The Developmental Sequence of Social-Communicative Skills In Young Children with Autism: A Longitudinal Study

Background:  The long-term outcome and adaptation in autism was an important issue but not really known clear. Previous studies suggested that acquisition of spoken language plays an important role. And there were a few early social-communicative skills (i.e. joint attention, imitation and play) prior to the development of expressive language in typically developing infants. Recent research has found a different developmental sequence for preschool children with autism (Carpenter, Pennington, & Rogers, 2002). However, few researches explored the developmental sequence of social-communicative abilities in young children with autism below three years old.

Objectives:  The purposes of the longitudinal study were to explore the emergence sequence of social-communicative skills in young children with autism below three years old by comparing to the autism children and the developmental delay children. The children were tested two times, eighteen months apart- first at the about thirty-month-olds.

Methods: The participants were twenty three 29-month-olds (range = 24-36 months) young children with autism, 23 27-month-olds (range = 24-36 months) young children with developmental delay. All participants were recruited from one local hospital in Taiwan and assessed and diagnosed by multidisciplinary team according DSM-IV-TR (APA, 2000). We modified the STAT (Stone, et al., 2000, 2004) to measure social-communicative skills, including initiating joint attention, responding joint attention, object imitation, manual imitation, and doll-directed play. 

Results:  The results revealed that the emergence sequence of social-communicative skills in young children with developmental delay were RJA, IJA, object imitation, the other/doll directed play, language and manual imitation. However, the developmental sequence of social-communicative abilities in young children with autism performed different pattern. The young autistic children emerged object imitation first, and language was developed before the IJA.

Conclusions:  The first three emerged social-communicative abilities in young children with autism were object imitation, RJA, and other/doll play. It indicted that the process of language development in young children with autism relied on salience effects companied by directed language of the caregivers, for example, touching and manipulating object. The atypical developmental sequence and learning strategy could not make them understand the intention of others. This is the reason why autism performed the errors and inappropriate usage of language.