The Interrelationship Between Adaptative Receptive Language and Behavior In Children with ASD: Exploration for Inform Pivotal Interventions

Background:   Researchers have found that targeting pivotal skills, such as self-initiation and self-management, has resulted in successful interventions and increased skills for children with autism spectrum disorders (ASD).  Research has also shown a strong connection between language skills and different aspects of the child’s behavior, including both externalizing and internalizing behaviors. However, less is known about the relationship between adaptive language skills and behaviors in ASD. Given the importance of adaptive language in ASD, examining these relationships may provide guidance and direct identification of pivotal skills to target for intervention, especially adaptive language skills.

Objectives: This exploratory study examines the interrelationship between adaptive language ability and behavioral performance to identify whether or not targeted language-based intervention research should be further explored. In addition to language and behavioral performance, we include (1) cognitive ability to examine direct and indirect linkages between IQ and language, and (2) a calibrated Autism Diagnostic Observation Schedule (ADOS) score to explore both adaptive language ability, and IQ’s relationship with autism symptomatology.

Methods: The sample included 130 subjects from the Autism Treatment Network (ATN) database at the Thompson Center for Autism and Neurodevelopmental Disorders. ATN is a collaborative network of clinics and physicians dedicated to developing better ways to identify, manage and treat children with autism. Subscales of The Vineland Adaptive Behavior Scales (VABS) were utilized as measures of adaptive receptive language, adaptive expressive language, and social skills.  The Child Behavior Checklist was used for a measure of internalizing and externalizing behavior.  The calibrated severity score from the ADOS was utilized for a measure of autism symptomatology, and various IQ tests were used for a measure of cognitive ability. A path analysis modeling procedure was utilized to empirically examine the interrelationship among the constructs.

Results: Results indicated there was a significant relationship among adaptive receptive language and all behavioral performance measures, specifically externalizing behavior (β = -.428), internalizing behavior (β = -.376), and social skills (β = .257), suggesting an increase in one’s adaptive receptive language ability is associated with an increase in social skill performance, and decreases in externalizing and internalizing behavior. There was also a significant relationship between adaptive expressive language and social skills that suggests increased expressive language is associated with increased social skill performance (β = .631).

Conclusions: The results point to adaptive receptive language as a potential pivotal intervention point. Unlike adaptive expressive language, the receptive construct was significantly related to all the behavioral performance measures. Increased adaptive receptive language abilities has implications for targeting language interventions in children with ASD that could result in decreased levels of externalizing and internalizing behaviors, and improved social skill performance. Significant differences were identified for cognitive abilitity and its association with social skills, autism symptomatology, and internalizing behavior, suggesting IQ may be an important component for further analysis. We hope that the results of this exploratory study lead to further interest and research into language interventions and potential distal behavioral outcomes for children with ASD.