The Role of Receptive and Expressive Language on Social Initiations in Young Children with Autism

Background: Children with autism spectrum disorder (ASD) often experience challenges with social interaction from an early age, which may be associated with social withdrawal and emotional and behavioral dysregulation later in life (Krasch, 2015). Additionally, many children with ASD have deficits in the usage and/or production of language (Farrar, Seung, & Lee, 2017; Hudry et al., 2009). Previous research suggests that for children with ASD, receptive language may be more delayed than expressive language (Hudry et al., 2009). Lower receptive and expressive skills may make it particularly challenging for children with ASD to initiate or engage in social interactions.

Objectives: The purpose of this study was to examine the unique roles of expressive and receptive language on social initiative behaviors for children with ASD compared to their TD peers. We hypothesized that both receptive and expressive language would moderate the association between developmental status and social initiation, such that children with ASD and lower levels of either receptive or expressive language would initiate less frequently than TD children.

Methods: Our sample included 115 children (ages 3:0 to 6:11), 71 (49% female) with TD and 44 children with ASD (20% female). Videotaped recordings of an 8-minute parent-child free-play task were coded using an adapted version of the Modified-Classroom Observation Schedule to Measure Intentional Communication (M-COSMIC; Clifford, Hudry, Brown, Pasco, & Charman, 2010), from which a percentage of child social initiations was later calculated. Child language ability for expressive and receptive language was assessed through the Verbal Comprehension and Naming Vocabulary subtests of the DAS-II (Elliott, 2007).

Results: A double moderation model was conducted using the PROCESS macro for SPSS (Hayes, 2013), to evaluate the effects of receptive and expressive language on the association between developmental status and the percentage of social initiations. Age and gender were controlled for in the analysis. Results indicated the main effect of status on percentage of initiations during a parent-child free-play task was significant (B = -.581, CI₉₅ [-.937, -.225], p = .002). The main effects of expressive (B = .000, CI₉₅ [-.003, .003], p = .980) and receptive language (B = .001, CI₉₅ [-.003, .005], p = .722) on social initiations were not significant. The interaction effect of receptive language and status was significant (B = .006, CI₉₅ [.001, .012], p = .033) but expressive language and status was not (B = .003, CI₉₅ [-.003, .008], p = .336). Children with ASD and lower receptive language had the lowest percentage of social initiations. Results indicated that 39% of the variance in social initiation was accounted for by the variables in our model.

Conclusions: Supporting previous research, children with ASD in this study exhibited fewer social initiations than their TD peers. In the current study, social initiative behaviors were moderated by receptive but not expressive language, consistent with prior research on differences in receptive and expressive language for children with ASD (Hudry et al., 2009). Our findings suggest receptive language may be an important target for intervention to increase social initiation in young children with ASD.