Expressive Language Profiles in Chinese Preschool Children with Autism Spectrum Disorders: Assessment with the Putonghua Communicative Development Inventory (Toddler Form)

Background:  Recent research has highlighted the heterogeneity of language abilities in English-exposed children with autism spectrum disorders (ASD) (Kjelgaard & Tager-Flusberg, 2001), including their different trajectories in early language production (Tek et al., 2013). Little is known about expressive language profiles in children with ASD learning other languages.

Objectives:  To depict expressive language profiles in Chinese preschool children with ASD via the Putonghua Communicative Development Inventory: Words and Sentences (PCDI-Toddler Form).

Methods:  Parents of 26 2-5-year-old children with ASD (24 boys and 2 girls, mean = 49. 92 ± 12. 46 months) completed the PCDI-Toddler Form. Children were divided into three subgroups - Low Verbal (LV) (n = 9, mean = 42.33 ± 10.43 months), Middle Verbal (MV) (n = 10, mean = 51.50 ± 13.96 months) and High Verbal (HV) (n = 7; mean = 57.43 ± 7.27 months), based on word production in the vocabulary checklist (LV: 0 – 69 words; MV: 70 – 392 words; HV: 393 words and above). Language abilities were compared among the subgroups and with the published TD norms (Tardif et al., 2008).

Results:  (1) Word production differed significantly across subgroups (LV: 8. 44 ± 12.02; MV: 281.00 ± 70.20; HV: 564.43 ± 149.37, ps ≤ 0.002). The LV group scored less than the HV group in all the 10 items (ps ≤ 0.014) and than the MV group on 4 items (ps ≤ 0.009) in sections of “how children use words”, “words and sentences” and “combining”; the MV group performed worse than the HV group on 6 items (ps ≤ 0.034). MLUs for the LV, MV, and HV groups were 0, 2.33 ± 1.07 and 3.57 ±1.69 respectively, significantly lower in the LV group than in the other two groups (ps ≤ 0.014). Sentence complexity scores differed significantly across subgroups (LV: 0, MV: 18.78 ± 12.80, HV: 49.14 ± 24.09, ps ≤ 0.045). (2) The LV group performed poorer than TD children aged 16 months in all the measures. The MV and the HV groups were matched to TD children aged 20.20 ± 0.92 and 25. 00 ± 3.27 months based on word production. The proportions of children’s use of words referring to “past, future and absent objects/people” were significantly lower than the TD norms by the MV group in all the 5 items (ps≤0.002) and by the HV group in 4 items (ps≤0.001). Both groups were compatible to matched TD groups in the use of classifiers (ps ≥ 0.395), but not with possessives and tense markers (MV: ps ≤0.026; HV: ps = 0.070) or word combination (ps ≤ 0.001). MLUs were similar in the MV group but lower in the HV group. The MV group scored higher and the HV group equivalently as TD children in sentence complexity.

Conclusions:  There is an overall expressive language delay for Chinese children with ASD: the LV group demonstrated a global impairment; the HV group performed generally better than the MV group, both showing difficulties in some uses of sentences and grammar than the vocabulary-matched TD groups.