https://doi.org/10.1177/1362361318801617
Autism
1–13
© The Author(s) 2018
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/1362361318801617
journals.sagepub.com/home/aut
Introduction
Autism spectrum disorder (ASD) is characterised by dif-
ficulties with social communication and repetitive and
restricted behaviours and interests (American Psychiatric
Association, 2013). Difficulty with pragmatic language
(the way we use language to interact with others) is a uni-
versal feature of ASD; yet there is substantial variability in
children’s use of semantics, grammar and syntax (Tager-
Flusberg, 2006). Some children with ASD have average or
advanced vocabulary, grammar and sentence structure but
around 15%–25% are nonverbal or minimally verbal and
use less than five words (Norrelgen et al., 2014; Rose
et al., 2016). There has been ongoing debate about whether
there is a subgroup of children with ASD who have a phe-
notype that closely resembles those with specific language
impairment (Rapin et al., 2009; Tager-Flusberg, 2006) and
whether children with ASD and specific language impair-
ment have shared or separate aetiological underpinnings
(Kjelgaard and Tager-Flusberg, 2001; Whitehouse et al.,
2008). Receptive and expressive language difficulties are
one of the most commonly co-occurring features of ASD
(Carlsson et al., 2013), with just over 60% estimated to
have some degree of language impairment (Carlsson et al.,
2013; Levy et al., 2010). The ability to use language by
5 years of age is an important predictor of later outcomes
in children with ASD (Pickett et al., 2009) and difficulties
using language in children with ASD are associated with
several adverse outcomes including behaviour difficulties
Predictors and growth in receptive
vocabulary from 4 to 8 years in children
with and without autism spectrum
disorder: A population-based study
Amanda Brignell
1,2
, Tamara May
1,3
,
Angela T Morgan
1,2
and Katrina Williams
1,2,4
Abstract
Few studies have examined growth and predictors of receptive vocabulary in children with autism spectrum disorder.
Here we aimed to compare receptive vocabulary from 4 to 8 years and identify predictors of receptive vocabulary, at
8 years, in children with and without autism spectrum disorder. Participants were drawn from a nationally representative
population-based study with two cohorts recruited at birth (N = 4983) and kindergarten (N = 5107). Receptive vocabulary
growth was compared for children with and without autism spectrum disorder at 4 (n = 188, n = 7136), 6 (n = 215,
n = 7297) and 8 (n = 216, n = 7408) years. Predictors of receptive vocabulary were analysed. Estimated mean receptive
vocabulary scores for children without autism spectrum disorder were 2.3 units higher than the autism spectrum
disorder group across three time points. This difference was significant (p = 0.004; 95% confidence interval 0.769–3.927).
Children with and without autism spectrum disorder progressed at a similar pace. There was no significant difference
between the proportions of children with and without autism spectrum disorder who had stable, improving and declining
trajectories. Age was the only significant predictor of greater receptive vocabulary growth in children with autism
spectrum disorder. Baseline receptive language and nonverbal IQ were significant predictors of receptive vocabulary
ability at 8 years. These findings inform prognostic advice given to families on language outcomes.
Keywords
autism spectrum disorder, communication, development, language, longitudinal, trajectory
1
Murdoch Children’s Research Institute, Australia
2
The University of Melbourne, Australia
3
Deakin University, Australia
4
Royal Children’s Hospital, Australia
Corresponding author:
Amanda Brignell, Murdoch Children’s Research Institute, 50 Flemington
Rd., Parkville, VIC 3052, Australia.
Email: amanda.brignell@mcri.edu.au
801617AUT 0 0 10.1177/1362361318801617AutismBrignell et al.
research-article 2018
Original Article