understanding of levels of communicative functioning is critical for effective program planning and intervention. Communication skills should be viewed in a broad context of an individual’s development (Lord and Paul, 1997; Prizant and Schuler, 1997); standardized tests constitute only one part of the assessment of communication abilities in younger children with autism and related conditions. The selection of appropriate assessment instruments, combined with a general understanding of autism, can provide important information for purposes of both diagnostic assessment and intervention.

In addition to assessing expressive language, it is very important to obtain an accurate assessment of language comprehension. The presence of oral-motor speech difficulties should be noted. In children with autism, the range of communicative intents may be restricted in multiple respects (Wetherby et al., 1989). Delayed and immediate echolalia are both common in autism (Fay, 1973; Prizant and Duchan, 1981) and may have important functions. In addition, various studies have documented unusual aspects even of very early communication development in autism (Ricks and Wing, 1975; Tager-Flusberg et al., 1990).

In assessing language and communication skills, parent interviews and checklists may be used, and specific assessment instruments for children with autistic spectrum disorders have been developed (Sparrow, 1997). For children under age 3, scores on standardized tests may be particularly affected by difficulties in assessment and by the need to rely on parent reports and checklists. For preverbal children, the speech-communication assessment should include observation of a child’s level of awareness of communication “bids” from others, the child’s sense of intentionality, the means used for attempting communication, and the quality and function of such means, sociability, and play behaviors. The evaluator should be particularly alert to the child’s capacity for symbolic behavior, because this has important implications for an intervention program (Sparrow, 1997). There are also several standardized instruments that provide useful information on the communication and language development of preverbal children with autism; these include the Communication and Symbolic Behavior Scales, the Mullen Scales of Early Learning, and the MacArthur Communicative Development Inventory. For children with some verbal ability, social and play behaviors are still important in terms of clinical observation but various standardized instruments are available as well, particularly when a child exhibits multiword utterances. Areas to be assessed include receptive and expressive vocabulary, expressive language and comprehension, syntax, semantic relations, morphology, pragmatics, articulation, and prosody.

The choice of specific instruments for language-communication assessment will depend on the developmental levels and chronological age of the child. For higher functioning individuals with autism or Asperger’s

The National Academies of Sciences, Engineering, and Medicine
500 Fifth St. N.W. | Washington, D.C. 20001

Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement