Early Sociocognitive Skills, Language and Autism Severity in Children with Autism Spectrum Disorder
The Early Sociocognitive Battery (ESB; Chiat & Roy, 2008) is a novel measure of early sociocognitive skills. Scores on the ESB predict language expression and comprehension and social communication skills in typically developing children and those with language impairments. Results of longitudinal studies also indicate that scores on the ESB predict long-term social communication outcomes for children with early language difficulties. Children with very low ESB scores in the early years appear to be particularly vulnerable to later social communication difficulties and possible ASD (Chiat & Roy, 2013). Early improvements in these skills, e.g., through targeted interventions, may lead to improved long-term outcomes in children with ASD.
Little is currently known about the profile of ESB scores in children with ASD. In this study, we investigated the profile of ESB scores in a group of children with ‘core’ autism. We hypothesised that children who had not yet developed early sociocognitive skills would have more severe ASD symptoms and worse language than those children who demonstrated joint attention, social responsiveness and symbolic comprehension, as measured by the ESB.
ESB data were collected for 249 children aged 2-11 years, taking part in the Paediatric Autism Communication Trial-Generalised (PACT-G) study. PACT-G is a randomised controlled trial of a social communication intervention for children with ASD. Measures of nonverbal ability (Mullen Scales of Early Learning, or British Ability Scales), expressive and receptive language (CDI, Oneword Picture Vocabulary Tests), Communication (Vineland Communication subdomain scores) and ASD severity (ADOS-2 subdomain scores) were also available. All data were collected at the baseline assessment, prior to randomisation and delivery of any trial intervention.
We divided the PACT-G sample into quintiles based on ESB scores and investigated how membership in each quintile related to other child characteristics, such as ASD symptom severity and language. Children who had high ESB scores, i.e., better early sociocognitive skills, had significantly lower ADOS-2 Social Affect scores, F(4, 219) = 52.52, p < .001, Ƞ2 = .49, and fewer repetitive behaviours (ADOS-2 Rigid and Repetitive Behaviour scores), F(4, 219) = 3.37, p = .01, Ƞ2 = .06, than children who had low ESB scores. Similarly, children with better early sociocognitive skills also had better expressive and receptive language, as measured by the Vineland Adaptive Behaviour Scales (Receptive Communication, F(4, 230) = 24.78, p <.001, Ƞ2 = .30; Expressive Communication, F(4, 230) = 34.73, p <.001, Ƞ2 = .38) and the Receptive, F(4, 229) = 51.43, p <.001, Ƞ2 = .48, and Expressive, F(4, 226) = 39.27, p <.001, Ƞ2 = .41, One Word Picture Vocabulary Tests.
These findings show a differential pattern of language and ASD symptoms, based on the profile of early sociocognitive skills, for children with ‘core’ autism. Identifying difficulties in these skills may lead to targeted interventions that could improve long-term communication outcomes for children with ASD. Early sociocognitive skills could also be used to predict differential response to social-communication interventions.