Pragmatic contributions to early vocabulary and social communication in young autistic children with language and cognitive delays.

INTRODUCTION

There are limited data on the interrelationships among pragmatic skills and expressive vocabulary and their contribution to later social communication. Understanding these relationships could inform developmental processes and early intervention strategies. This study explored the relationship among pragmatics skills (i.e., communicative intents and responding to parents' preceding utterances) and concurrent expressive vocabulary as well as the predictive nature of these skills on later social communication in young autistic children with language and cognitive delays.

METHOD

Data from 56 autistic children (age 18-57 months) who participated in a larger randomized control trial of Pathways Early Autism Intervention were used in this secondary analysis. Video recordings of pre-intervention (Time 1) parent-child interactions were analyzed for number of different words (NDW; expressive vocabulary), number of different (ND) communicative intents, and response to parents' preceding utterances. Residual scores from an assessment of social communication were used to measure Time 2 social communication. First-order correlations and hierarchical regression were used for analyses.

RESULTS

Adjusting for age and receptive language, both ND communicative intents and response to parents' preceding utterances were associated with pre-intervention NDW. Further, adjusting for receptive language age and intervention group, NDW and response to parents' preceding utterances - but not ND communicative intents-was related to Time 2 social communication. NDW, however, was no longer related to Time 2 social communication skills after accounting for response to parents' preceding utterances.

CONCLUSIONS

This study provides evidence that autistic children with language and cognitive delays use their expressive vocabularies to respond, hence allocating attention to parent speech, a rudimentary form of social orienting. Our results support approaches to intervention that leverage responding as a rudimentary form of social orienting while encouraging more mature forms of social attention (i.e., social orienting to faces and joint attention) within developmentally appropriate activities, such as routines.