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Language and communication disorders in children associated with neuropsychiatric disorders/ESSENCE

Participants: Carmela Miniscalco, Christopher Gillberg & Bibbi Hagberg.

Background: Children with neuropsychiatric disorders/ESSENCE such as ASD or ADHD are a heterogeneous group with language abilities that range from normal to nonverbal. Many of these children are identified due to absent or delayed language, or loss of meaningful words during their second or third year of life.

Method: Some studies were performed in order to shed light on the overlap/distinction between various disorders subsumed under the ESSENCE umbrella.

A) 40 newly referred seven-year old children with ASD, ADHD or both were compared with language impairment (LI) children from the community on cognitive and language measures.

B) 56 children with LI only, neuropsychiatric disorder (NPD) only and LI + NPD were assessed with a non-word repetition task (NWR). They were also assessed with a story re-telling task and the picture arrangement subtest from the WISC-III, a test of nonverbal temporal sequencing.

C) 31, probably population representative, one- to three-year-olds with ASD were given the MacArthur Communicative Developmental Inventory (CDI) for parent completion and the Reynell Developmental Language Scales III (RDLS) for assessment by a speech and language therapist.

Results: A) 24 of these 40 children had been in contact with a speech and language therapist during the preschool years. Children who present with ASD and ADHD have a similar cognitive and early language development profile, as do those children from the community, followed prospectively. Early concern about language delay was a strong predictor of lower IQ and of distinguishing between "pure" cases of ASD and ADHD.

B) All three subgroups had difficulties with NWR and real word repetition compared to the norm, but the within-sub group variations were considerable. The subgroup with NPD only performed best for both NWR and real word repetitions, but remarkably low given that they never had been noted for having language problems. NPD with LI consistently had the lowest scores. Of the subgroups, only NPD with LI scored lower than the normal range on Verbal Comprehension and Freedom from Distractibility. Significant correlations were found between NWR, Freedom from Distractibility and Verbal Comprehension.
At group level, all children also had problems with oral narrative re-telling. The study showed that language level is an important correlate of narrative performance more generally in this diagnostically heterogeneous sample, and that nonverbal temporal sequencing functions are important especially for conveying story information.

C) Correspondence across scales was good to excellent, indicating that parents of children with ASD can often be trusted in their report on children's language and communication abilities. The children had considerably better word production than comprehension skills, which is a pattern that is reversed as compared with typically developing children.


Åsberg, J., & Miniscalco, C. (2014). Excellent word reading ability in the context of an autism spectrum disorder: A case study of a Swedish-speaking seven-year-old boy. Journal of Cognitive Education and Psychology, 13.

Åsberg, J., Hagberg, B., Gillberg, C. & Miniscalco, C. (2013). Brief report: Narrative production in children with neurodevelopmental disorders: Is it an exclusively language-based skill? Scandinavian Journal of Psychology, 54, 376-385.

Miniscalco, C., Fränberg, J., Schachinger-Lorentzon, U. & Gillberg, C. (2012). Meaning what you say? Comprehension and word production skills in young children with autism. Research in Autism Spectrum Disorders, 6, 204-211.

Hagberg, B.S., Miniscalco C., & Gillberg C. (2010). Clinic attenders with autism or attention-deficit/hyperactivity disorder. cognitive profile at school age and its relationship to preschool indicators of language delay. Research in Developmental Disabilities, 31, 1-8.

Miniscalco, C., & Gillberg C. (2009). Non-word repetition in young school-age children with language impairment and/or neuropsychiatric disorder. Research in Developmental Disabilities, 30, 1145-1154.

Page Manager: Anna Spyrou|Last update: 9/12/2014

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