Lay Abstract Children with autism produce few wh-questions, compared to their typically developing peers. It is unclear if this is because of social-pragmatic difficulties, or if they have not yet learned the grammar for asking wh-questions. If children do not know how to use grammatical rules to produce questions, they might simply repeat sentences that they have heard without completely understanding them first. We visited the homes of 15 children with autism and 18 typically developing children with similar language abilities, across a three-year period. At each visit, children watched a video that depicted an apple hitting a flower and keys hitting a book. The children were then shown the items side-by-side on the screen and the audio asked “what hit the flower?” and “what did the keys hit?” We filmed the children’s eye movements and analyzed how long they looked at the named item, compared to when they heard “where is the flower/keys?” At each visit, we also filmed a 30-minute mother-child play session and analyzed the types of questions that the children asked. Children with autism showed comprehension of wh-questions at a later age than typically developing children, but at a similar level of overall language development. Neither group produced wh-questions before they had demonstrated that they understood the underlying grammatical rules. Therefore, children with autism seem to process wh-questions in the same way as their typically developing peers, just at a later age. This paper discusses the implications of our findings for the language development of children with autism. Scientific Abstract Children with autism (ASD) rarely produce wh-questions (e.g., “What hit the book?”) in naturalistic speech. It is unclear if this is due to social-pragmatic difficulties, or if grammatical deficits are also involved. If grammar is impaired, production of wh-questions by rote memorization might precede comprehension of similar forms. In a longitudinal study, 15 children with ASD and 18 initially-language-matched typically developing toddlers were visited in their homes at four-month intervals across a three-year period. The wh-question task was presented via intermodal preferential looking. Silent ‘hitting’ events (e.g., an apple hitting a flower) were followed by test trials in which the apple and flower were juxtaposed on the screen. During test trials, subject-wh and object-wh-question audios were sequentially presented (e.g., “What hit the flower?”/”What did the apple hit?”). Control audios were also presented (e.g., “Where’s the apple/flower?”). Children’s eye movements were coded off-line, frame-by-frame. To show reliable comprehension, children should look longer to the named item (i.e., apple or flower) during the “where” questions, but less at the named item during the subject-wh and object-wh-questions. To compare comprehension to production, we coded 30-minute spontaneous speech samples drawn from mother-child interactions at each visit. Results indicated that comprehension of subject and object-wh-...

Social deficits have been implicated in the language delays and deficits of children with autism (ASD); thus, the extent to which these children use language input in social contexts similarly to typically developing (TD) children is unknown. The current study investigated how caregiver input influenced the development of wh-question comprehension in TD children and language-matched preschoolers with ASD. Children were visited at four-month intervals over 1.5 years; mother-child play sessions at visits 1-2 were coded for maternal wh-question use. At visits 3-5 children watched videos in the Intermodal Preferential Looking paradigm, to assess their comprehension of subject and object wh-questions. Mothers' use of wh-questions with verbs and complex wh-questions positively predicted wh-question comprehension in the TD group; in contrast, mothers' use of wh-questions with 'be' as the main verb negatively predicted wh-question comprehension in the ASD group. Thus, TD children and children with ASD appear to use their linguistic input differently.

Research suggests that toddlers with no language delay (NLD) should have better outcomes than those with language delay (LD). However, the predictive utility of language milestones relative to co-varying factors such as age at diagnosis, IQ, and ASD symptomatology is unclear. This study compared school-aged children with ASD and NLD (n = 59) to a well-matched group with ASD and LD (n = 59). The LD group was diagnosed at younger ages and their historical ASD symptoms were more severe than the NLD group. The groups were similar in current ASD symptoms and adaptive functioning at school age. Language milestones were correlated with adaptive functioning, but IQ and social symptoms of ASD were stronger predictors of functioning at school age. Therefore, language milestones may not be the best indicators of prognosis for children who are diagnosed after toddlerhood.

Despite efforts to detect autism spectrum disorder during toddlerhood, many children with autism spectrum disorder remain undiagnosed until school age. To identify characteristics of children whose autism spectrum disorder might not be diagnosed during toddlerhood, this study used archived Autism Diagnostic Interview-Revised records to examine the historical presentation of autism spectrum disorder symptoms in 48 school-age children with autism spectrum disorder. Children diagnosed after starting school (Late-Diagnosed; n = 24) were compared to age-matched children diagnosed before school age (Early-Diagnosed; n = 24). Symptom presentation was similar between groups, with the Late-Diagnosed group exhibiting only marginally fewer symptoms historically. The most commonly reported historical symptoms were negative symptoms, namely, deficits in social behaviors. Positive symptoms, such as unusual preoccupations, rituals, and mannerisms, were less commonly reported. These findings may aid earlier identification of autism spectrum disorder in children who would likely be diagnosed at school age.