USING THE CHILDREN'S COMMUNICATION CHECKLIST (CCC-2) AND THE TEST OF PRAGMATIC LANGUAGE TO IDENTIFY PRAGMATIC LANGUAGE IMPAIRMENT IN SPEAKERS WITH AUTISM SPECTRUM DISORDER

Background: Pragmatic language dysfunction persists despite typical structural language skills in high-functioning speakers with ASD (Landa, 2000), yet there are few standardized measures that can be used to identify it (Bishop, 1998; Adams, 2002). Young et al. (2005) found that the TOPL discriminated speakers with ASD with age-appropriate structural language skills from typically developing controls, but their performance varied and some performed as well as matched controls.  Bishop (2003) found that the General Communication Composite (GCC) of the CCC-2 was also useful in identifying clinically significant communication problems. Further, Social Interaction Deviance Composite (SIDC) scores less than 0 identified those with an autism spectrum communicative profile

Objectives: This study compares the CCC-2 and the TOPL in speakers with ASD who have typical levels of structural language skill, in order to determine if one was more successful than the other at identifying pragmatic language impairment.

Methods: 15 children and adolescents with ASD (CA:  5;10 – 13;4; diagnosed with ASD by ADOS, ADI and expert clinical opinion) with CELF-IV Composite Language standard scores greater than 85, were given the TOPL and their parents completed the CCC-2. 

Results: Average TOPL (84.13) and GCC (78.27) were both significantly different from average scores on the CELF-IV (105.93) (t (14) = 6.49, p <.001 for TOPL; t (14) = 6.76, p <.001 for GCC).

All 15 had SIDC scores below 0 on the CCC-2 (Accuracy = 100%), while only 7 had TOPL scores less than 80 (Accuracy = 46%). 

Conclusions:

Lower standard scores on pragmatics tests than on structural tests suggests that pragmatics tests evaluate additional communication skills. 

While mean score on the TOPL did not indicate pragmatic impairment in this sample, the mean score on the CCC-2’s GCC indicated clinically significant communication disability.  In addition, the SIDC identified all as exhibiting an autism spectrum communicative profile.