Preschoolers with autism show greater impairment in receptive compared with expressive language abilities

TLDR

In typical development children grasp words before speaking, whereas children with ASD usually have deficits in both comprehension and production, and the relative imbalance between these domains is poorly understood, with abilities ranging from pre‑verbal to fluent speech. The study examined the relative delay between receptive and expressive language skills in a large sample of preschoolers with autism. The authors assessed 152 preschoolers with core autism using one direct clinician assessment and two parent‑report language measures. On average, children with autism scored below typical age norms, with receptive ability more impaired than expressive across all three measures, and higher non‑verbal ability correlated with this atypical profile; about one‑third of preschoolers exhibited marked receptive‑language impairment, underscoring implications for intervention.

Abstract

Background: In early typical language development, children understand words before they are able to use them in speech. Children with autism spectrum disorders (ASD) generally show impairments in both the comprehension and the production of language. However, the relative degree of delay or impairment in each of these sub‐domains may also be atypical and remains less well‐understood. Aims: Relative delay in receptive and expressive language skills was examined within a large sample of preschoolers with autism. Children's language abilities varied from pre‐verbal to fluent speech. Method & Procedures: Scores on one direct clinician assessment and two parent‐report measures of language were obtained for 152 preschoolers with core autism. Outcomes & Results: As expected, on average, the language ability of the children with autism was lower than typical age norms, albeit with substantial individual variability. On all three language measures, receptive ability was relatively more impaired than expressive ability. Higher non‐verbal ability was associated with such an atypical language profile. Conclusions & Implications: Recognition of the marked receptive language impairment relative to expressive language, found to affect at least one‐third of preschoolers with autism in this sample, has important implications for interacting with these children and for informing appropriate targets in language and communication intervention.