Patterns of Learning in Young Children with Autism Spectrum Disorders
Understanding the cognitive profile of children with autism spectrum disorders (ASD) is important to determining whether there is a pattern that is unique to this learning style, potentially informing prognosis and targeting appropriate interventions.
The purpose of this pilot study was to examine the pattern of language and nonverbal intelligence in young children with ASD as measured on standardized developmental and achievement testing as a way to guide future therapeutic and educational interventions.
The study design was a retrospective chart review of 168 children with ASD (median age 4.11 years; SD=1.08) evaluated at Lurie Children’s Development Clinic from 8/1/11 to 8/1/16. The following data was extracted from the electronic medical record: date of visit, date of birth, sex, race and ethnicity, educational and therapeutic interventions, and testing results.
Statistical analyses utilized included Student’s t-test and paired t-test, Chi-squared tests and the use of the Bonferroni correction when appropriate. A two-sided p value ≤ 0.05 was considered statistically significant.
Of the 168 children, 80% were male and 20% were female. In regards to ethnicity, 56% were Caucasian, 26% Hispanic, 13% African American, and 5% responded as “other” or did not report ethnicity.
Sixty-six percent of the sample attended school. Ten percent attended a general education preschool classroom with the remaining in special education settings. Forty-three percent received school based therapy services. Sixteen percent participated in applied behavior analysis therapy (ABA).
Fifty-three participants were evaluated using the Bayley Scales of Infant Development- Third Edition due to lower developmental attainment. They were significantly younger when first diagnosed with ASD (x=4.27, SD=0.9, p<0.0005), suggesting that they required increased levels of support.
One hundred nineteen children completed all of the subtests on the Differential Abilities Scales, Second Edition. The mean GCA score was 77; the mean verbal score was 73; the mean nonverbal score was 82; the mean spatial score was 83. A significant difference was found between verbal and nonverbal reasoning scores, with nonverbal skills being higher (mean difference 7.5, p<0.0005).
Eighty-five children completed all of the subtests on the Bracken School Readiness Assessment. Composite scores fell in the average range (mean 93, SD=16.7). Significant differences between subtests on the Bracken were found. Identifying colors, shapes, letters and numbers were strengths in our population as all fell in the average range. Understanding of size/set comparisons (B-R-S/C), a more language based skill, fell significantly below the mean (x=4.17, SD= 3.736). Performance on this subtest was found to be significantly higher among subjects attending school (mean 4.53, SD=3.836, p=0.004).
School attendance correlated with more flexible thinking as indicated by improved scores on the set comparisons subtest of the Bracken. Children with ASD display a unique learning style characterized by strengths in visual learning and memory. Future research is required to understand the effects of school and socioeconomic status on learning performance.