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Background: There is variability in the language of children with autism, even those who are high functioning. However, little is known about how they process language structures in real time, including how they handle potential ambiguity, and whether they follow referential constraints. Previous research with older autism spectrum disorder (ASD) participants has shown that these individuals can use context to access rapidly the meaning of ambiguous words. The severity of autism has also been shown to influence the speed in which children with ASD access lexical information., Aims: To understand more about how children with ASD process language in real time (i.e., as it unfolds). The focus was the integration of information and use of referential constraints to identify a referent named in a sentence., Methods & Procedures: We used an eye-tracking task to compare performance between young, high-functioning children with autism (HFA) and children with typical development (TD). A large sample of 5-9-year-old children (mean age = 6;8 years), 48 with HFA and 56 with TD participated; all were attending mainstream schools. For each item participants were shown a display of four images that differed in two dimensions. Each sentence contained an adjective and noun that restricted the choice from four to two (the target and competitor), followed by a prepositional phrase (e.g., the blue square with dots); this added modifying information to provide a unique description of the target. We calculated looking time at the target, the competitor and the two distractors for each 200 ms time interval as children processed the sentence and looked at the display. Generalized estimating equations were used to carry out repeated-measures analyses on the proportion of looking time to target and competitor and time to fixate to target., Outcomes & Results: Children in both groups (HFA and TD) looked at the target and competitor more than at the distractors following the adjective and noun and following the modifying information in the prepositional phrase more at the target. However, the HFA group was significantly slower in both phases and looked proportionally less at the target. Across the sample, IQ and language did not affect the results; however, age and attention had an impact. The older children showed an advantage in processing the information as did the children with higher attention scores., Conclusions & Implications: The HFA group took longer than the TD group to integrate the disambiguating information provided in the course of processing a sentence and integrate it with the visual information, indicating that for the ASD group incremental processing was not as advanced as for children with ASD, and they were less sensitive to referential conventions. Training for young children with ASD on the use of referential conventions and available contextual clues may be of benefit to them in understanding the language they hear., (© 2015 Royal College of Speech and Language Therapists.)

Background: Language impairment (LI) in the preschool years is known to vary over time. Stability in the diagnosis of LI may be influenced by children’s individual variability, the measurement error of commonly used assessment instruments and the cut-points used to define impairment., Aims: To investigate the agreement between two different age-based versions of a language assessment instrument and the stability of the classification of LI using the two measures over a 12-month period., Methods & Procedures: A total of 945 participants completed the Clinical Evaluation of Language Fundamentals(CELF—Preschool 2 or 4th Edn) at 4 and 5 years of age. Agreement and stability were analysed using Bland–Altman plots, correlation and odds ratios. Sensitivity and specificity were calculated for two thresholds of the CELF-P2 using the diagnostic category on the child’s subsequent CELF-4., Outcomes & Results: For all CELF scores, mean differences for the cohort between 4 and 5 years were within 1.5 scale score units. In contrast, at the individual level variability was found across the range of scores and was of a greater magnitude than previously reported. Stability in LI classification was low, with 36% of 5-year-olds with LI (defined as a standard score below –1.25) classified as typical at 4 years, even though odds ratios calculated from classifications at the two time points suggested that 4-year-olds with LI had 23 times greater odds than their typical peers to receive a diagnosis of LI at 5 years. The CELF-P2 did not demonstrate adequate levels of diagnostic accuracy for LI at 5 years: sensitivity of 64% and specificity of 92.9%., Conclusions: Substantial variability across the entire range of possible CELF scores was observed in this community cohort between the ages of 4 and 5 years. The stability of LI classification was lower than that reported in previous research conducted primarily on smaller clinical cohorts. The current study’s results suggest that the variability observed in developmental language pathways is the result of a combination of limitations in measurement instruments, individual children’s abilities and the arbitrary nature of the boundaries defining LI.

Background: Despite somewhat spared structural language development in high-functioning autism, communicative comprehension deficits persist. Comprehension involves the integration of meaning: global processing is required. The Weak Central Coherence theory suggests that individuals with autism are biased to process information locally. This cognitive style may impair comprehension, particularly if inferencing is required. However, task performance may be facilitated by this cognitive style if local processing is required., Aims: The current study was designed to examine the extent to which the 'weak central coherence' cognitive style affects comprehension and inferential processing of spoken narratives. The children with autism were expected to perform comparatively poorer on inferences relating to event scripts and comparatively better on inferences requiring deductive reasoning., Methods & Procedures: Fourteen high-functioning children with autism were recruited from databases of various autism organizations (mean age = 6:7, 13 males, one female) and were matched on a receptive vocabulary and a picture-completion task with 14 typically developing children recruited from a local childcare centre (mean age = 4:10, seven males, seven females). The children were read short stories and asked questions about the stories., Outcomes & Results: Results indicated that the children with autism were less able to make inferences based on event scripts, but the groups did not differ significantly on inferences requiring deductive logical reasoning. Despite similar group performance on questions relating to the main idea of the stories, only for the typically developing group was good performance on extracting the main idea of the narratives significantly correlated with performance on all other comprehension tasks., Conclusions & Implications: Findings provide some support for the Weak Central Coherence theory and demonstrate that young children with autism do not spontaneously integrate information in order to make script inferences, as do typically developing children. These findings may help to explain communicative problems of young children with autism and can be applied to intervention programme development. More research on the link between a 'weak central coherence' cognitive style and communicative comprehension in autism will be valuable in understanding the comprehension deficits associated with autism., (© 2010 Royal College of Speech & Language Therapists.)