Language growth in very young siblings at risk for autism spectrum disorder

Clarifying the developmental association between gesture and later vocabulary for autistic children

Gestures serve as both a communication and a word-learning tool, with typically developing children consistently showing that early gestures are positively associated with later vocabulary skills. However, many autistic children experience delays and challenges in both gesture and vocabulary skills, and studies also show mixed gesture-vocabulary associations; thus, it is unclear whether gestures in autistic children support emerging vocabulary skills. To address previous conflicting findings, the current conceptual replication study uses linear models with a large sample (N = 451) of 12- to 24-month-old English-raised infants to investigate whether gestures are associated with expressive and receptive vocabulary. Using the infant-sibling design, gesture-vocabulary associations and group moderation were investigated in three groups: infant-siblings of autistic children who later meet the criteria for autism themselves (HL-ASD, n = 73), infant-siblings who did not meet criteria for autism (HL-Neg, n = 238), and a control group without a family history of autism (LL-Neg, n = 140). Both LL-Neg and HL-ASD groups showed positive associations between 12-month gestures and 18-month receptive vocabulary; however, only the LL-Neg group showed a positive association between 12-month gestures and 18-month expressive vocabulary. For 12-month gestures and 24-month receptive and expressive vocabulary, the LL-Neg and HL-Neg groups showed positive association, whereas the HL-ASD group did not. Similarly, the LL-Neg and HL-Neg groups showed positive associations between 18-month gestures and 24-month vocabulary, but the HL-ASD did not. Overall, the LL-Neg group showed significant gesture-vocabulary associations across all tested models, while the HL-ASD only showed one significant positive association.

Preliminary Results of Sensorimotor Room Training for the Improvement of Sensory and Motor Skills in Children with Autism Spectrum Disorders

Background: Motor skills in early and middle childhood are essential for physical play, social interactions, and academic development. Children with autism spectrum disorder (ASD) often exhibit atypical sensory responses, which can impact self-care and other developmental areas. This study explores the impact of sensory and motor rehabilitation using a Motor Sensory Room to stimulate motor development in children with ASD. Methods: Twenty-five children with ASD, preschool and school-aged (2-10 years), were divided into three groups based on the DSM-5 severity levels. The PEP-3 scale was used to assess cognitive, language, motor, emotional, social, and behavioral development. Ten children underwent a 3-month Motor Sensory Room intervention, and data were collected longitudinally. A control group of ten children, matched in age, sex, and diagnosis, did not receive the intervention. A 12-month follow-up is planned for all participants. Results: Children exhibited diverse profiles. Type B subjects displayed more severe symptoms, while Type A showed milder symptoms with better language and interpersonal skills. After the 3-month intervention, improvements were noted in several PEP-3 areas. For sensory levels (hypo-reactivity), the percentage of individuals at medium levels increased from 44% to 50%. For hyper-reactivity, the percentage at medium levels rose from 30% to 40%. Motor skills improved, with the percentage of individuals with high motor abilities rising from 20% to 25%. Relational behaviors also saw gains, with an increase from 50% to 55% in medium-level behaviors. The experimental group demonstrated better outcomes compared to the control group, particularly in sensory and motor skills. Conclusions: Preliminary findings suggest that sensory and motor training in a Motor Sensory Room improves sensory integration, motor coordination, and social interaction in children with ASD. Further research is needed to confirm long-term benefits.

Reciprocal Associations Between Language Ability and Social Functioning Development in Pre-verbal Autistic Children

Longitudinal research on language abilities and social functioning in young children suggests that gains in one domain affect gains in the other. However, few studies have examined inter-relations of language and social functioning jointly among young children diagnosed with autism spectrum disorder (ASD). Pre-verbal toddlers with ASD are a group of particular clinical relevance, given that greater language abilities at school entry have been associated with positive long-term adjustment in many areas, including adaptive and social functioning. Reduced attention to and engagement in social interactions among autistic toddlers who are not yet speaking may interfere with language development concurrently and over time. The present study examined reciprocal associations between language ability and social functioning over a 2-year period across three time points in a sample of 90 pre-verbal autistic toddlers using cross-lagged panel analyses conducted in MPlus. Cross-lagged panel analyses revealed significant within-timepoint synchronous correlations, within-domain autoregressive paths over time, and as hypothesized, reciprocal significance in all cross-lagged paths. For very young pre-verbal children with ASD, language ability and social functioning appear to exert concurrent and cascading developmental influences on one another. Targeting both language and social functioning simultaneously may enhance intervention efficacy for very young pre-verbal children with ASD.

Efficacy of Children Neuropsychological and Behavioral Scale in Screening for Autism Spectrum Disorders through a Combination of Developmental Surveillance

OBJECTIVE

This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016 (CNBS-R2016) for Autism Spectrum Disorder (ASD) screening in the presence of developmental surveillance.

METHODS

All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules (GDS). Spearman's correlation coefficients and Kappa values were obtained. Taking GDS as a reference assessment, the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic (ROC) curves. The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule, Second Edition (ADOS-2).

RESULTS

In total, 150 children aged 12-42 months with ASD were enrolled. The developmental quotients of the CNBS-R2016 were correlated with those of the GDS (r=0.62-0.94). The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays (Kappa=0.73-0.89), except for Fine Motor. There was a significant difference between the proportions of Fine Motor, delays detected by the CNBS-R2016 and GDS (86.0% vs. 77.3%). With GDS as a standard, the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor, which was 0.70. In addition, the positive rate of ASD was 100.0% and 93.5% when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used, respectively.

CONCLUSION

The CNBS-R2016 performed well in developmental assessment and screening for children with ASD, especially by Communication Warning Behaviors subscale. Therefore, the CNBS-R2016 is worthy of clinical application in children with ASD in China.

The relationship between object play, language, and visual and motor skills in children at risk of developmental disorders between 12 and 37 months

BACKGROUND

Exploratory object play is a primary strategy in amassing knowledge about one's environment and determines the development of language skills at a later age. However, still much remains unknown about how object play is related to visual and language development in children at risk of developmental disorders.

PARTICIPANTS AND PROCEDURE

Forty-four children at risk of developmental disorders aged 13 to 37 months took part in the study. The measurement of object play relied on observation of children manipulating novel objects. Language skills were assessed by the Mullen Scales.

RESULTS

The results indicate that there is a correlation between specific object play behaviours, language and visual skills.

CONCLUSIONS

The findings from this study support the hypothesis that the relationship between visual and language skills and object play in children at risk of developmental disorders is different in younger and older children.

Specific Language Impairment, Autism Spectrum Disorders and Social (Pragmatic) Communication Disorders: Is There Overlap in Language Deficits? A Review

Analysing language characteristics and understanding their dynamics is the key for a successful intervention by speech and language therapists (SLT). Thus, this review aims to investigate a possible overlap in language development shared by autism spectrum disorders (ASD), specific language impairment (SLI) and social (pragmatic) communication disorder (SPCD). The sources of this work were the PubMed, PsycInfo and SciELO databases, as well as the Scientific Open Access Repositories of Portugal. The final selection included 18 studies, focused on several linguistic areas. Results suggest that when individuals are matched according to some language or cognitive skills, they will also show similar characteristics in other language domains. Future work should be done based on spontaneous speech.

Relations of Restricted and Repetitive Behaviors to Social Skills in Toddlers with Autism

We examined the relations of restricted and repetitive behaviors (RRB; insistence on sameness, repetitive sensory-motor, self-injurious behavior) to social skills overall and aspects that comprise social skills as measured by the VABS-II (coping skills, play/leisure time, interpersonal relationships) in 24- (n = 63) and 36-month old (n = 35), high-familial-risk toddlers with ASD. Hierarchical linear regression results indicated that repetitive sensory-motor was the best predictor of social skills overall. Secondary results indicated that all three RRB subtypes were associated with each subdomain of social skills; however, repetitive sensory-motor was the strongest and most consistent among these effects. While our results suggests a general negative relation of subtypes of RRB to aspects of adaptive social function, repetitive sensory-motor behaviors may be of particular relevance to the development of social skills during toddlerhood.

Trajectories of Vocabulary Development in Children with Autism Spectrum Disorder Across Multiple Measures

This longitudinal study examined how receptive and expressive vocabulary assessments capture vocabulary development in children with Autism Spectrum Disorder (ASD) and typically developing (TD) children. Using mixed regression modelling, we explored when children with ASD significantly different from TD children. We also examined the variability of individual trajectories of vocabulary development in children with ASD. Children with ASD showed slowed trajectories and significantly differed from TD children by 24 months on all assessments except for picture-based assessments. Children with ASD also showed high heterogeneity in trajectories, with some showing inconsistent patterns of growth, stagnation, and regression across assessments. This suggests that conclusions based on individual assessments of vocabulary can vary and assessment characteristics must be considered when monitoring vocabulary development.

A comparative study of cognitive and socio-emotional development in children with Rubinstein-Taybi syndrome and children with Autism Spectrum Disorder associated with a severe intellectual disability, and in young typically developing children with matched developmental ages

BACKGROUND

Cognitive and socio-emotional profiles of children with CREBBP-related Rubinstein-Taybi syndrome (RSTS 1), children with Autism Spectrum Disorder (ASD) with severe intellectual disability and developmental ages (DA) under 24 months, and typically developing (TD) children with similar DA were compared.

PARTICIPANTS

Thirty-one children with RSTS 1 (mean chronological age, CA = 59,8 months; 33-87) and thirty children with ASD, matched on CA and DA and developmental quotients (DQ), were compared to thirty TD children (CA ranged from 12 to 24 months).

METHODS

Cognitive and socio-emotional developmental levels, DA and DQ were assessed with appropriated tests.

RESULTS

More socio-emotional developmental similarities were observed between TD and RSTS 1 than between TD and ASD children. Clinical groups displayed similar developmental delays in cognitive (self-image, symbolic play, means-ends, and object permanence) and socio-emotional domains (language and imitation). Children with RSTS 1 exhibited higher developmental levels in behavior regulation, joint attention, affective relations, emotional expression domains, and a lower developmental level in spatial relations domain.

CONCLUSIONS

Common interventions centered on symbolic play, self-image, language, and imitation for both clinical groups, and differentiated interventions centered on spatial abilities for RSTS 1 children and on social abilities for ASD could be used by caregivers were suggested.

In Prototypical Autism, the Genetic Ability to Learn Language Is Triggered by Structured Information, Not Only by Exposure to Oral Language

What does the way that autistic individuals bypass, learn, and eventually master language tell us about humans’ genetically encoded linguistic ability? In this theoretical review, we argue that autistic non-social acquisition of language and autistic savant abilities provide a strong argument for an innate, human-specific orientation towards (and mastery of) complex embedded structures. Autistic non-social language learning may represent a widening of the material processed during development beyond oral language. The structure detection and manipulation and generative production of non-linguistic embedded and chained material (savant abilities in calendar calculation, musical composition, musical interpretation, and three-dimensional drawing) may thus represent an application of such innate mechanisms to non-standard materials. Typical language learning through exposure to the child’s mother tongue may represent but one of many possible achievements of the same capacity. The deviation from typical language development in autism may ultimately allow access to oral language, sometimes in its most elaborate forms, and also explain the possibility of the absence of its development when applied exclusively to non-linguistic structured material. Such an extension of human capacities beyond or in parallel to their usual limits call into question what we consider to be specific or expected in humans and therefore does not necessarily represent a genetic “error”. Regardless of the adaptive success or failure of non-social language learning, it is the duty of science and ethical principles to strive to maintain autism as a human potentiality to further foster our vision of a plural society.

Early developmental trajectories of expressive vocabulary and gesture production in a longitudinal cohort of Italian infants at high-risk for Autism Spectrum Disorder

Delays in language are a hallmark feature of Autism Spectrum Disorder (ASD). However, little is known about the predictive role of language developmental trajectories on ASD. The present study aimed at identifying early different language developmental profiles of infants at high familial risk for ASD (HR-ASD) and testing their predictive role on ASD symptoms at 2 years. The role of gestures on socio-communicative skills has also been explored. Trajectories of expressive vocabulary were investigated in 137 HR-ASD infants at 12, 18, and, 24 months of age. Parents were requested to complete the Italian version of the MacArthur-Bates Communicative Development Inventory and ASD symptoms were measured by ADOS-2. Latent class growth analysis defined four trajectories: above average language development group (above-average LD, 18.2%), normal language development group (NLD, 38.7%), late-onset language development group (late-onset LD, 11.7%), and a group of children with stable language delay (SLD, 31.4%). Results showed that the SLD group obtained higher communicative difficulties and restricted/repetitive behavior compared to the other groups. Examining early increase of produced gestures in the different language classes, we found fewer produced gestures between 12 and 18 months in the SLD group compared to the late-onset LD group. The results identified clusters of HR infants who follow similar estimated trajectories based on individual differences in language development. These patterns of early language acquisition, together with produced gestures, may be predictive of later ASD symptoms and useful for planning prompt intervention. LAY SUMMARY: Language/gesture deficits are hallmark features of Autism Spectrum Disorder (ASD), but the predictive role of communicative trajectories on ASD remains unclear. In a longitudinal Italian sample of infants at high familial risk for ASD (HR-ASD), we tested if language trajectories and their link with gestures can predict ASD symptoms. We found four trajectories and HR infants with a stable language delay (SLD) trajectory showed more ASD symptoms later on. SLD infants produced fewer gestures compared to late-onset language development group that show more typical communicative skills.