The Relationship Between Gesture Use and Adaptive Functioning in Autism

Background: Researchers have taken several different behavioral approaches to examine the deficits of imitation and gesture in children with autism.  Results vary among studies but indicate impairments in gesture production during naturalistic interactions as well as during various tasks, including the performance of gestures to verbal commands, the imitation of manual and oral gestures, and the imitation of tool use.  Some suggest that such deficits in gesture constitute a core feature of ASD symptomology and have a functional relationship to other areas of development such as language, social skills, and motor abilities.
Objectives: The purpose of the current study is to examine the relationship between gestures of children with ASD and areas of adaptive functioning using both parent report and direct observation.

Methods: The sample consists of 155 children diagnosed with ASD (M CA = 9 years, 3 months; SD = 3.70, range 4 years, 0 months-17 years, 10 months; 134 M, 21F) who are participating in ongoing genetics studies. Parent reports of gesture use and adaptive functioning (from the ADI-R, and Vineland Adaptive Behavior Scales (VABS)) and observational measures of gesture use (ADOS-WPS) were collected.  The sample was divided into three gesture groups (significant, moderate, and no impairment in gesture use) based on a composite of current gesture use derived by ADI-R and ADOS-WPS item scores. Differences were investigated between gestural groups on areas of adaptive functioning, specifically social, communicative, and daily living skills.  Additionally, gestural groups were split into two age groups (Group #1: ages 4 years, 0 months to 8 years, 11 months; Group #2: ages 9 years, 0 months to 17 years, 11 months) based on Capone & McGregor (2004).

Results:Using MANOVA a significant effect of gestural group was found for scores on the VABS personal (p = .006), domestic (p = .039), and community (p = .023) subdomains, as well as the daily living skills standard scores, (p < .002), with children with greater gesture use deficits showing greater adaptive deficits.  A significant effect of age group was found for the following VABS subdomain scores: receptive (p = .012), expressive (p = .002), written (p = .015), fine motor (p < .001), gross motor (p < .001), interpersonal relationships (p = .018), and domestic (p = .009); and for the following standard scores: motor (p < .001), communication (p = .003), and composite (p = .032).  For all effects of age group, the older age group showed fewer VABS deficits regardless of gestural ability, except for the written language subdomain for which there was a significant interaction effect between gesture and age (p = .028).

Conclusions: The preliminary findings in the current sample of children with ASD suggest that deficits in gesture use have meaningful effects on areas of adaptive functioning, specifically in the area of daily living skills.  These results provide partial support for the theory that gesture deficits in autism may be part of more global impairments related to ASD but also indicate that age also has a strong effect on adaptive skills in ASD.