Stephanie Perry
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Kjellmer, L., Hedvall, Å., Fernell, E., Gillberg, C., & Norrelgen, F. (2012). Language and
communication skills in preschool children with autism spectrum disorders:
Contribution of cognition, severity of autism symptoms, and adaptive functioning to
the variability. Research In Developmental Disabilities, 33(1), 172-180.
It is known that individuals diagnosed with Autism Spectrum Disorder (ASD) typically
display delays in verbal and non-verbal communication. These delays can be attributed to
several factors that impact communication in children with ASD. Some of these factors
include cognition, severity of autism symptoms, and adaptive functioning. However,
severity of expressive and receptive language delays is not consistent across diagnoses,
with some children displaying much higher verbal and non-verbal language abilities than
others. The authors of this research explored how these factors attribute to the
development of expressive and receptive language in these children. Specifically, this study
aimed to identify the impact of cognition, severity of autism symptoms, and adaptive
function on the variability of language skills in preschoolers diagnosed with ASD.
The study was comprised of 129 participants (111 boys, 18 girls) who ranged in age from
24 months to 63 months (mean = 3;9 years; S.D = 8.4 months). These children were selected
from a prior research study conducted at the Autism Centre for Young Children. Expressive
and receptive language abilities were measured by parent report using an adapted version
of the MacArthur-Bates Communicative Development Inventory. To determine cognitive
abilities, researchers carefully examined each child’s referral from the child and adolescent
psychiatrist and placed participants into one of three categories depending on the
information presented. The three categories included, (i) clear indication of learning
disability/ intellectual disability, (ii) learning problems, but not to the extent of learning
disability (developmental delay) and (iii) general cognitive ability within normal limits. An
Autistic Behavior Checklist was used assess presence autistic behaviors. Possible scores for
the checklist range from 0-157, with higher scores indicating higher severity of autism
symptoms. Finally, adaptive behaviors were measured using two subscales, Daily Living
Skills (DLS) and Socialization (Soc), from the Vineland Adaptive Behavior Scales.
Results indicated that on average, children with higher cognitive function displayed higher
verbal language skills and children with clear learning disability/ intellectual disability
displayed lower language skills. Likewise, those diagnosed with Asperger’s syndrome, ASD
unspecified, and PDD-NOS displayed higher language abilities, respectively, than children
diagnosed with AD. Results also indicated that children in the normal intelligence group had
less severe autistic symptoms than the children with learning disability/ intellectual
disability. After controlling for age and other variables, the investigators reported that
cognition impacted verbal language more than autistic symptoms and adaptive functioning.
Conversely, autistic symptoms and adaptive functioning impacted non-verbal language
more than cognition.
From these results, several implications for SLPs are evident. One major implication is that
cognition plays a significant role in the development of verbal language. Not only is this
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important for the SLP to understand when developing goals and objectives for their client, it
is also important for the SLP to explain this dynamic to families. Having this understanding
of the connection between cognition and verbal language development is imperative in a
parent’s understanding of potential for verbal communication growth in their children.
Another important implication is the converse of the first finding; autistic symptoms and
adaptive functioning significantly impact non-verbal language. This is important to
understand because SLPs work with clients to develop and improve communication as a
whole, not just verbal language. Therefore, understanding the factors that may impede or
enhance non-verbal communication is imperative in predicting the success of intervention.
Several strengths and weaknesses of methodology were noted. Strengths of the
methodology include clear and concise explanation of procedures and tool development
and an extensive and informative literature search. The authors clearly explained, in detail,
specifically how data was collected and analyzed for each factor examined. This is important
for consistency across data collection. Also, the researchers conducted an extensive
literature search and frequently compared and contrasted their findings to the findings of
similar studies. Weaknesses were also noted. One weakness was the adaptation of the tool
used to measure language ability. Because the tool was adapted, the investigators
computed language scores differently than outlined by the creators of the assessment. This
adaptation in scoring may have impacted the results of the language measure and may have
skewed the findings presented. Another weakness was the lack of gender matching among
participants. The study consisted of a significantly higher number of male than female
participants and because males and females develop language differently, this incongruence
may have negatively impacted the findings as well.
In conclusion, the authors of this study aimed to explain the contribution of cognition,
autism symptoms, and adaptive functioning on the language development of children with
ASD. They found that generally, children with higher cognitive abilities have higher
language skills. These findings are congruent with other findings of similar research studies
and the information presented in this article is important for SLPs to understand when
developing treatment goals and objectives for children on the spectrum.