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J Autism Dev Disord (2006) 36:9931005 DOI 10.1007/s10803-006-0137-7
ORIGINAL PAPER
Early Predictors of Communication Development in Young Children with Autism Spectrum Disorder: Joint Attention, Imitation, and Toy Play
Karen Toth Jeffrey Munson Andrew N. Meltzoff Geraldine Dawson
Published online: 15 July 2006 Springer Science+Business Media, Inc. 2006
Abstract This study investigated the unique contributions of joint attention, imitation, and toy play to language ability and rate of development of communication skills in young children with autism spectrum disorder (ASD). Sixty preschool-aged children with ASD were assessed using measures of joint attention, imitation, toy play, language, and communication ability. Two skills, initiating protodeclarative joint attention and immediate imitation, were most strongly associated with language ability at age 34 years, whereas toy play and deferred imitation were the best predictors of rate of communication development from age 4 to 6.5 years. The implications of these results for understanding the nature and course of language development in autism and for the development of targeted early interventions are discussed.
Keywords Autism Language Communication Joint attention Imitation Play
Introduction
It is well established that there is tremendous variability in outcome in autism. Long-term outcome studies have shown that while a majority of individuals exhibit poor to very poor outcomes, many individuals with autism go on to achieve adequate levels of academic, social, and occupational functioning (Gillberg & Steffenburg, 1987; Lotter,
1978; Nordin & Gillberg, 1998; Sigman & Norman, 1999). In a recent study that followed children with autism from age 2 to 9, as many as 40% were found to have good outcomes based on language and cognitive scores (Stone, Turner, Pozdol, & Smoski, 2003). One of the strongest predictors of positive long-term outcomes for children with autism is the acquisition of spoken language (Bartak, Rutter, & Cox, 1975; Gillberg, 1991; Gillberg & Steffenburg, 1987; Lincoln, Courchesne, Kilman, Elmasian, & Allen, 1988; Lotter, 1978; Rutter, 1970). Early language ability (i.e., meaningful speech by 56 years of age) has been associated with both later academic achievement and social competence in individuals with autism (Howlin, Mawhood, & Rutter, 2000; Sigman & Ruskin, 1999; Venter, Lord, & Schopler, 1992). Given the critical importance of early language development for later prognosis, a better understanding of developmental factors that underlie, facilitate, and predict language...