Language and Academic Deficits Among Children with Autism Spectrum Disorders Attending Regular School Classes After Intensive Long Term Treatment

Background:  reatment programs providing intensive long term (usually 2 years) treatment for children with ASD in experimental settings report significant results, even loss of the diagnosis of autism in some cases. Reports though are still sparse on possible language and academic deficits which may prevent continuing progress of children with ASD in regular classes. 

Objectives: Objective of the present study was the evaluation of the language and academic profiles of five children (all boys) with ASD who attended and completed an intensive treatment program (from 2 to 4 year) and continued to receive follow up focused treatment while attending regular school classes, in order to identify possible persisting deficits which might still impede progress.  

 Methods: The five children, with an IQ within the average range (Raven) were evaluated: three of them (age, all 8 yrs old) attended regular grade 3 and two (age 6 and 7 yrs old) attended grade 1 classes in different schools and locations in a Greek province, The children at the initial referral 5 to 3 years previously at the Day Centre, received the diagnosis ASD (DSM-IV criteria), corroborated by CARS and VINELAND. At that time none of the children had communicative linguistic skills. For the present evaluation the following test were administered: ADOS, PPVT-III, EOWPVT-R, Sentence Structure of CELF-4, Phonetic and Phonological Development, ERRNI, DELV – Pragmatics Domain, and the Reading and Writing Scales by Floratou (Greek language).    

Results: ADOS: one child (Th) scored (4) below the cut-off point and did not maintain the initial diagnosis of ASD whilst the other 4 maintained it (scoring 7 or 8). Speech and Language: Four of the children had adequate speech and one was at the last stage of treatment for developmental dyspraxia. On the PPVT-III the three older children scored average and on the comprehension of ‘complex sentences’ of CELF-4 all scored below average. On the test ERRNI which provides a measure of narrative skills their performance was unequal. On the Pragmatic Domain – DELV the three older children were within the average range. Academic performance: On the Reading and Writing Scales by Floratou the results were unequal. Only the child Th (out of ASD) was performing within the average range for reading and writing with mild delay in math. The others performed within the average range in reading decoding but were experiencing difficulties in reading comprehension and writing (spelling, letter omissions, word accents) and had substantial delays in math. All children cooperated eagerly for the academic assessment but all showed signs of fatigue and expressed it verbally.         

Conclusions: Children with ASD and average intelligence, who have progressed satisfactorily through an intensive treatment program upon entering regular school classes may still continue to present with language and academic difficulties requiring ongoing support.