Asperger syndrome and "non-verbal learning problems" in a longitudinal perspective: neuropsychological and social adaptive outcome in early adult life.

Co-existence of Asperger syndrome (AS) and non-verbal learning disability (NLD) has been proposed based on the observation that people with AS tend to have significantly higher verbal than performance IQ (VIQ > PIQ by ≥ 15 points), one of the core features of NLD. In the present study we examined neuropsychological and social adaptive profiles with "non-verbal learning problems" associated with NLD in a group of individuals with AS followed from childhood into early adult life. The group was divided into three subgroups: (i) persistent NLD (P-NLD), i.e. NLD (VIQ > PIQ) both in childhood and early adulthood occasions, (ii) childhood NLD (CO-NLD), i.e. NLD (VIQ > PIQ) only at original diagnosis, or (iii) No NLD (VIQ > PIQ) ever (NO-NLD). All three subgroups were followed prospectively from childhood into adolescence and young adult life. One in four to one in five of the whole group of males with AS had P-NLD. The P-NLD subgroup had poorer neuropsychological outcome in early adult life than did those with CO-NLD and those with NO-NLD. There were no unequivocal markers in early childhood that predicted subgroup status in early adult life, but early motor delay and a history of early speech-language problems tended to be associated with P-NLD.

Clinic attenders with autism or attention-deficit/hyperactivity disorder: cognitive profile at school age and its relationship to preschool indicators of language delay.

Many studies have shown that children with autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD) have had early indicators of language delay. The aim of the present study was to examine the cognitive profile of school age children referred to a specialist clinic for ASD, ADHD, or both, and relate this profile specifically to the age at which these children were first flagged up (or not) as suspected from language delay during the preschool years. Forty clinic children with ASD, ADHD, or the combination of the two (without clinical suspicion of learning disability) were assessed cognitively and as regards language development and language function at a mean age of 7.3 years. They were contrasted with a group of 21 children from the community who had been flagged at 2.5 years as suspected of language delay, and who had been followed up neuropsyhiatrically/neuropsychologically and in respect of language at a mean age of 7.9 years. Mean WISC-III full scale IQ was lower than population norms (in spite of the exclusion in both samples of cases with obvious learning disability) and similar across diagnostic groups (ASD and ADHD), and across settings (clinic and community). WISC-III Kaufman factor profiles separated the diagnostic groups as regards Perceptual Organisation. Early concern about language delay was a strong predictor of lower IQ and of distinguishing between "pure" cases of ASD and ADHD. School age clinic 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, who present with a suspicion of early preschool language delay and are shown at school age to suffer from ASD or ADHD. Concern about early language delay in the preschool age should prompt assessments (psychiatric and cognitively) for ASD and ADHD in a multidisciplinary setting much more often than is currently the case. In many cases early language delay, even in the absence of clear learning disability should be taken as a signal that - regardless of specific diagnosis - intellectual functioning might be in the low average range.