Subtypes of Language Disorders in School-Age Children With Autism

Abstract

Cluster analysis of test scores on expressive phonology and comprehension of words and sentences in 7-9-year-old children with preschool diagnosis of Autistic Disorder yielded 4 clusters. Cluster 1 (N = 11): phonology and comprehension both low; Cluster 2 (N = 4): phonology low, near average comprehension; Cluster 3 (N = 40): average phonology, comprehension low to low average; Cluster 4 (N = 7): average or better phonology and comprehension. The clusters support two major types of language disorders in autism driven by impaired expressive phonology, each divisible by comprehension ability. The clusters refute a single language disorder in autism and are consonant with earlier-defined clinical subtypes.

A Comprehensive Examination of Reading Heterogeneity in Students with High Functioning Autism: Distinct Reading Profiles and Their Relation to Autism Symptom Severity

“…Unlike Readers with Comprehension Disturbance, Readers with Global Disturbance demonstrated overall low word reading and decoding abilities commensurate with their poor language skills. Similar to children in the Readers with Global Disturbance, the Readers with Severe Global Disturbance resembled Rapin et al (2009) andTager-Flusberg andJoseph's (2003) language impaired subtypes previously described, but with far more severe impairment. The distinction between the two latter profiles may be thought of as categorically distinct areas of a continuum, such as the difference between the terms "below average" and "far below average" that are sometimes used in diagnostic measures.…”

“…This subgroup has been frequently reported in prior studies of reading with individuals with ASD (e.g., Brown et al 2013;Jones et al 2009;Nation et al 2006;Newman et al 2007;Huemer and Mann 2010;Wei et al 2015;Zuccarello et al 2015) and shares characteristics with a language subgroup reported by Rapin et al (2009) whose members demonstrated adequate phonology and vocabulary alongside linguistic comprehension deficits. Grigorenko et al (2003) noted disagreement in the literature as to whether hyperlexia is synonymous with a reading comprehension disorder, or whether it is a unique condition characterized by an almost obsessive interest in letters and words, precocious and unprompted emergence of word decoding, and an extreme degree of discrepancy between word recognition and other cognitive skills that emerges between 3 and 5 years of age (Healy 1982).…”

“…There is some evidence that beyond reading comprehension disturbance, there are different profiles of readers in school-aged children with ASD (e.g., Brown et al 2013;Jones et al 2009;Nation et al 2006). In addition, research has delineated language subgroups in children and adolescents with ASD (Rapin et al 2009;Tager-Flusberg and Joseph 2003), and language impairments have been linked to reading difficulties in this population (Lindgren et al 2009;Lucas and Norbury 2014;Norbury and Nation 2011). However, the relation between these language and reading subgroups was previously unexamined using comprehensive reading and language batteries.…”

“…However, the two measures reported to be sensitive markers of language impairment, Nonword Repetition and Recalling Sentences (Condouris et al 2003;Norbury and Nation 2011;Rapin et al 2009), posed a challenge for many of these children. Therefore, in this subgroup, word recognition abilities did not necessarily align with structural language abilities as reported in prior studies of reading and language in ASD (Lindgren et al 2009;Lucas and Norbury 2014;Norbury and Nation 2011).…”

Longitudinal Study of High and Low Functioning Preschool Children with ASD and the Progress Made Following Therapeutic Intervention

“…Also, in a longitudinal study of seven years, Anderson et al (2007) found that at the age of 9 years 29.7% of the children who participated in the study never developed speech. In two other studies (Cleland, Gibbon, Peppé, O'Hare, & Rutherford, 2010;Rapin et al, 2009) 33% of 3 to 9 years old children presented with delayed speech, phonological difficulties and speech disorders that remained even after therapy. Furthermore the percentage of children with ASD who present with feeding disorders reaches 46% to 89% (Ledford & Gast, 2006;Kodak & Piazza, 2008).…”