Sub-groups of spoken language and broader communication skills in a large heterogenous cohort of minimally verbal school-age children: evidence of discrepant profiles.

The study is cross-sectional, so it cannot tell us whether these communication profiles remain stable over time or predict later outcomes. Diagnoses were based on unverified parent report rather than clinical assessment, so diagnostic accuracy is uncertain. Some measures were non-normed, and scores had to be estimated at floor for 7% to 32% of participants on tasks requiring them to follow instructions. The sample was heavily skewed towards autism, with 77% having an autism diagnosis, which limits how well the findings generalise to other neurodevelopmental conditions.

Do not assume that a minimally verbal child with good comprehension lacks the knowledge to communicate. The discrepant clusters showed strong receptive and symbolic skills alongside weak speech output, pointing to a speech-motor barrier rather than a cognitive or language deficit. Treating this as a lack of understanding would miss the need for speech-sound specific support and AAC.