Comparing methods for assessing receptive language skills in minimally verbal children and adolescents with autism spectrum disorders

Abstract

This research addresses the challenges of assessing receptive language abilities in minimally verbal children with autism spectrum disorder by comparing several adapted measurement tools: a standardized direct assessment of receptive vocabulary (i.e. Peabody Picture Vocabulary Test-4); caregiver report measures including scores on the Vineland-II Communication domain and a vocabulary questionnaire consisting of a list of words ranging from simple, developmentally early, to more advanced words expected to be understood by at least some older children and adolescents; an eye-tracking test of word comprehension, using a word-image pair matching paradigm similar to that often used in studies of infant language acquisition; and a computerized assessment using a touch screen for directly measuring word comprehension with the same stimuli used in the eye-tracking experiment. Results of this multiple-method approach revealed significant heterogeneity in receptive language abilities across participants and across assessment methods. Our findings underscore the need to find individualized approaches for capturing the potential for language comprehension of minimally verbal children with autism spectrum disorder who remain otherwise untestable, using several types of assessment that may include methods based on eye-tracking or touch-screen responding.

Understanding definitions of minimally verbal across instruments: evidence for subgroups within minimally verbal children and adolescents with autism spectrum disorder

“…verbal and nonverbal mental ages falling below 18 months). However, it may overestimate the number of MV children who have nonverbal abilities in the borderline‐to‐average range; our estimate was higher than reported in younger children (Norrelgen et al., ), but similar to an older sample (Plesa‐Skwerer et al., ).…”

“…Such studies should incorporate objective methods, such as eye tracking and intermodal preferential looking paradigms (e.g. Brady et al., ; Naigles & Chin, ; Plesa‐Skwerer et al., ), which have shown promise for measuring behavior in MV children. Longitudinal studies with detailed multi‐modal information regarding early development are needed to explore whether VIQ‐NVIQ profiles are stable across development and, if so, what factors contribute to the failure to develop spoken language in children with relatively higher NVIQ.…”

“…Data from existing longitudinal studies suggest that 30%–40% of clinically ascertained children with ASD remain minimally verbal into adulthood (Howlin et al., ; Pickles, Anderson, & Lord, ). Studies of school‐aged children have begun to examine the utility of different instruments to estimate cognitive and language abilities (Brady, Anderson, Hahn, Obermeier, & Kapa, ; Courchesne, Meilleur, Poulin‐Lord, Dawson, & Soulières, ; Naigles & Chin, ; Plesa‐Skwerer, Jordan, Brukilacchio, & Tager‐Flusberg, ) and interventions to improve spontaneous communication (Kasari et al., ; Shire et al., ).…”

“…In another study, Plesa‐Skwerer et al. () included children who, per parent report, did not use phrase speech on a daily basis and/or produced fewer than 30 words/phrases. Although age differences limit comparability of these samples, it is noteworthy that only 2/17 (12%) MV children (and 0/25 nonverbal children) had NVIQ above 70 in the first study, whereas 4/18 (22%) children had NVIQ above 70 in the second study.…”

Behavioral predictors of improved speech output in minimally verbal children with autism

“…As with most research on a population as heterogeneous as MV children with ASD, a limitation of this study is its small number of participants. MV children are particularly challenging to work with, which is why it is only fairly recently that researchers have begun to include them in studies [Wan et al, ; Tager‐Flusberg et al, ; Plesa‐Skwerer, Jordan, Brukilacchio, & Tager‐Flusberg, ; Chenausky et al ; Chenausky, Kernbach, Norton, & Schlaug, ]. In addition, the heterogeneity in this population is quite wide; approximately half of the children we screen do not meet inclusion criteria for our studies.…”