Grammatical language impairment in autism spectrum disorder: Exploring language phenotypes beyond standardized testing

Linguistic and cognitive abilities manifest huge heterogeneity in children with autism spectrum disorder (ASD). Some children present with commensurate language and cognitive abilities, while others show more variable patterns of development. Using spontaneous language samples, we investigate the presence and extent of grammatical language impairment in a heterogeneous sample of children with ASD. Findings from our sample suggest that children with ASD can be categorized into three meaningful subgroups: those with normal language, those with marked difficulty in grammatical production but relatively intact vocabulary, and those with more globally low language abilities. These findings support the use of sensitive assessment measures to evaluate language in autism, as well as the utility of within-disorder comparisons, in order to comprehensively define the various cognitive and linguistic phenotypes in this heterogeneous disorder.