Autism and Developmental Language Impairments最新文献

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.

Background and aims: Speech-language pathologists actively participate in the assessment of pragmatics in children with Autism Spectrum Disorder (ASD). However, in Portugal, there is a shortage of valid and reliable instruments to assess this domain in detail. Therefore, it was deemed relevant to help validate the Escala de Avaliação de Competências Comunicativas (EAC) (Communicative Skills Assessment Scale) in this population.

Methods: A cross-sectional, descriptive correlational study was conducted. The sample included 97 children, aged between 4 and 7 years and 11 months, diagnosed with ASD with European Portuguese as their native language. As an exclusion criterion, the co-occurrence of intellectual developmental disorder was defined. The internal consistency of the EAC was analyzed through the calculation of Cronbach's alpha and test-retest reliability through the calculation of the intraclass correlation coefficient. Convergent validity was also analyzed using Spearman's correlation coefficient.

Results: The EAC presented a high internal consistency value, with a Cronbach's alpha of 0.956. The test-retest reliability analysis (n = 27) revealed good stability in the participants' responses at both assessment moments, with ICC values varying between 0.642 and 0.842. In the study of convergent validity, statistically significant correlations were observed between the EAC total score and the two scales of the Strengths and Difficulties Questionnaire-Portuguese Version (SDQ-Por): relationship problems with colleagues (r_s = -0.273; p < .01) and prosocial behavior (r_s = 0.606; p < .01).

Conclusion: The EAC presents good reliability and validity for children with ASD, suggesting its adequacy as a research and clinical tool for testing pragmatics within this population.

Implications: This study will improve clinical decision making regarding ASD and guide future research.

Background and aims: Language development in autism varies widely, from fluently verbal to minimally verbal individuals, with socio-communicative difficulties often cited as key explanatory factors. Statistical learning (SL)-the ability to detect regularities in language-has also emerged as a potential contributor to language acquisition in autism. However, SL research in autism has predominantly focused on verbally fluent individuals, leaving non- and minimally verbal populations underexplored. This study aimed to examine the predictive roles of joint attention and statistical learning, specifically nonadjacent dependency learning, on expressive vocabulary and morphosyntactic outcomes in autistic children.

Methods: Participants included 40 autistic children aged 5-8 years with diverse linguistic profiles, ranging from verbally fluent to minimally verbal, and 40 non-autistic children. Joint attention was assessed during a semi-structured play protocol, which also provided naturalistic language samples for analysis. Measures of expressive vocabulary and morphosyntax were derived from the number of different words and verb flexions produced, respectively. Sensitivity to nonadjacent dependencies was evaluated through an artificial language learning task.

Results: Neither joint attention nor sensitivity to nonadjacent dependencies predicted expressive vocabulary or morphosyntactic skills in autistic children. Response to joint attention scores were significantly lower in autistic children than in non-autistic children but higher than in previous research. This may be due to the less structured and, therefore, more ecologically valid context in which joint attention was assessed (free play), in conjunction with age and maturation factors. Regarding the SL task, both autistic and non-autistic children demonstrated sensitivity to nonadjacent dependencies. Most interestingly perhaps, only 15 autistic children completed the SL task, with non-verbal cognitive abilities significantly predicting task completion.

Conclusions and implications: This study highlights the complexity of investigating the role of statistical learning in language development in autism. It underscores the limitations of behavioral SL paradigms for minimally verbal children. Future research should prioritize developing more ecologically valid and accessible paradigms to accurately assess statistical learning in minimally verbal children, thereby clarifying the role SL may play in language acquisition in autism.

Background: Increasingly, research has explored autistic mothers' experiences of motherhood. However, understanding is largely based on single studies. Existing syntheses of qualitative and quantitative research are highly specific, focusing on pregnancy, sensory, infant feeding, and perinatal periods. Thus, a review taking a broader perspective which encapsulates autistic mothers' experiences beyond early motherhood is warranted.

Aims: To systematically identify, appraise, and synthesize existing qualitative research on autistic mothers' experiences of motherhood to enrich understanding, and guide future research and practice.

Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and a qualitative synthesis of extant peer-reviewed qualitative studies and grey literature sources using Thomas and Harden Thematic Synthesis. Methodological rigor was assessed using the Critical Appraisal Skills Programme (CASP) checklist.

Results: Three themes representing the collective experiences and perspectives of 629 autistic mothers from 23 primary studies were developed: "The Embodied Autistic Experience of Motherhood," "Navigating the Non-Autistic World as an 'Other' Mother" and "Recalibrating Identities."

Conclusions: Autistic mothers report having unique autistic strengths and prioritizing their children. However, their experiences of motherhood are largely colored by autism-specific and identity-related challenges, and adverse experiences related to systemic, structural, and societal othering, specifically, from feeling policed, pathologized and overpowered by professionals. This translates into an increased prevalence of psychological difficulties and need for support. Further research, professional training, systemic changes, and societal awareness are urgently needed to inform understanding and support.

Background and aims: A significant body of research focuses on the negative outcomes of parenting Autistic children, particularly when parents identify as non-Autistic. Less attention has been paid to the experiences of Autistic parents of Autistic children, and even less to the positive or fulfilling elements of parenting Autistic children, regardless of parent neurotype. This study therefore asked: What do parents value about their Autistic children, and what characterizes parents' positive relationships with their Autistic children?

Methods: Here, 40 Autistic and 40 non-Autistic parents completed semistructured interviews to understand better their positive experiences of parenting Autistic children. We analyzed participant responses using reflexive thematic analysis, using an inductive approach.

Results: We identified five themes: parenting is both challenging and enjoyable and "there's the good and the bad and the highs and the lows" (theme 1); parents value time with their Autistic children and "there is nowhere else that I'd rather be than with them" (theme 2); parents value their Autistic child's personality and "just love watching her be who she is" (theme 3); parenting Autistic children is fulfilling and "I know I must be doing something right" (theme 4); and collaboration, learning, and acceptance are key to parenting fulfillment so that "I wouldn't have it any other way" (theme 5). Overall, parents told us that parenting could be complex and challenging, and that they had good and bad days. But many parents felt happy to parent their Autistic child, and they enjoyed laughing and doing things together with their child. Parents often really liked their Autistic child, who they thought was caring, funny, and interesting, and they described enjoying their child's company, speaking about the qualities and characteristics they valued in their Autistic child. Some parents felt happy when their child needed them. They liked it when they could help their child and make their child feel safe. This made them feel like they were doing a good job as parent. Parents discussed the personal positive impact of experiencing feelings of self-efficacy and the role of Autistic children in their personal growth. Finally, parents thought that it was important to accept their child and that their life would be different than what they imagined. They reflected on the role of acceptance and flexibility in their experiences of joy and fulfillment.

Conclusions: We show that both Autistic and non-Autistic parents of Autistic children have positive, joyful, and valuable parenting experiences. Our findings have far-reaching implications, including how researchers and practitioners conceptualize parenting Autistic children, and the ways in which parents can be supported to foster such experiences.

Background: Children with autism spectrum disorder (ASD) and children with development language disorder (DLD) often experience syntactic impairments. It is of the utmost importance to implement evidence-based intervention at the earliest possible stage to mitigate the adverse effects of these difficulties. Internationally, several programs are supported by scientific evidence. In Portugal, there are currently only two intervention programs, one of which is PROsyntax. However, its effectiveness has not yet been established.

Aim: This study aims to determine the effects of PROsyntax on expressive and receptive syntax in preschool-age children with syntactic impairments diagnosed with DLD or ASD.

Methods and procedures: This study is a nonrandomized controlled trial with a nonprobabilistic convenience sample. Thirty-one children aged between 3 and 6 years were recruited and allocated into an experimental group (EG, intervention group) (n = 14) and a control group (CG, without intervention) (n = 17). A blind pre- (T1) and postintervention (T2) assessment was conducted using two standardized instruments (SIN:TACS for expression and Subtest 3 of Avaliação da Linguagem Oral (ALO) for comprehension). Children in the EG received intervention with PROsyntax, comprising 24 sessions, biweekly, lasting 1 hr each. The intervention was conducted within the school setting by a speech and language therapist.

Outcomes and results: Statistically significant improvements were observed in the EG compared to the CG in both expressive (F_{Time × Group}(1,27) = 293.22; p < .001; η_p ² = 0.92) and receptive (F_{Time × Group}(1,27) = 147.18; p < .001; η_p ² = 0.85) syntax. Large effect sizes were found (SIN:TACS: d = 4.07 (DLD) and d = 11.67 (ASD); ALO: d = 3.29 (DLD) and d = 4.31 (ASD)). Strong correlations between measures were observed at both time points. Postintervention, the CG also received the intervention and showed comparable gains. High satisfaction ratings were reported by both families and early childhood educators.

Conclusions and implications: The findings provide preliminary evidence supporting the effects of PROsyntax in improving expressive and receptive syntactic skills in preschool-age children with ASD or DLD. These findings have important implications for clinical practice, suggesting that explicit interventions can yield significant gains in preschool-age children with syntactic impairment. However, the nonrandomized design, small sample size, and absence of long-term follow-up limit the generalizability of results. Further research is needed to confirm these effects and explore differential responses across diagnostic groups.

Background and aims: Narrative abilities are crucial for effective communication and social interactions. Children with autism often struggle with narrative production and comprehension due to their unique developmental profiles. This study examines the macrostructure and microstructure narrative skills of Hebrew speaking children with autism compared to age-matched typically developing (TD) children, aiming to uncover specific areas of difficulty and proficiency.

Methods: The study included 64 children aged 6-8 years, divided equally between those diagnosed with autism and TD peers. Participants underwent narrative production tasks involving both fictional and everyday narratives, and modes of generating and retelling. Narrative comprehension was also assessed immediately after each task. Macrostructure analysis examined the organization and structure of the narratives while microstructure analysis focused on linguistic elements such as syntax and word use.

Results: Both groups exhibited comparable overall narrative production and comprehension skills. However, subtle distinctions were noted such that children with autism showed difficulties in creating complex narrative structures and integrating syntactic elements effectively compared to their TD peers. Despite the differences, children with autism demonstrated notable strengths, particularly in the retelling mode, where they sometimes achieved higher scores in the use of function words. Both groups achieved similar scores in narrative comprehension tasks.

Conclusions: The findings indicate that while children with autism can develop narrative skills comparable to their TD peers, they continue to experience specific challenges that affect their narrative production, particularly in syntactic complexity. Although not always statistically significant, these findings suggest that autistic children possess narrative abilities that emerge under certain conditions, emphasizing the importance of considering varied narrative contexts in assessments.

Implications: The study highlights the need for targeted narrative intervention programs that address the specific challenges and strengths faced by children with autism. Educational strategies should focus on enhancing syntactic construction and narrative structure to improve both academic and social communication outcomes.