Examining gender effects in autistic written language skills: A small sample exploratory study.

Background and aims: Gender differences in the written language of autistic individuals are an overlooked but important area of research. We contend that the gender differences in spoken language of autistic individuals may extend to written language, mirroring the gender differences of writing in the general population and reflecting the shared dimensionality of oral and written language. Our research question was: Do autistic adolescent females demonstrate written language characteristics, across persuasive, expository, and narrative genres, that are distinct from those of autistic adolescent males and non-autistic (NA) adolescent females? Methods: We performed a secondary, exploratory analysis on writing samples collected from 18 participants (11 autistic males, three autistic females, and four NA females) from a larger investigation of autistic adolescents' writing skills. Each participant completed three writing samples-one persuasive, one expository, and one narrative (for a total of 54 writing samples). We compared sample length (total number of words), writing productivity (words written per minute), syntactic length (mean length of T-unit in words), vocabulary diversity (type-token ratio), and macrostructure of autistic females' samples to autistic males' and NA females' samples. Results: Based on non-parametric analyses using variable medians, autistic males, but not autistic females, wrote significantly shorter expository samples than NA females. Autistic males' writing productivity was significantly lower in the persuasive and expository genres than both autistic females and NA females. Several other comparisons of sample length, productivity, vocabulary diversity, and persuasive and narrative macrostructure yielded large effect sizes but were not statistically significant. Conclusions: Though our small sample sizes prevent us from drawing generalizable conclusions, we observed that some gender-specific findings of the current study differ from previous findings based on a single autistic group (females and males combined). Combining data of autistic females with autistic males may cloud the distinct written language characteristics of each group. Implications: Our findings, especially when situated in the context of relevant literature, suggest that larger-scale investigation of gender differences in written language is essential in order to more fully describe the unique characteristics of autistic females. Clinicians should be prepared to support autistic writers' needs for producing written language to meet their developmental, academic, social, and employment-related goals.

Interprofessional education on autism and intellectual disabilities: Program description and initial evaluation.

Project INTERprofessional Autism Collaborative Training (INTERACT) is an interprofessional education program designed to prepare graduate students in psychology, special education, and speech-language pathology to work with autistic children with moderate to severe intellectual disabilities. The rising prevalence of autism, coupled with increased appreciation for interprofessional approaches to service delivery, indicates the need for university training programs to prepare graduate students to work interprofessionally with this population; yet descriptions of such programs and their effectiveness are not reported in the literature. In this article, we explain the process through which an interprofessional faculty team developed Project INTERACT, describe the sequence of coursework and team-based clinical experiences that comprise the program, and present preliminary data regarding its effectiveness. Twenty-four graduate students in psychology, special education, and speech-language pathology participated in this quantitative study. We report results from three rating scales that participants completed at program entry, midpoint, and program exit. Participants endorsed positive attitudes toward interprofessional practice and demonstrated high levels of knowledge about autism. Self-rated knowledge and abilities in interprofessional practice increased significantly by program exit. Project INTERACT scholars developed knowledge and skills related to understanding, assessing, and treating autistic children with intellectual disabilities, through the lens of team-based interprofessional collaboration. We discuss implications for practice with Project INTERACT. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Preliminary Study of Writing Skills in Adolescents with Autism Across Persuasive, Expository, and Narrative Genres.

Writing is often difficult for individuals with autism spectrum disorder (ASD), yet relatively little literature exists that profiles specific strengths and needs within this area. This preliminary investigation compares the written language skills of adolescents with ASD without intellectual disability (n = 14) to typically developing (TD) adolescents (n = 12). Writing samples from persuasive, expository, and narrative genres were elicited. Variables of sample length, writing productivity, syntax, lexical diversity, and macrostructure were analyzed. In the persuasive and expository genres, the ASD group scored significantly lower than the TD group on sample length and some aspects of macrostructure. The ASD group scored higher than the TD group on lexical diversity in the persuasive genre. Other comparisons yielded large effect sizes but were not statistically significant.

Procedures for Obtaining and Analyzing Writing Samples of School-Age Children and Adolescents.

PURPOSE: Many students' writing skills are below grade-level expectations, and students with oral language difficulties are at particular risk for writing difficulties. Speech-language pathologists' (SLPs') expertise in language applies to both the oral and written modalities, yet evidence suggests that SLPs' confidence regarding writing assessment is low. Writing samples are a clinically useful, criterion-referenced assessment technique that is relevant to helping students satisfy writing-related requirements of the Common Core State Standards (National Governors Association Center for Best Practices and Council of Chief State School Officers, 2010a). This article provides recommendations for obtaining and analyzing students' writing samples. METHOD: In this tutorial, the authors provide a comprehensive literature review of methods regarding (a) collection of writing samples from narrative, expository (informational/explanatory), and persuasive (argument) genres; (b) variables of writing performance that are useful to assess; and (c) manual and computer-aided techniques for analyzing writing samples. The authors relate their findings to expectations for writing skills expressed in the Common Core State Standards (National Governors Association Center for Best Practices & Council of Chief State School Officers, 2010a). CONCLUSION: SLPs can readily implement many techniques for obtaining and analyzing writing samples. The information in this article provides SLPs with recommendations for the use of writing samples and may help increase SLPs' confidence regarding written language assessment.

Expressive morphosyntax in boys with Fragile X syndrome with and without autism spectrum disorder.

BACKGROUND: Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability, and the most common single gene disorder associated with autism. Language impairments in this disorder are well documented, but the nature and extent of syntactic impairments are still unclear. AIMS: To compare the performance of boys with FXS with and without autism spectrum disorder on measures of verb (VM) and noun (NM) morphosyntax with that of typically developing boys of similar non-verbal mental ages. METHODS & PROCEDURES: Conversational samples were obtained from 33 boys with FXS with autism spectrum disorder (FXS-ASD), 35 boys with FXS and no ASD (FXS-O), and 46 typically developing boys (TD). Production of verbal and nominal morphosyntax was assessed separately in these two subdomains. A hierarchical linear model compared morphosyntactic scores in all groups after adjusting for non-verbal cognition, articulatory skill, and caregiver education. The model also tested interactions between group and morphosyntactic subdomain. OUTCOMES & RESULTS: Boys with FXS in both groups scored lower than the TD boys on both measures. The FXS-O and the FXS-ASD groups did not differ on either composite measure. All covariates were significantly related to morphosyntactic scores. CONCLUSIONS & IMPLICATIONS: Part of the morphosyntactic impairment in FXS may be attributable to cognitive, environmental, and speech factors. However, it is clear that boys with FXS perform at levels lower than expected from differences in these extra-linguistic factors alone, across both the verb and the noun domains. Clinical interventions should therefore seek to address specific syntactic targets.

Syntactic complexity during conversation of boys with fragile X syndrome and Down syndrome.

PURPOSE: This study compared the syntax of boys who have fragile X syndrome (FXS) with and without autism spectrum disorder (ASD) with that of (a) boys who have Down syndrome (DS) and (b) typically developing (TD) boys. METHOD: Thirty-five boys with FXS only, 36 boys with FXS with ASD, 31 boys with DS, and 46 TD boys participated. Conversational language samples were evaluated for utterance length and syntactic complexity (i.e., Index of Productive Syntax; H. S. Scarborough, 1990). RESULTS: After controlling for nonverbal mental age and maternal education levels, the 2 FXS groups did not differ in utterance length or syntactic complexity. The FXS groups and the DS group produced shorter, less complex utterances overall and less complex noun phrases, verb phrases, and sentence structures than did the TD boys. The FXS with ASD group and the DS group, but not the FXS-only group, produced less complex questions/negations than did the TD group. Compared with the DS group, both FXS groups produced longer, more complex utterances overall, but on the specific complexity measures, they scored higher only on questions/negations. CONCLUSION: Boys with FXS and DS have distinctive language profiles. Although both groups demonstrated syntactic delays, boys with DS showed greater delays.

Receptive vocabulary, expressive vocabulary, and speech production of boys with fragile X syndrome in comparison to boys with down syndrome.

Boys with fragile X syndrome with (n = 49) and without (n = 33) characteristics of autism spectrum disorder, boys with Down syndrome (39), and typically developing boys (n = 41) were compared on standardized measures of receptive vocabulary, expressive vocabulary, and speech administered annually over 4 years. Three major findings emerged. Boys with fragile X without autism spectrum disorder did not differ from the younger typically developing boys in receptive and expressive vocabulary and speech production when compared at similar levels of nonverbal cognitive skills. Boys with fragile X without autism spectrum disorder and typically developing boys had higher receptive vocabulary and speech production than did boys with Down syndrome. There were mixed patterns of results for the boys with fragile X and characteristics of autism spectrum disorder.

Language and communication development in Down syndrome.

Although there is considerable variability, most individuals with Down syndrome have mental retardation and speech and language deficits, particularly in language production and syntax and poor speech intelligibility. This article describes research findings in the language and communication development of individuals with Down syndrome, first briefly describing the physical and cognitive phenotype of Down syndrome, and two communication related domains-hearing and oral motor skills. Next, we describe language development in Down syndrome, focusing on communication behaviors in the prelinguistic period, then the development of language in children and adolescents, and finally language development in adults and the aging period. We describe language development in individuals with Down syndrome across four domains: phonology, semantics, syntax, and pragmatics. Wethen suggest strategies for intervention and directions for research relating to individuals with Down syndrome.

Expressive language during conversational speech in boys with fragile X syndrome.

We compared the expressive syntax and vocabulary skills of 35 boys with fragile X syndrome and 27 younger typically developing boys who were at similar nonverbal mental levels. During a conversational speech sample, the boys with fragile X syndrome used shorter, less complex utterances and produced fewer different words than did the typically developing boys after controlling for their nonverbal MA, speech intelligibility, and mother's education. The boys with fragile X used less complex noun phrases, verb phrases, and sentence structure, but did not use fewer questions and negations. These findings suggest that the language difficulties in boys with fragile X reflect an overall expressive language delay and not a specific syntactic or vocabulary delay.

Structural development of the fictional narratives of African American preschoolers.

PURPOSE: This study examined the structural development of African American preschoolers' narratives. It also investigated the effect of background variables (e.g., gender, maternal education, stimulation and responsiveness of the home environment, and whether or not the child lived in poverty) on the children's narratives. METHOD: Sixty-five children completed a story-retelling task at age 4 and again at kindergarten entry. Narratives were then coded for story grammar elements. RESULTS: Four-year-olds narrated some attempts to solve the problem and some elements of the story ending. At kindergarten entry, children had higher total narrative scores and included more of every type of story grammar element except relationship. Overall, narratives were not related to background variables. CLINICAL IMPLICATIONS: The Bus Story Language Test (C. Renfrew, 1991) appears to be an assessment tool that is sensitive to structural growth in African American children's narratives from 4 years to kindergarten entry.

Speech and language development in six infants adopted from China.

Children adopted from China currently represent the largest group of newly internationally adopted children in the US. An exploratory investigation of the communicative development of six young females adopted at ages 9 to 17 months from China by US families was conducted. Children were followed longitudinally from approximately three months post-adoption to age three years. English language skills were assessed at approximately three-month intervals, detailed communicative analyses were conducted at six months post-adoption, and outcomes were measured at three years of age. Results indicated wide variability in rates of English language development. Phonological, social-communicative, and lexical bases of communication were intact for each child at six months post-adoption. At age three years, four of the children demonstrated speech and language skills within one standard deviation of standardized test norms, one child demonstrated skills above the normal range, and one child's skills were below the normal range. This study provides evidence of the resiliency of children's language learning abilities.

Language development in preschool-age children adopted from China.

This study examined the language development of 55 preschool-age children adopted from China who had resided in their permanent homes for approximately 2 years or longer. Slightly over 5% of the children scored below average on 2 or more measures from a battery of standardized speech-language tests normed on monolingual English speakers. However, the vast majority scored within or well above the average range on 2 or more measures. Contrary to other reports on the language development of internationally adopted children, the results suggest that "second first language" acquisition proceeds rapidly in the majority of preschool-age children adopted as infants and toddlers. For the children in the sample who scored below average, results indicated that they were among the children who had been exposed to English for the least amount of time. The results of this study demonstrate both the robustness of the language system in the majority of adopted children from China as well as slower growth in a small subset of lower performers in the 1st years after adoption.

Phonological skills of children adopted from China: implications for assessment.

Little is known about the acquisition of English phonology by children adopted from China. Data are summarized from three recent studies with a focus on the phonological skills of children adopted from China as infants or toddlers. Two longitudinal studies (combined n = 8) described early phonological behaviors (e.g., babbling, phonetic inventories), and found substantial individual variation. In spite of this variation by 3 years of age, nearly all of the children were performing at a level comparable to nonadopted monolingual English-speaking peers. No clear relationship between the early behaviors and outcome at age 3 was found. The third study provided descriptions of the phonological skills of preschoolers ( n = 25) who had been adopted 2 or more years earlier, and found that only a few had persistent phonological delays. Errors were predominantly common developmental errors frequently observed in nonadopted monolingual English-speaking children. These findings suggest that tests and measures developed for monolingual English-speaking children may be used cautiously with children adopted as infants or toddlers who have been in their permanent homes for 2 or more years. Prior to that time, assessment should focus on independent analyses of phonological behaviors with consideration of the child's chronological age, length of exposure to English, and development in other language domains.

Early Intervention Practices and Communication Intervention Strategies for Young Males With Fragile X Syndrome.

PURPOSE: This study describes speech-language pathologists' impressions of the communication difficulties of young males with fragile X syndrome (FXS) and the need for both syndrome-specific and individualized interventions. The findings of a regional study that identified speech-language pathologists' impressions of the speech, language, and behavioral difficulties experienced by males with FXS and an array of interventions used by speech-language pathologists to improve communication skills for these children are reported. METHODS: Fifty-one speech-language pathologists providing intervention for males with FXS ranging in age from 2 to 9 years (mean age=6;3 [years;months]) were interviewed. RESULTS: The majority of the speech-language pathologists reported that boys with FXS exhibit a visually based, experiential or wholistic learning preference. They emphasized the necessity of making environmental accommodations for limited attention span, difficulties with topic and activity transitions, sensory deficits, and low threshold for anxiety. They reported that speech goals focused on slowing rate and increasing precision for verbal children and both low and high levels of assistive technology for nonverbal or minimally verbal children. Language goals focused on listening, auditory comprehension, and narrative/conversation skills. Pragmatic goals emphasized social dialogue, role playing, and topic maintenance. CLINICAL IMPLICATIONS: This study suggests that young males with FXS present the clinician with a constellation of behaviors and communication impairments that are both syndrome specific and symptom familiar. The specific communication strengths and deficits described by clinicians working with these children are common to many children with speech and language impairments compounded by cognitive deficits. Intervention programs for young boys with FXS should also attend closely to the specific behavioral (e.g., increased anxiety, attention deficits) and sensory "overload" problems they often exhibit before designing a tailored intervention program.