Abstract
Deficits in gestures act as early signs of impairment in social interaction (SI) and communication in children with autism spectrum disorder (ASD). However, the pieces of literature on atypical gesture patterns in ASD children are contradictory. This investigation aimed to explore the atypical gesture pattern of ASD children from the dimensions of quantity, communicative function, and integration ability; and its relationship with social ability and adaptive behavior. We used a semi-structured interactive play to evaluate gestures of 33 ASD children (24–48 months old) and 24 typically developing (TD) children (12–36 months old). And we evaluated the social ability, adaptive behavior, and productive language of ASD and TD children by using the Adaptive Behavior Assessment System version II (ABAS-II) and Chinese Communication Development Inventory (CCDI). No matter the total score of CCDI was corrected or not, the relative frequency of total gestures, behavior regulation (BR) gestures, SI gestures, and joint attention (JA) gestures of ASD children were lower than that of TD children, as well as the proportion of JA gestures. However, there was no significant group difference in the proportion of BR and SI gestures. Before adjusting for the total score of CCDI, the relative frequency of gestures without vocalization/verbalization integration and vocalization/verbalization-integrated gestures in ASD children was lower than that in TD children. However, after matching the total score of CCDI, only the relative frequency of gestures without vocalization/verbalization integration was lower. Regardless of the fact that the total score of CCDI was corrected or not, the relative frequency and the proportion of eye-gaze-integrated gestures in ASD children were lower than that in TD children. And the proportion of gestures without eye-gaze integration in ASD children was higher than that in TD children. For ASD children, the social skills score in ABAS-II was positively correlated with the relative frequency of SI gesture and eye-gaze-integrated gestures; the total score of ABAS-II was positively correlated with the relative frequency of total gestures and eye-gaze-integrated gestures. In conclusion, ASD children produce fewer gestures and have deficits in JA gestures. The deficiency of integrating eye gaze and gesture is the core deficit of ASD children’s gesture communication. Relatively, ASD children might be capable of integrating vocalization/verbalization into gestures. SI gestures and the ability to integrate gesture and eye gaze are related to social ability. The quantity of gestures and the ability to integrate gesture with eye gaze are related to adaptive behavior.Clinical Trial Registration: www.ClinicalTrials.gov, identifier ChiCTR1800019679.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with heterogeneous manifestations mainly characterized by impairments in social interaction (SI) and communication, as well as the presence of restrictive and repetitive behaviors [Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V); American Psychiatric Association, 2013]
Whether we use analysis of variance (ANOVA) [F1(1,56) = 43.2801, p1 < 0.001] or ANCOVA [corrected for the total score of Communication Development Inventory (CCDI), F2(1,55) = 26.841, p2 < 0.001], we found that the relative frequency of total gestures in ASD group was lower than that in typically developing (TD) group (Table 2)
The Communicative Function of Whether we use ANOVA or ANCOVA, we found that the relative frequency of behavior regulation (BR) gestures [F1(1,56) = 33.346, p1 < 0.001; F2(1,55) = 20.136, p2 < 0.001], the relative frequency of SI gestures [F1(1,56) = 9.453, p1 = 0.003; F2(1,55) = 4.451, p = 0.040], the relative frequency [F1(1,56) = 17.111, p1 < 0.001; F2(1,55) = 10.083, p2 = 0.002], and the proportion [F1(1,56) = 8.416, p1 = 0.005; F2(1,55) = 4.913, p2 = 0.031] of joint attention (JA) gestures in the ASD group were significantly lower than those in the TD group, while there was no significant difference in the proportion of BR gestures and SI
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with heterogeneous manifestations mainly characterized by impairments in social interaction (SI) and communication, as well as the presence of restrictive and repetitive behaviors [Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V); American Psychiatric Association, 2013]. From very early in life, expressive behavior is multimodal, and early behavioral coordination is refined and strengthened for communication over time (Iverson, 2010). In the first months of life, typically developing (TD) children can communicate with others non-verbally through gestures, vocalizations, and facial expressions (Russell, 2007). At the multi-word stage, TD children use verbalization as their principal means of communication (Wetherby et al, 1988). They communicate with others through complex, fluid, and rapid coordination between speech, altering facial expression, changing eyebrows or head position, and gestures (Iverson, 2010)
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