Verbal and nonverbal outcomes of toddlers with and without autism spectrum disorder, language delay, and global developmental delay
Verbal and nonverbal outcomes of toddlers with and without autism spectrum disorder, language delay, and global developmental delay
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DOI：
10.1177/2396941518764764
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发表时间：
2018-01-01
影响因子：
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通讯作者：
Wetherby, Amy M.
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文献类型：
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作者：
Delehanty, Abigail D.;Stronach, Sheri;Wetherby, Amy M.
背景和目的：自闭症谱系障碍（ASD）儿童表现出异质的临床表型，在语言和智力方面具有广泛的差异，这使得早期发现的努力变得复杂。目前对观察性措施的研究有限，无法描述患有和不患有自闭症的幼儿以及同时发生的语言迟缓（LD）和整体发育迟缓（GDD）之间的差异。本研究的第一个目的是比较3岁时被诊断为ASD、发育迟缓（DD）和典型发育（TD）的儿童在出生后第二年的早期社会沟通。第二个目的是比较六个亚组儿童的早期社会沟通：ASD， ASD+LD, ASD+GDD， LD， GDD和TD。我们的第三个目标是确定早期社会沟通的集体和独特贡献，以预测有和没有ASD的儿童在三岁时的语言和非语言发展结果。方法：采用协方差分析对431名初诊幼儿进行社会交往能力的组间差异分析。采用多元线性回归分析评估有和无ASD儿童的沟通与符号行为量表（CSBS）行为样本复合标准分数与Mullen早期学习T分数之间的相关性。结果：到20个月时，早期社会交流模式明显。TD儿童与ASD和DD儿童在所有三个CSBS行为样本组合上都有显著差异。自闭症儿童在社交和符号综合方面的得分明显低于DD和TD儿童。在六个亚组中，CSBS行为样本的所有三个复合材料都将TD儿童与所有其他亚组区分开来。ASD+GDD儿童在社交和符号合成方面的得分明显低于所有其他亚组。社会交流的模式出现在有和没有ASD的儿童身上，这在按发展水平划分的亚组中是存在的。CSBS行为样本社会和符号组合在预测两组的发展结果方面贡献了独特的差异。言语复合对非ASD儿童的表达性语言、接受性语言和视觉接受有独特的贡献，对ASD儿童的表达性语言有独特的贡献。结论：CSBS行为样本是一项针对12-24个月大的儿童的观察性测量，它检测到社会沟通延迟，并解释了一年后在按ASD诊断和发育水平分组的大样本幼儿中语言和非语言结果的显著差异。
Background and Aims: Children with autism spectrum disorder (ASD) exhibit a heterogeneous clinical phenotype with wide variability in their language and intellectual profiles that complicates efforts at early detection. There is limited research examining observational measures to characterize differences between young children with and without ASD and co-occurring language delay (LD) and global developmental delay (GDD). The first aim of this study was to compare early social communication measured in the second year of life in children diagnosed at age 3 with ASD, developmental delays (DD), and typical development (TD). The second aim was to compare early social communication in six subgroups of children: ASD, ASD+LD, ASD+GDD, LD, GDD, and TD. Our third aim was to determine the collective and unique contributions of early social communication to predict verbal and nonverbal developmental outcomes at three years of age for children with and without ASD.Methods: Analyses of covariance controlling for maternal education were employed to examine group differences in social communication in 431 toddlers recruited through screening in primary care. Multiple linear regression analyses were conducted to evaluate associations between the Communication and Symbolic Behavior Scales (CSBS) Behavior Sample composite standard scores and Mullen Scales of Early Learning T scores for children with and without ASD.Results: Distinct patterns of early social communication were evident by 20 months. Children with TD differed significantly from children with ASD and DD on all three CSBS Behavior Sample composites. Children with ASD had significantly lower scores than those with DD and TD on the social and symbolic composites. Among the six subgroups, all three composites of the CSBS Behavior Sample differentiated children with TD from all other subgroups. Children with ASD+GDD scored significantly lower than all other subgroups on social and symbolic composites. Patterns of social communication emerged for children with and without ASD, which held among subgroups divided by developmental level. The CSBS Behavior Sample social and symbolic composites contributed unique variance in predicting developmental outcomes in both groups. The speech composite contributed unique variance to expressive language, receptive language, and visual reception in children without ASD, and contributed uniquely to expressive language only for children with ASD.Conclusions: The CSBS Behavior Sample, an observational measure for children aged 12-24 months, detected social communication delays and explained a significant amount of variance in verbal and nonverbal outcomes a year later in this large sample of young children grouped by ASD diagnosis and developmental level.