Assessing global developmental delay across instruments in minimally verbal preschool autistic children: The importance of a multi-method and multi-informant approach.
Always add Vineland adaptive data to Mullen cognitive scores before calling a minimally verbal preschooler globally delayed.
01Research in Context
What this study did
Girard et al. (2022) looked at preschoolers with autism who speak few or no words.
They compared two tests: the Mullen thinking test and the Vineland daily-living test.
The goal was to see if using both tests together gives a fairer picture of global delay.
What they found
Mullen scores alone often made kids look more delayed than they really were.
When the team added Vineland adaptive scores, many children no longer met the cutoff for global developmental delay.
In short, single-test labels can undersell a child’s true ability.
How this fits with other research
Ohan et al. (2015) already showed that autistic kids usually score higher on cognitive tests than on adaptive tests. Dominique’s team moves that idea forward by proving the gap can change a GDD diagnosis.
Taddei et al. (2023) used the newer Griffiths test and found that autism plus delay creates a special profile with social-communication dips. Together, the studies say: pick the right mix of tools for the question you need to answer.
Chen et al. (2024) carried the same worry into older, still-minimally-verbal youth. They found receptive language keeps falling behind with age. The message across papers: keep checking more than one domain as kids grow.
Why it matters
If you label a child globally delayed too early, you may place them in overly restrictive classrooms or set goals too low. Pairing Mullen with Vineland gives a fuller view and can open doors to higher-level programs. Next time you review an intake file, check both scores before you sign off on the delay box.
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02At a glance
03Original abstract
Intellectual assessment in preschool autistic children bears many challenges, particularly for those who have lower language and/or cognitive abilities. These challenges often result in underestimation of their potential or exclusion from research studies. Understanding how different instruments and definitions used to identify autistic preschool children with global developmental delay (GDD) affect sample composition is critical to advance research on this understudied clinical population. This study set out to examine the extent to which using different instruments to define GDD affects sample composition and whether different definitions affect resultant cognitive and adaptive profiles. Data from the Mullen Scales of Early Learning and the Vineland Adaptive Behavior Scales-Second Edition, a parent-report tool, were analyzed in a sample of 64 autistic and 73 neurotypical children (28-69 months). Our results highlight that cognitive assessment alone should not be used in clinical or research practices to infer a comorbid diagnosis of GDD, as it might lead to underestimating autistic children's potential. Instead, using both adaptive and cognitive levels as a stratification method to create subgroups of children with and without GDD might be a promising approach to adequately differentiate them, with less risk of underestimating them.
Autism research : official journal of the International Society for Autism Research, 2022 · doi:10.1002/aur.2630