Quantitative Aspects of Communicative Impairment Ascertained in a Large National Survey of Japanese Children

The Japanese version of the Children’s Communication Checklist-2 (CCC-2) was rated by caregivers in a large national population sample of 22,871 children aged 3–15 years. The General Communication Composite (GCC) of the CCC-2 exhibited a distribution with a single-factor structure. The GCC distribution between autism spectrum disorders (ASD) and language impairment (LI) groups in the general population fit inside a bell curve with significant overlap with the general population, and a continuum was evident between groups. No evidence of a natural cutoff that would differentiate categorically affected from unaffected children was seen. The Social Interaction Deviance Composite (SIDC) supported the notion that ASD and LI are on the opposite endpoints of a SIDC continuum of communication impairment.