Social Communication Skills, Cognitive Ability, and Language Development of Young Children at Risk for Autism

Background: Many studies have shown that children with autism are able to use protoimperative gestures (i.e. gestures to request objects) but show deficits in protodeclarative gestures (i.e. gestures to share objects with people) (Baron-Cohen, 1989; Mundy et al., 1986). Previous research has demonstrated that children at risk for autism and children with autism initiate less joint attention, and display fewer gestures compared to typically developing children. In addition, joint attention has been found to be associated with language development (Mundy, Sigman, & Kasari, 1990; Mundy and Gomes, 1998) and cognitive ability (Mundy, Sigman, and Kasari, 1994).

Objectives: The purpose of this study is to examine the relationships between social communication skills, cognitive ability, and improvements in language in young children at risk for autism.

Methods: The sample is comprised of 36 children (29 boys, 7 girls) between 15-30 months of age at entry (CA: M =21.5, SD =3.8, MA: M =14.5, SD =5.2). Participants were recruited from the community in the Los Angeles area and were enrolled if they showed high risk for autism on the: 1) Modified Checklist for Autism in Toddlers (MCHAT, Robins & Dumont-Mathieu, 2006), 2) MCHAT: Follow-Up Telephone Interview, and 3) Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP, Wetherby & Prizant, 2002).

Measures

The Early Social-Communication Scales (ESCS, Mundy et al, 1986; Seibert, Hogan, & Mundy, 1982) is a social-communication assessment.  It assesses joint attention behaviors, behavioral requests and social interaction behaviors.

The Mullen Scales of Early Learning (MSEL) (Mullen, 1989) assesses general cognitive ability. The Mullen yields age-equivalent scores for young children in four domains: Visual Reception, Fine Motor, Receptive and Expressive Language.

Results: Of the 36 children identified with concern for autism, 91.6% had concern in the emotion and eye gaze cluster, 97% had concern in the communication cluster, and 100% had concern in the gesture cluster within the social domain of the CSBS. The amount of concern was not associated with initial social, language or cognitive abilities.  However, greater joint attention and requesting behaviors were associated with better language outcomes 3 months later.   Pearson’s correlation analysis revealed that more behavioral regulation points at entry were associated with greater improvements in receptive language from entry to exit, (r = 0.44, p <0.008), and more joint attention gives at entry were associated with greater improvements in expressive language from entry to exit (r = 0.35, p< 0.04). In addition, higher developmental quotients at entry were associated with greater frequencies of behavioral regulation points (r = 0.46, p < 0.01) and joint attention points at exit (r = 0.5, p < 0.005).

Conclusions: Results from this study contribute to the autism literature by exploring the links between social communication skills, cognitive ability and language development in young children at risk for autism. These data are consistent with data for children with clear diagnoses of autism (Mundy, et al., 1986; Mundy & Gomez, 1998; Mundy, Sigman, and Kasari, 1994).