Objectives: To examine the ability of the VCI score of WISC-IVUK to detect receptive and expressive language impairments in a group of school-aged children with a diagnosed ASC.
Methods: A cognitive assessment (WISC-IVUK) and language assessment (Clinical Evaluation of Language Fundamentals - Fourth Edition UK; CELF-4UK) were individually administered to a sample of children (n=26) with a confirmed diagnosis of an ASC who were in their final year at mainstream primary school (Mean age: 11 years; 3 months). A comparison was made of the following composite scores for each participant: the Perceptual Reasoning Index (PRI) and Verbal Comprehension Index (VCI) of WISC-IVUK; the Receptive Language Index (RLI), Expressive Language Index (ELI) and Language Memory Index (LMI) of CELF-4UK.
Results: Just under two-thirds of the sample (17 children) performed within the language impairment range (mild, moderate or severe) on at least one of the three CELF-4UK composites. However, 8 of these children (or 47% of those with language impairments) performed within the average range (score of 90 or above) on the VCI of WISC-IVUK. The VCI did not detect linguistic difficulties in almost half of those scoring in the language impairment range on CELF®–4, therefore. Furthermore, the majority of children (7 out of 8 or 87.5%) in this undetected group had language difficulties in the moderate and/ or severe range (CELF-4UK). The VCI proved accurate in detecting linguistic difficulties in children whose assessment profiles were characteristic of a Specific Language Impairment (SLI), however. Just over a quarter (26.9%) of the sample of 26 children had language profiles which met ICD-10 and DSM-IV criteria for SLI (with the exception of the coexistent ASC diagnosis) and the majority of their VCI scores (6 out of 7 or 85.7%) fell below the average range (i.e. 90 or below).
Conclusions: Undiagnosed language impairments are known to affect many aspects of the lives of children with ASC, including their psychological wellbeing, social interaction with peers, self-regulation of behaviour and ability to access the educational curriculum. Clinicians must be wary of drawing conclusions about a child’s language development based solely on the VCI score, since it evaluates only certain aspects of linguistic development. Our findings highlight the importance of access to a comprehensive multidisciplinary assessment for children with ASC, which includes a standardised language assessment.
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