European Child & Adolescent Psychiatry

, Volume 21, Issue 5, pp 267–276 | Cite as

Social use of language in children with reactive attachment disorder and autism spectrum disorders

  • Fareeha Amber Sadiq
  • Louise Slator
  • David Skuse
  • James Law
  • Christopher Gillberg
  • Helen Minnis
Original Contribution

Abstract

Children with a diagnosis of reactive attachment disorder (RAD) appear to show difficulties in social understanding. We aimed to compare the pragmatic language functioning of children with (RAD) and autism spectrum disorder (ASD). Assessments were made in three groups of children aged 5–8 years, with verbal IQ estimates in the normal range: 35 with a RAD diagnosis, 52 with an ASD diagnosis and 39 with typical development. The Children’s Communication Checklist (CCC) was used to compare their pragmatic language skills, and ADI-R algorithms were used to compare autistic symptomatology, according to parent report. According to the CCC, the RAD group demonstrated significant problems in their use of context, rapport and social relationships with a degree of severity equivalent to children in the ASD comparison group. More than 60% of the group with RAD met ADI-R clinical criteria on the Use of Language and Other Social Communication Skills subscale, 46% on the Reciprocal Social Interaction subscale, and 20% had significant repetitive and stereotyped behaviours. Children with RAD appear to be at least as impaired as children with ASD in certain domains of social relatedness, particularly in their pragmatic language skills.

Keywords

Reactive attachment disorder Autism Pragmatic language Social communication 

References

  1. 1.
    AACAP Official Action (2005) Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder in infancy and early childhood. J Am Acad Child Adolesc Psychiatry 44:1206–1219Google Scholar
  2. 2.
    Adams C (2001) Clinical diagnostic and intervention studies of children with semantic-pragmatic language disorder. Int J Lang Commun Disord 36:289–305PubMedGoogle Scholar
  3. 3.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders. 4th edn. Revised. American Psychiatric Association, Washington DCGoogle Scholar
  4. 4.
    Angold A, Costello EJ (2000) The Child and Adolescent Psychiatric Assessment (CAPA). J Am Acad Child Adolesc Psychiatry 39:39–48PubMedCrossRefGoogle Scholar
  5. 5.
    Atkinson L (1992) The British Picture Vocabulary Scale. Br J Disord Commun 26:272Google Scholar
  6. 6.
    Bennett J, Espie C, Duncan B, Minnis H (2009) A qualitative exploration of children’s understanding of indiscriminate friendliness. Clin Child Psychol Psychiatry 14:595–618PubMedCrossRefGoogle Scholar
  7. 7.
    Bishop DVM (1998) Development of the children’s communication checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children. J Child Psychol Psychiatry 39:879–891PubMedCrossRefGoogle Scholar
  8. 8.
    Bishop DVM, Baird G (2001) Parent and teacher report of pragmatic aspects of communication: use of the children’s communication checklist in a clinical setting. Dev Med Child Neurol 43:809–818PubMedCrossRefGoogle Scholar
  9. 9.
    Byrne JG (2003) Referral biases and diagnostic dilemmas. Attachment Hum Dev 5:249–252CrossRefGoogle Scholar
  10. 10.
    Geurts HM, Embrechts M (2008) Language profiles in ASD, SLI, and ADHD. J Autism Dev Disord 38:1931–1943PubMedCrossRefGoogle Scholar
  11. 11.
    Gilmour J, Hill B, Place M (2004) Social communication deficits in conduct disorder: a clinical and community survey. J Child Psychol Psychiatry 45:967–978PubMedCrossRefGoogle Scholar
  12. 12.
    Gilmour J, Hill B, Place M, Skuse DH (2004) Social communication deficits in conduct disorder: a clinical and community survey. J Child Psychol Psychiatry 45:967–978PubMedCrossRefGoogle Scholar
  13. 13.
    Green Jonathan, Goldwyn Ruth (2002) Annotation: attachment disorganisation and psychopathology: new findings in attachment research and their potential implications for developmental psychopathology in childhood. J Child Psychol Psychiatry 43:835–846Google Scholar
  14. 14.
    Green J (2003) Are attachment disorders best seen as social impairment syndromes? Attachment Hum Dev 5:259–264CrossRefGoogle Scholar
  15. 15.
    Kadesjo B, Gillberg G (2001) The comorbidity of ADHD in the general population of Swedish school age children. J Child Psychol Psychiatry 42:487–492PubMedCrossRefGoogle Scholar
  16. 16.
    Kadesjo B, Gillberg C (2001) The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychiatry Psychol 42:487–492CrossRefGoogle Scholar
  17. 17.
    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 Austim Dev Disord 19:185–212CrossRefGoogle Scholar
  18. 18.
    Lord C, Risi S, Lambrecht L, Cook JrEH, Leventhal BL, DiLavore PC, 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. J Autism Dev Disord 30:205–223Google Scholar
  19. 19.
    Mandy W, Charman T, Gilmour J, Skuse D (2011) Toward specifying pervasive developmental disorder—not otherwise specified. Autism Res 4(2):121–131Google Scholar
  20. 20.
    McLaughlin A, Espie C, Minnis H (2010) Development of a brief waiting room observation for behaviours typical of reactive attachment disorder. Child Adolesc Ment Health 15:73–79CrossRefGoogle Scholar
  21. 21.
    Miller JN, Ozonoff S (1997) Did Asperger’s cases have Asperger disorder? A research note. J Child Psychol Psychiatry 38:247–251PubMedGoogle Scholar
  22. 22.
    Millward R, Kennedy E, Towlson K, Minnis H (2006) Reactive attachment disorder in looked after children. Emot Behav Diffic 11:273–279CrossRefGoogle Scholar
  23. 23.
    Minnis H, Green J, O’Connor T, Liew A, Glaser D, Taylor E, Follan M, Young D, Barnes J, Gillberg C, Pelosi A, Arthur J, Burston A, Connolly B, Sadiq FA (2009) An exploratory study of the assoication between reactive attachment disorder and attachment narratives in early school-age children. J Child Psychol Psychiatry 58:931–942CrossRefGoogle Scholar
  24. 24.
    O’Connor T, Bredenkamp D, Rutter M (1999) Attachment disturbances and disorders in children exposed to severe early deprivation. Infant Ment Health J 20:10–29CrossRefGoogle Scholar
  25. 25.
    Psychological Corporation. Weschler Abbreviated Scale of Intelligence: manual. 1999. San Antonio (TX), Harcourt BraceGoogle Scholar
  26. 26.
    Ronald A, Smirnoff E, Kuntsi J, Asherson P, Plomin R (2008) Evidence for overlapping genetic influences on autistic and ADHD behaviours in a community twin sample. J Child Psychol Psychiatry 49:535–542PubMedCrossRefGoogle Scholar
  27. 27.
    Rutter M, Anderson-Wood L, Beckett C, Bredenkamp D, Castle J, Groothues C, Kreppner J, Keaveney L, Lord C, O’Connor T (1999) Quasi-autistic patterns following severe early global privation. J Child Psychol Psychiatry 40:537–549PubMedCrossRefGoogle Scholar
  28. 28.
    Rutter M, Kreppner J, Sonuga-Barke E (2009) Emanuel Millar Lecture: attachment insecurity, disinhibited attachment, and attachment disorders: where do the research findings leave the concepts? J Child Psychol Psychiatry 50:529–543PubMedCrossRefGoogle Scholar
  29. 29.
    Rutter M, Beckett C, Castle J, Colvert E, Kreppner J, Mehta M, Stevens S, Sonuga-Barke E (2007) Effects of profound early institutional deprivation: an overview of findings from a UK longitudinal study of Romanian adoptees. Eur J Dev Psychol 4:332–350CrossRefGoogle Scholar
  30. 30.
    Rutter M, Colvert E, Kreppner J, Beckett C, Castle J, Groothues C, Hawkins A, O’Connor TG, Stevens SE, Sonuga-Barke EJS (2007) Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: disinhibited attachment. J Child Psychol Psychiatry 48:17–30PubMedCrossRefGoogle Scholar
  31. 31.
    Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G (2008) Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry 47:921–929PubMedCrossRefGoogle Scholar
  32. 32.
    Skuse D, Warrington R, Bishop Deal (2004) The developmental, dimensional and diagnostic interview (3di): a novel computerized assessment for autism spectrum disorders. J Am Acad Child Adolesc Psychiatry 43:548–558Google Scholar
  33. 33.
    Smyke AT, Dumitrescu A, Zeanah CH (2002) Attachment disturbances in young children. I: the continuum of caretaking casualty. J Am Acad Child Adolesc Psychiatry 41:972–982PubMedCrossRefGoogle Scholar
  34. 34.
    Szatmari P (2000) The classification of autism, Asperger’s Syndrome, and pervasive developmental disorder. Can J Psychiatry 45:731–738PubMedGoogle Scholar
  35. 35.
    Szatmari P, Bryson SE, Streiner DL, Wilson F, Archer L, Ryerse C (2000) Two-year outcome of preschool children with autism or Asperger’s syndrome. Am J Psychiatry 157:1980–1987PubMedCrossRefGoogle Scholar
  36. 36.
    Wechsler D (2003) Wechsler Intelligence Scale for Children (WISC-IV). Psychological Corporation, San AntonioGoogle Scholar
  37. 37.
    Wing L, Gould J (1979) Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. J Autism Dev Disord 9:11–29PubMedCrossRefGoogle Scholar
  38. 38.
    World Health Organisation (1993) The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. World Health Organisation, GenevaGoogle Scholar
  39. 39.
    World Health Organisation (2007) The ICD-10 International statistical classificastion of diseases and related health problems: mental and behavioural problemsGoogle Scholar
  40. 40.
    Zeanah C, Smyke AT (2008) Attachment disorders in family and social context. Infant Ment Health J 29:219–233CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Fareeha Amber Sadiq
    • 1
  • Louise Slator
    • 2
  • David Skuse
    • 2
  • James Law
    • 3
  • Christopher Gillberg
    • 1
  • Helen Minnis
    • 1
    • 4
  1. 1.Section of Psychological Medicine, Faculty of Medicine, Caledonia House, Royal Hospital for Sick ChildrenUniversity of GlasgowGlasgowUK
  2. 2.Behavioural and Brain Sciences Unit, Institute of Child HealthUniversity College LondonLondonUK
  3. 3.Institute of Health and Society, School of Education, Communication and Language SciencesUniversity of NewcastleNewcastle-upon-TyneUK
  4. 4.Psychological Medicine, College of Medicine, Veterinary and Life Sciences, Caledonia House, Yorkhill HospitalUniversity of GlasgowGlasgowUK

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