Journal of Autism and Developmental Disorders

, Volume 38, Issue 8, pp 1426–1438 | Cite as

Language Assessment and Development in Toddlers with Autism Spectrum Disorders

  • Rhiannon J. Luyster
  • Mary Beth Kadlec
  • Alice Carter
  • Helen Tager-Flusberg
Original Paper

Abstract

One of the primary diagnostic criteria for the diagnosis of autism spectrum disorders (ASD) is the presence of a language delay or impairment. Children with ASD are now being identified at significantly younger ages, and prior research has consistently found that early language skills in this population are heterogeneous and an important predictor for later outcome. The goal of this study was to systematically investigate language in toddlers with ASD and to identify early correlates of receptive and expressive language in this population. The study included 164 toddlers with ASD between the ages of 18 and 33 months who were evaluated on several cognitive, language and behavioral measures. Results suggested good agreement among different measures of early language, including direct assessment and parent report measures. Significant concurrent predictors of receptive language included gestures, non-verbal cognitive ability and response to joint attention. For expressive language, the most significant predictors were non-verbal cognitive ability, gestures and imitation. These findings have important implications for intervention programs targeting this population.

Keywords

Language Toddlers Early childhood Development Assessment 

Notes

Acknowledgements

This research was supported by grants from NIH (U54 MH 66398; U19 DC 03610) and funding for the GCRC at Boston University School of Medicine (M01-RR0533). We thank the following people for their help in data collection and management: Anneliese Bass, Christine Connolly, Kristin Dame, Nicole Edwards, Amy Gower, Angelina Rayno and Gretchen Schuman. We also extend our sincere gratitude to the children and families who participated in this study.

References

  1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (Fourth ed.). Washington, DC: Author.Google Scholar
  2. Arbib, M. A., & Rizzolatti, G. (1996). Neural expectations: A possible evolutionary path from manual skills to language. Communication & Cognition, 29(3–4), 393–424.Google Scholar
  3. Bailey, A., Phillips, W., & Rutter, M. (1996). Autism: Towards an integration of clinical, genetic, neuropsychological, and neurobiological perspectives. Journal of Child Psychology and Psychiatry, 37, 89–126.PubMedCrossRefGoogle Scholar
  4. Baldwin, D. (1995). Understanding the link between joint attention and language. In C. Moore & P. J. Dunham (Eds.), Joint attention: Its origins and role in development (pp. 131–158). Lawrence: Erlbaum Associates, Inc.Google Scholar
  5. Bartak, L., Rutter, M., & Cox, A. (1975). A comparative study of infantile autism and specific developmental receptive language disorder. British Journal of Psychiatry, 126, 127–145.PubMedCrossRefGoogle Scholar
  6. Bates, E., & Dick, F. (2002). Language, gesture and the developing brain. Developmental Psychobiology, 40, 293–310.PubMedCrossRefGoogle Scholar
  7. Bates, E., Thal, D., Whitesell, K., Fenson, L., & Oakes, L. (1989). Integrating language and gesture in infancy. Developmental Psychology, 25(6), 1004–1019.CrossRefGoogle Scholar
  8. Bornstein, M., Haynes, M., & Painter, K. (1998). Sources of child vocabulary competence: A multivariate model. Journal of Child Language, 25, 367–393.PubMedCrossRefGoogle Scholar
  9. Bosseler, A., & Massaro, D. (2003). Development and evaluation of a computer-animated tutor or vocabulary and language learning in children with autism. Journal of Autism and Developmental Disorders, 33, 653–672.PubMedCrossRefGoogle Scholar
  10. Boucher, J. (2003). Language development in autism. International Journal of Pediatric Otorhinilaryngology, 67S1, S159–S163.CrossRefGoogle Scholar
  11. Bruner, J., & Sherwood, V. (1983). Thought, language and intersection in infancy. In J. D. Call, E. Galenson, & R. L. Tyson (Eds.), Frontiers of Infant Psychiatry (pp. 38–52). New York: Basic Books.Google Scholar
  12. Carpenter, M., Nagell, K., Tomasello, M., Butterworth, G., & Moore, C. (1998). Social cognition, joint attention and communicative competence from 9 to 15 months of age. Monographs of the Society for Research in Child Development, 63(4), 1–166.CrossRefGoogle Scholar
  13. Carpenter, M., Pennington, B., & Rogers, S. (2002). Interrelations among social-cognitive skills in young children with autism. Journal of Autism & Developmental Disorders., 32(2), 91–106.CrossRefGoogle Scholar
  14. Carpenter, M., Tomasello, M., & Striano, T. (2005). Role reversal imitation and language in typically developing infants and children with autism. Infancy, 8(3), 253–278.CrossRefGoogle Scholar
  15. Charman, T. (2004). Matching preschool children with autism spectrum disorders and comparison children for language ability: Methodological challenges. Journal of Autism and Developmental Disorders, 34(1), 59–64.PubMedCrossRefGoogle Scholar
  16. Charman, T. (2006). Imitation and the development of language. In S. Rogers & J. Willams (Eds.), Imitation and the social mind: Autism and typical development (pp. 96–117). New York, NY, US: Guilford Press.Google Scholar
  17. Charman, T., Baron-Cohen, S., Swettenham, J., Baird, G., Cox, A., & Drew, A. (2000). Testing joint attention, imitation and play as infancy precursors to language and theory of mind. Cognitive Development, 15, 1–18.CrossRefGoogle Scholar
  18. Charman, T., Baron-Cohen, S., Swettenham, J., Baird, G., Cox, A., & Drew, A. (2003). Predicting language outcome in infants with autism and pervasive developmental disorder. International Journal of Language and Communication Disorders, 38(3), 265–285.PubMedCrossRefGoogle Scholar
  19. Charman, T., Drew, A., Baird, C., & Baird, G. (2003). Measuring early language development in pre-school children with autism spectrum disorder using the MacArthur communicative development inventory (Infant Form). Journal of Child Language, 30, 213–236.PubMedCrossRefGoogle Scholar
  20. Charman, T., Taylor, E., Drew, A., Cockerill, H., Brown, J., & 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 & Psychiatry, 46(5), 500–513.CrossRefGoogle Scholar
  21. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
  22. Condouris, K., Meyer, E., & Tager-Flusberg, H. (2003). The relationship between standardized measures of language and measures of spontaneous speech in children with autism. American Journal of Speech-Language Pathology, 12, 349–358.PubMedCrossRefGoogle Scholar
  23. Dawson, G., Toth, K., Abbott, R., Osterling, J., Munson, J., Estes, A., & Liaw, J. (2004). Early social attention impairments in autism: Social orienting, joint attention, and attention to distress. Developmental Psychology, 40(2), 271–283.PubMedCrossRefGoogle Scholar
  24. DeGiacomo, A., & Fombonne, E. (1998). Parental recognition of developmental abnormalities in autism. European Journal of Child & Adolescent Psychiatry, 7, 131–136.CrossRefGoogle Scholar
  25. Delgado, C., Mundy, P., Crowson, M., Markus, J., Yale, M., & Schwartz, H. (2002). Responding to joint attention and language development: A comparison of target locations. Journal of Speech, Language & Hearing Research, 45, 715–719.CrossRefGoogle Scholar
  26. Desrochers, S., Morissette, P., & Ricard, M. (1995). Two perspectives on pointing in infancy. In C. Moore & P. Dunham (Eds.), Joint attention: Its origins and role in development (pp. 85–101). Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
  27. Dyck, M. J., Piek, J. P., Hay, D., Smith, L., & Hallmayer, J. (2006). Are abilities abnormally interdependent in children with autism? Journal of Clinical Child and Adolescent Psychology, 35(1), 20–33.PubMedCrossRefGoogle Scholar
  28. Eisenmajer, R., Prior, M., Leekam, S., Wing, L., Ong, B., Gould, J., & Welham, M. (1998). Delayed language onset as a predictor of clinical symptoms in pervasive developmental disorders. Journal of Autism and Developmental Disorders, 28(6), 527–533.PubMedCrossRefGoogle Scholar
  29. Fenson, L., Dale, P., Reznick, J., Bates, E., Thal, D., & Pethick, S. (1994). Variability in early communicative development. Monographs of the Society for Research in Child Development, 59(5), 1–173.PubMedCrossRefGoogle Scholar
  30. Fenson, L., Dale, P., Reznick, J., Thal, D., Bates, E., Hartung, J., Pethick, S., & Reilly, J. (1993). MacArthur Communicative Development Inventories: User's guide and technical manual. Baltimore, MD: Paul H. Brookes.Google Scholar
  31. Fenson, L., Dale, P., Reznick, J., Thal, D., Bates, E., Hartung, J., Pethick, S., & Reilly, J. (2003). MacArthur communicative development inventories: User’s guide and technical manual. Baltimore, MD: Paul H. Brookes.Google Scholar
  32. Floel, A., Ellger, T., Breitenstein, C., & Knecht, S. (2003). Language perception activates the hand motor cortex: Implications for motor theories of speech perception. European Journal of Neuroscience, 18, 704–708.PubMedCrossRefGoogle Scholar
  33. Ghaziuddin, M., Butler, E., Tsai, L., & Ghaziuddin, N. (1994). Is clumsiness a marker for Asperger syndrome? Journal of Intellectual Disability Research, 38(5), 519–527.PubMedCrossRefGoogle Scholar
  34. Goldin-Meadow, S. (2000). Beyond words: The importance of gesture to researchers and learners. Child Development, 71(1), 231–239.PubMedCrossRefGoogle Scholar
  35. Iverson, J., & Goldin-Meadow, S. (2005). Gesture paves the way for language development. Psychological Science, 16(3), 367–371.PubMedCrossRefGoogle Scholar
  36. Kjelgaard, M. M., & Tager-Flusberg, H. (2001). An investigation of language impairment in autism: Implications for genetic subgroups. Language and Cognitive Processes, 16(2/3), 287–308.PubMedCrossRefGoogle Scholar
  37. Koegel, L. K., Koegel, R. L., & Smith, A. (1997). Variables related to differences in standardized test outcomes for children with autism. Journal of Autism and Developmental Disorders, 27, 233–243.PubMedCrossRefGoogle Scholar
  38. Laakso, M.-L., Poikkeus, A.-M., Eklund, K., & Lyytinen, P. (2000). Social interactional behaviors and symbolic play competence as predictors of language development and their associations with maternal attention-directing strategies. Infant Behavior & Development, 22(4), 541–556.CrossRefGoogle Scholar
  39. Leslie, A. M. (1987). Pretense and representation: The origins of “Theory of Mind”. Psychological Review, 94(4), 412–426.CrossRefGoogle Scholar
  40. Lord, C., Risi, S., DiLavore, P., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from two to nine. Archives of General Psychiatry, 63(6), 694–701.PubMedCrossRefGoogle Scholar
  41. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P., Pickles, A., & Rutter, M. (2000). The autism diagnostic observation schedule––Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism & Developmental Disorders, 30(3), 205–223.CrossRefGoogle Scholar
  42. Lord, C., Risi, S., & Pickles, A. (2004). Trajectory of language development in autistic spectrum disorders. In M. Rice & S. Warren (Eds.), Developmental language disorders: From phenotypes to etiologies (pp. 7–29). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  43. 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. Journal of Autism and Developmental Disorders, 19, 185–212.PubMedCrossRefGoogle Scholar
  44. Lord, C., Rutter, M., & Le Couteur, A. (1994). The autism diagnostic interview–Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism & Developmental Disorders, 24(5), 659–685.CrossRefGoogle Scholar
  45. Lord, C., Spence, S. J., Moldin, S. O., & Rubenstein, J. L. R. (2006). Autism spectrum disorders: Phenotype and diagnosis. In Understanding autism: From basic neuroscience to treatment (pp. 1–23). Boca Raton, FL, US: CRC Press.Google Scholar
  46. Lord, C., & Ventner, A. (1992). Outcome and follow-up studies of high-functioning autistic individuals. In E. Schopler & G. Mesibov (Eds.), High-functioning individuals with autism (pp. 187–199). New York: Plenum.Google Scholar
  47. Loveland, K., & Landry, S. (1986). Joint attention and language in autism and developmental language delay. Journal of Autism and Developmental Disorders, 16, 335–349.PubMedCrossRefGoogle Scholar
  48. Lyytinen, P., Ahonen, T., Eklund, K., Guttorm, T., Laakso, M.-L., Leinonen, S., Leppanen, P., Lyytinen, P., Poikkeus, A.-M., Puolakanaho, A., Richardson, U., & Viholainen, H. (2001). Developmental pathways of chidlren with and without familial risk for dyslexia during the first years of life. Developmental Neuropsychology, 20(2), 535–554.PubMedCrossRefGoogle Scholar
  49. Masur, E. F., & Eichorst, D. L. (2002). Infants’ spontaneous imitation of novel versus familiar words: Relations to observational and maternal report measures of their lexicons. Merrill-Palmer Quarterly, 48(4), 405–426.CrossRefGoogle Scholar
  50. McDuffie, A., Yoder, P., & Stone, W. (2005). Prelinguistic predictors of vocabulary in young children with autism spectrum disorders. Journal of Speech, Language, and Hearing Research, 48(5), 1080–1097.PubMedCrossRefGoogle Scholar
  51. McEwen, F., Happé, F., Bolton, P., Rijsdijk, F., Ronald, A., Dworzynski, K., & Plomin, R. (2007). Origins of individual differences in imitation: Links with language, pretend play, and socially insightful behavior in two-year-old twins. Child Development, 78(2), 474–492.PubMedCrossRefGoogle Scholar
  52. Meister, I. G., Boroojerdi, B., Foltys, H., Sparing, R., Huber, W., & Topper, R. (2003). Motor cortex hand area and speech: Implications for the development of language. Neuropsychologia, 41, 401–406.PubMedCrossRefGoogle Scholar
  53. Morales, M., Mundy, P., Delgado, C., Yale, M., Neal, A. R., & Schwartz, H. (2000). Gaze following, temperament and language development in 6-month-olds: A replication and extension. Infant Behavior & Development, 23, 231–236.CrossRefGoogle Scholar
  54. Mullen, E. (1995). Mullen Scales of Early Learning. Circle Pines, MN: American Guidance Service, Inc.Google Scholar
  55. Mundy, P., Delgado, C., Block, J., Venezia, M., Hogan, A., & Seibert, J. (2003). A manual for the abridged early social communication scales (ESCS). Available through the university of Miami Psychology Department, Coral Gables, FL. Google Scholar
  56. Mundy, P., & Hogan, A. (1996). Preliminary Manual for the Abridged Early Social Communication Scales. Coral Gables, FL: University of Miami.Google Scholar
  57. Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. Journal of Autism & Developmental Disorders, 20(1), 115–128.CrossRefGoogle Scholar
  58. Mundy, P., Sigman, M., & Kasari, C. (1994). Nonverbal communication, developmental level and symptom presentation in autism. Development and Psychopathology, 6, 389–401.Google Scholar
  59. Mundy, P., Sigman, M., Ungerer, J., & Sherman, T. (1987). Nonverbal communication and play correlates of language development in autistic children. Journal of Autism & Developmental Disorders., 17(3), 349–364.CrossRefGoogle Scholar
  60. Nagy, E. (2006). From imitation to conversation: The first dialogues with human neonates. Infant and Child Development, 15(3), 223–232.CrossRefGoogle Scholar
  61. Noterdaeme, M., Mildenberger, K., Minow, F., & Amorosa, H. (2002). Evaluation of neuromotor deficits in children with autism and children with a specific speech and language disorder. European Child & Adolescent Psychiatry, 11, 219–225.CrossRefGoogle Scholar
  62. Paul, R., & Fountain, R. (1999). Predicting outcomes of early expressive language delay. Infant-Toddler Intervention, 9(2), 123–135.Google Scholar
  63. Rapin, I. (1996). Preschool children with inadequate communication. London: MacKeith Press.Google Scholar
  64. Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., Cook, E. H. Jr., Leventhal, B. L., & Pickles, A. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 45(9), 1094.CrossRefGoogle Scholar
  65. Rogers, S., Charman, T., & Stone, W. (2006). Evidence-based interventions for language development in young children with autism. New York: Guilford Press.Google Scholar
  66. Rogers, S., Hepburn, S. L., Stackhouse, T., & Wehner, E. (2003). Imitation performance in toddlers with autism and those with other developmental disorders. Journal of Child Psychology & Psychiatry, 44(5), 763–781.CrossRefGoogle Scholar
  67. Seal, B., & Bonvillian, J. (1997). Sign language and motor functioning in students with autistic disorder. Journal of Autism and Developmental Disorders, 27, 437–466.PubMedCrossRefGoogle Scholar
  68. Sigman, M. (1998). The Emanuel Miller memorial lecture 1997: Change and continuity in the development of children with autism. Journal of Child Psychology and Psychiatry, 19(6), 817–827.CrossRefGoogle Scholar
  69. Sigman, M., & McGovern, C. (2005). Improvement in cognitive and language skills from preschool to adolescence in autism. Journal of Autism and Developmental Disorders, 35(1), 15–23.PubMedCrossRefGoogle Scholar
  70. Siller, M., & Sigman, M. (2002). The behaviors of parents of children with autism predict the subsequent development of their children’s communication. Journal of Autism and Developmental Disorders, 32(2), 77–89.PubMedCrossRefGoogle Scholar
  71. Sparrow, S., Balla, D., & Cicchetti, D. (1984). Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Service.Google Scholar
  72. Stone, W., Ousley, O. Y., & Littleford, C. (1997). Motor imitation in young children with autism: What’s the object? Journal of Abnormal Child Psychology, 25(6), 475–485.PubMedCrossRefGoogle Scholar
  73. Stone, W., & Yoder, P. J. (2001). Predicting spoken language level in children with autism spectrum disorders. Autism, 5(4), 341–361.PubMedCrossRefGoogle Scholar
  74. Thorp, D., & Mundy, P. (submitted). Observational and parent report measures of social communication skills in young children with autism. Journal of Autism and Developmental Disorders.Google Scholar
  75. Thurm, A., Lord, C., Lee, L., & Newschaffer, C. (2007). Predictors of language acquisition in preschool children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 37(9), 1731–1734.CrossRefGoogle Scholar
  76. Tomasello, M., & Mervis, C. B. (1994). The instrument is great, but measuring comprehension is still a problem. Monographs of the Society for Research in Child Development, 59, 174–179.CrossRefGoogle Scholar
  77. Toth, K., Munson, J., Meltzoff, A. N., & Dawson, G. (2006). Early predictors of communication development in young children with autism spectrum disorder: Joint attention, imitation, and toy play. Journal of Autism and Developmental Disorders, 36(8), 993–1005.PubMedCrossRefGoogle Scholar
  78. Ungerer, J., & Sigman, M. (1984). The relation of play and sensorimotor behavior to language in the second year. Child Development, 55, 1448–1455.PubMedCrossRefGoogle Scholar
  79. Van Hecke, A. V., Mundy, P. C., Acra, C. F., Block, J. J., Delgado, C. E. F., Parlade, M. V., Meyer, J. A., Neal, A. R., & Pomares, Y. B. (2007). Infant joint attention, temperament, and social competence in preschool children. Child Development, 78(1), 53–69.CrossRefGoogle Scholar
  80. Watt, N., Wetherby, A., & Shumway, S. (2006). Prelinguistic predictors of language outcome at 3 years of age. Journal of Speech, Language, and Hearing Research, 49(6), 1224–1237.PubMedCrossRefGoogle Scholar
  81. Webster, R. I., & Shevell, M. I. (2004). Neurobiology of specific language impairment. Journal of Child Neurology, 19(7), 471–481.PubMedCrossRefGoogle Scholar
  82. Wetherby, A., Woods, J., Allen, L., Cleary, J., Dickinson, H., & Lord, C. (2004). Early indicators of autism spectrum disorders in the second year of life. Journal of Autism and Developmental Disorders, 34(5), 473–493.PubMedCrossRefGoogle Scholar
  83. Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005). Behavioral manifestations of autism in the first year of life. International Journal of Developmental Neuroscience, 23, 143–152.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Rhiannon J. Luyster
    • 1
  • Mary Beth Kadlec
    • 2
  • Alice Carter
    • 3
  • Helen Tager-Flusberg
    • 2
  1. 1.Autism ConsortiumBostonUSA
  2. 2.Department of Anatomy and NeurobiologyBoston University School of MedicineBostonUSA
  3. 3.University of MassachusettsBostonUSA

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