The Language Gap: Disparities in Expressive Versus Receptive Language in Young Children With Neurodevelopmental...

This study examined factors related to three language profiles (i.e., expressive dominance [ED], receptive dominance [RD], and non-dominance [ND]), among children with autism spectrum disorder (ASD), other developmental delays (DD), and a sample of controls from the general population (POP).

Data were from the Study to Explore Early Development (SEED), a multi-site, US-based, case-control study of correlates of ASD among 2.5-to-5-year-olds (N = 4905). We examined factors associated with language dominance using multinomial regression models to estimate odds ratios and 95% confidence intervals.

Across all groups, children had the greatest odds of an ND language profile, but ED and RD profiles were relatively more common in ASD versus DD and POP. Autistic children had greater odds of: (a) ED if they demonstrated lower developmental levels (i.e., younger age, lower nonverbal cognition, limited imaginative play, or below average fine motor) or had more severe characteristics of attention deficit hyperactivity disorder (ADHD) or autism across both social interaction and restricted and repetitive behaviors; and (b) RD if they performed at higher developmental levels (i.e., older age or above average fine motor), but also demonstrated limited initiations of joint attention or limited imaginative play. Autistic children had lower odds of ND at older ages, in contrast with DD and POP, who had greater odds of ND at older ages.

This study extended findings showing that, although an ND profile is most common across groups, ED and RD profiles occur relatively more frequently among autistic children. These findings have implications for differential diagnosis and intervention targets.