Language Predictors in Autism Spectrum Disorder: Insights from Neurodevelopmental Profile in a Longitudinal Perspective
Language outcome in individuals with autism spectrum disorder (ASD) is predicted by early developmental milestones and cognitive abilities. The development and acquisition of expressive language (particularly the onset of first phrases) is a relevant clinical milestone by school age, since its early presentation is associated to better long-term life outcomes and to lower core clinical severity of ASD. Focusing on predictors of language in ASD children, a number of outstanding questions remain to be answered, namely, whether there are differences in the early key neurodevelopmental abilities and whether those differences in a specific period of time might predict verbal development and acquisition of expressive language. We aim to understand how the neurodevelopmental profile of ASD children evolves from the preschool to the school age and if and which subarea can better predict acquisition of expressive language. Children with ASD (N = 205) were evaluated with a structured assessment of neurodevelopment in two different age periods: 1) preschool period (mean age four years) and 2) reassessment in the school period (mean age seven years). Our findings demonstrate that in nonverbal preschool children with ASD normal or near normal Performance Developmental Quotient (superior to 73.5) evaluated at preschool age is a good predictor of later language development in ASD, which has important implications for intervention programs targeting this population and family information.
KeywordsAutism spectrum disorder Neurodevelopmental milestones Verbal ability Early neurodevelopmental predictor Griffiths mental development scales
This research was supported by the Portuguese Foundation for Science and Technology: individual PhD scholarship: SFRH/BD/102779/2014 to SM and MEDPERSYST - Redes Sinápticas e abordagens compreensivas de medicina personalizada em doenças neurocomportamentais ao longo da vida (POCI-01-0145-FEDER-016428) [postdoctoral fellowship to BRC]. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
All authors have declared that no conflict of interests exists.
All the procedures in this study were reviewed in accordance with the ethical standards and approved by the Health Ethics Commission of our Hospital (Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra) and were conducted in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
The clinicians obtained informed consent from the parents/guardians of all younger participants. Children, when competent to do so, also gave oral informed consent. The database is approved by the Portuguese Data Protection Authority.
- Anderson, D. K., Lord, C., Risi, S., DiLavore, P., Shulman, C., Thurm, A., et al. (2007). Patterns of growth in verbal abilities among children with autism spectrum disorder. Journal of Consulting and Clinical Psychology, 75(4), 594–604. https://doi.org/10.1037/0022-006X.75.4.594.CrossRefGoogle Scholar
- Associação Portuguesa de Paralisia Cerebral. (n.d.). Instruções para aplicação das Escalas de Desenvolvimento de Ruth Griffiths, tradução e adaptação portuguesa (vol I e II). (A. P. de P. Cerebral, Ed.). Lisboa.Google Scholar
- Billstedt, E., Carina Gillberg, I., & Gillberg, C. (2007). Autism in adults: Symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood. Journal of Child Psychology and Psychiatry and Allied Disciplines, 48(11), 1102–1110. https://doi.org/10.1111/j.1469-7610.2007.01774.x.CrossRefGoogle Scholar
- Centers for Disease Control and Prevention. (2009). Prevalence of autism spectrum disorders - Autism and Developmental Disabilities Monitoring Network, United States, 2006. MMWR Surveill Summ, 58(10), 1–20.Google Scholar
- Charman, T., Baron-Cohen, S., Swettenham, J., Baird, G., Drew, A., & Cox, A. (2003). Predicting language outcome in infants with autism and pervasive developmental disorder. International journal of language & communication disorders / Royal College of Speech & Language Therapists, 38(3), 265–285. https://doi.org/10.1080/136820310000104830.CrossRefGoogle Scholar
- Charman, T., Taylor, E., Drew, A., Cockerill, H., Brown, J. A., & Baird, G. (2005). Outcome at 7 years of children diagnosed with autism at age 2: Predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. Journal of Child Psychology and Psychiatry and Allied Disciplines, 46(5), 500–513. https://doi.org/10.1111/j.1469-7610.2004.00377.x.CrossRefGoogle Scholar
- Ellis Weismer, S., & Kover, S. T. (2015). Preschool language variation, growth, and predictors in children on the autism spectrum. Journal of Child Psychology and Psychiatry, 12, n/a-n/a. https://doi.org/10.1111/jcpp.12406.
- Gillberg, C., & Steffenburg, S. (1987). Outcome and prognostic factors in infantile autism and similar conditions: a population-based study of 46 cases followed through puberty. J Autism Dev Disord, 17(2), 273–287 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3610999.CrossRefGoogle Scholar
- Griffiths, R. (1984). The Abilities of young children. London: University of London press.Google Scholar
- Howlin, P., Mawhood, L., & Rutter, M. (2000). Autism and Developmental Receptive Language Disorder—a Follow-up Comparison in Early Adult Life. II: Social, Behavioural, and Psychiatric Outcomes. Journal of Child Psychology and Psychiatry, 41(5), 561–578. https://doi.org/10.1111/1469-7610.00643.CrossRefGoogle Scholar
- Johnson, C. J., Beitchman, J. H., & Brownlie, E. B. (2010). Twenty-year follow-up of children with and without speech-language impairments: Family, educational, occupational, and quality of life outcomes. American Journal of Speech-Language Pathology, 19(1), 51–65. https://doi.org/10.1044/1058-0360(2009/08-0083.CrossRefGoogle Scholar
- Kover, S. T., Edmunds, S. R., & Ellis Weismer, S. (2016). Brief Report: Ages of Language Milestones as Predictors of Developmental Trajectories in Young Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 46(7), 2501–2507. https://doi.org/10.1007/s10803-016-2756-y.CrossRefPubMedCentralGoogle Scholar
- Le Couteur, A., Lord, C., & Rutter, M. (2003). The Autism Diagnostic Interview-Revised (ADI-R). Western Psychological Services: Los Angeles CA Western Psychological Services.Google Scholar
- Lord, C., & Rutter, M. (1999). Autism diagnostic observation schedule-WPS (ADOS-WPS). Los Angeles CA Western Psychological. http://scholar.google.com/scholar?hl=en&q=Autism+Diagnostic+Observation+Schedule+–+WPS+%28ADOS-PS%29&btnG=Search&as_sdt=0%2C11&as_ylo=&as_vis=0#0
- Lord, C., Rutter, M., Goode, S., Heemsbergen, J., Jordan, H., Mawhood, L., & Schopler, E. (1989). Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. J Autism Dev Disord, 19(2), 185–212 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2745388.CrossRefGoogle Scholar
- Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord, 24(5), 659–685 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7814313.CrossRefGoogle Scholar
- Oliveira, G., Ataíde, A., Marques, C., Miguel, T. S., Coutinho, A. M., Mota-Vieira, L., et al. (2007). Epidemiology of autism spectrum disorder in Portugal: prevalence, clinical characterization, and medical conditions. Developmental Medicine and Child Neurology, 49(10), 726–733 http://www.ncbi.nlm.nih.gov/pubmed/17880640.CrossRefGoogle Scholar
- Sutera, S., Pandey, J., Esser, E. L., Rosenthal, M. A., Wilson, L. B., Barton, M., et al. (2007). Predictors of optimal outcome in toddlers diagnosed with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 98–107. https://doi.org/10.1007/s10803-006-0340-6.CrossRefGoogle Scholar
- Szatmari, P., Bryson, S. E., Boyle, M. H., Streiner, D. L., & Duku, E. (2003). Predictors of outcome among high functioning children with autism and Asperger syndrome. J Child Psychol Psychiatry, 44(4), 520–528 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12751844.CrossRefGoogle Scholar
- Thunberg, G. (2013). Early Communication Intervention for Children with Autism Spectrum Disorders. Recent Advances in Autism Spectrum Disorders - Volume I. https://doi.org/10.5772/54881.
- Venter, A., Lord, C., & Schopler, E. (1992). A follow-up study of high-functioning autistic children. J Child Psychol Psychiatry, 33(3), 489–507 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1577895.CrossRefGoogle Scholar
- Yoder, P., Watson, L. R., & Lambert, W. (2015). Value-Added Predictors of Expressive and Receptive Language Growth in Initially Nonverbal Preschoolers with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 45(5), 1254–1270. https://doi.org/10.1007/s10803-014-2286-4.CrossRefPubMedCentralGoogle Scholar