Skip to main content

Advertisement

SpringerLink
Log in

Social use of language in children with reactive attachment disorder and autism spectrum disorders

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Children with a diagnosis of reactive attachment disorder (RAD) appear to show difficulties in social understanding. We aimed to compare the pragmatic language functioning of children with (RAD) and autism spectrum disorder (ASD). Assessments were made in three groups of children aged 5–8 years, with verbal IQ estimates in the normal range: 35 with a RAD diagnosis, 52 with an ASD diagnosis and 39 with typical development. The Children’s Communication Checklist (CCC) was used to compare their pragmatic language skills, and ADI-R algorithms were used to compare autistic symptomatology, according to parent report. According to the CCC, the RAD group demonstrated significant problems in their use of context, rapport and social relationships with a degree of severity equivalent to children in the ASD comparison group. More than 60% of the group with RAD met ADI-R clinical criteria on the Use of Language and Other Social Communication Skills subscale, 46% on the Reciprocal Social Interaction subscale, and 20% had significant repetitive and stereotyped behaviours. Children with RAD appear to be at least as impaired as children with ASD in certain domains of social relatedness, particularly in their pragmatic language skills.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. AACAP Official Action (2005) Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder in infancy and early childhood. J Am Acad Child Adolesc Psychiatry 44:1206–1219

    Google Scholar 

  2. Adams C (2001) Clinical diagnostic and intervention studies of children with semantic-pragmatic language disorder. Int J Lang Commun Disord 36:289–305

    PubMed  CAS  Google Scholar 

  3. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders. 4th edn. Revised. American Psychiatric Association, Washington DC

  4. Angold A, Costello EJ (2000) The Child and Adolescent Psychiatric Assessment (CAPA). J Am Acad Child Adolesc Psychiatry 39:39–48

    Article  PubMed  CAS  Google Scholar 

  5. Atkinson L (1992) The British Picture Vocabulary Scale. Br J Disord Commun 26:272

    Google Scholar 

  6. Bennett J, Espie C, Duncan B, Minnis H (2009) A qualitative exploration of children’s understanding of indiscriminate friendliness. Clin Child Psychol Psychiatry 14:595–618

    Article  PubMed  Google Scholar 

  7. Bishop DVM (1998) Development of the children’s communication checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children. J Child Psychol Psychiatry 39:879–891

    Article  PubMed  CAS  Google Scholar 

  8. Bishop DVM, Baird G (2001) Parent and teacher report of pragmatic aspects of communication: use of the children’s communication checklist in a clinical setting. Dev Med Child Neurol 43:809–818

    Article  PubMed  CAS  Google Scholar 

  9. Byrne JG (2003) Referral biases and diagnostic dilemmas. Attachment Hum Dev 5:249–252

    Article  Google Scholar 

  10. Geurts HM, Embrechts M (2008) Language profiles in ASD, SLI, and ADHD. J Autism Dev Disord 38:1931–1943

    Article  PubMed  Google Scholar 

  11. Gilmour J, Hill B, Place M (2004) Social communication deficits in conduct disorder: a clinical and community survey. J Child Psychol Psychiatry 45:967–978

    Article  PubMed  CAS  Google Scholar 

  12. Gilmour J, Hill B, Place M, Skuse DH (2004) Social communication deficits in conduct disorder: a clinical and community survey. J Child Psychol Psychiatry 45:967–978

    Article  PubMed  CAS  Google Scholar 

  13. Green Jonathan, Goldwyn Ruth (2002) Annotation: attachment disorganisation and psychopathology: new findings in attachment research and their potential implications for developmental psychopathology in childhood. J Child Psychol Psychiatry 43:835–846

    Google Scholar 

  14. Green J (2003) Are attachment disorders best seen as social impairment syndromes? Attachment Hum Dev 5:259–264

    Article  Google Scholar 

  15. Kadesjo B, Gillberg G (2001) The comorbidity of ADHD in the general population of Swedish school age children. J Child Psychol Psychiatry 42:487–492

    Article  PubMed  CAS  Google Scholar 

  16. Kadesjo B, Gillberg C (2001) The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychiatry Psychol 42:487–492

    Article  CAS  Google Scholar 

  17. Lord C, Rutter M, Goode S, Heemsbergen J, Jordan H, Mawhood L, Schopler E (1989) Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. J Austim Dev Disord 19:185–212

    Article  CAS  Google Scholar 

  18. Lord C, Risi S, Lambrecht L, Cook JrEH, Leventhal BL, DiLavore PC, Pickles A, Rutter M (2000) The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord 30:205–223

    Google Scholar 

  19. Mandy W, Charman T, Gilmour J, Skuse D (2011) Toward specifying pervasive developmental disorder—not otherwise specified. Autism Res 4(2):121–131

    Google Scholar 

  20. McLaughlin A, Espie C, Minnis H (2010) Development of a brief waiting room observation for behaviours typical of reactive attachment disorder. Child Adolesc Ment Health 15:73–79

    Article  Google Scholar 

  21. Miller JN, Ozonoff S (1997) Did Asperger’s cases have Asperger disorder? A research note. J Child Psychol Psychiatry 38:247–251

    PubMed  CAS  Google Scholar 

  22. Millward R, Kennedy E, Towlson K, Minnis H (2006) Reactive attachment disorder in looked after children. Emot Behav Diffic 11:273–279

    Article  Google Scholar 

  23. Minnis H, Green J, O’Connor T, Liew A, Glaser D, Taylor E, Follan M, Young D, Barnes J, Gillberg C, Pelosi A, Arthur J, Burston A, Connolly B, Sadiq FA (2009) An exploratory study of the assoication between reactive attachment disorder and attachment narratives in early school-age children. J Child Psychol Psychiatry 58:931–942

    Article  Google Scholar 

  24. O’Connor T, Bredenkamp D, Rutter M (1999) Attachment disturbances and disorders in children exposed to severe early deprivation. Infant Ment Health J 20:10–29

    Article  Google Scholar 

  25. Psychological Corporation. Weschler Abbreviated Scale of Intelligence: manual. 1999. San Antonio (TX), Harcourt Brace

  26. Ronald A, Smirnoff E, Kuntsi J, Asherson P, Plomin R (2008) Evidence for overlapping genetic influences on autistic and ADHD behaviours in a community twin sample. J Child Psychol Psychiatry 49:535–542

    Article  PubMed  Google Scholar 

  27. Rutter M, Anderson-Wood L, Beckett C, Bredenkamp D, Castle J, Groothues C, Kreppner J, Keaveney L, Lord C, O’Connor T (1999) Quasi-autistic patterns following severe early global privation. J Child Psychol Psychiatry 40:537–549

    Article  PubMed  CAS  Google Scholar 

  28. Rutter M, Kreppner J, Sonuga-Barke E (2009) Emanuel Millar Lecture: attachment insecurity, disinhibited attachment, and attachment disorders: where do the research findings leave the concepts? J Child Psychol Psychiatry 50:529–543

    Article  PubMed  Google Scholar 

  29. Rutter M, Beckett C, Castle J, Colvert E, Kreppner J, Mehta M, Stevens S, Sonuga-Barke E (2007) Effects of profound early institutional deprivation: an overview of findings from a UK longitudinal study of Romanian adoptees. Eur J Dev Psychol 4:332–350

    Article  Google Scholar 

  30. Rutter M, Colvert E, Kreppner J, Beckett C, Castle J, Groothues C, Hawkins A, O’Connor TG, Stevens SE, Sonuga-Barke EJS (2007) Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: disinhibited attachment. J Child Psychol Psychiatry 48:17–30

    Article  PubMed  Google Scholar 

  31. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G (2008) Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry 47:921–929

    Article  PubMed  Google Scholar 

  32. Skuse D, Warrington R, Bishop Deal (2004) The developmental, dimensional and diagnostic interview (3di): a novel computerized assessment for autism spectrum disorders. J Am Acad Child Adolesc Psychiatry 43:548–558

    Google Scholar 

  33. Smyke AT, Dumitrescu A, Zeanah CH (2002) Attachment disturbances in young children. I: the continuum of caretaking casualty. J Am Acad Child Adolesc Psychiatry 41:972–982

    Article  PubMed  Google Scholar 

  34. Szatmari P (2000) The classification of autism, Asperger’s Syndrome, and pervasive developmental disorder. Can J Psychiatry 45:731–738

    PubMed  CAS  Google Scholar 

  35. Szatmari P, Bryson SE, Streiner DL, Wilson F, Archer L, Ryerse C (2000) Two-year outcome of preschool children with autism or Asperger’s syndrome. Am J Psychiatry 157:1980–1987

    Article  PubMed  CAS  Google Scholar 

  36. Wechsler D (2003) Wechsler Intelligence Scale for Children (WISC-IV). Psychological Corporation, San Antonio

    Google Scholar 

  37. Wing L, Gould J (1979) Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. J Autism Dev Disord 9:11–29

    Article  PubMed  CAS  Google Scholar 

  38. World Health Organisation (1993) The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. World Health Organisation, Geneva

  39. World Health Organisation (2007) The ICD-10 International statistical classificastion of diseases and related health problems: mental and behavioural problems

  40. Zeanah C, Smyke AT (2008) Attachment disorders in family and social context. Infant Ment Health J 29:219–233

    Article  Google Scholar 

Download references

Acknowledgments

The study was funded by the Chief Scientist Office of the Scottish Executive. We are grateful to all the families who took part in the study. The study statistical expert was Dr. David Young, Consultant Statistician, NHS Greater Glasgow and Clyde.

Conflict of interest

None

Author information

Authors and Affiliations

  1. Section of Psychological Medicine, Faculty of Medicine, Caledonia House, Royal Hospital for Sick Children, University of Glasgow, Glasgow, G3 8SJ, UK

    Fareeha Amber Sadiq, Christopher Gillberg & Helen Minnis

  2. Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 30 Guildford Street, London, WC1N 1EH, UK

    Louise Slator & David Skuse

  3. Institute of Health and Society, School of Education, Communication and Language Sciences, University of Newcastle, Newcastle-upon-Tyne, NE1 7RU, UK

    James Law

  4. Psychological Medicine, College of Medicine, Veterinary and Life Sciences, Caledonia House, Yorkhill Hospital, University of Glasgow, Glasgow, G3 8SJ, UK

    Helen Minnis

Authors
  1. Fareeha Amber Sadiq
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Louise Slator
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Skuse
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. James Law
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christopher Gillberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Helen Minnis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Helen Minnis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sadiq, F.A., Slator, L., Skuse, D. et al. Social use of language in children with reactive attachment disorder and autism spectrum disorders. Eur Child Adolesc Psychiatry 21, 267–276 (2012). https://doi.org/10.1007/s00787-012-0259-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-012-0259-8

Keywords

Search

Navigation