Slušná Dominika, Rodríguez Andrea, Salvadó Berta, Vicente Agustín, Hinzen Wolfram
Department of Translation and Language Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
Centre for Orientation and Assistance of Infants' and Youth's Neurodevelopment (COADI), Barcelona, Spain.
Autism Dev Lang Impair. 2021 Nov 3;6:23969415211053264. doi: 10.1177/23969415211053264. eCollection 2021 Jan-Dec.
BACKGROUND & AIMS: Individuals with non- or minimally verbal autism (nvASD) are primarily characterized by a severe speech production deficit, with speech limited to no or only a few words by school age. Significant unclarity remains over variability in language profiles across the lifespan, the nature of the language impairment seen, and (dis-) associations between linguistic and nonverbal cognitive measures.
To address these questions, we recruited both a school-age and an adult group with nvASD (total N = 49) and investigated relations between expressive and receptive language, and between these and nonverbal intelligence quotient (NVIQ) and sense-making capacities (the ComFor test).
Results revealed limited variation across this sample in receptive language, which in turn predicted expressive language levels. Importantly, an upward trend in verbal mental age (VMA) across increasing chronological age was seen in the youngsters (only). A radical dissociation between NVIQ and both expressive and receptive language transpired as well, and a subset of individuals with normal NVIQ were comparable in terms of any other cognitive aspect. Sense-making reached symbolic levels in 62.2% of the sample and loaded on both verbal and nonverbal factors.
These patterns inform theories of nvASD by revealing an impairment that is not conceptualizable as one of expressive language only, sharply limits learning opportunities across the lifespan, and cannot be compensated for by nonverbal cognition.
These findings stress the need to seize developmental opportunities that may disappear when youngsters turn into adults, via therapies that specifically target language as a central cognitive system comprising both production and comprehension.
非言语或极少言语自闭症（nvASD）患者的主要特征是严重的言语表达缺陷，到学龄期时言语仅限于无或仅有几个单词。关于整个生命周期中语言特征的变异性、所观察到的语言障碍的性质以及语言和非语言认知测量之间的（非）关联，仍存在重大的不明确之处。
为了解决这些问题，我们招募了一个学龄期nvASD组和一个成人nvASD组（共N = 49），并研究了表达性语言和接受性语言之间的关系，以及它们与非言语智商（NVIQ）和理解能力（ComFor测试）之间的关系。
结果显示，该样本中接受性语言的变化有限，而接受性语言又预测了表达性语言水平。重要的是，仅在青少年中观察到随着实际年龄增长，言语心理年龄（VMA）呈上升趋势。NVIQ与表达性语言和接受性语言之间也出现了完全分离，并且一部分NVIQ正常的个体在任何其他认知方面都具有可比性。62.2%的样本达到了符号水平的理解能力，且理解能力同时受言语和非言语因素影响。
这些模式为nvASD理论提供了信息，揭示了一种不能仅被概念化为表达性语言障碍的损伤，这种损伤严重限制了整个生命周期中的学习机会，并且无法通过非言语认知得到补偿。
这些发现强调了通过专门针对作为包括表达和理解的核心认知系统的语言的疗法，抓住青少年成年后可能消失的发展机会的必要性。
