Autism and Developmental Language Impairments最新文献

This article presents the historical roots of the dimensional perspective on autism, the epistemological and clinical critics of its assumptions and effects, and offers an alternative to it. Autism is increasingly being described as the "extreme far end" of a spectrum of traits distributed continuously and heterogeneously throughout the general population, and various comorbid neurodevelopmental conditions. This dimensional perspective, initially a response to the excesses of nominalism in the DSM, creates its own heuristic and clinical dead ends. In contrast with this dimensional paradigm, clinical experts recognize and diagnose prototypical autism based on the high similarity of specific clinical signs that are present during the preschool period. We propose viewing autism as a universal and evolutionarily stable, quasi-categorical possibility of human development, offering a prototypical presentation within a certain age range. We argue that prototypical autism needs to be further clinically described and scientifically investigated before anticipating the inclusion of nonprototypical presentations in an informative "autism spectrum." To achieve this, instruments based on qualitatively defined signs, with weighted diagnostic value, and universally associated with clinical certainty, must be developed. In the meantime, we recommend that all clinicians suspend the use of DSM-5 clinical specifiers to focus on clinical certainty and the application of differential diagnoses, rather than on the diagnostic thresholds of DSM-5 and of standardized instruments.

Background & aims: Mental state verbs (MSVs) describe people's internal states and processes. Reports on the use of MSVs in school-age children with autism spectrum disorder (ASD) are contradictory, and little is known about the developmental trajectories of these verbs in this population during early childhood. In contrast, among young, typically developing (TD) children, research has shown that the use of desire, perception, and physiological verbs precedes the use of cognitive and emotion verbs. This study aimed to describe the development of MSV use among autistic children as compared to TD children and investigate the variables that influence this development.

Methods: A total of 118 children participated in the study (59 autistic and 59 TD children), aged 3-10 years. Parents of all children completed an MSV questionnaire indicating whether their child produced the MSVs included in it. Additionally, two variables influencing MSV use were examined: sentence repetition for estimating syntax and measures of theory of mind (TOM) ability, which included three tasks: diverse desires and first- and second-order false belief.

Results: According to the parental questionnaire, cognitive and emotion verbs have a more protracted developmental trajectory in both autistic and TD children than other MSV categories (desire, perception, and physiological verbs), and they are more challenging for autistic children than for TD children. Cognitive and emotion verbs are also less common in preschoolers' speech than in that of school-aged children. In addition, language abilities, TOM, and group (autistic vs. TD) explained the variance in the development of cognitive and emotion verb use beyond age.

Conclusions and implications: These findings demonstrate the development of MSVs from all five semantic categories from the age of three years to the age of ten in autistic children. In addition, our results indicate a specific linguistic difference between autistic and TD children in the development of cognitive and emotion verbs, as was found in the MSV parental questionnaire. The study also highlights the role of syntax, TOM, and autism in relation to the development of these verbs, supporting the notion of complex developmental conditions associated with MSV development and, thus, the need to evaluate them in autistic children.

Background and aim: Ensuring equitable education for all students, including those with autism, is a core international commitment. The OECD (2018) defines equitable education as providing equal learning opportunities through responsive support tailored to individual needs. From this perspective, inclusive education involves both rights-based and needs-based approaches and emphasizes the importance of quality and adaptability in educational provision. Teachers' self-efficacy-their perceived confidence and belief in their ability to teach and support autistic students-is a critical factor in achieving these aims. However, despite growing commitments to inclusion, challenges are frequently reported not only by teachers, but also by parents and autistic students, including feelings of exclusion, misunderstanding, and inadequate support within educational settings. This review aims to synthesize existing research on teachers' self-efficacy in educating autistic students, identify influencing factors, assess methodological approaches, and outline future directions.

Methods: A mixed-methods systematic review was conducted using a convergent integrated design. Qualitative, quantitative, and mixed-methods studies were synthesized. Searches were carried out in four databases: PsycInfo, ERIC, Education Source, and SCOPUS. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT; Hong et al., 2018), and the review followed PRISMA guidelines.

Main contribution: Fifty-seven studies were included. Findings indicate that although many teachers are willing to support autistic students, their self-efficacy is often undermined by limited professional development, structural barriers, and insufficient support. Key facilitators include sustained, practice-oriented professional development and supportive leadership. However, the predominance of self-report methods limits understanding of how self-efficacy translates into classroom practice.

Conclusions: Teacher self-efficacy is shaped by both systemic conditions and individual perceptions of the ability to meet diverse student needs. Strengthening self-efficacy is essential to advancing equitable education for autistic students.

Caregiver language input is a key component of children's early developmental environment, with its nature likely varying based on certain characteristics. This study explored how caregiver language input differed across different engagement states for 12-24-month-old toddlers with autism spectrum disorder (ASD; n = 39) or typically developing (TD) toddlers (n = 31) based on their ages and spoken language during the interaction in Chinese contexts. Caregiver language was analyzed during 10-min naturalistic dyadic play interactions, including the mean length of utterances, total frequency of input, functional features (include affect-salient speech, directives, questions, labeling, descriptions, and attention getters), and the integrated proportion of utterances and gestures. Toddlers' spoken language during the interaction and ages were also assessed. Caregivers of toddlers with ASD employed fewer questions and more attention-getters compared to those of TD toddlers. Caregivers adjusted language input based on toddlers' engagement states and ages but not spoken language during the interaction. These findings indicate that Chinese caregiver language input is dynamic and context sensitive. The behavioral characteristics of Chinese toddlers with ASD might shape the unique characteristics of such input.

Autism spectrum disorder is a neurodevelopmental condition characterized by significant deficits in social skills that impact youths' academic, adaptive, and psychological functioning. Social skills deficits are imperative targets for interventions. This pilot study explored the feasibility and preliminary effectiveness of the translated and culturally adapted Arabic version of the UCLA PEERS^® among autistic adolescents (ages 11-17) in Saudi Arabia. The study utilized a quasi-experimental design, collected pre-, post-, and three-month follow-up data, and used focus group discussion and a prospective cohort study with pre- and postintervention assessments. Feasibility was assessed based on subjective methods: recruitment, retention, attendance rate, comprehension of the translated material, and homework completion. Effectiveness was evaluated based on postintervention and three-month follow-up interval changes in scores on three outcome measures: the Social Responsiveness Scale, Second Edition, Child Behavior Checklist, QSQ, and Test of Adolescent Social Skills Knowledge. Written informed consent was obtained from caregivers, and oral assent was obtained from the study participants. These initial findings support the feasibility and preliminary effectiveness of the PEERS-AA. The outcomes suggested significant improvement in the subjects' social skills and knowledge of social etiquette, as reported by the adolescents and their parents, with improvements retained at the three-month follow-up. However, there was no reported improvement in the number of get-togethers, which was likely explained by COVID-19 pandemic restrictions and culture-related considerations. This study represents the first cross-cultural validation trial of an established evidence-based social skills intervention for autistic adolescents in an Arabic-speaking country. The PEERS-AA manual's feasibility and preliminary effectiveness indicate its promising applicability for interventions and research. Further research to evaluate the generalizability and long-term effectiveness of the PEERS-AA program is needed.

Background and aims: Children with autism spectrum disorder (ASD) without intellectual disability often face challenges in understanding written text. However, considerable variability in this area underscores the need to examine their reading profiles and the factors influencing the development of reading comprehension (RC). This study investigates the RC of upper elementary school children with ASD compared to typically developing (TD) peers and explores the role of broader linguistic abilities in RC, with a specific focus on pragmatic competence (e.g., figurative language comprehension). Nonlinguistic factors such as age and nonverbal cognitive capacity are also considered. A secondary aim is to assess the potential heterogeneity in RC and linguistic abilities within the ASD sample.

Methods: In total, 35 children with ASD and 35 TD controls (mean age = 10.7 years, SD = 0.97) were matched for age, gender, and nonverbal cognitive ability using Raven's Colored Progressive Matrices. Both groups completed assessments of RC, structural language skills (receptive vocabulary and morphosyntax), and figurative language competence. To evaluate variability, the ASD group was divided into two subgroups based on RC performance.

Results: Participants with ASD scored significantly lower than their TD peers in RC, morphosyntactic skills, and figurative language comprehension, but no significant differences were observed in receptive vocabulary. For children with ASD, chronological age, nonverbal cognitive ability, and receptive vocabulary accounted for significant variance in RC. In contrast, RC in TD children was predicted by morphosyntactic ability and figurative competence. Furthermore, the substantial heterogeneity within the ASD group was evident, highlighting their variability across the range of examined variables.

Conclusions and implications: The findings indicate that children with ASD as a group experience notable difficulties in text comprehension and language processing at the morphosyntactic and pragmatic levels, despite achieving receptive vocabulary and nonverbal cognitive scores comparable to those of their TD peers. The two groups appear to employ distinct strategies for deriving meaning from text. The pronounced variability in RC and linguistic abilities among ASD participants underscores the complexity of their reading and language profiles, highlighting the importance of tailored educational assessments and interventions, which are further discussed.

Autism spectrum disorder (ASD) typically exhibits stereotyped or repetitive behavior that can be described as rigid, but also certain characteristics in the domain of language that can equally be characterized as rigid. These include heightened, enhanced sensitivity to the rules of grammar (morpho-syntax), often resulting in hyper-systemizing, as well as rigidity interpreting metaphorical, non-literal language. Human cognition and behavior (including language) believably resulted from an intense feedback loop between an increase in cognitive flexibility (primarily through a gradual emergence and complexification of language/grammar) and a reduction in reactive aggression and impulsivity (this resulting in more prosocial behaviors). Neurobiologically, this feedback loop contributed to a relatively recent evolution of denser connectivity between some cortical structures and the striatum, which is found affected in ASD. In this paper, we propose that the seemingly disparate features of ASD, including linguistic and behavioral rigidity, result from a common cause: an enhanced striatal function, linked to a reduced control of the striatum by selected cortical structures. The striatum is associated with both impulsiveness (including reactive aggression) and with automated, rigid, ritualized responses. Our proposal is specific enough that it can be experimentally tested, with implications for clinical approaches to autism.

Purpose: This study aimed to investigate the impact of fathers' and mothers' involvement in treatments by speech-language pathologists (SLPs) on parent-child communication, play, and feelings of caregiver emotional load in families with children diagnosed with autism spectrum disorder (ASD).

Methods: Data from 51 families, including 51 fathers and 51 mothers, were analyzed, focusing on measures of involvement in treatments, parent-child play, parent-child communication experience, the child's communication skills, and feelings of caregiver emotional load. Pearson correlations were conducted to explore associations between parental involvement, child variables, and parental factors. Path analysis was employed to delineate the relationships between parental involvement and treatment outcomes.

Results: Mothers exhibited significantly higher scores in involvement in treatments and feelings of caregiver emotional load compared to fathers, while no significant difference was found in parent-child communication experience. Both fathers and mothers demonstrated direct association between involvement in treatment, enhanced play and better communication experience with their children. Only fathers demonstrated direct associations between involvement in treatment and reduced caregiver emotional load, as well as improved communication skills in their children. The involvement of fathers in treatment mediated the association between paternal education level and the child's gender to treatment outcomes. Communication experience with the child was negatively associated with parental feelings of emotional load.

Conclusions: Active involvement by both parents is important for supporting parent-child play and communication. Fathers, in particular, experience benefits from involvement in treatments by SLPs, including decreased feelings of emotional load. These findings underscore the significance of considering demographic factors such as parental gender, education level, and the child's gender when designing SLP treatments for children with ASD and guiding their parents.