Receptive-Expressive Language Phenotypes in Infants and Toddlers With Autism Features.
An expressive > receptive language profile before age 2 flags slower expressive gains—monitor these kids closely and adjust language goals accordingly.
01Research in Context
What this study did
Cohenour et al. (2026) watched babies and toddlers who showed early signs of autism. They looked at who had stronger expressive than receptive language at the first visit.
One year later they tested the same kids again to see whose expressive language had grown the most.
What they found
Kids who started out with more expressive than receptive words actually gained new expressive words more slowly over the next year.
Children whose receptive and expressive skills were balanced, or who understood more than they said, made faster expressive gains.
How this fits with other research
Delehanty et al. (2023) saw the opposite pattern: when parents used more language-building responses, toddlers with autism made faster language gains. Torrey’s slower growth only appeared in kids with the expressive > receptive profile, so parent input may still help those same children.
Brignell et al. (2018) tracked verbal children with autism from 4 to 7 years and found that starting language scores, not the autism label, predicted later growth. Their null result for diagnosis fits Torrey’s warning: early language profile matters more than the diagnosis alone.
Hellendoorn et al. (2015) showed that fine motor and exploration skills drive later language in preschoolers with autism. Torrey adds a new early flag: the expressive-receptive balance at 12–24 months can also steer the pace of future words.
Why it matters
If a toddler talks more than they understand, don’t celebrate too soon. Mark that profile as higher risk and check progress every few months. Shift goals toward building comprehension and balanced turn-taking before pushing more single words. Pair this with parent coaching on responsive talk so the slower trajectory can still get a boost.
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02At a glance
03Original abstract
Children diagnosed with autism often present with an atypical discrepancy between their receptive and expressive language levels, or an atypical receptive-expressive language phenotype. Children with an atypical receptive-expressive phenotype present with a relative receptive language advantage (expressive level < receptive level) or a relative expressive language advantage (expressive level > receptive level), whereas those with a typical phenotype have balanced receptive and expressive language levels. It remains unclear whether atypical receptive-expressive language phenotypes are evident before 24 months in children with autism features or whether they are associated with concurrent child developmental functioning or later language growth. Participants (N = 80) were drawn from a randomized comparative efficacy intervention study for 12-23-month-olds with autism features and elevated scores on an autism diagnostic instrument. Baseline receptive and expressive language age equivalent (AE) scores were used to describe continuous variation in receptive-expressive language phenotypes by quantifying the gap between each child's receptive and expressive language levels. These continuous metrics were then used to classify children into discrete language profile groups: expressive advantage (EA), receptive advantage (RA), and balanced. On average, children had a gap of three AE "months" between their receptive and expressive language levels. Over 75% of children presented with an atypical receptive-expressive phenotype (40% EA profile, 36% RA profile), whereas only 24% of children had a typical receptive-expressive phenotype (balanced profile). Language profiles were not concurrently associated with age, autism features, joint attention skills, motor or cognitive functioning. However, children with the EA profile at baseline showed significantly slower expressive language growth over 12 months than those with RA or balanced language profiles, suggesting that receptive-expressive language profiles may hold promise as early prognostic markers of expressive language growth in emerging autism.
Autism research : official journal of the International Society for Autism Research, 2026 · doi:10.1002/aur.70214