Differentiating ASD From DLD in Toddlers

    Abstract

    Failure to begin speaking, or acquiring words and word combinations, is the most common presenting problem in young children. For children with very limited communication skills, it can be difficult to differentiate between children suffering from autism spectrum disorders (ASD) and those with a more circumscribed delay in language development (DLD). This article reviews evidence derived from studies of toddlers who present with poor communication and social skills and summarizes characteristics of early development in these children to assist clinicians in differentiating between ASD and DLD in toddlers.

    References

    • Bartak, L., Rutter, M., & Cox, A. (1975). A comparative study of infantile autism and specific developmental receptive language disorder.British Journal of Psychiatry, 126, 127–145.
    • Casby, M. (1997). Symbolic play of children with language impairment.Journal of Speech, Language, and Hearing Research, 40, 468–479.
    • Chakrabarti, S., & Fombonne, E. (2001). Pervasive developmental disorders in preschool children.Journal of the American Medical Association, 285(24), 3093–3099.
    • Charman, T., & Baird, G. (2002). Practitioner review: Diagnosis of autism spectrum disorders in 2- and 3-year-old children.Journal of Child Psychology & Psychiatry & Allied Disciplines, 43, 289–305.
    • Charman, T., Taylor, E., Drew, A., Cockerill, J., Brown, & Barid, G. (2005). Outcome at 7 years of children diagnosed with autism at age 2: Predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time.Journal of Child Psychology & Psychiatry, 46, 500–513.
    • Chawarska, K., Klin, A., Paul, R., & Volkmar, F. (2007). Autism spectrum disorder in the second year: Stability and change in syndrome expression.Journal of Child Psychology & Psychiatry, 48, 128–138.
    • Cox, A., Klein, K., Charman, T., Baird, G., Baron-Cohen, S., & Swettenham, J. (1999). Autism spectrum disorders at 20 and 42 months of age: Stability of clinical and ADI-R diagnosis.Journal of Child Psychology & Psychiatry & Allied Disciplines, 40, 719–732.
    • Eaves, L., & Ho, H. (2004). The very early identification of autism: Outcome to 4 ½ - 5.Journal of Autism and Developmental Disorders, 34, 367–378.
    • Fensen, L., Dale, P., Reznick, S., Thal, D., Bates, E., Hartung, J., Pethick, S., & Reilly, J. (1993). MacArthur Communicative Developmental Inventories. Baltimore: Paul H. Brookes.
    • Filipek, P., Accardo, P., Baranek, G., Cook, E., Dawson, G., & Gordon, B. (1999). The screening and diagnosis of autistic spectrum disorders.Journal of Autism and Developmental Disorders, 29, 439–484.
    • Fombonne, E. (2005). Epidemiological studies of Pervasive Developmental Disorders.In F. Volkmar, R. Paul, & A. Klin (Eds.), Handbook of autism and pervasive developmental disorders (Vol. 1, 3rd ed., pp. 42–69). New York: Wiley & Sons.
    • Guralnick, M. J. (1997). The effectiveness of early intervention. Baltimore: Paul H. Brookes.
    • Lord, C. (1995). Follow-up of two-year-olds referred for possible autism.Journal of Child Psychology & Psychiatry & Allied Disciplines, 36(8), 1365–1382.
    • Lord, C., Risi, S., & DiLavore, P. (2006). Autism from 2 to 9 years of age.Archives of General Psychiatry, 63, 694–701.
    • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., & DiLavore, P. C. (2000). The Autism Diagnostic Observation Schedule--Generic: A standard measure of social and communication deficits associated with the spectrum of autism.Journal of Autism & Developmental Disorders, 30(3), 205–223.
    • Lord, C., Rutter, M., & Conture, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders.Journal of Autism and Developmental Disorders, 24, 659–685.
    • Matson, J., Wilkins, J., & Gonzalez, M. (2008). Early identification and diagnosis in autism spectrum disorders in young children and infants: How early is too early?.Research in Autism Spectrum Disorders, 2, 75–84.
    • Mullen, E. (1995). Mullen scales of early learning: AGS Edition. Circle Pines, MN: AGS Publishing.
    • National Research Council. (2001). Educating children with autism. Washington, DC: Author.
    • Paul, R., & Shiffer, M. (1991). Communicative initiations in normal and late-talking toddlers.Applied Psycholinguistics, 12(4), 419–431.
    • Rescorla, L., & Goossens, M. (1992). Symbolic play development in toddlers with expressive specific language impairment.Journal of Speech and Hearing Research, 35, 1290–1302.
    • Rogers, S. (2006). Evidence-based intervention for language development in young children with autism.In T. Charman, & W. Stone (Eds.). Social and communication development in autism spectrum disorders: Early identification, diagnosis, and intervention. New York: Guilford.
    • Sparrow, S., Balla, D., & Cicchetti, D. V. (1984). The Vineland Adapative Behavior Scales (Survey Form). Circle Pines, MN: American Guidance Service.
    • Stahmer, A., Intersoll, B., & Koegel, R. (2005). Inclusive programming for toddlers with autism spectrum disorders: Outcomes from a children’s toddler school.Journal of Positive Behavior Interventions, 6, 67–82.
    • Stone, W., Lee, E., Ashford, L., Brissie, J., Hepburn, S., Coonrod, E., & Weiss, B. (1999). Can autism be diagnosed accurately in children under 3 years?.Journal of Child Psychology and Psychiatry, 40, 219–226.
    • Toppelberg, C. O., & Shapiro, T. (2000). Language disorders: A 10-year research update review.Journal of the American Academy of Child and Adolescent Psychiatry, 39, 143–52.
    • Turner, L., Stone, W., Pozdol, S., & Coonrod, E. (2006). Follow-up of children with autism spectrum disorders from age 2 to age 9.Autism, 10, 243–265.
    • Wetherby, A., Cain, D., Yonclas, D., & Walker, V. (1988). Analysis of intentional communication of normal children from the prelinguistic to the multiword stage.Journal of Speech and Hearing Research, 31, 240–252.
    • Wetherby, A., & Prizant, B. (2003). Communication and Symbolic Behavior Scales-Developmental Profile. Baltimore: Paul H. Brookes.
    • Wetherby, A., Woods, J., Allen, L., Cleary, J., Dickinson, H., & Lord, C. (2004). Early indicators of autism spectrum disorders in the second year of life.Journal of Autism and Developmental Disorders, 34, 473–493.

    Additional Resources