Observational and Reported Measures of Language and Pragmatics in Young People with Autism: A Comparison of Respondent Data and Gender Profiles

Alexandra Sturrock,Catherine Adams,Antonia Marsden,Jenny Freed

doi:10.1007/s10803-019-04288-3

Abstract

Female children with autism spectrum disorder (FwASD) and performance intelligence quotient (PIQ) over 70 were compared with male children with ASD (MwASD) and typically developing (TD) controls (age 8–11 years) using a range of language and pragmatic measures. Functional ability was assessed using clinical observations and parent, teacher and self-reports. Results were compared between measures, and with direct assessments of language and pragmatics, in order to identify potential biases. This study found that FwASD performed better than MwASD but worse than TD controls on clinical observations of pragmatic ability. FwASD also performed worst overall on a parental measure of emotions. Additionally, there were patterns of differences between clinician, parent, teacher and self- reports and direct assessments, which indicate the need for assessment data to be collected from multiple informants. Findings also have implications for the accurate identification of ASD in females and appropriate provision of support.

Highlights

Introduction and BackgroundFemales who meet the criteria for autism spectrum disorder (ASD) are at much greater risk than males of going undiagnosed (Dworzynski et al 2012), or being diagnosed with other conditions (Giarelli et al 2010)
Direct assessment typically included the full cohort of 52 children, any discrepancies are noted in the relevant table
By providing gender-normative data our study shows that Female children with autism spectrum disorder (FwASD) were positioned in the middle of a performance slope, scoring better than male children with ASD (MwASD) but worse than FwTD

Summary

Introduction

Introduction and BackgroundFemales who meet the criteria for autism spectrum disorder (ASD) are at much greater risk than males of going undiagnosed (Dworzynski et al 2012), or being diagnosed with other conditions (Giarelli et al 2010). Pragmatic and associated higher-level structural language skills have been identified as areas of difference between the male and female phenotype of autism, using a range of direct assessments (Conlon et al 2018; Kauschke et al 2016; Sturrock et al 2019) Data in this area are complex, with differences between findings often appearing to be influenced by the person reporting on behaviours (clinicians, parents, teachers or the individual themselves), which may, in turn, be affected by the setting in which the child is being observed (e.g. at home or school; Mandy et al 2012; Szatmari et al 1994)

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