Observational and Reported Measures of Language and Pragmatics in Young People with Autism: A Comparison of Respondent Data and Gender Profiles.
Alexandra Sturrock, Antonia Marsden, Catherine Adams and 1 others
PMID 31758367WHAT IT FOUND
Parents reported significantly more pragmatic difficulties for girls with autism than clinicians did, and direct testing showed better skills than observation.
Clinicians should combine parent reports with functional observation, as testing alone may miss real-world struggles in girls.
Key findings
01Clinicians observed fewer pragmatic difficulties in girls with autism than their parents reported, a gap that was significantly larger than for boys.
02Direct assessments showed better pragmatic performance for the autism group than clinician observations did, particularly on inference tasks.
03Parents reported significantly more emotional difficulties for girls with autism than for any other group, including boys with autism.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was small, with only 13 participants per autism gender group. Clinicians could not be blinded to the child's gender or diagnosis during observation. The girls with autism were selected from those already diagnosed, potentially missing those who are less visible. No single primary outcome was pre-registered; multiple secondary comparisons were made without correction for multiple testing.
The easy way to misread this
Do not assume a girl with autism has no pragmatic disorder because she scores well on direct tests. This study found that girls often perform better in testing than in functional observation, and parents report more difficulties than clinicians observe.