The study explored whether children with high functioning autism (HFA), Asperger syndrome (AS), and pervasive developmental disorder not otherwise specified (PDD-NOS) can be differentiated on the Children's Communication Checklist (CCC). The study also investigated whether empirically derived autistic subgroups can be identified with a cluster analytic method based on the Autism Diagnostic Interview–Revised. Fifty-seven children with HFA, 47 with AS, 31 with PDD-NOS, and a normal control group of 47 children between 6 and 13 years participated. Children with HFA,AS, and PDDNOS showed pragmatic communication deficits in comparison to the controls. Little difference was found between the three subtypes with respect to their CCC profile.A three-cluster solution explained the data best.The HFA cluster showed most autism characteristics, followed by the combined HFA + AS cluster, and then the PDD-NOS cluster. The findings support the autism spectrum concept based on severity of symptom impairment rather than distinct categories.
AMERICAN PSYCHIATRIC ASSOCIATION (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edn text rev. (DSM-IV-TR). Washington, DC: APA .
2.
BEGLINGER, L .J. & SMITH, T.H. (2001) ‘A Review of Subtyping in Autism and Proposed Dimensional Classification Model’ , Journal of Autism and Developmental Disorders31 (4): 411–422 .
3.
BISHOP, D.V.M. (1998) ‘Development of the Children's Communication Checklist (CCC): A Method for Assessing Qualitative Aspects of Communicative Impairment in Children’ , Journal of Child Psychology and Psychiatry39 (6): 879–891 .
4.
BISHOP, D.V.M. & BAIRD, G. (2001) ‘Parent and Teacher Report of Pragmatic Aspects of Communication: Use of the Children's Communication Checklist in a Clinical Setting’ , Developmental Medicine and Child Neurology43 (12): 809–818 .
5.
BISHOP, D.V.M. & NORBURY, C.F. (2002) ‘Exploring the Borderlands of Autistic Disorder and Specific Language Impairment: A Study Using Standardised Diagnostic Instruments’ , Journal of Child Psychology and Psychiatry43 (7): 917–929 .
6.
BOTTING, N. & CONTI-RAMSDEN, G. (1999) ‘Pragmatic Language Impairment without Autism’ , Autism3 (4): 371–396 .
7.
BOUCHER, J. (1998) ‘Some Issues in the Classification of Developmental Disorders’ , International Journal of Language and Communication Disorders33 (1): 95–108 .
8.
DODD, B. & CROSBIE, S. (2002) ‘Language and Cognition: Evidence from Disordered Language’, in U. GOSWAMI (ed.) Blackwell Handbook of Childhood Cognitive Development, pp. 470–490. Oxford: Blackwell .
9.
EAVES, L .C. , HO, H .H. & EAVES, D.M. (1994) ‘Subtypes of Autism by Cluster Analysis’ , Journal of Autism and Developmental Disorders24 (1): 3–22 .
10.
EISENMAJER, R. , PRIOR, M. , LEEKAM, S. , WING, L. , ONG, B. , GOULD, J. & WELHAM, M. (1998) ‘Delayed Language Onset as a Predictor of Clinical Symptoms in Pervasive Developmental Disorders’ , Journal of Autism and Developmental Disorders28 (6): 527–533 .
11.
EVERITT, B.S. (1996) Making Sense of Statistics in Psychology:A Second-Level Course, pp. 257–269. Oxford: Oxford University Press .
12.
FEIN, D. , STEVENS, M. , DUNN, M. , WATERHOUSE, L. , ALLEN, D. , RAPIN, I. & FEINSTEIN, C. (1999) ‘Subtypes of Pervasive Developmental Disorder: Clinical Characteristics’ , Child Neuropsychology5 (1): 1–23 .
13.
FILIPEK, P.A. , ACCARDO, P.J. , BARANEK, G.T. , COOK, E .H. , DAWSON, G. , GORDON, B. , GRAVEL, J.S. , JOHNSON, C.P. , KALLEN, R .J. , LEVY, S .E. , MINSHEW, N.J. , PRIZANT, B.M. , RAPIN, I. , ROGERS, S .J. , STONE, W.L. , TEPLIN, S. , TUCHMAN, R .F. & VOLKMAR, F.R. (1999) ‘The Screening and Diagnosis of Autistic Spectrum Disorders’ , Journal of Autism and Developmental Disorders29 (6): 439–484 .
14.
FOMBONNE, E. (1998) ‘Epidemiology of Autism and Related Conditions’, in F.R. VOLKMAR (ed.) Autism and Pervasive Developmental Disorders, pp. 32–63. Cambridge: Cambridge University Press .
15.
GAGNON, L. , MOTTRON, L. & JOANETTE, Y. (1997) ‘Questioning the Validity of the Semantic-Pragmatic Syndrome Diagnosis’ , Autism1 (1): 37–55 .
16.
GHAZIUDDIN, M. & GERSTEIN, L. (1996) ‘Pedantic Speaking Style Differentiates Asperger Syndrome from High-Functioning Autism’ , Journal of Autism and Developmental Disorders26 (6): 585–595 .
17.
GHAZIUDDIN, M. , THOMAS, P. , NAPIER, E. , KEARNEY, G. , TSAI, L. , WELCH, K. & FRASER, W. (2000) ‘Brief Report. Brief Syntactic Analysis in Asperger Syndrome: A Preliminary Study’ , Journal of Autism and Developmental Disorders30 (1): 67–70 .
18.
GILCHRIST, A. , GREEN, J. , COX, A. , BURTON, D. , RUTTER, M. & LECOUTEUR, A. (2001) ‘Development and Current Functioning in Adolescents with Asperger Syndrome: A Comparative Study’ , Journal of Child Psychology and Psychiatry42 (2): 227–240 .
19.
GILLBERG, C. & EHLERS, S. (1998) ‘High-Functioning People with Autism and Asperger's Syndrome: A Literature Review’, in E. SCHOPLER , G.B. MESIBOV & L .J. KUNCE (eds), Asperger Syndrome or High-Functioning Autism?, pp. 79–106. New York: Plenum .
20.
GROTH-MARNAT, G. (1997) Handbook of Psychological Assessment, 3rd ednNew York: Wiley .
21.
HARTMAN, C.A., GEURTS, H .M, BENNINK, A .C., VERTÉ, S., ROEYERS, H., SERGEANT, J.A.& BISHOP, D.V.M. (1998) ‘The Three C's: Children's Communication Checklist (Dutch translation)’, unpublished manuscript,Vrije Universiteit, Amsterdam.
22.
HOWLIN, P. (2003) ‘Outcome of High-Functioning Adults with and without Early Language Delays: Implications for the Differentiation between Autism and Asperger Syndrome’ , Journal of Autism and Developmental Disorders33 (1): 3–13 .
23.
KAUFMAN, L. & ROUSSEEUW, P.J. (1990) Finding Groups in Data:An Introduction to Cluster Analysis, pp. 44–48, 199–208. New York:Wiley .
24.
KLIN, A. & VOLKMAR, F.R. (1997) ‘Asperger Syndrome’, in D.J. COHEN & F.R. VOLKMAR (eds) Handbook of Autism and Pervasive Developmental Disorders, 2nd edn, pp. 94–122. New York:Wiley .
25.
KUGLER, B. (1998) ‘The Differentiation between Autism and Asperger Syndrome’ , Autism2 (1): 11–32 .
26.
LEEKAM, S. , LIBBY, S. , WING, L. , GOULD, J. & GILLBERG, C. (2000) ‘Comparison of ICD-10 and Gillberg's Criteria for Asperger Syndrome’ , Autism4 (1): 11–28 .
27.
LORD, C. & PAUL, R. (1997) ‘Language and Communication in Autism’, in D.J. COHEN & F.R. VOLKMAR (eds) Handbook of Autism and Pervasive Developmental Disorders, 2nd edn, pp. 195–225. New York:Wiley .
28.
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 Disorders24 (5): 659–685 .
29.
LORR, M. (1983) Cluster Analysis for the Social Sciences. San Francisco, CA: Jossey-Bass .
30.
LUTEIJN, E .F. , SERRA, M. , JACKSON, S. , STEENHUIS, M .P. , ALTHAUS, M. , VOLKMAR, F. & MINDERAA, R. (2000) ‘How Unspecified Are Disorders of Children with a Pervasive Developmental Disorder Not Otherwise Specified? A Study of Social Problems in Children with PDD-NOS and ADHD’ , European Child and Adolescent Psychiatry9 (3): 168–179 .
31.
MAHONEY, W.J. , SZATMARI, P. , MCLEAN, J.E. , BRYSON, S .E. , BARTOLUCCI, G. , WALTER, S .D. , JONES, M .B. & ZWAIGENBAUM, L. (1998) ‘Reliability and Accuracy of Differentiating Pervasive Developmental Disorder Subtypes’ , Journal of the American Academy of Child and Adolescent Psychiatry37 (3): 278–285 .
32.
MAWHOOD, L. , HOWLIN, P. & RUTTER, M. (2000) ‘Autism and Developmental Receptive Language Disorder: A Comparative Follow-Up in Early Adult Life. I: Cognitive and Language Outcomes’ , Journal of Child Psychology and Psychiatry41 (5): 547–559 .
33.
MAYES, L. , VOLKMAR, F. , HOOKS, M. & CICCHETTI, D. (1993) ‘Differentiating Pervasive Developmental Disorder Not Otherwise Specified from Autism and Language Disorders’ , Journal of Autism and Developmental Disorders23 (1): 79–90 .
34.
MAYES, S .D. & CALHOUN, S .L. (2001) ‘Non-Significance of Early Speech Delay in Children with Autism and Normal Intelligence and Implications for DSM-IV Asperger's Disorder’ , Autism5 (1): 81–94 .
35.
MINSHEW, N.J. , GOLDSTEIN, G. & SIEGEL, D.J. (1995) ‘Speech and Language in High-Functioning Autistic Individuals’ , Neuropsychology9 (2): 255–261 .
36.
NATHAN, L. (2002) ‘Functional Communication Skills of Children with Speech Difficulties: Performance on Bishop's Children's Communication Checklist’ , Child Language Teaching and Therapy18 (3): 213–231 .
37.
OOSTERLAAN, J. , SCHERES, A. , ANTROP, I. , ROEYERS, H. & SERGEANT, J.A. (2000) Vragenlijst voor Gedragsproblemen bij Kinderen (VvGK) (Dutch translation of The Disruptive Behavior Disorders Rating Scale). Lisse: Swets & Zeitlinger .
38.
OZONOFF, S. , SOUTH, M. & MILLER, J.N. (2000) ‘DSM-IV-Defined Asperger Syndrome: Cognitive, Behavioral and Early History Differentiation from High-Functioning Autism’ , Autism4 (1): 29–46 .
39.
POMEROY, J.C. (1998) ‘Subtyping Pervasive Developmental Disorder: Issues of Validity and Implications for Child Psychiatric Diagnosis’, in E. SCHOPLER , G.B. MESIBOV & L .J. KUNCE (eds) Asperger Syndrome or High-Functioning Autism?, pp. 29–60. New York: Plenum .
40.
PRIOR, M. , EISENMAJER, R. , LEEKAM, S. , WING, L. , GOLD, J. , ONG, B. & DOWE, D. (1998) ‘Are There Subgroups within the Autistic Spectrum? A Cluster Analysis of a Group of Children with Autistic Spectrum Disorders’ , Journal of Child Psychology and Psychiatry39 (6): 893–902 .
41.
RAMBERG, C. , EHLERS, S. , NYDEN, A. , JOHANSSON, M. & GILLBERG, C. (1996) ‘Language and Pragmatic Functions in School Age Children on the Autism Spectrum’ , European Journal of Disorders of Communication31 (4): 387–413 .
42.
RAPIN, I. (1996a) Preschool Children with Inadequate Communication:Developmental Language Disorder,Autism,Low IQ . Clinics in Developmental Medicine139. London: Mac Keith .
43.
RAPIN, I. (1996b) ‘Practitioner Review. Developmental Language Disorders: A Clinical Update’ , Journal of Child Psychology and Psychiatry37 (6): 643–655 .
44.
SEVIN, J.A. , MATSON, J.L. , COE, D. , LOVE, S .R. , MATESE, M .J. & BENAVIDEZ, D.A. (1995) ‘Empirically Derived Subtypes of Pervasive Developmental Disorders: A Cluster Analytic Study’ , Journal of Autism and Developmental Disorders25 (6): 561–578 .
45.
SHESKIN, D.J. (2000) Handbook of Parametric and Nonparametric Statistical Procedures, 2nd edn.Boca Raton, FL: Chapman & Hall/CRC .
46.
STEINLEY, D. (2004) ‘Properties of the Hubert–Arabie Adjusted Rand Index’ , Psychological Methods9 (3): 386–396 .
47.
STONE, W. , OUSLEY, O. , HEPBURN, S. , HOGAN, K. & BROWN, C. (1999) ‘Patterns of Adaptive Behavior in Very Young Children with Autism’ , American Journal on Mental Retardation104 (2): 187–199 .
48.
SZATMARI, P. (1998) ‘Differential Diagnosis of Asperger Disorder’, in E. SCHOPLER , G.B. MESIBOV & L .J. KUNCE (eds) Asperger Syndrome or High-Functioning Autism?, pp. 61–76. New York: Plenum .
49.
SZATMARI, P. , BRYSON, S .E. , BOYLE, M .H. , STREINER, D.L. & DUKU, E. (2003) ‘Predictors of Outcome among High-Functioning Children with Autism and Asperger Syndrome’ , Journal of Child Psychology and Psychiatry44 (4): 520–528 .
50.
TAGER-FLUSBERG, H. (1997) ‘Perspectives on Language and Communication in Autism’, in D.J. COHEN & F.R. VOLKMAR (eds) Handbook of Autism and Pervasive Developmental Disorders, 2nd edn, pp. 894–900. New York:Wiley .
51.
TWACHTMAN-CULLEN, D. (1998) ‘Language and Communication in High-Functioning Autism and Asperger Syndrome’, in E. SCHOPLER , G.B. MESIBOV & L .J. KUNCE (eds) Asperger Syndrome or High-Functioning Autism?, pp. 199–225. New York: Plenum .
52.
VAN HAASEN, P.P. , DE BRUYN, E .E .J. , PIJL, Y.J. , POORTINGA, Y.H. , SPELBERG, L .H .C. , VANDER STEENE, G. , COETSIER, P. , SPOELDERS-CLAEYS, R. & STINISSEN, J. (1986) WISC–R: Wechsler Intelligence Scale for Children–Revised. Nederlandstalige uitgave. Handleiding voor instructies en scoring. Lisse: Swets & Zeitlinger .
53.
WALKER, D.R. , THOMPSON, A. , ZWAIGENBAUM, L. , GOLDBERG, J. , BRYSON, S .E. , MAHONEY, W.J. , STRAWBRIDGE, C.P. & SZATMARI, P. (2004) ‘Specifying PDDNOS: A Comparison of PDDNOS, Asperger Syndrome, and Autism’ , Journal of the American Academy of Child and Adolescent Psychiatry43 (2): 172–180 .
54.
WARD, J.H. (1963) ‘Hierarchical Groupings to Optimize an Objective Function’ , Journal of the American Statistical Association58 (301): 236–244 .
55.
WATERHOUSE, L. , MORRIS, R. , ALLEN, D. , DUNN, M. , FEIN, D. , FEINSTEIN, C. , RAPIN, I. & WING, L. (1996) ‘Diagnosis and Classification in Autism’ , Journal of Autism and Developmental Disorders26 (1): 59–86 .
