Background & Aims Measuring emerging language in young autistic children is notoriously difficult. Conventional approaches—including standardized assessment, caregiver report, and natural language samples—offer valuable information but also have their respective limitations. The Quick Interactive Language Screener (QUILS) is a newer approach that has proven useful in non-autistic children. It is a computer-based tool designed to screen early language comprehension skills in vocabulary and syntax, as well as the processes underlying word learning. The present investigation aims to explore the usefulness of the QUILS when used with young autistic children, in terms of (1) correlations across the QUILS subtests and (2) correlations between the QUILS and other frequently used language measures (CDI-III vocabulary, CDI-III sentences, natural language sample metrics including lexical diversity and MLU, and Vineland-3). Methods Secondary data analysis was used to explore a subset of participants derived from a national remote (i.e., Zoom-based) study on language development in children with autism. Participants (N = 54) aged 38–71 months ( M = 56.2, SD = 8.8) were administered the QUILS; their caregiver completed the CDI-III and Vineland-3 about their development, and caregivers and children completed a brief caregiver–child interaction, from which natural language samples were transcribed. Results The three subtests of the QUILS showed high correlations with each other (all p s < .001). Similarly, a QUILS composite score was highly correlated (all p s < .001) with words and sentences produced on the CDI-III, two metrics derived from our natural language sample (lexical diversity and MLU), and the Vineland-3 Communication Domain raw score. Conclusions These results indicate that with young autistic children, the subtests of the QUILS cohere with each other, and the QUILS (overall) converges with other measures of emergent language. Implications These findings indicate that the QUILS may be a useful addition to the toolbox of early language assessment in autism. Our preliminary findings suggest that the QUILS is feasible for use with young autistic children and that it may be a useful complement to other instruments, providing promising directions for quantification of language skills using computer-based, remote administration.
Background and Aims The current study aimed to examine the communicative level of 3-year-old children with suspected autism spectrum disorder (ASD) in a population-representative sample focusing on communication initiation, communication modes and communication functions. Potential differences in communication between children who later met diagnostic criteria for ASD and those who did not, and possible differences between girls and boys were analysed. Methods Video recordings from a standardised play observation of 75 children (14 girls, 61 boys, M age = 3.2), of whom 59 were diagnosed with ASD and 16 did not receive such a diagnosis, were analysed using the Modified – Classroom Observation Schedule to Measure Intentional Communication . Results The whole group of children ( n = 75) were more likely to respond to others than to take their own communicative initiatives. The most frequent communicative functions were confirming and requesting, often expressed through vocalisations or actions. No significant differences between girls and boys could be detected. Children without ASD ( n = 16, all boys) gave more responses, used more verbal communication forms and more frequently established joint attention and dyadic social interaction than children with ASD ( n = 59). Conclusions Reduced use of conventional spoken and gestural forms, as well as lower rates of contingent responding, distinguished children who later received an ASD diagnosis. Although results need to be interpreted cautiously, findings indicate that gender-related communicative differences associated with ASD may not be apparent in very early childhood. Implications This study contributes to understanding communication in suspected ASD. Future studies should examine longitudinal trajectories of communication functions, forms and initiative/response in children with ASD.
Background and Aims Speech-language pathologists (SLPs) have reported using over 30 interventions to support autistic children and youth, but large caseloads limit time to review relevant research for informed clinical decision-making. To support the implementation of evidence-based practice, this umbrella review evaluates and compares the evidence for these interventions to provide clinicians, researchers and policymakers with an easy-access guide summarizing the existing evidence. Methods The protocol was pre-registered in PROSPERO. Eight databases were searched to identify systematic reviews of randomized controlled trials. Risk of bias was assessed using the Joanna Briggs Institute Checklist for Systematic Reviews. Summary tables were developed synthesizing the outcomes relevant to the field of speech-language pathology. Main Contributions Twenty-three systematic reviews of interventions used by SLPs met our inclusion criteria and were categorized as either general intervention approaches or specific manualized interventions. Seven intervention approaches were identified (joint attention, caregiver-delivered, technology-assisted caregiver-delivered, play-based, pragmatic, social pragmatic, social skills), and all had consistent evidence for at least one positive outcome. Four of six manualized interventions had consistent evidence of a positive effect for at least one outcome (Early Start Denver Model; Joint Attention, Symbolic Play, Engagement, Regulation; PEERS ® ; Social Stories TM ). Conclusions and Implications This umbrella review generated an overview of the existing evidence for interventions that may be used by SLPs to support autistic children and youth. Variability in evidence quantity and how outcomes were synthesized prohibited assessing relative efficacy or providing clinical recommendations on which interventions have the best evidence to support their use in practice; however, SLPs will be able to use the quick reference guide in conjunction with their clinical experience and client preferences to provide evidence-based practice. For researchers, results highlighted a need for the use of a consistent outcome measure to support comparison between interventions, describe participants in further detail and prioritize systematic reviews of interventions that are sufficiently similar in format and goals.
Background and Aims Research shows that language abilities in autism are highly heterogeneous and that parents play a crucial role in children's development. However, the bidirectional relationships between parenting stress, parenting behaviours and children's language abilities in autism remain under-researched. Furthermore, fathers are often excluded from autism parenting research. This study therefore aimed (1) to compare mothers and fathers with respect to the levels of self-reported parenting stress and behaviours and (2) to examine associations between parenting stress, parenting behaviours and children's language abilities, as well as whether these associations differ between mothers and fathers. Methods This cross-sectional study included 92 autistic children aged 2–6 with their mothers and fathers. Parenting stress and parenting behaviours were measured with self-report questionnaires. Children's receptive and expressive language abilities were measured using a combination of standardised tests, which were chosen depending on the children's age, abilities and community language (i.e., Dutch or French). Wilcoxon signed-rank tests were used to compare mothers and fathers. Zero-order and partial Spearman correlations were adopted to examine associations among variables, and Fisher's r-to-z transformations compared the strength of associations between maternal and paternal correlations. Results Mothers reported higher scores on parenting stress and several positive parenting behaviours (i.e., positive parenting, supervision, rules, rewarding, stimulating the development and adapting the environment) than fathers. No significant differences were found in the amount of autonomy support, discipline and indulging. In mothers, multiple parenting behaviours (i.e., autonomy support, supervision, discipline and stimulating the development) were significantly correlated with children's language abilities, although these associations weakened when controlling for children's non-verbal cognitive abilities. In fathers, only supervision correlated significantly with children's language abilities. Mothers showed no significant associations between self-reported parenting stress and behaviours. In fathers, however, higher parenting stress was linked to lower positive parenting, rewarding and stimulating the development and to higher discipline and indulging. Paternal stress was also related to lower receptive language abilities, a pattern not observed in mothers. Conclusions More differences than similarities emerged in parenting experiences and practices between mothers and fathers. Mothers reported more parenting stress and positive parenting practices compared to fathers, whereas no differences were found for negative parenting practices. Gender differences also appeared in the associations between parenting stress, parenting behaviours and child's language abilities. More specifically, maternal parenting behaviours were more strongly related to children's language abilities than paternal parenting behaviours. Importantly, these associations weakened after controlling for children's cognition, suggesting a complex interplay between these variables to be further researched. Parenting stress was related to both parenting behaviours and children's language abilities only in fathers, and not in mothers. Implications These findings suggest the importance of including both mothers and fathers in autism parenting research and clinical practice. They encourage future longitudinal and intervention studies to further examine the interrelations between parenting stress, parenting behaviours and children's language development, while also considering the role of child characteristics that may influence these associations, in order to inform parent-mediated language interventions.
Background and Aims Although developmental language disorder (DLD) is a lifelong, neurodevelopmental condition, its presentation in adulthood has received scant research and clinical attention. Several longitudinal studies have demonstrated that poor language ability may be negatively associated with wider life factors in adulthood. Moreover, although a growing body of qualitative evidence illustrates the lived experience of adults with DLD, more quantitative research on this subject is needed, which may guide evidence-informed assessment and support practices for adults. In this short report, we aim to explore the presentation of DLD in adulthood. We share the demographic characteristics, language difficulties, and mental health profile of a sample of adults with DLD based on self-report data. Methods We collected data from 92 adult participants recruited via Engage with Developmental Language Disorder (E-DLD), an international database set up to facilitate DLD research. Participants completed a DLD screening questionnaire, a set of demographic questions, and measures of emotional health including anxiety, depression, and self-esteem. We used the resulting data to construct an overview of the characteristics and profiles of two subgroups in the database: (a) adults who self-reported a clinical diagnosis of DLD (n = 30); and (b) adults who scored highly on the screening questionnaire (“possible DLD,” n = 62) but who did not have a formal diagnosis. For some measures, we also include a comparative sample of typical adults with no confirmed or suspected DLD (n = 91). Results More women than men completed the survey, with the average age of the DLD participants being just under 37 years of age, whereas the controls were on average 43 years of age. About 70% of the DLD participants were UK residents, while 30% were from countries across the world. Participants with DLD tended to be lower earners than controls but were represented in all income bands. In total, 43% (39) were parents and 43% (39) were living with a partner. Word finding and expressive language were the most reported areas of language difficulty, and the clinically diagnosed sample reported significantly more pragmatic language challenges than the “possible DLD” group. Respondents across both DLD groups had higher levels of emotional challenges including anxiety, depression, alexithymia, and low self-efficacy compared to the comparison sample. Conclusions Adults with DLD are a diverse group, with potentially more women than men seeking diagnosis or recognition in adulthood. It is possible that the high rates of emotional difficulties may indicate notable levels of need in those with DLD in adulthood. Implications Our findings show that there are many adults with likely DLD without a formal diagnosis. As such, they are unlikely to qualify for support. We recommend that services providing for adults with DLD should make every effort to be accessible to those on lower incomes, given our income findings, and services could usefully collaborate with mental health services to understand the complexities of co-occurring needs. Speech and language services should also consider how to work alongside other advocates to increase recognition of DLD in adulthood, given the lifelong impact of DLD, whether diagnosed or not.
