Developmental pathways of language and social communication problems in 9-11 year olds: unpicking the heterogeneity.
One in five preschoolers referred for language delay later show ASD-level social-communication problems, so track joint-attention skills yearly.
01Research in Context
What this study did
The team followed a mixed group of preschoolers who had been referred for language problems.
They tracked the same kids until age 9–11 to see which communication patterns showed up later.
At the final check, they sorted each child into one of four clear outcome profiles.
What they found
One in nine children had shifted into a social-communication profile that looked like ASD.
Another one in five kept language-only problems, and one in five had both issues.
The rest—about four in ten—had no clear deficits by middle childhood.
Early joint-attention and social-response scores best predicted who would land in the ASD-like group.
How this fits with other research
Brignell et al. (2024) extends these findings. They show that starting language level, not the autism label, predicts how fast verbal skills grow through age 11.
Davidovitch et al. (2023) echo the warning: many children who get an ASD diagnosis after age 6 first carried a simple “language delay” tag.
Eussen et al. (2016) add stability data: over 90 % of preschool ASD diagnoses still apply at age 11. Taken together, the studies say screen early, watch long, and expect different roads.
Why it matters
If a preschooler lands on your caseload with “expressive delay,” run a quick joint-attention and social-response probe. Flag low scores for re-check every year. Catching the one in five who will later need social-communication support lets you start peer-interaction goals sooner and saves re-evaluation time down the road.
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02At a glance
03Original abstract
This paper addressed relations between language, social communication and behaviour, and their trajectories, in a sample of 9-11-year-olds (n=91) who had been referred to clinical services with concerns about language as pre-schoolers. Children were first assessed at 2½-4 years, and again 18 months later. Results revealed increasing differentiation of profiles across time. By 9-11 years, 11% of the sample had social communication deficits, 27% language impairment, 20% both, and 42% neither. The size of group differences on key language and social communication measures was striking (2-3 standard deviations). Social communication deficits included autistic mannerisms and were associated with social, emotional and behavioural difficulties (SEBDs); in contrast, language impairment was associated with hyperactivity only. Children with both language and social communication problems had the most severe difficulties on all measures. These distinct school-age profiles emerged gradually. Investigation of developmental trajectories revealed that the three impaired groups did not differ significantly on language or SEBD measures when the children were first seen. Only low performance on the Early Sociocognitive Battery, a new measure of social responsiveness, joint attention and symbolic understanding, differentiated the children with and without social communication problems at 9-11 years. These findings suggest that some children who first present with language delay or difficulties have undetected Autism Spectrum Disorders which may or may not be accompanied by language impairment in the longer term. This new evidence of developmental trajectories starting in the preschool years throws further light on the nature of social communication and language problems in school-age children, relations between language impairment and SEBDs, and on the nature of early language development.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.06.014