Developmental profiles of infants and toddlers with autism spectrum disorders identified prospectively in a community-based setting.
By 18–24 months, autistic toddlers understand fewer words than they can say—track receptive language closely.
01Research in Context
What this study did
Barbaro et al. (2012) watched babies and toddlers who were picked up by a community screening program.
They looked at how language and other skills changed between 18 and 24 months.
The goal was to see which early signs separate kids later diagnosed with autism from kids with general delays.
What they found
Kids with autism already understood fewer words than they could say.
This receptive-expressive gap showed up before age two.
Growth in understanding slowed during the six-month window, pointing to receptive language as a red flag.
How this fits with other research
Garrido et al. (2017) pooled many studies and found the same gap in baby siblings of autistic children, giving the toddler result a wider family link.
Yirmiya et al. (2007) saw the split even earlier, at 24–36 months, so Josephine’s work fits between early risk and preschool data.
Chen et al. (2024) followed minimally verbal youth and showed the gap keeps widening with age, turning the toddler flag into a lifelong pattern.
Nevill et al. (2019) used several language tests and found scores jump around by tool, warning us to check receptive skills with more than one measure before deciding.
Why it matters
If an 18-month-old says words but does not follow simple directions, do not wait. Add a direct receptive language probe, bring the child back in three months, and track the gap. Catching the lag early lets you start targeted comprehension work before the divide hardens.
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02At a glance
03Original abstract
This prospective, longitudinal, study charted the developmental profiles of young children with Autism Spectrum Disorders (ASD) identified through routine developmental surveillance. 109 children with Autistic Disorder (AD), 'broader' ASD, and developmental and/or language delays (DD/LD) were assessed using the Mullen Scales of Early Learning (MSEL) at 12-months (n = 10 assessments), 18-months (n = 45 assessments), and 24-months (n = 99 assessments). The children with AD performed most poorly, overall, than the ASD and DD/LD groups on the MSEL. Furthermore, the children with AD/ASD displayed an uneven cognitive profile, with poorer performance on verbal (particularly receptive language) relative to nonverbal skills. There was also evidence of developmental slowing in verbal skills from 18- to 24-months for children on the spectrum, especially those with AD. Given that the poor receptive, relative to expressive, language profile emerges very early in life for children with AD/ASD, this cognitive profile may serve as an additional red flag to social attention and communication deficits. Receptive language should therefore be stringently monitored in any developmental surveillance program for autism spectrum disorders in the second year of life.
Journal of autism and developmental disorders, 2012 · doi:10.1007/s10803-012-1441-z