Expressive and Receptive Language Impairment in Young Children with Autism

Background:   Autism is a developmental disorder involving primary impairments in both language and communication.  Language difficulties vary widely in the autism population and improving our understanding of these problems is key to furthering our understanding of autism.  Language deficits are often one of the first presenting symptoms [1, 2] and certainly are one of the most important features for predicting the prognosis and developmental course for children with this disorder [3, 4].

Objectives:   The goal of this study was to investigate the presence and extent of language deficits in children with autism compared to healthy age-matched controls.  In broad terms, language can be divided into two processes:  receptive language which involves the processing of incoming language information; and expressive language, which involves producing language either by speaking or writing.

Methods:   We investigated expressive and receptive language functioning in a group of 17 children (14M/3F; 3-8 yrs of age) diagnosed with autism using the ADOS and ADI-R, and meeting DSM-IV criteria, compared to a group of healthy age-matched controls (n=30; 11M/19F).  The children with autism had some verbal ability, normal hearing and no co-morbid neurological or psychiatric diagnoses.  To determine whether there were differences in expressive and receptive language abilities between children with autism and control children, standardized language tests were administered to both groups. Depending on their age and ability, children were tested using the OWLS (Oral and Written Language Scale), PLS-3 (Preschool Language Scale) or CELF-3 (Clinical Evaluation of Language Fundamentals).

Results:   Among the children with autism there was heterogeneity in their language skills, although across the entire group of children, articulation skills were spared.  Compared to healthy children, children with autism scored significantly lower in both expressive (p=0.0001) and receptive (p=0.0001) language domains.  Compared to one another, children with autism showed no significant receptive-expressive differences.  Interestingly, we did not find significant differences between the younger (defined as 3-5 yrs) and older children (6-8 yrs) with autism in this study.  This is consistent with other studies [5, 6] although our inclusion of a large control group further substantiates the literature.

Conclusions:   Our findings confirm that children with autism also have language deficits that need to be addressed and monitored to enhance effective communication in everyday life.  This finding replicates and extends, as well as supports, the hypothesis that autism and speech and language impairments may be linked etiologically [5, 7].

References:

[1] Kurita H. (1985). J Am Acad Child Psychiatry, 24(2):191-6.

[2] Lord C, Paul R. (1997). In: DJ Cohen & FR Volkmar (Eds.), Handbook of Autism and Pervasive Development Disorders (2^nd Ed.). NY: John Wiley, pp. 195-225.

[3] Rutter M. (1970). Semin Psychiatry, 2(4):435-50.

[4] Ventner A, Lord C, Schopler E. (1992). J Child Psychol Psychiatry, 33:489–507.

[5] Kjelgaard MM, Tager-Flusberg H. (2001). Lang Cogn Process, 16:287–308.

[6] Jarrold C, Boucher J, Russell J. (1997). Autism, 1:57–76.

[7] Conti-Ramsden G, Simkin Z, Botting N. (2006). J Child Psychol Psychiatry, 47:621-8.