Factors related to social communication functionality in children with autism spectrum disorder: a preliminary study

Lima, Leilane Júlia Chaves de; Britto, Denise Brandão de Oliveira e; Dias, Rafael Teixeira Scoralick; Lemos, Stela Maris de Aguiar

doi:10.1590/2317-6431-2022-2754en

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Original Article • Audiol., Commun. Res. 28 • 2023 • https://doi.org/10.1590/2317-6431-2022-2754en copy

Factors related to social communication functionality in children with autism spectrum disorder: a preliminary study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

to analyze the association between social communication functionality in children with Autism spectrum disorder (ASD) according to sociodemographic aspects, communicative acts, severity of ASD and family perception.

Methods

this is the pilot stage of a cross-sectional analytical observational study. Children with ASD were evaluated and their caregivers were interviewed. The variables analyzed were ASD severity, socioeconomic aspects, communicative acts, communicative difficulties and the classification of functionality of social communication. For association analyses, the Pearson and Kruskal-Wallis chi-square tests were used.

Results

Sixteen children aged between 3 and 10 years were evaluated. The participants included in the study presented median levels of social communication functionality. The children with the greatest social communication difficulties were the ones caregivers had the impression other people made fun of . There was no association regarding communication functionality and socioeconomic aspects, ASD severity and communicative acts per minute.

Conclusion

This study triangulates the communication functionality of children with ASD with environmental and social factors. Children with ASD in outpatient care at a specialized service showed intermediate levels of social communication. Difficulties in acceptance and social inclusion are more commonly observed in children with ASD with greater communication deficits.

Keywords:
Autism Spectrum Disorder; Child language; International classification of functioning, disability and health; Social communication disorder

Variables	ACSF:SC Performance				ACSF:SC Capacity
Variables	Level II N (%)	Level III N (%)	Level IV N (%)	p-value	Level II N (%)	Level III N (%)	Level IV N (%)	p-value
Sex
Females	1 (33.3)	3 (33.3)	0 (0.0)	0.411	2 (50.0)	1 (12.5)	0 (0.0)	0.239
Males	2 (66.7)	6 (66.7)	4 (100.0)		2 (50.0)	7 (87.5)	2 (100.0)
Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
Caregiver’s educational attainment
Elementary school complete/middle school incomplete	0 (0.0)	1 (11.1)	0 (0.0)	0.123	0 (0.0)	0 (0.0)	0 (0.0)	0.497
Middle school complete/high school incomplete	2 (66.7)	2 (22.2)	3 (75.0)		2 (50.0)	3 (37.5)	1 (50.0)
High school complete/higher education incomplete	0 (0.0)	6 (66.7)	1 (25.0)		1 (25.0)	5 (62.5)	1 (50.0)
Higher education complete	1 (33.3)	0 (0.0)	0 (0.0)		1 (25.0)	0 (0.0)	0 (0.0)
Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
CCEB
A/B	1 (33.3)	3 (33.3)	1 (25.0)	0.953	2 (50.0)	2 (25.0)	1 (50.0)	0.627
C/D-E	2 (66.7)	6 (66.7)	3 (75.0)		2 (50.0)	6 (75.0)	1 (50.0)
Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)

Variables	ACSF:SC Performance				ACSF:SC Capacity
Variables	Level II	Level III	Level IV	p-value	Level II	Level III	Level IV	p-value
Age (years)
Mean	5.67	5.89	6.25	0.932	5.50	6.38	4.00	0.350
Standard deviation	2.08	2.09	2.75		1.73	2.45	1.41
Median	5.00	6.00	6.50		5.00	6.00	4.00

Variables	ACSF:SC Performance				ACSF:SC Capacity
Variables	Level II N (%)	Level III N (%)	Level IV N (%)	p-value	Level II N (%)	Level III N (%)	Level IV N (%)	p-value
CARS
Mild-moderate ASD	3 (100.0)	6 (66.7)	1 (25.0)	0.118	4 (100.0)	5 (62.5)	1 (50.0)	0.307
Severe ASD	0 (0.0)	3 (33.3)	3 (75.0)		0 (0.0)	3 (37.5)	1 (50.0)
Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
Pragmatics test
Expected for the age	2 (66.7)	3 (37.5)	0 (0.0)	0.231	3 (75.0)	2 (25.0)	0 (0.0)	0.122
Changed	1 (33.3)	5 (62.5)	3 (100.0)		1 (25.0)	6 (75.0)	2 (100.0)
Total	3 (100.0)	8 (100.0)	3 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)

	Variables	ACSF:SC Performance				ACSF:SC Capacity
		Level II	Level III	Level IV	p-value	Level II	Level III	Level IV	p-value
		N (%)	N (%)	N (%)	p-value	N (%)	N (%)	N (%)	p-value
Domain 1: Parents’ Attitudes to their children	1. I don’t know how to react to some of my child’s behaviors.
	Disagree	1 (33.3)	1 (11.1)	2 (50.0)	0.306	1 (25.0)	2 (25.0)	1 (50.0)	0.769
	Agree	2 (66.7)	8 (88.9)	2 (50.0)		3 (75.0)	6 (75.0)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	7. I get all objects my child points to.
	Disagree	2 (66.7)	6 (66.7)	3 (75.0)	0.953	3 (75.0)	6 (75.0)	1 (50.0)	0.769
	Agree	1 (33.3)	3 (33.3)	1 (25.0)		1 (25.0)	2 (25.0)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	13. I always talk to my child, even if he/she doesn’t talk to me.
	Disagree	1 (33.3)	3 (33.3)	1 (25.0)	0.953	2 (50.0)	2 (25.0)	1 (50.0)	0.627
	Agree	2 (66.7)	6 (66.7)	3 (75.0)		2 (50.0)	6 (75.0)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	19. I can’t teach new things to my child.
	Disagree	2 (66.7)	4 (44.4)	3 (75.0)	0.545	3 (75.0)	4 (50.0)	2 (100.0)	0.364
	Agree	1 (33.3)	5 (55.6)	1 (25.0)		1 (25.0)	4 (50.0)	0 (0.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
Domain 2: Parents’ self-perception regarding their children	2. I have difficulties communicating with my child.
	Disagree	1 (33.3)	7 (77.8)	2 (50.0)	0.324	2 (50.0)	6 (75.0)	1 (50.0)	0.627
	Agree	2 (66.7)	2 (22.2)	2 (50.0)		2 (50.0)	2 (25.0)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	4. I have difficulties communicating with my child when we’re just the two of us.
	Disagree	3 (100.0)	8 (88.9)	3 (75.0)	0.602	4 (100.0)	7 (87.5)	2 (100.0)	0.668
	Agree	0 (0.0)	1 (11.1)	1 (25.0)		0 (0.0)	1 (12.5)	0 (0.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)

	6. I have difficulties communicating with my child when there are other people in the same place.
	Disagree	1 (33.3)	4 (44.4)	2 (50.0)	0.906	1 (25.0)	5 (62.5)	1 (50.0)	0.472
	Agree	2 (66.7)	5 (55.6)	2 (50.0)		3 (75.0)	3 (37.5)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	8. I have difficulties playing with my child.
	Disagree	3 (100.0)	6 (66.7)	2 (50.0)	0.361	3 (75.0)	7 (87.5)	1 (50.0)	0.502
	Agree	0 (0.0)	3 (33.3)	2 (50.0)		1 (25.0)	1 (12.5)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	10. I have difficulties understanding what my child wants.
	Disagree	2 (66.7)	5 (55.6)	2 (50.0)	0.906	3 (75.0)	4 (50.0)	1 (50.0)	0.694
	Agree	1 (33.3)	4 (44.4)	2 (50.0)		1 (25.0)	4 (50.0)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	12. I have difficulties understanding what my child feels.
	Disagree	1 (33.3)	3 (33.3)	1 (25.0)	0.953	1 (25.0)	3 (37.5)	1 (50.0)	0.823
	Agree	2 (66.7)	6 (66.7)	3 (75.0)		3 (75.0)	5 (62.5)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
Domain 2: Parents’ self-perception regarding their children
	14. I don’t know what to do when my child doesn’t understand me or when I don’t understand him/her.
	Disagree	2 (66.7)	3 (33.3)	3 (75.0)	0.311	3 (75.0)	3 (37.5)	2 (100.0)	0.194
	Agree	1 (33.3)	6 (66.7)	1 (25.0)		1 (25.0)	5 (62.5)	0 (0.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	16. I don’t feel comfortable in public places with my child.
	Disagree	3 (100.0)	5 (55.6)	1 (25.0)	0.141	4 (100.0)	5 (62.5)	0 (0.0)	0.056
	Agree	0 (0.0)	4 (44.4)	3 (75.0)		0 (0.0)	3 (37.5)	2 (100.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	18. I worry about my child’s future.
	Disagree	0 (0.0)	2 (22.2)	1 (25.0)	0.649	0 (0.0)	2 (25.0)	1 (50.0)	0.346
	Agree	3 (100.0)	7 (77.8)	3 (75.0)		4 (100.0)	6 (75.0)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	20. I get frustrated when I realize my child will not begin communication.
	Disagree	2 (66.7)	6 (66.7)	1 (25.0)	0.347	3 (75.0)	4 (50.0)	1 (50.0)	0.694
	Agree	1 (33.3)	3 (33.3)	3 (75.0)		1 (25.0)	4 (50.0)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	22. I’m bothered by my child’s apathy/restlessness.
	Disagree	1 (33.3)	3 (33.3)	0 (0.0)	0.411	1 (25.0)	3 (37.5)	0 (0.0)	0.566
	Agree	2 (66.7)	6 (66.7)	4 (100.0)		3 (75.0)	5 (62.5)	2 (100.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	24. I’d like to have further information on how to communicate with my child.
	Disagree	0 (0.0)	2 (22.2)	0 (0.0)	0.412	0 (0.0)	2 (25.0)	0 (0.0)	0.417
	Agree	3 (100.0)	7 (77.8)	4 (100.0)		4 (100.0)	6 (75.0)	2 (100.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	Domain 3: Parents’ perception of people’s acceptance of their children	3. I feel that other people don’t understand what my child wants to communicate.
Disagree		0 (0.0)	1 (11.1)	0 (0.0)	0.660	1 (25.0)	0 (0.0)	0 (0.0)	0.260
Agree		3 (100.0)	8 (88.9)	4 (100.0)		3 (75.0)	8 (100.0)	2 (100.0)
Total		3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
9. I feel that other people make fun of my child when he/she wants to communicate something.
Disagree		3 (100.0)	7 (77.8)	0 (0.0)	0.009^* * = p-value ≤ 0.05; Pearson’s chi-square test	3 (75.0)	6 (75.0)	0 (0.0)	0.122
Agree		0 (0.0)	2 (22.2)	4 (100.0)		1 (25.0)	2 (25.0)	2 (100.0)
Total		3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
15. I feel that other people avoid my child.
Disagree		2 (66.7)	6 (66.7)	1 (25.0)	0.347	3 (75.0)	4 (50.0)	1 (50.0)	0.694
Agree		1 (33.3)	3 (33.3)	3 (75.0)		1 (25.0)	4 (50.0)	1 (50.0)
Total		3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
21. I feel that other people find my child strange.
Disagree		3 (100.0)	5 (55.6)	1 (25.0)	0.141	4 (100.0)	3 (37.5)	1 (50.0)	0.116
Agree		0 (0.0)	4 (44.4)	3 (75.0)		0 (0.0)	5 (62.5)	1 (50.0)
Total		3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)

Domain 4: Parents’ perceptions regarding their children		5. I feel that my child doesn’t understand what I say.
		Disagree	2 (66.7)	6 (66.7)	2 (50.0)	0.837	2 (50.0)	6 (75.0)	1 (50.0)	0.627
	Agree	1 (33.3)	3 (33.3)	2 (50.0)	2 (50.0)		2 (25.0)	1 (50.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)	4 (100.0)		8 (100.0)	2 (100.0)
	11. I feel that my child doesn’t understand what other people say.
	Disagree	1 (33.3)	5 (55.6)	0 (0.0)	0.159	1 (25.0)	4 (50.0)	0 (0.0)	0.364
	Agree	2 (66.7)	4 (44.4)	4 (100.0)		3 (75.0)	4 (50.0)	2 (100.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)

	17. I realize my child says things unrelated to the moment and/or topic.
	Disagree	0 (0.0)	4 (44.4)	0 (0.0)	0.116	0 (0.0)	4 (50.0)	0 (0.0)	0.122
	Agree	3 (100.0)	5 (55.6)	4 (100.0)		4 (100.0)	4 (50.0)	2 (100.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)
	23. I feel that my child has few friends.
	Disagree	2 (66.7)	3 (33.3)	0 (0.0)	0.166	2 (50.0)	3 (37.5)	0 (0.0)	0.478
	Agree	1 (33.3)	6 (66.7)	4 (100.0)		2 (50.0)	5 (62.5)	2 (100.0)
	Total	3 (100.0)	9 (100.0)	4 (100.0)		4 (100.0)	8 (100.0)	2 (100.0)

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[1] Conflict of interests: No.