Structural language impairment in Autism Spectrum Disorder versus Loss of Autism Diagnosis: Behavioral and neural characteristics

• Published in: NeuroImage clinical 2022-01, Vol.34, p.103043-103043, Article 103043
• Main Authors: Larson, Caroline, Rivera-Figueroa, Karla, Thomas, Hannah R., Fein, Deborah, Stevens, Michael C., Eigsti, Inge-Marie
• Format: Article
• Language: English
• Subjects: Autism Spectrum Disorder; Autistic Disorder; Brain - diagnostic imaging; Functional magnetic resonance imaging; Humans; Language; Language Development Disorders - diagnostic imaging; Lateralization; Loss of Autism Diagnosis; Magnetic Resonance Imaging - methods; Regular
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2022.103043

•Structural language impairment present in individuals with a current or past autism diagnosis.•Heightened leftward neural lateralization of language function related to language impairment.•Behavioral and neural patterns reflect language impairment distinct from autism features. This study probed for structural language impairment using behavioral and functional neuroimaging methods in individuals with Autism Spectrum Disorder (ASD) and those diagnosed with ASD in childhood who no longer meet criteria for ASD, referred to as Loss of Autism Diagnosis (LAD1). Participants were drawn from Fein et al. (2013): ASD (n = 35), LAD (n = 31), and Neurotypical (NT; n = 34). Criteria for structural language impairment were: Scores ≤ 82 on Clinical Evaluation of Language Fundamentals-4 (CELF) Core Language, an omnibus measure of language; and scores ≤ 7 on CELF Recalling Sentences, a clinical marker of structural language impairment. Task-based fMRI examined lateralization of significantly activated language-related brain regions in groups with structural language impairment (LI2) versus normal-range language (LN3), collapsed across ASD, LAD1, and NT status. Results showed no ASD versus LAD group differences in the proportion of participants with structural language impairment according to either metric (Recalling Sentences or Core Language). Functional MRI results indicated greater left hemisphere lateralization within significantly activated regions in the LI2 group. Structural language abilities were not meaningfully associated with either social abilities or lifetime ADHD symptoms in LI2 subgroups, further suggesting the presence of structural language impairment. Findings indicate the presence of persistent structural language difficulty even in the absence of ASD symptoms in some individuals within the LAD1 group and unique patterns of language-related neural specialization for language function in LI2 relative to LN3.