Academic journal article Studies in Literature and Language

Language Outcomes for Preverbal Toddlers with Autism

Academic journal article Studies in Literature and Language

Language Outcomes for Preverbal Toddlers with Autism

Article excerpt


Research on late talking toddlers who do not have autism indicates the majority of late talkers will perform within normal limits on comprehensive language measures by the time they reach school age, and toddlers with higher receptive language skills will have better language outcomes. There is little research on school-age outcomes for late-talking toddlers who have autism. The present research investigated 75 children between 2 and 3 years of age who presented with language delays and characteristics of autism. Results indicated the majority (81%) of children with autism use verbal language by the time they reach school age. A subset of 40 of these children who were reported to use verbal language completed language testing. Results revealed that children with better language scores between the ages of 2 and 3 demonstrated better language scores upon follow-up. These findings add to our knowledge of the nature of language use and performance in children with autism.

Key words: Autism; Nonverbal; Language; Preschool; School age; Outcomes


Autism is a developmental disorder of unknown origin manifested by notably impaired social skills, impaired communication skills, and patterns of repetitive and restrictive stereotypic behaviors resulting in variable difficulties across a wide range of developmental domains. Young children with autism exhibit delays in early communication and language acquisition. These delays are often the first indication of the disorder (Lord & Paul, 1997; Rutter & Bartak, 1971). The general language trajectory of children with autism can be variable, often involving deficits in both the form and function of language (Kjelgaard & Tager-Flusberg, 2001; Lord & Paul, 1997; Tager-Flusberg & Joseph, 2003; Tager-Flusberg, Paul, & Lord, 2005). Typical language characteristics of autism include: delayed onset of speech and/or limited word repertoire in expressive vocabulary, immediate or delayed echolalia, misuse of pronouns, abnormal word use, lack of communication initiation, and in some instances a total lack of speech (Bartak, Rutter, & Cox, 1975; Kanner, 1943).

There is a great deal of information about long-term language outcomes of children with language delays who do not exhibit characteristics of autism (e.g., Armstrong, 2006; Paul, 1996; Rescorla, 2002). Studies of 2-yearold children who have few words in their expressive vocabulary; adequate nonverbal intelligence; and no signs of hearing loss or physical, neurological, behavioral or social disorders (such as autism) show that approximately 70% of these "late talkers" will recover by age 5, performing within the normal range on a test of expressive language, while the remaining 30% will continue to exhibit expressive language delays (Armstrong, 2006). There is also evidence that early receptive language skills are related to later language outcomes, i.e., late talking toddlers with low comprehension have poorer outcomes than late talking toddlers with normal comprehension (Paul, 1996; Rescorla, 2002).

Parents and professionals often wonder about the prognosis of young late-talking children with characteristics of autism; however, there is no consensus on language outcomes for this population. It is still unknown what percentage of nonverbal toddlers with characteristics of autism will continue to be nonverbal into middle childhood and beyond. In 1996, Bailey, Phillips and Rutter predicted that 50% of children with autism do not acquire useful language, an estimate that is still cited by many researchers (e.g., McDuffie, Yoder, & Stone, 2005; Prizant, 1996), developmental pediatricians, and other professionals, and yet lacks any supporting empirical evidence (Sir M. Rutter, personal communication, December, 2006). It is also unknown if early receptive language scores are related to language outcomes in later childhood and adolescence for individuals with autism. …

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