Children with Autism Spectrum Disorders (ASDs) exhibit symptoms that, historically, have been considered part of a lifelong disorder. A growing body of research indicates that, through intensive early intervention, children with ASDs may show notably reduced problems in language, cognition, and social interaction and may even lose their ASD diagnosis (Harris & Handleman, 2000; Kelley, Paul, Fein, & Naigles, 2006). Kelley et al. (2006, 2010) have reported some residual linguistic weaknesses in such optimal outcome (OO) children at 7-10 years of age; however, comprehensive assessments of the language abilities of OO adolescents are needed, especially using both standardized and psycholinguistic tests.
The current study examines the language of OO adolescents, who were diagnosed with ASD before age 5, but who no longer meet criteria for an ASD diagnosis and are placed in mainstream classrooms. Their language is compared to group with age-matched individuals with high-functioning autism (HFA) and typically developing individuals (TD).
Participants include TD children and adolescents (mean age = 13.23), children and adolescents with high-functioning autism (HFA) (mean age = 13.18), and OO children and adolescents (mean age = 12.91). Group Ns varied depending on the task; all Ns >15. Groups did not differ in NVIQ (p> .4). Children participated in standardized tests, including Comprehensive Evaluation of Language Fundamentals (CELF), Peabody Picture Vocabulary Test (PPVT), Comprehensive Test of Phonological Processing (CTOPP), Test of Language Competence (TLC) and a narrative elicitation task (Tuesday Story from the ADOS).
The OO group had significantly lower scores than the TD group on the formulated sentences subscale of the CELF; all other standardized test measures yielded no TD/OO group differences. The HFA group had significantly lower scores than the TD group on the CELF, PPVT, CTOPP, and TLC, and performed worse than the OO group on the CELF and TLC. On the narrative task, the OO and HFA groups produced more dysfluencies and idiosyncratic language than the TD group. HFA (but not OO) children also produced more ambiguous pronouns and fewer story elements than the TD group.
The HFA participants continued to show a range of receptive, expressive, and pragmatic deficits. Overall, the Optimal Outcome children showed remarkably good language abilities. Residual difficulties relative to the TD group were observed only with subtle expressive skills, including creating new sentences and showing mild disfluencies in telling stories. The use of ambiguous pronouns, however, which arguably reflects failure to take the perspective of the listener, was elevated in the HFA but not the OO group, suggesting that this aspect of pragmatics has reached normal levels in the OO group.
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