Abstract
This study compared behavioral presentation of toddlers with autistic spectrum disorders (ASD) and toddlers with global developmental delay (DD) or developmental language disorder (DLD) who display some characteristics of ASD using the diagnostic algorithm items from the Autism Diagnostic Observation Schedule, Generic (ADOS), the Childhood Autism Rating Scale (CARS), and Modified Checklist for Autism in Toddlers (M-CHAT). To date, 195 children have failed the M-CHAT and have been diagnosed with ASD, DD or DLD. Children with ASD had prominent and consistent impairments in socialization skills, especially joint attention skills and were more impaired in some aspects of communication, play, and sensory processing. Children with ASD and children with DD/DLD shared common features, but certain behavioral markers differentiated the two groups.
Similar content being viewed by others
Notes
Due to changes in the protocol and missing data, the sample sizes for the individual measures are different. Differences are noted when applicable in the methods and results sections.
References
Adrien, J. L., Deletang, N., Martineau, J., Couturier, G., & Barthelemy, C. (2001). Regulation of cognitive activity and early communication development in young autistic, mentally retarded, and young normal children. Developmental Psychobiology, 39, 124–136.
American Psychiatric Association (1994). Diagnostic and statistics manual of mental disorders (4th ed., DSM-IV). Washington, DC: Author.
Baron Cohen, S., Cox, A., Baird, G., Sweettenham, J., & Nighingale, N. (1996). Psychological markers in the detection of autism in infancy in a large population. British Journal of Psychiatry, 168(2), 158–163.
Bartak, L., Rutter, M., & Cox, A. (1977). A comparative study of infantile autism and specific developmental receptive language disorders: III. Journal of Autism and Childhood Schizophrenia, 7, 383–396.
Bayley, N. (1993). The Bayley scales of infant development (2nd ed.). San Antonio, TX: Hartcourt Brace.
Charman, T., Swettenham, J., Baron Cohen, S., Cox, A., Baird, G., & Drew, A. (1998). An experimental investigation of social-cognitive abilities in infants with autism: Clinical implications. Infant Mental Health Journal, 19(2), 260–275.
Charman, T. (2004). Matching preschool children with autism spectrum disorders and comparison children for language ability: Methodological challenges. Journal of Autism and Developmental Disorders, 34(1), 59–64.
Cox, A., Klein, K., Charman, T., Baird, G., Baron Cohen, S., Swettenham, J., Drew, A., & Wheelwright, S. (1999). Autism spectrum disorders at 20 and 42 months of age: Stability of clinical and ADI-R diagnosis. Journal of Child Psychology and Psychiatry and Allied Disciplines, 40(5), 719–732.
Gillberg, C., Ehlers, S., Schaumann, H., Joacobsen, G., Dahlgren, S., Lindblom, R., Bagenholm, A., Tjuus, T., & Blinder, B. (1990). Autism under age 3 years: A clinical study of 28 cases referred for autistic symptoms in infancy. Journal of Child Psychology and Psychiatry, 6, 921–934.
Klin, A., Lang, J., Cicchetti, D., & Volkmar, F. (2000). Brief report: Interrater reliability of clinical diagnosis and DSM-IV criteria for autistic disorder: Results of the DSM-IV autism field trial. Journal of Autism and Developmental Disorders, 30(2), 163–167.
Landry, S. H., & Loveland, K. A. (1988). Communication behaviors in autism and developmental language delay. Journal of Child Psychology and Psychiatry and Allied Disciplines, 29(5), 621–634.
Lord, C., & Schopler, E. (1989). The role of age at assessment, developmental level, and test in the stability of intelligence scores in young autistic children. Journal of Autism and Developmental Disorders, 19, 483–499.
Lord, C., Storoschuk, S., Rutter, M., & Pickles, A. (1993). Using the ADI-R to diagnose autism in preschool children. Infant Mental Health Journal, 14(3), 234–252.
Lord, C., Rutter, M., & Le Couteur, 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(5), 659–685.
Lord, C. (1995). Follow-up of two-year-olds referred for possibly autism. Journal of Child Psychology and Psychiatry, 36, 1–18.
Lord, C., & Pickles, A. (1996). Language level and nonverbal social-communicative behaviors in autistic and language-delayed children. Journal of the American Academy of Child and Adolescent Psychiatry, 35(11), 1542–1550.
Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism diagnostic observation schedule—WPS edition. Los Angles, California: Western Psychological Services.
Loveland, K. A., Landry, S. H., Hughes, S. O., Hall, S. K., & McEvoy, R. E. (1988). Speech acts and the pragmatic deficits of autism. Journal of Speech and Hearing Research, 31(4), 593–604.
Mayes, L., Volkmar, F. R., Hooks, M., & Cicchetti, D. V. (1993). Differentiating pervasive developmental disorder not otherwise specified from autism and language disorders. Journal of Autism and Developmental Disorders, 23(1), 79–90.
Mervis, C. B., & Klein-Tasman, B. P. (2004). Methodological issues in group-mathcing designs: A levels for control variable comparisons and measurement characteristics of control and target variables. Journal of Autism and Developmental Disorders, 34(1), 7–17.
Mildenberger, K., Sitter, S., Noterdaeme, M., & Amorosa, H. (2001). The use of the ADI-R as a diagnostic tool in the differential diagnosis of children with infantile autism and children with a receptive language disorder. European Journal and Child and Adolescent Psychiatry, 10(5), 248–255.
Mullen, E. (1989). Mullen scales of early learning. Cranston, RI: T.O.T.A.L. Child, Inc.
Noterdaeme, M., Sitter, S., Mildenberger, K., & Amorosa, H. (2000). Diagnostic assessment of communicative and interactive behaviours in children with autism and receptive language disorder. European Child and Adolescent Psychiatry, 9(4), 295–300.
Robins, D., Fein, D., Barton, M., & Green, J. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31(2), 131–144.
Rogers, S. J., Hepburn, S., Stackhouse, T., & Wehner, E. (2003). Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders. Journal of Autism and Developmental Disorders, 33(6), 631–642.
Saemundsen, E., Magnusson, P., Smari, J., & Sigurdardottir, S. (2003). Autism diagnostic interview-revised and the childhood autism rating scale: Convergence and discrepancy in diagnosing autism. Journal of Autism and Developmental Disorders, 33(3), 319–328.
Schopler, E., Reichler, R. J., & Renner, B. R. (1988). The Childhood Autism Rating Scale. Los Angeles: Western Psychological Services.
Sparrow, S., Bala, D., & Cicchetti, D. (1984). The vineland adaptive behavior scales. Circle Pines, MN: American Guidance Services.
Spitzer, R., & Siegel, B. (1990) The DSM-III-R field trial of pervasive developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 29(6), 855–862.
Stone, W. L., Lee, E. B., Ashford, L., Brissie, J., Hepburn, S. L., Coonrod, E. E. et al. (1999). Can autism be diagnosed accurately in children under 3 years? Journal of Child Psychology and Psychiatry and Allied Disciplines, 40(2), 219–226.
Trillingsgaard, A., Sorensen, E. U., Nemec, G., & Jorgensen, M. (2005). What distinguishes autism spectrum disorders from other developmental disorders before the age of four years? European Journal of Child and Adolescent Psychiatry, 14, 65–72.
Ventola, P., Kleinman, J., Pandey, P., Barton, M., Allen, S. Green, J., Robins, D., & Fein, D. Agreement among four diagnostic instruments for autism spectrum disorders in toddlers. Journal of Autism and Developmental Disorders (in press).
Vig, S., & Jedrysek, E. (1999). Autistic features in young children with significant cognitive impairment: Autism or mental retardation? Journal of Autism and Developmental Disorders, 29(3), 235–248.
Wainwright, L., & Fein, D. (1996). Results of play analyses. In Rapin, I. (Editor for the Autism and Language Disorders Collaborative Project: Preschool Study Group). Preschool children with inadequate communication: Developmental language disorder, autism, low IQ. Clinics in developmental medicine, No. 139. London: Mac Keith Press, pp. 173–189.
Acknowledgements
This research was supported by the University of Connecticut's Research Foundation Faculty Grant, National Alliance of Autism Research, National Institute of Child Health and Human Development (5 R01 HD039961), Maternal and Child Health Bureau (R40 MC 00270). We are very grateful to the children and families who participated in this research, as well as the doctors and early intervention sites that screened the children. We would also like to acknowledge the invaluable assistance of the undergraduate research assistants.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ventola, P., Kleinman, J., Pandey, J. et al. Differentiating between Autism Spectrum Disorders and Other Developmental Disabilities in Children Who Failed a Screening Instrument for ASD. J Autism Dev Disord 37, 425–436 (2007). https://doi.org/10.1007/s10803-006-0177-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-006-0177-z