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Objectives: To examine prelinguistic predictors of development using the MacArthur-Bates Communicative Development Inventory (MCDI, Words and Gestures) in a cohort of young children with autism who were followed over 4-5 years.
Methods: Longitudinal data were collected for 69 children with ASD prior to intervention (T1) and 6, 12, 24, 32, and 53 months later, using the Peabody Picture Vocabulary Test, Expressive One-Word Picture Vocabulary Test, Preschool Language Scale, and Vineland Adaptive Behavior Scale. Prelinguistic predictor variables were constructed using items from the MCDI. After controlling for chronological age, nonverbal IQ at T1, and autism severity, predictors of developmental trajectories for each outcome measure were examined with SAS Proc mixed analyses.
Results: Children's scores on the Games and Routines section of the MCDI at T1 predicted development on all language measures and Vineland subscales over 4-5 years, and accounted for between 14%-53% of the variance. Rates of change for children with high Games and Routines scores ranged from .40-.97 per month, while rates of change for children with low scores ranged from .12-.56 per month.
Conclusions: Games and Routines, which consists of five items (plays peek-a-boo, plays patty cake, plays ‘so big,' sings, and dances) encompasses many of the individual skills that are known to be critical for social and language development. These include joint attention (both initiation and responding), immediate imitation, a desire for social interaction, and turn taking skills. Children who enter early intervention with these skills in their repertoires are likely to make more progress, even over a period of as long as 4-5 years.