risk participants who were not subsequently diagnosed with ASD. Group differences remained when verbal skills and general social responsiveness were included in the analytic models. Conclusions: Diagnostic groups differ on distress response from 12 to 36 months of age. Distress‐response measures are predictive of later ASD diagnosis above and beyond verbal impairments. Distress response is a worthwhile target for early intervention programs.     

The broader language phenotype of autism: a comparison with specific language impairment

BACKGROUND: Some individuals with autism spectrum disorders (ASD) experience linguistic difficulties similar to those found in individuals with specific language impairment (SLI). Whether these behaviours are indicative of a common underlying genetic cause or a superficial similarity is unclear. METHODS: Standardised language assessments were administered to three participant groups: parents of children with ASD (Par-A), parents of children with specific language/literacy impairment (Par-L) and parents of typically developing children (Par-T) (n = 30, in each group). Additionally, the Autism-Spectrum Quotient (AQ) was used to assess autism-like tendencies, in particular, social language use. RESULTS: The Par-A group performed better than the Par-L group (and identical to the Par-T group) on all language tests. Conversely, the Par-A group was characterised by higher levels of pragmatic difficulties than the other two groups, as measured by the communication subscale of the AQ. CONCLUSIONS: No evidence was found for a shared phenotype in parents of children with ASD and SLI. A model is presented describing the relation between SLI and ASD.     

专业人员指导下孤独症谱系障碍儿童家长执行的家庭康复疗效观察的前瞻性研究

目的 探讨专业人员指导下,由家长执行的家庭康复对孤独症谱系障碍（autism spectrum disorder,ASD）儿童的治疗作用。 方法 前瞻性选取ASD儿童60例（月龄24~60个月）,随机分为观察组和常规组。常规组儿童仅对家长进行线上理论培训。观察组儿童家长,除线上理论培训外,还进行专业人员团队指导下由家长执行的家庭康复。采用心理教育评估第3版（Psycho-Education Profile Third Edition,PEP-3）、儿童期孤独症评定量表（Childhood Autism Rating Scale,CARS）评估两组儿童干预前、干预后能力变化情况。 结果 经6个月干预后,观察组PEP-3量表各维度和常规组大部分维度得分较干预前提高（P<0.01）;两组CARS量表得分较干预前降低（P<0.05）。与常规组相比,干预后观察组儿童PEP-3量表语言理解、语言表达、大肌肉、小肌肉、个人自理、适应行为维度得分提高（P<0.05）,CARS量表得分降低（P<0.05）。 结论 对家长培训,由家长执行的干预可以提升ASD儿童的能力,改善其核心临床症状;但以专业人员组成的团队为资源平台,以家长为主要干预力量的家庭康复服务模式,对提升ASD儿童语言、运动等能力,改善其症状严重程度的效果更为显著。