Prevalence and functional impact of social (pragmatic) communication disorders

2021 ◽  
Author(s):  
Jo Saul ◽  
Sarah Louise Griffiths ◽  
Courtenay Norbury
Keyword(s):  
Diagnostic Algorithm ◽  
Communication Disorders ◽  
Autism Spectrum ◽  
Early Years ◽  
Considerable Proportion ◽  
Prevalence Rates ◽  
Functional Impact ◽  
Pragmatic Communication ◽  
Pragmatic Skills ◽  
Structural Language

Background:To evaluate the utility of the Children’s Communication Checklist-2 (CCC-2) for measuring inclusion and exclusion criteria of Social (Pragmatic) Communication Disorder (SPCD) and to ascertain prevalence rates and functional impact of SPCD in a community sample.Method:We used parent and teacher responses to the CCC-2 to approximate inclusion (poor social-pragmatic skills) and exclusion (poor structural language skills or autistic symptomatology) criteria for SPCD. We tested the prevalence of SPCD using these criteria in a population-based sample of children (n = 386) aged 5-6 years old. We also investigated the academic and behavioural profiles of children with more broadly-defined limitations in social-pragmatic competence.Results:Regardless of the diagnostic algorithm used, the resulting prevalence rates for SPCD indicated that very few children had isolated social communication difficulties (0-1.3%). However, a larger proportion of children (range: 6.1-10.5%) had social-pragmatic skills outside the expected range alongside structural language difficulties and/or autism spectrum symptoms, and this was associated with a range of adverse academic and behavioural outcomes. Conclusions:A considerable proportion of children in the early years of primary school have social-pragmatic deficits that interfere with social and scholastic activity, however these rarely occur in isolation. Exclusionary criteria articulated by DSM-5 may lead to under-identification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention.

scholarly journals Social (pragmatic) communication disorders and autism spectrum disorder

2015 ◽  
Vol 101 (8) ◽  
pp. 745-751 ◽  
Author(s):  
Gillian Baird ◽  
Courtenay Frazier Norbury
Keyword(s):  
Autism Spectrum Disorder ◽  
Language Impairment ◽  
Communication Disorders ◽  
International Classification Of Diseases ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Pragmatic Language ◽  
Clinical Disorder ◽  
Dsm 5 ◽  
Pragmatic Communication

Changes have been made to the diagnostic criteria for autism spectrum disorder (ASD) in the recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and similar changes are likely in the WHO International Classification of Diseases (ICD-11) due in 2017. In light of these changes, a new clinical disorder, social (pragmatic) communication disorder (SPCD), was added to the neurodevelopmental disorders section of DSM-5. This article describes the key features of ASD, SPCD and the draft ICD-11 approach to pragmatic language impairment, highlighting points of overlap between the disorders and criteria for differential diagnosis.

scholarly journals The DSM-5 introduction of the Social (Pragmatic) Communication Disorder as a new mental disorder: a philosophical review

2021 ◽  
Vol 43 (4) ◽  
Author(s):  
M. Cristina Amoretti ◽  
Elisabetta Lalumera ◽  
Davide Serpico
Keyword(s):  
Mental Disorder ◽  
Communication Disorders ◽  
Autism Spectrum ◽  
Response To Treatment ◽  
Communication Disorder ◽  
Validity And Reliability ◽  
Dsm 5 ◽  
The Social ◽  
Pragmatic Communication ◽  
Definition Of

AbstractThe latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included the Social (Pragmatic) Communication Disorder (SPCD) as a new mental disorder characterized by deficits in pragmatic abilities. Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons—including bridging a nosological gap in the macro-category of Communication Disorders—in the last few years researchers have identified major issues in such revision. For instance, the symptomatology of SPCD is notably close to that of (some forms of) Autism Spectrum Disorder (ASD). This opens up the possibility that individuals with very similar symptoms can be diagnosed differently (with either ASD or SPCD) and receive different clinical treatments and social support. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. In the second part, we focus on the validity and reliability of SPCD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography.

Social Communication and Structural Language of Girls With High-Functioning Autism Spectrum Disorder

2020 ◽  
Vol 51 (4) ◽  
pp. 1139-1155
Author(s):  
Jenny M. Burton ◽  
Nancy A. Creaghead ◽  
Noah Silbert ◽  
Allison Breit-Smith ◽  
Amie W. Duncan ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Adaptive Behavior ◽  
Social Communication ◽  
High Functioning Autism ◽  
Autism Spectrum ◽  
Vineland Adaptive Behavior Scales ◽  
High Functioning ◽  
Expressive Communication ◽  
Vineland Adaptive Behavior ◽  
Structural Language

Purpose The purpose of this study was to characterize social communication and structural language of school-age girls with high-functioning autism spectrum disorder (HF-ASD) compared to a matched group of girls who are typically developing (TD). Method Participants were 37 girls between 7;5 and 15;2 (years;months)—18 HF-ASD and 19 TD. Children completed the Test of Pragmatic Language–Second Edition (TOPL-2) and Clinical Evaluation of Language Fundamentals–Fifth Edition. Parents completed the Children's Communication Checklist–2 United States Edition (CCC-2) and Receptive and Expressive Communication subdomains of the Vineland Adaptive Behavior Scales–Second Edition. Results In the area of social communication, girls with HF-ASD earned significantly lower scores and were more often classified as having an impairment on the TOPL-2 and the CCC-2. However, 28% and 33% earned average scores on the TOPL-2 and the CCC-2, respectively. In the area of structural language, no significant differences were found between groups on Clinical Evaluation of Language Fundamentals–Fifth Edition indexes. In contrast, girls with HF-ASD earned significantly lower scores and were more often classified as having an impairment on the Vineland Adaptive Behavior Scales–Second Edition. Sixty-one percent and 83% scored below average on the Receptive and Expressive Communication subdomains, respectively. Conclusions It has been argued that girls with HF-ASD, when compared to boys with HF-ASD, may have advantages for social communication and structural language that mask their impairments. However, when compared to girls who are TD, girls with HF-ASD demonstrated impaired social communication and structural language. Clinicians should include and carefully examine multiple sources of information when assessing girls with HF-ASD.

Aging and Autism

2012 ◽  
Vol 17 (2) ◽  
pp. 69-75 ◽  
Author(s):  
Pamela A. Smith
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorders ◽  
Patient Group ◽  
Older Patients ◽  
Geriatric Patients ◽  
Recent Literature ◽  
Communication Disorders ◽  
Autism Spectrum ◽  
Need For Support ◽  
Spectrum Disorders

In this article, I will review the available recent literature about the aging population with autism, a patient group that researchers know little about and a group that is experiencing a growing need for support from communication disorders professionals. Speech-language pathologists working with geriatric patients should become familiar with this issue, as the numbers of older patients with autism spectrum disorders is likely to increase. Our profession and our health care system must prepare to meet the challenge these patients and residents will present as they age.

scholarly journals Developmental trajectories of autistic social traits in the general population

2021 ◽  
pp. 1-9
Author(s):  
Richard Pender ◽  
Pasco Fearon ◽  
Beate St Pourcain ◽  
Jon Heron ◽  
Will Mandy
Keyword(s):  
General Population ◽  
Full Range ◽  
Population Sample ◽  
Autistic Traits ◽  
Communication Disorders ◽  
Autism Spectrum ◽  
Growth Mixture Modelling ◽  
Autistic People ◽  
Social Difficulties ◽  
Autism Trait

Abstract Background Autistic people show diverse trajectories of autistic traits over time, a phenomenon labelled ‘chronogeneity’. For example, some show a decrease in symptoms, whilst others experience an intensification of difficulties. Autism spectrum disorder (ASD) is a dimensional condition, representing one end of a trait continuum that extends throughout the population. To date, no studies have investigated chronogeneity across the full range of autistic traits. We investigated the nature and clinical significance of autism trait chronogeneity in a large, general population sample. Methods Autistic social/communication traits (ASTs) were measured in the Avon Longitudinal Study of Parents and Children using the Social and Communication Disorders Checklist (SCDC) at ages 7, 10, 13 and 16 (N = 9744). We used Growth Mixture Modelling (GMM) to identify groups defined by their AST trajectories. Measures of ASD diagnosis, sex, IQ and mental health (internalising and externalising) were used to investigate external validity of the derived trajectory groups. Results The selected GMM model identified four AST trajectory groups: (i) Persistent High (2.3% of sample), (ii) Persistent Low (83.5%), (iii) Increasing (7.3%) and (iv) Decreasing (6.9%) trajectories. The Increasing group, in which females were a slight majority (53.2%), showed dramatic increases in SCDC scores during adolescence, accompanied by escalating internalising and externalising difficulties. Two-thirds (63.6%) of the Decreasing group were male. Conclusions Clinicians should note that for some young people autism-trait-like social difficulties first emerge during adolescence accompanied by problems with mood, anxiety, conduct and attention. A converse, majority-male group shows decreasing social difficulties during adolescence.

Neurodevelopmental disorders among Spanish school-age children: prevalence and sociodemographic correlates

2021 ◽  
pp. 1-11
Author(s):  
Rosa Bosch ◽  
Mireia Pagerols ◽  
Cristina Rivas ◽  
Laura Sixto ◽  
Laura Bricollé ◽  
...  
Keyword(s):  
Neurodevelopmental Disorders ◽  
Rating Scales ◽  
Communication Disorders ◽  
Autism Spectrum ◽  
Self Report ◽  
Motor Disorder ◽  
School Type ◽  
Final Population ◽  
Prevalence Estimates ◽  
Sociodemographic Correlates

Abstract Background Prevalence estimates of neurodevelopmental disorders (ND) are essential for treatment planning. However, epidemiological research has yielded highly variable rates across countries, including Spain. This study examined the prevalence and sociodemographic correlates of ND in a school sample of Spanish children and adolescents. Methods The Child Behaviour Checklist/Teacher's Report Form/Youth Self-Report and the Conners' Rating Scales were administered for screening purposes. Additionally, teachers provided information on reading and writing difficulties. Subjects who screened positive were interviewed for diagnostic confirmation according to the Diagnostic and Statistical Manual of Mental Disorders criteria. The final population comprised 6834 students aged 5–17. Multivariate analyses were performed to determine the influence of gender, age, educational stage, school type, socioeconomic status (SES), and ethnicity on the prevalence estimates. Results A total of 1249 (18.3%) subjects met criteria for at least one ND, although only 423 had already received a diagnosis. Specifically, the following prevalence rates were found: intellectual disabilities (ID), 0.63%; communication disorders, 1.05%; autism spectrum disorder (ASD), 0.70%; attention-deficit/hyperactivity disorder (ADHD), 9.92%; specific learning disorder (SLD), 10.0%; and motor disorders, 0.76%. Students of foreign origin and from low SES evidenced higher odds of having ID. Boys were more likely to display ASD or a motor disorder. Age, SES, and ethnicity were significant predictors for SLD, while communication disorders and ADHD were also associated with gender. Conclusions The prevalence of ND among Spanish students is consistent with international studies. However, a substantial proportion had never been previously diagnosed, which emphasise the need for early detection and intervention programmes.

scholarly journals A combined prosodic and linguistic treatment approach for language-communication skills in children with autism spectrum disorders: A proof-of-concept study

2016 ◽  
Vol 6 (1) ◽  
pp. 8
Author(s):  
Silva Kuschke ◽  
Bart Vinck ◽  
Salomé Geertsema
Keyword(s):  
Social Interaction ◽  
Statistical Significance ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Listening Skills ◽  
Language Therapy ◽  
Baseline Design ◽  
Traditional Language ◽  
Pragmatic Skills ◽  
Pre Treatment

<p>This study aimed to determine whether the use of prosodically varied speech within a traditional language therapy framework had any effect on the listening skills, pragmatic skills and social interaction behaviour of three children with autism spectrum disorder (ASD). A single participant multiple baseline design across behaviours was implemented. Three participants with ASD were selected for this research. The listening skills, pragmatic skills and social interaction behaviour of the participants were compared before treatment, after a 3-week <br />period of treatment and after a 2-week withdrawal period from treatment, utilising prosodically varied speech within a traditional language therapy approach. Statistical significance was not calculated for each individual due to the limited data, but visual inspection indicated that all the participants showed positive behavioural changes in performance across all areas after 3 weeks of treatment, independent of their pre-treatment performance level. The use of <br />prosodically varied speech within a traditional language therapy framework appears to be a viable form of treatment for children with ASD.</p>

scholarly journals Pragmatic versus structural difficulties in the production of pronominal clitics in French-speaking children with autism spectrum disorder

2018 ◽  
Vol 3 ◽  
pp. 239694151879964 ◽  
Author(s):  
Philippe Prévost ◽  
Laurice Tuller ◽  
Racha Zebib ◽  
Marie Anne Barthez ◽  
Joëlle Malvy ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Language Impairment ◽  
Specific Language Impairment ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
First Person ◽  
Specific Language ◽  
Third Person ◽  
Structural Language

Background and aims Impaired production of third person accusative pronominal clitics is a signature of language impairment in French-speaking children. It has been found to be a prominent and persistent difficulty in children and adolescents with specific language impairment. Previous studies have reported that many children with autism spectrum disorder also have low performance on these clitics. However, it remains unclear whether these difficulties in children with autism spectrum disorder are due to structural language impairment or to pragmatic deficits. This is because pragmatics skills, notoriously weak in children with autism spectrum disorder, are also needed for appropriate use of pronouns. Use of pronouns without clear referents and difficulty with discourse pronouns (first and second person), which require taking into account the point of view of one’s interlocutor (perspective shifting), have frequently been reported for autism spectrum disorder. Methods We elicited production of nominative, reflexive and accusative third and first person pronominal clitics in 19 verbal children with autism spectrum disorder (aged 6–12, high and low functioning, with structural language impairment, or with normal language) and 19 age-matched children with specific language impairment. If pragmatics is behind difficulties on these elements, performance on first-person clitics would be expected to be worse than performance on third person clitics, since it requires perspective shifting. Furthermore, worse performance for first person clitics was expected in the children with autism spectrum disorder compared to the children with specific language impairment, since weak pragmatics is an integral part of impairment in the former, but not in the latter. More generally, different error patterns would be expected in the two groups, if the source of difficulty with clitics is different (a pragmatic deficit vs. a structural language deficit). Results Similar patterns of relative difficulties were found in the autism spectrum disorder language impairment and specific language impairment groups, with third person accusative clitics being produced at lower rates than first-person pronouns and error patterns being essentially identical. First-person pronouns did not pose particular difficulties in the children with autism spectrum disorder (language impairment or normal language) with respect to third-person pronouns or to the children with specific language impairment. Performance was not related to nonverbal intelligence in the autism spectrum disorder group. Conclusions The elicitation task used in this study included explicit instruction, and focus on perspective shifting (both visual and verbal), allowing for potential pragmatic effects to be controlled. Moreover, the task elicited a variety of types of clitics in morphosyntactic contexts of varying complexity, providing ample opportunities for employment of perspective shifting, which may have also curtailed perseveration of third person over first person. These properties of the task allowed for the grammatical nature of children’s difficulties with third-person accusative clitics to emerge unambiguously. Implications Assessment of structural language abilities in children with autism spectrum disorder requires careful consideration of task demands. The influence of pragmatic abilities on structural language performance can be circumvented by making the pragmatic demands of the task explicit and salient. Filtering out this potential influence on structural language performance is fundamental to understanding language profiles in children with autism spectrum disorder and thus which children could benefit from which kinds of language intervention.

scholarly journals Clinical phenotype of autism spectrum disorders in children of preschool and school age, burdened epileptic seizures

2019 ◽  
Vol 25 (2) ◽  
pp. 81-87
Author(s):  
I. A. Martsenkovsky ◽  
T. O. Skrypnyk ◽  
I. I. Martsenkovska ◽  
I. F. Zdoryk ◽  
H. V. Makarenko
Keyword(s):  
Clinical Phenotype ◽  
Repetitive Behavior ◽  
Epileptic Seizures ◽  
Communication Disorders ◽  
Epileptic Activity ◽  
Autism Spectrum ◽  
Obsessive Compulsive ◽  
Social Reciprocity ◽  
Children With Asd ◽  
Comparison Groups

Background. Clinical polymorphism and polymorphism are inherent in the clinical phenotype of children with autism spectrum disorders (ASD). There is a consensus, relatively high, between 5% and 38% of the prevalence of epilepsy in ASD. There are reasons to believe that ASD with epilepsy and specific epileptic activity on EEG and ASD with hyperkinetic symptoms without signs of epileptic process can be determined by different variants of genetic polymorphism or by different variants of gene expression, determined by different influences. Objective – to study the features of the clinical phenotype of ASD in preschool and school-age children with epileptic seizures and specific epileptic activity on EEG. Materials and methods. In the Department of Mental Disorders of Children and Adolescents of the Institute of Psychiatry of the Ministry of Health of Ukraine 116 children aged 2-10 years with ASD were examined. The study group was divided into three subgroups: subgroup A – 23 children with a history of epileptic seizures, subgroup B – 35 children with specific forms of epileptic activity on EEG without epileptic seizures, subgroup C – 19 children with ASD having specific epileptic activity for EEG repetitive involuntary movements (motor stereotypes, motor tics) and vocalizations (vocal tics). The control group consisted of 39 children with ASD non a history of seizures and specific epileptic activity on the EEG. The follow-up of children with ASD in the comparison groups was performed for 1-1.5 years. We used such research methods: clinical-psychopathological, psychodiagnostic, psychometric, statistical. Results. In children with ASD and comorbid epileptic seizures, disorders of social reciprocity are of crucial diagnostic importance. Communication disorders and recurrent, stereotyped behaviors, movements, and interests in children in this group are significantly less common than in comparison groups. Incidents of repetitive stereotypes in these children are associated with sensory impairments and autostimulations. Children with ASD, complicated by severe and frequent epileptic seizures, are characterized by impaired social reciprocity and communication against the background of regression or stagnation of speech and motor skills development. Disorders of communication and repetitive behavior in ASD in children of different ages are represented by different monoqualitative syndrome (phenotypes). Younger children less than 6 years of age are dominant in stereotypical movements, while children aged 6-8 years have repetitive behaviors associated with the overriding interests. Two subtypes of clinical phenotypes of ASD were identified: the variant with symptoms, which more closely determined the stereotypical sensor and motor behavior and the variant with symptoms of insistence on equality, with the overriding interests of preservation, identity. Movement stereotypes predominated in children with ASD without epileptic seizures and without epileptic activity on EEG. In children with ASD and epileptic activity on EEG, motor stereotypes and repetitive identity-preserving behavior were equally common. Conclusions. Disorders of social reciprocity, communication, repetitive behavior, in particular stereotyped movements are diagnostically significant signs of ASD, in particular ASD complicated by epileptic seizures, ASD with specific epileptic activity on EEG. According to the results of a long 1-1.5 years’ prospective study, it was established that the clinical phenotype of ASD with epileptic seizures, ASD without epileptic seizures with specific epileptic activity on EEG and RAS without epileptic seizures and changes in EEG are characterized by differing clinical picture and course. Qualitative communication disorders and stereotypical movements in addition to ASD are observed in other psychiatric disorders, including Tourette disorder, obsessive-compulsive disorders, and intellectual disability. Expressed repeated identity-preserving behavior is the basis for dual diagnosis of ASD and obsessive-compulsive disorder. Motor and vocal tics may be the basis for dual diagnosis of ASD and Tourette’s disorder. The presence of age-related pathoplasty of clinical manifestations of ASD in the comparison groups was established.

Sign in / Sign up

Export Citation Format

Share Document