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Journal of Autism and Developmental Disorders

Gepubliceerd in:

01-02-2013 | Original Paper

Non-word Repetition Impairment in Autism and Specific Language Impairment: Evidence for Distinct Underlying Cognitive Causes

Auteurs: David Williams, Heather Payne, Chloë Marshall

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 2/2013

Abstract

Language-impaired individuals with autism perform poorly on tests such as non-word repetition that are sensitive clinical markers of specific language impairment (SLI). This has fuelled the theory that language impairment in autism represents a co-morbid SLI. However, the underlying cause of these deficits may be different in each disorder. In a novel task, we manipulated non-word stimuli in three ways known to influence the repetition accuracy of children with SLI. Participants with SLI were affected differently by these manipulations to children with autism. Children with autism performed similarly to language-matched typical children in terms of levels and patterns of performance, and types of error made, suggesting that the underlying cognitive cause of non-word repetition deficits is different in each disorder.

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Three participants with ASD scored under the ASD cut-off of 15 on the SCQ, with scores of 12, 13, and 4, respectively. Two of these participants (who scored 12 and 13) were taking part in another of our studies and, as a result, had data from another measure of ASD severity; the Developmental, Dimensional and Diagnostic Interview (3di; Skuse et al. 2004), a more detailed parent interview schedule that is based on the Autism Diagnostic Interview (Le Couteur et al. 2003). Each of these participants scored well above the ASD cut-off on the 3di. The final participant (who scored 4 on the SCQ) did not have any other parent report data available. However, this participant had been diagnosed by a UK-leading clinician in London. This, combined with our clinical impression of the child, make us entirely confident of his diagnosis, regardless of his score on the SCQ.

It may strike the reader as out of keeping with a diagnosis of specific language impairment that four participants in the SLI group had a NVIQ score outside of the normal range. However, a notable proportion of individuals who manifest SLI early in life (during the period in which most receive a diagnosis) show below average NVIQ later in life (e.g., Conti-Ramsden et al. 2001; Mawhood et al. 2000), with NVIQ dropping as much as 20 points across time (Botting 2005). Therefore, to obtain a representative sample of children who receive a diagnosis of SLI, we did not set as an inclusion criterion that NVIQ be in the normal range. We did, however, decide that in cases where NVIQ was below 80, non-verbal abilities must be substantially superior to verbal abilities, reflecting the fact that language problems are identified as the most clinically significant feature among all participants with SLI.

In fact, it is important to note that ADOS-G and ADI-R appear to have a surprisingly low specificity, which raises questions about their suitability for use in research studies. In the largest study of its kind, Risi, Lord, Gotham, Corsello, Chrysler et al. (2006) found that, if used in isolation, the specificity of each measure was less than 50 %, with the identification of around 29 % of non-spectrum children as having autism. If used together, specificity is improved, but in over 15 % of cases the instruments disagree on spectrum vs. non-spectrum diagnoses. These measures (particularly the ADI) have come under recent scrutiny, with some offering what we view as persuasive arguments that measures such as the SCQ and 3di are preferable to ADOS and ADI for research purposes (Bishop 2011, May 30).

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Titel: Non-word Repetition Impairment in Autism and Specific Language Impairment: Evidence for Distinct Underlying Cognitive Causes
Auteurs: David Williams
Heather Payne
Chloë Marshall
Publicatiedatum: 01-02-2013
Uitgeverij: Springer US
Gepubliceerd in: Journal of Autism and Developmental Disorders / Uitgave 2/2013
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI: https://doi.org/10.1007/s10803-012-1579-8

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