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Autistic and dysphasic children. I: Clinical characteristics
R F Tuchman1, I Rapin, S Shinnar
1Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York.
Pediatrics
|December 1, 1991
Summary
Autism and dysphasia share language impairment in preschoolers. Autistic children more often show central processing issues, family psychiatric history, and behavioral regression compared to dysphasic children.
Area of Science:
- Neurodevelopmental Disorders
- Child Neurology
- Developmental Psychology
Background:
- Autism and dysphasia are distinct neurodevelopmental disorders affecting higher cerebral functions in preschool children.
- Impaired language development is a core shared symptom between autism and dysphasia in early childhood.
- Understanding the clinical distinctions is crucial for accurate diagnosis and intervention.
Purpose of the Study:
- To compare the clinical characteristics of autistic and dysphasic children.
- To identify differentiating features between these two conditions in preschool-aged children.
- To investigate potential differences in medical history, language subtypes, family history, and regression patterns.
Main Methods:
- Clinical evaluation of 314 autistic and 237 dysphasic nonautistic preschool children by a single child neurologist.
- Analysis of gestational age, birth weight, associated medical disorders, and history of resuscitation or ventilatory support.
- Assessment of language subtypes, family psychiatric history, behavioral regression, sensorimotor examination, and sex-based differences in clinical presentation.
Main Results:
- No significant differences in gestational age, birth weight, or prevalence of medical disorders were found between the groups.
- Dysphasic children had a higher incidence of resuscitation or ventilatory support history (P = .03).
- Autistic children were more likely to exhibit language processing/formulation deficits, family psychiatric history, and language/behavioral regression.
- After excluding Rett syndrome cases, sensorimotor examination differences were not significant.
- Autistic girls showed higher rates of severe mental deficiency (38% vs 23%, P = 0.012) and motor deficits (27% vs 11%, P = .0009) compared to autistic boys.
Conclusions:
- While sharing core language impairments, autism and dysphasia exhibit distinct clinical profiles in preschool children.
- Autism is associated with specific language processing issues, genetic/familial predispositions, and regression, differentiating it from dysphasia.
- Sex-based differences are notable in autism, with girls more prone to severe intellectual disability and motor deficits.