International Meeting for Autism Research (London, May 15-17, 2008): Phrase speech milestone predicts autism symptoms and adaptive ability in high functioning school age children with autism spectrum disorders

Saturday, May 17, 2008

Champagne Terrace/Bordeaux (Novotel London West)

L. Kenworthy , Center for Autism Spectrum Disorders, Children's National Medical Center, George Washington University, Rockville, MD

D. O. Black , Pediatrics and Developmental Neuropsychiatry, NIMH, Bethesda, MD

L. K. Case , Laboratory of Brain and Cognition, NIMH, Bethesda, MD

J. Strang , Center for Autism Spectrum Disorders, Children's National Medical Center, George Washington University, Rockville, MD

J. L. Sokoloff , Center for Autism Spectrum Disorders, Children's National Medical Center, George Washington University, Rockville, MD

A. Youmatz , Center for Autism Spectrum Disorders, Children's National Medical Center, George Washington University, Rockville, MD

C. Anselmo , Center for Autism Spectrum Disorders, Children's National Medical Center, George Washington University, Rockville, MD

J. A. Silvers , Laboratory of Brain and Cognition, NIMH, Bethesda, MD

G. L. Wallace , Laboratory of Brain and Cognition, NIMH, Bethesda, MD

Background: Language ability is an important predictor of outcome for children with autism. This study examines the relationship between early language development and outcome in a high functioning cohort of children with autism spectrum disorders (ASDs).

Objectives: Investigate the relationship of parent reported language milestones (age of first word and age of phrase speech) to autism symptoms and adaptive behavior in school age children.

Methods: Subjects were a clinically referred sample of 88 high functioning children (mean age=8.4±3.3 years; IQ > 75 on verbal or nonverbal ability) diagnosed with an ASD based on the Autism Diagnostic Interview (ADI), Autism Diagnostic Observation Schedule (ADOS), and clinical impression. The relationships between autism symptoms (based on a composite of ADI and ADOS domain scores), adaptive behavior (Vineland Adaptive Behavior Scale (VABS)) and early language milestones were analyzed using partial correlations, controlling for age. Because nonverbal ability was related to VABS Communication, both age and nonverbal ability were partialled out of the correlations with VABS Communication.

Results: Age at first phrase speech was moderately correlated (pr = .26) with autism social symptoms but not communication or repetitive behavior symptoms. Age at first phrase speech was negatively correlated with adaptive behavior in all VABS domains: Communication (pr=-.49), Daily Living Skills (pr=-.30), and Socialization (pr=-.35). Age of first word was not correlated with any measures of symptoms or adaptive behavior.

Conclusions: In this group of high functioning children with ASD, attainment of phrase speech is a predictor of later autism symptoms and adaptive skills, while age at first word is not. This may reflect the fact that language abilities become more stable over time, as phrase speech occurs later in development than first words. Alternatively, phrase speech may be distinct from uttering single words because it is associated with communicative intent, representing early social-communicative abilities.

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