Sigman, M., & McGovern, C.W. (2005).  Improvement in cognitive and language skills from preschool to adolescense in autism.  JADD, 35, 15-23.

• lots of variation in cognition and language in autism.
  • some quite capable and some nonverbal
• many start with poor language skills
• we don't know about the development of kids with autism across the lifespan as it relates to communication and language skills
  • longitudinal studies - short term or descriptive
  • cognition is variable from preschool to middle childhood
  • stabilizes into adulthood
  • siezures - may be a deterioration
• current study - investigates the improvement in about 50 children with autism
  • started in 1978 before the advent of intensive interventions
  • attended school and some speech therapy
• preschool to middle childhood - documented in Sigman & Ruskin, 1999
  • showed significan increases in IQ
  • 28% moved out of the MR range - "remarkable" changes in intelligence
• does this growth continue into adolescence and adulthood?
  • middle childhood follow-up - language gains only 28 months
  • age of recruitment is 18 months
  • consisten with Mawhood, Howlin and Rutter (2000)
    • gains in language - 23-24 years of age
• present study - intelligence levels did not predict language gains - similar to Lord and Schopler
  • do variables that predict language improvement continue to do so over time?
  • non-verbal language
  • social communication
  • play skills
    • places where there is a great deal of variability
  • is joint attention predictive of language abilities in later adolescence and adulthood?
  • language - does is predict play behavior or the other way around?
    • language requires conceptual skills
    • requires representational thinking and the ability to symbolize
    • play allows children to practice language and nonverbal skills
  • previous study  joint attention 43% of all expressive language skills
• Participants
  • 48 students out of the original 70 were followed in this follow-up
  • 45 of the 48 were seen in the mid school follow up
    • 6 females
    • 42 males
  • mean age at follow up 19 years
• procedures - standardized assessments
  • no questions about what interventions were received due to the possible unreliability of the information
  • cognitive assessments
    • Cattel
    • Stanford-Binet (if a basal could be achieved)
    • Bayley for lowest functioning
    • Mullen used if could not use Stanford-Binet
      • developmental quotients calculated
  • language assessments
    • Reynell
    • higher functioning - Clinical Evaluation of Language Fundaments-Revised (CLEF-R) and its preschool counterpart
  • nonverbal communication skills
    • early social communication skills ( ESCS) - behaviors coded:
      • initiates joint attention
      • responds to bids of joint attention
      • initiates requesting behavior
  • pretend play skills coded
• results
  • changes in cognitive scores
    • non MR - more gains than MR
    • Higher IQ - half the change
    • lower IQ - mental age improves more disproportionatley
    • not as much of a dramatic change
      • 21% had a decline in IQ scores
      • IQ in middle childhood predicted scoresin adulthood
    • none moved out from MR to non MR range
  • change in language abilities
    • showed a 12 month increase in language abilities
    • childhood language predicted adult language ability
  • IQ of 70 or above - more language gains than those below 70
  • 49% had little or no functional language, 36% fluent language
  • nonverbal communication
    • no change in responding to joint attention
    • joint attention in middle childhood did predict joint attention in adulthood
    • initiation of joint attention decreased with age
    • requesting declined with age
    • predictors
      • predicted by preschool functional play, response to joint attention, initiation of requesting,
      • nonverbal language scores did not predict language
• Discussion
  • improvements of children with autism more likely to be seen in the early childhood years
  • more likely to be seen in higher IQ children than those with lower IQ
  • lower functioning - more disproportional development
  • seems to be a critical period of development for children with autism
  • there might be a ceiling effect
    • do kids need less intensive intervention?
    • symbolic play and initiation of joint attention were not predictors - could be an artifact of autism itself
  • joint attention and play - critical parts of language acquisition
    • need more intervention studies