Follow-up of children with language delay and features of autism from preschool years to middle childhood

Abstract

Eighteen children (13 males, five females) who had severe developmental language delay/disorder and some features of autism (although insufficient in severity and combination to meet ICD-10 diagnostic criteria for childhood autism) at preschool age (Time 1; mean age 4 years 4 months) were followed up 4 years later (Time 2; mean age 8 years 7 months). At the initial assessment the diagnostic dilemma was how much the social communication impairments and behavioural problems were secondary to the language problem and how much they constituted a genuine case of a pervasive developmental disorder. It was anticipated that at follow-up some children would continue to show social impairments but that in others social impairments would have receded as language competence improved. Follow-up assessments included the Wechsler Intelligence Scale for Children, the Clinical Evaluation of Language Fundamentals, the Children's Communication Checklist, and the Social Communication Questionnaire. At follow-up, five children had continuing language disorder and were considered to fulfil diagnostic criteria for childhood autism, four children had continuing language disorder and met criteria for atypical autism, and nine met criteria for atypical autism but had somewhat recovered language skills. Thus, even in the subgroup of children whose language ability had improved the features of autism had not dissipated. Severity of social communication impairments and repetitive behaviours at Time 1, rated retrospectively from case notes, were associated with severity of autism symptoms and pragmatic competence at Time 2. The findings are discussed in relation to the unclear boundary between autism spectrum disorders and language delay/disorder.

A longitudinal study of autism spectrum disorders in individuals diagnosed with a developmental language disorder as children

“…The main finding from the present study was that an ASD diagnosis was approximately 25‐fold more common in the DLD case group than in a age‐ and sex‐matched comparison group from the overall population (2.1% vs. 0.09%; P < 0.0001). This is a much lower rate than in some earlier published studies (Bishop & Norbury 2002; Michelotti et al. 2002; Miniscalco et al.…”

“…Even though the DLD group had been deliberately selected to exclude those with autistic features, the long‐term follow‐up studies of Howlin and colleagues (2000), Mawhood and colleagues (2000) and Clegg and colleagues (2005) suggested that problems in some individuals with early language delays may actually increase with time and that similarities between ASD and DLD become more apparent with age. Bishop and Norbury (2002), Michelotti and colleagues (2002), Conti‐Ramsden and colleagues (2006), Miniscalco and colleagues (2007) and Pinborough‐Zimmerman and colleagues (2007), all studying younger‐aged participants, have reported similar findings. In addition, further evidence for an association between the two disorders comes from recent genetic research (Smith 2007).…”

“…The main finding from the present study was that an ASD diagnosis was approximately 25-fold more common in the DLD case group than in a age-and sex-matched comparison group from the overall population (2.1% vs. 0.09%; P < 0.0001). This is a much lower rate than in some earlier published studies (Bishop & Norbury 2002;Michelotti et al 2002;Miniscalco et al 2007;Bishop et al 2008). This could be explained by the fact that our sample was recruited in the 1970s, before the publication of ICD-10, which use broader diagnostic criteria than ICD-8.…”

“…Bishop and Norbury (2002), Michelotti and colleagues (2002), Miniscalco and colleagues (2007) and Pinborough‐Zimmerman and colleagues (2007), all studying groups of younger‐aged children diagnosed with DLD, have also reported increased risk of ASD (and other neuropsychiatric) disorders in children with DLD.…”

Measuring Pragmatic Language in Children with Developmental Dysphasia: Comparing Results of Arabic Versions of TOPL-2 and CELF-4 (PP and ORS Subtests)

“…In a longitudinal-study, Michelotti, Charman, Slonims, & Baird (2002) assess children's language delays and autism spectrum disorder features. Different assessment tools were used, including the CCC (Children's Communication Checklist), Wechsler Intelligence Scale for children, CELF (Clinical Evaluation of Language Fundamentals), and SCQ (Social Communication Questionnaire).…”