Autism, Language Disorder, and Social (Pragmatic) Communication Disorder: DSM-V and Differential Diagnoses

2015 ◽  
Vol 36 (8) ◽  
pp. 355-363
Author(s):  
Mark D. Simms ◽  
Xing Ming Jin
2020 ◽  
Vol 63 (10) ◽  
pp. 3263-3276
Author(s):  
Sean M. Redmond

Purpose Estimates of the expected co-occurrence rates of idiopathic language disorder and attention-deficit/hyperactivity disorder (ADHD) provide a confusing and inconsistent picture. Potential sources for discrepancies considered so far include measurement and ascertainment biases ( Redmond, 2016a , 2016b ). In this research symposium forum article, the potential impact of applying different criteria to the observed co-occurrence rate is examined through an appraisal of the literature and an empirical demonstration. Method Eighty-five cases were selected from the Redmond, Ash, et al. (2019) study sample. Standard scores from clinical measures collected on K–3rd grade students were used to assign language impairment status, nonverbal impairment status, social (pragmatic) communication disorder status, and ADHD status. Criteria extrapolated from the specific language impairment ( Stark & Tallal, 1981 ), developmental language disorder ( Bishop et al., 2017 ), and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition language disorder ( American Psychiatric Association, 2013 ) designations were applied. Results The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition language disorder designation and its separation of language disorder from the social (pragmatic) communication disorder designation provided the clearest segregation of idiopathic language deficits from elevated ADHD symptoms, showing only a 2% co-occurrence rate. In contrast, applying the broader developmental language disorder designation raised the observed co-occurrence rate to 22.3%. The specific language impairment designation yielded an intermediate value of 16.9%. Conclusions Co-occurrence rates varied as a function of designation adopted. The presence of pragmatic symptoms exerted a stronger influence on observed co-occurrence rates than low nonverbal abilities. Impacts on clinical management and research priorities are discussed. Presentation Video https://doi.org/10.23641/asha.13063751


2020 ◽  
Vol 63 (6) ◽  
pp. 1916-1932 ◽  
Author(s):  
Haiying Yuan ◽  
Christine Dollaghan

Purpose No diagnostic tools exist for identifying social (pragmatic) communication disorder (SPCD), a new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition category for individuals with social communication deficits but not the repetitive, restricted behaviors and interests (RRBIs) that would qualify them for a diagnosis of autism spectrum disorder (ASD). We explored the value of items from a widely used screening measure of ASD for distinguishing SPCD from typical controls (TC; Aim 1) and from ASD (Aim 2). Method We applied item response theory (IRT) modeling to Social Communication Questionnaire–Lifetime ( Rutter, Bailey, & Lord, 2003 ) records available in the National Database for Autism Research. We defined records from putative SPCD ( n = 54), ASD ( n = 278), and TC ( n = 274) groups retrospectively, based on National Database for Autism Research classifications and Autism Diagnostic Interview–Revised responses. After assessing model assumptions, estimating model parameters, and measuring model fit, we identified items in the social communication and RRBI domains that were maximally informative in differentiating the groups. Results IRT modeling identified a set of seven social communication items that distinguished SPCD from TC with sensitivity and specificity > 80%. A set of five RRBI items was less successful in distinguishing SPCD from ASD (sensitivity and specificity < 70%). Conclusion The IRT modeling approach and the Social Communication Questionnaire–Lifetime item sets it identified may be useful in efforts to construct screening and diagnostic measures for SPCD.


Author(s):  
Lauren B Swineford ◽  
Audrey Thurm ◽  
Gillian Baird ◽  
Amy M Wetherby ◽  
Susan Swedo

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