Language And Communication In Autism – A lack of understanding of the manifestations of autism in women is believed to contribute to delayed or late diagnosis, especially for people without intellectual disability. Specific studies of social and behavioral differences suggest a distinct female phenotype of autism. However, although sex/gender differences are known in typically developing populations, little has been done to examine language and communication profiles. This article summarizes recent work in this small but emerging field. It focuses on four series of preliminary and exploratory studies carried out by the authors, and contextualizes them in the wider literature. The research shows a clear picture of the language and communication strengths and weaknesses of autistic women without intellectual disability (compared to typically developing women with autism). Furthermore, despite the relatively subtle expression of the difficulties (compared to males with autism), the impact on functioning, social communication and emotional well-being is fair and significant. The discussion highlights the need for further empirical research and suggests areas for investigation. Implications for clinical practice include the need for better recognition, testing, and interventions for language and communication difficulties in women with autism. This applies to diagnostic, mental health and speech and language therapy services.
Differences in the language and communication profiles of typically developing individuals are well documented in the literature. Women acquire first words earlier (Bleses et al., 2008), integrate language better and earlier with gestures (Eriksson et al., 2012), and show earlier examples of social-emotional vocabulary ( eg, “like,” “please,” etc.). ), and the use of more complex linguistic forms during spontaneous speech (Bouchard et al., 2009). They also use language and communication in a different way than men, focusing on anthropocentric themes and emotions (Newman et al., 2008), and using collective and consensual speech (Ladegaard and Bleses, 2003). Importantly, this profile seems to be expected in the context of interaction (Newman et al., 2008) and the successful integration of women into social groups (Tierney et al., 2016).
Language And Communication In Autism
Sex/gender differences in autism have received increasing attention in recent years, but this has focused on social and behavioral domains rather than language and communication. Currently, women are diagnosed less often than men (1:3) (Loomes et al., 2017), especially in groups with higher cognitive functioning (1:7; Nicholas et al., 2008). This is despite a relative parity (2:1) of autism in all samples of the population (Giarelli et al., 2010). A clinical concern is that women may be left undiagnosed due to the lack of recognition of the female autistic phenotype (Kreiser and White, 2014). Sex/gender differences in severe/repetitive behaviors have been identified using diagnostic measures (Van Wijngaarden-Cremer et al., 2014; Hull et al., 2017a), and males typically show a frequency and greater severity than women. Differences in social interaction were better characterized using specific measures, avoiding homogenous effects of data collection and restricting groups of participants to the same diagnostic instrument (Lai et al., 2015). Several studies using measures of empathy (Rieffe et al., 2021), friendship (Sedgewick et al., 2016), and play behavior (Dean et al., 2016) show a distinct picture of social interaction difficulties in women compared to men. , 2014), and emotional interactions (Kap et al., 2014). A review of the literature found little evidence of gender/sex differences in language and communication in autism (Hull et al., 2017a). However, the data from these studies were collected using separate measures (parent report or core vocabulary tasks) and may have underestimated the differences for reasons discussed in this paper. Others have used diagnostic measures, which can have homogenizing effects by limiting participants and measuring differences using the same instrument (Lai et al., 2015). This article focuses on a small task that examines subtle sex/gender differences in pragmatic and sentence-level language using specific measures of language and communication. Essentially, it will review four clinically relevant studies from the authors’ research group; These are combined using direct assessment (Sturrock et al., 2019b), observation and report measures (Sturrock et al., 2019a), child interviews (Sturrock et al., 2021) and parent interviews. parents (Sturrock et al., 2021). and recent findings from a wide range of literature. It is believed that females with autism (intellectual disability: IQ ≥ 70) are more likely to be delayed in diagnosis, and to have language and communication skills that differ from typically developing males and females with autism, and that these differences predispose them to such disorders. negative social, functional and emotional consequences. It calls for further research and suggests directions for investigation.
Speech And Language Therapy For Children With Autism
Although subtle differences in language and communication have been identified between individuals with autism (without intellectual disability) and typically developing (TD) controls (Howlin, 2003; Kelley et al., 2006), these cannot be captured by basic assessments. of language structure (eg, vocabulary tests). and grammar at the sentence level). The basic language of the construct should not differ between school-aged and older males and females (Newman et al., 2008). Therefore, attempts to study gender differences should use measures capable of comparing slightly different profiles.
Sturrock et al. (2019b) proposed a direct assessment scale aimed at various levels of language (expressive and receptive) (word level/narrative, sentence and super-sentences), word knowledge (semantics), emotional judgment, and vocabulary. In subsequent work, the authors proposed several functional communication measures for the social use of language (pragmatic skills), including parent-child questionnaires and observation checklists (Sturrock et al., 2019a). See Appendix 1 for details of assessment measures. These measures were administered to groups of 52 children without intellectual disability by 2 (diagnosis: Autism/TD) in a 2 (gender/gender: female/male) design. Children were recruited from a narrow age range (8 years 11 to 11 years 6 months) to minimize effects on language development. Middle-aged children were purposefully selected, young enough not to have a secondary mental health condition (girls with autism are thought to have increased social interaction difficulties in middle school; 6 ) but old enough after diagnosis (likely to occur later). For girls with autism (Rutherford et al., 2016), participants had a PIQ ≥ 70, and there were no statistical differences between groups in basic vocabulary and grammar skills or autism severity (see Supplementary Appendix 2).
As predicted by the literature (Howlin, 2003; Kelley et al., 2006), no group differences were found in receptive or expressive vocabulary or sentence-level language. However, other measures may assess differences more discretely; for example, the Productive Syntax Index (Scarborough, 1990) showed group differences in expressive grammar at the sentence level when comparing spontaneous language samples of children with learning disabilities (Eigsti et al. , 2007). Likewise, verbal instruction following subtests within the CELF (Semel et al., 1987) and NEPSY (Korkman et al., 1997) assessment batteries have shown receptive difficulties (Koning and Magill-Evans, 2001; Saalasti et al., 2008) in children with autism without intellectual disability compared to controls. Gender differences in these language subtests have not been studied, but they are able to identify subtle differences and are worth investigating. Another consideration is the heterogeneity among individuals with autism and the probable existence of subgroups with specific language difficulties (Roberts et al., 2004; Wittke et al., 2017). While language difficulties specific to the non-autistic population can occur in autistic individuals without other intellectual disabilities, the prevalence of this disorder in girls with autism is currently unknown. It is important to isolate this group so that it can be considered separately in larger population studies. The results of the author’s series of studies show the appearance of autistic girls without such additional and specific grammatical difficulties as evidenced by the children’s performance of basic grammatical tasks.
The narratives were used to show that individuals with autism without intellectual disability have mild deficits in language and communication skills, despite normal levels of basic structural language. The narrative requires the individual to recall, organize and present the information in a way that directs the audience to the meaning of the story; which combines cognitive and linguistic skills (Norbury et al., 2014) with listeners’ ability to interpret social cues (Wolden et al., 2017). Mixed gender/sex groups or autistic males without intellectual disability show structural (Diehl et al., 2006; Rumpf et al., 2012; McCabe et al., 2013) and pragmatic (Capps et al., 2000; Losch) deficits. . and Gordon, 2014; Bunny et al., 2015; Kauschke et al., 2016) narrative features. Therefore, it allows for high-level language and communication profiles and sex/gender differences.
Q&a: How To Recognize Signs Of Autism From Speech Delay?
Sturrock et al. (2019b) found that females and males with autism performed similarly, but were behind the TD in the use of temporal conjunctions (“and then”), number of causal conjunctions, and frame (” so”), structural complexity and pragmatic coherence. creates general restrictions with This can support the argument for subtle group differences in higher order linguistic abilities (Kelly et al., 2006; Eigsti et al., 2007; Saalasti et al., 2008). Other studies have shown gender differences in the pragmatic elements of narratives, with women with autism creating richer representations and representations of internalization, cognition, perception and judgment (Kauschke et al., 2016; Boorse et al., 2019; Conlon et al., 2019; al. ., 2019) and general skills to retell key elements of the story (Conlon et al., 2019). By comparison
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