Cognition and behavior: Early words improve autism outcome
Children with autism who spoke their first words before 2 years of age may have better outcomes than those who talked later, according to a study published 7 June in the Journal of Autism and Developmental Disorders1.
The finding suggests that clinicians should take language delay seriously and not wait to suggest interventions, the researchers say.
The language ability of 5- to 6-year-old children with autism has been shown to predict how they fare as adults2. Most studies focus on language skills in children at that age because toddlers do not typically undergo detailed language assessments.
In the new study, researchers looked at age at first word for 119 children between 45 and 72 months of age who have either autism or pervasive developmental disorder–not otherwise specific (PDD-NOS). The study did not include children with language regression, defined as those who lost the ability to speak at least five words for at least three months.
The researchers assessed the children using the Mullen Scales of Early Learning, which looks at cognitive abilities such as language and motor skills, and the Vineland Adaptive Behavior Scales, which assess communication and daily living skills. They also used the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview–Revised (ADI-R), which are widely used diagnostic measures for autism, and the Childhood Autism Rating Scale to assess the severity of autism symptoms.
As part of the ADI-R, parents reported the age at which their children spoke their first words other than ‘mama’ or ‘dada.’ The mean age for first word was 23 months, and 19 children still hadn’t spoken at the time of the study.
Children who spoke their first words before a particular age — 18, 24, 30 or 36 months — have better language and communication ability than those who didn’t speak by that age, the study found.
Children with a diagnosis of autism and those with a diagnosis of PDD-NOS who spoke at the same age fare similarly.
The researchers divided the children into six groups based on median age of 12, 18, 24, 30 or 36 months at first word. Children in the groups earlier than 24 months have similar outcomes, and fare better than children in any of the later groups. This suggests that 24 months is a key age for language learning, the researchers say.
1: Mayo J. et al. J. Autism Dev. Disord. Epub ahead of print (2012) PubMed
2: Howlin P. et al. J. Child Psychol. Psychiatry 45, 212-229 (2004) PubMed