J Autism Dev Disord (2007) 37:1525–1538
DOI 10.1007/s10803-006-0265-0
ORIGINAL PAPER
Communicative Competence and Metalinguistic Ability:
Performance by Children and Adults with Autism Spectrum
Disorder
Fiona M. Lewis Æ Bruce E. Murdoch Æ
Gail C. Woodyatt
Published online: 31 July 2007
Ó Springer Science+Business Media, LLC 2007
Abstract The Test of Language Competence-Expanded
Edition (TLC-E) was administered to children and adults
with a diagnosis of autism spectrum disorder (ASD). Rel-
ative to controls, those with ASD were less competent on a
range of TLC-E tasks. No differences were found for either
child or adult ASD groups on any of the TLC-E measures
when re-classified as Asperger syndrome (AS) and high
functioning autism (HFA) using DSM-IV language crite-
rion. Hierarchical cluster analyses of individuals with
ASD identified subgroups within the spectrum. The use of
developmental language history as an identifying marker in
autism is questioned. The findings suggest that compre-
hensive language assessments on individuals with ASD can
provide clinically relevant information regarding the het-
erogeneity of language skills within the autistic spectrum.
Keywords Autism spectrum disorder

Test of Language Competences-Expanded Edition

DSM-IV language criterion
Subgroups
Introduction
Language and communication difficulties are central to the
autistic presentation (American Psychiatric Association
[APA], 1994). It is therefore unsurprising that much
Fiona M. Lewis (&)
Gail C.Woodyatt
Division of Speech Pathology, School of Health and
Rehabilitation Sciences, University of Queensland, Brisbane,
QLD, 4072, Australia
e-mail: f.lewis@uq.edu.au
Bruce E.Murdoch
Head of School, School of Health and Rehabilitation Sciences,
University of Queensland, Brisbane, QLD, Australia
research has focused on the language skills associated with
Asperger syndrome (AS) and high functioning autism
(HFA). Determining the external validation of AS from
HFA using developmental language history has been one
area of ongoing research (e.g., Ghaziuddin et al., 2000;
Mayes & Calhoun, 2001). The theoretical basis for vali-
dation studies is the categorical distinction between AS and
autistic disorder (AD) (including HFA) established in
DSM-IV (APA, 1994). In contrast, another theoretical
approach has been to conceptualise AS and HFA as pre-
sentations on a spectrum of autistic disorders (e.g., Prior
et al., 1998; Wing, 1989). The resultant research however
has not conclusively determined the language profile
associated with AS and/or HFA. Further, the clinical
appreciation of the language difficulties associated with the
two disorders may have been hindered to date due to
methodological or theoretical limitations of these two
research approaches.
Validation Studies
DSM-IV (APA, 1994) established a categorical distinction
between AS and AD based on developmental language
history. As developmental language onset is the key to
differential diagnosis between AS and HFA (APA, 1994),
some researchers have examined whether language skills
differentiate the two disorders (e.g., Ghaziuddin et al.,
2000; Howlin, 2003; Mayes & Calhoun, 2001; Ramberg,
Ehlers, Nyden, Johansson, & Gillberg, 1996; Szatmari,
Archer, Fisman, Streiner, & Wilson, 1995; Szatmari, Bry-
son, Boyle, Streiner, & Duku, 2003; Szatmari et al., 2000;
Szatmari, Tuff, Finlayson, & Bartolucci, 1990). To date,
the results are inconclusive. Howlin (2003), for instance,
administered the British Picture Vocabulary Scale (Dunn,
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Dunn, Whetton, & Burley, 1997; Dunn, Dunn, Whetton, &
Pintillie, 1982) and the Expressive One Word Picture
Vocabulary (Gardner, 1982) to adults with a diagnosis of
autism or AS confirmed on the basis of the Autism Diag-
nostic Interview-Revised (Lord, Rutter, & LeCouteur,
1994), clinical records, current reports, and assessment of
current functioning. Nonverbal IQ for all participants was
in the normal range. Participants reported as having delays
in language were classified as having autism, while those
with a history of no delays either in the onset of the use of
words or phrases were classified as having AS. She found
marginally significant receptive and expressive language
differences between the two groups.
In contrast, Mayes and Calhoun (2001) examined whe-
ther a history of early speech/language delay with the
attendant diagnosis of autism, and a history of normal
language onset and the associated diagnosis of AS, had
significant outcomes for children. Children in their study
fulfilled DSM-IV (APA, 1994) requirements for AS or
autism, and all had average IQ. Mayes and Calhoun used
data from parent interviews, clinical observations of the
child, teacher reports, and previous evaluations to complete
the Checklist for Autism in Young Children (Mayes &
Calhoun, 1999). The authors determined there were no
significant differences on any of the expressive language
measures between the two groups.
Another research group (Szatmari et al., 1995) however
have posited that differences between AS and HFA may be
a quantitative only, rather than qualitative. Szatmari et al.
administered the Verbal Comprehension Scale A of the
Reynell Developmental Scales (Reynell & Huntley, 1987),
the Grammatical Completion Test of the Test of Language
Development-2 (Newcomer & Hammill, 1988), and the
Word Knowledge, Part 2, of the Oral Vocabulary section of
the McCarthy Scales of Children’s Abilities (McCarthy,
1972) to young children aged between four and six years
with a diagnosis of AS or autism. All children had a Leiter
IQ above 68 or a Stanford-Binet IQ of above 70. Szatmari
and colleagues described children with HFA as being
consistently two standard deviations below the mean on a
range of language tests, while the AS group performed just
below or within one standard deviation from the mean.
Spectrum Approach
The conceptualisation of AS and HFA as presentations that
differ only in level of impairment, as suggested by Szat-
mari et al. (1995), aligns with Wing’s (1989) proposed
spectrum of autistic disorders. In contrast to DSM-IV’s
(APA, 1994) categorical distinction between AS and HFA
based on language onset, the spectrum approach makes no
distinction between the two presentations regarding
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J Autism Dev Disord (2007) 37:1525–1538
developmental language history. Numerous studies have
taken the theoretical position of AS and HFA being dis-
orders on an autistic spectrum (e.g., Mandell, Walrath,
Manteuffel, Sgro, & Pinto-Martin, 2005; Paul, Augustyn,
Klin, & Volkmar, 2005; Prior et al., 1998; Seltzer et al.,
2003; Sperry & Mesibov, 2005; Warreyn, Roeyers, &
De Groote, 2005). Prior et al. (1998) for instance, exam-
ined the linguistic skills in children with diagnoses of either
AS, HFA, or a related pervasive developmental disorder.
The researchers focused on current language performance
using the Peabody Picture Vocabulary Test-Revised (Dunn
& Dunn, 1981) or the British Picture Vocabulary Test
(Dunn et al., 1982). Although IQ was in the normal range
for all children, Prior et al. described three significantly
different clusters of children based on verbal abilities.
Cluster membership however, did not correspond to the
developmental language histories of the participants.
Limitations to Previous Research Approaches
Findings from both the validation studies and the spectrum
studies have the potential to extend the current under-
standing of language skills in AS and HFA. However, there
are concerns regarding both research approaches that limit
the clinical application of findings. To date, language
assessments have been restricted to basic functional lan-
guage only, such as semantic (Howlin, 2003; Prior et al.,
1998; Szatmari et al., 1995) or grammatical development
(Szatmari et al., 1995).
This theoretical perspective aligns with DSM-IV’s
(APA, 1994) focus on language onset and early develop-
ment. The focus on early language milestones is for diag-
nostic purposes alone, yet the process of language
acquisition extends beyond the early childhood years. For
instance, the ability to resolve complex and demanding
language tasks such as resolving ambiguity (Sekerina,
Stromswold, & Hestvik, 2004) and producing figurative
language (Levorato & Cacciari, 2002) are later-emerging
language skills.
While the focus remains on those language skills that
are relevant only in determining diagnosis, the wider
clinical appreciation of the language skills in AS and HFA
may be hindered. Diagnosis allows access to intervention
(Bishop, 2006), but the determination of the level and type
of educational and vocational support services should not
be restricted to performance on functional linguistic tasks
such as knowledge of vocabulary and grammatical com-
petence only. More evidence on later-developing complex
language skills is needed to direct clinical intervention with
these client groups.
The current study aimed to broaden the scope of pre-
vious research into the language skills of individuals within
J Autism Dev Disord (2007) 37:1525–1538 1527

the autism spectrum. The first aim was to administer a Table 1 ASD child participant demographics
language assessment comprised of later-emerging complex ID Sex Age in Handedness Dev Lge Hist Given Diag
and demanding language tasks to a group of children and years; (Source)
adolescents and a group of adults with diagnoses of autism months
spectrum disorder (ASD) and two groups of matched
1 M 9; 4 Right Normal AS (paed)
controls to determine if performance significantly differed
2 M 11; 11 Right Normal ASD (paed)
between ASD and normally developing peers. Based on
3 M 14; 0 Right Normal AS (psych)
the methodology used in validation studies, the second aim
4 M 11; 0 Right Normal ASD (paed)
was to determine if performance on complex language
5 M 12; 1 Right Normal AS (paed)
tasks differed significantly when individuals with ASD
6 M 12; 6 Right Normal AS (psychiat)
were grouped according to developmental language onset
7 Fe 13; 6 Right Delayed AS (psychiat)
as outlined in DSM-IV (APA, 1994). The final aim, based
8 M 17; 1 Right Normal AS (paed)
on the methodology used in the spectrum approach to
9 M 15; 1 Right Normal AS (paed)
defining language characteristics, was to examine the
results of the language testing to determine if subgroups 10 Fe 9; 7 Right Delayed AS (paed)
from the experimental groups could be identified through 11 M 13; 7 Right Delayed AS (paed)
hierarchical cluster analyses based on current performance 12 M 9; 5 Right Unsure AS (paed)
on complex language tasks. 13 M 11; 6 Right Delayed AS (psychiat)
It was hypothesised that the experimental groups would 14 M 10; 5 Right Delayed AS/ASD (paed)
present with significantly different profiles when compared 15 M 10; 10 Right Normal AS (psych)
to the normally developing control groups. Given the 16 Fe 13; 3 Right Delayed AS/ASD (paed)
inconsistent results in terms of differences between those 17 M 9; 8 Right Delayed ASD (paed)
with, and those without, delayed developmental onset of 18 M 9; 0 Right Delayed ASD (paed)
language as assessed by semantic and grammatical tasks, 19 Fe 9; 0 Right Unsure ASD (paed)
no hypothesis was offered regarding whether later- 20 M 10; 5 Right Normal ASD (paed)
emerging complex language tasks differentiated individu- ASD = Autism spectrum disorder; AS = Asperger syndrome; Dev
als grouped according to developmental language history. Lge Hist = Developmental language history; Normal = Language
As subgroups of individuals within the autism spectrum onset prior to age two years; Delayed = Language onset after age two
years; Given Diag = Independently determined diagnosis; Source =
based on performance on basic functional language skills
Source of diagnosis; M = Male; Fe = Female; Psych = Psychologist;
such as semantic and grammatical development have been Paed = Paediatrician; Psychiat = Psychiatrist
described previously, it was hypothesised that subgroups
within the AS/HFA group, based on performance on
complex language tasks, would be evident from hierar- In addition to the diagnosis, inclusion criteria for the study
chical cluster analyses. were: aged nine years or older to allow for an examination
of later-emerging complex language skills, English as a
first language, no neurological disease or trauma, no other
Methods co-morbid condition, no history of drug and/or alcohol
abuse and normal vision and hearing.
Participants Participants were requested to provide documentation of
diagnosis. Diagnoses made by psychiatrists, paediatricians,
A total of 37 individuals with a diagnosis of AS, HFA, or and psychologists were accepted for inclusion into the
autism with average intelligence (henceforth referred to as study. There has been a range of diagnostic criteria proposed
ASD) were recruited. Tables 1 and 2 display the demo- for AS (e.g., APA, 1994; Gillberg & Gillberg, 1989; Szat-
graphic details of participants. Twenty participants were mari, Bremner, & Nagy, 1989; WHO, 1992), and the criteria
children (16 male; 4 female; M age: 11; 6 years; SD: 2; used by the various professionals for any of the given
2 years; range: 9; 0–17; 1 years). The remaining 17 par- diagnoses of participants were not known. It is acknowl-
ticipants were adults over the age of 18 years (8 male; 9 edged that some of the diagnoses may not adequately reflect
female; M age: 34; 8 years; SD: 12; 2 years; range: 18– DSM-IV criteria (APA, 1994) in regards to developmental
67 years). ASD participants were recruited through the language histories. Based on DSM-IV criteria, children with
Asperger Syndrome Support Network of Queensland, delayed onset of language do not meet the criteria for a
Autism Queensland, and newspaper articles. Recruitment diagnosis of AS, but rather, meet the criteria for Autistic
articles specified children, adolescents, and adults with a Disorder. For the current study, developmental language
diagnosis of AS, HFA, or autism with average intelligence. history took precedence over the given diagnosis.

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Table 2 ASD adult participant demographics

ID Sex Age in years Handedness Ed level Dev Lge Hist Given Diag (Source)

1 Fe 18 Left Secondary Delayed HFA (psychiat)

2 M 29 Right Secondary Delayed AS (psychiat)
3 M 27 Right Tertiary Unsure AS (psych)
4 M 28 Right Secondary Delayed HFA (psychiat)
5 M 48 Right Tertiary Unsure AS (psychiat)
6 M 29 Right Post-Sec Voc Normal AS (multi-disciplinary team:
Autistic Centre)
7 Fe 30 Left Post-Sec Voc Unsure AS (psychiat)
8 Fe 42 Right Secondary Delayed Autism (psych) *
9 Fe 31 Right Tertiary Unsure AS (psych)
10 M 30 Right Tertiary Unsure AS (psych)
11 Fe 22 Right Post-Sec Voc Delayed AS (psych)
12 Fe 26 Right Secondary Unsure ASD (psych)
13 M 67 Right Post-Sec Voc Unsure AS (psych)
14 Fe 38 Right Tertiary Unsure AS (psychiat)
15 Fe 32 Right Secondary Delayed AS (psychiat)
16 M 48 Right Post-Sec Voc Unsure AS (psych)
17 Fe 48 Right Primary Delayed AS (psych)
ASD = Autism spectrum disorder; AS = Asperger syndrome; HFA = High functioning autism; Ed level = Educational level; Dev Lge
Hist = Developmental language history; Normal = Language onset prior to age two years; Delayed = Language onset after age two years; Given
Diag = Independently determined diagnosis; Source = Source of diagnosis; Post-Sec Voc = Post-secondary vocational (trade); Psych = Psy-
chologist; Psychiat = Psychiatrist; M = Male; Fe = Female; *Diagnosed aged 3 as autistic by a psychologist, then diagnosed as AS in adulthood
by a psychiatrist

A total of 28 children and 16 adults with non-significant
developmental histories were recruited as control partici-
pants. Recruitment of controls was through newspaper
articles in local papers, local sporting clubs, and schools in
the south-east corner of Queensland. To be included in the
control group, participants were required to have English as
a first language, no history of neurological trauma or dis-
ease, no family history of autism, no developmental history
of language delays or difficulties, no family history of
language delays or difficulties, no history of drug and/or
alcohol abuse, and normal hearing and vision. Two control
children were excluded after being identified as receiving
learning support in the classroom. The 20 ASD children
were matched on age, sex, and educational level to 18
control children (mean age: 11; 5 years; standard devia-
tion: 1; 8 years; range: 9; 1–14; 8 years). The 17 ASD
adults were matched to 13 control adults (mean age: 34;
7 years; standard deviation: 13; 6 years; range: 18–
65 years) also on age, sex, and educational level.
Measures
All participants were assessed using the Test of Language
Competence-Expanded Edition (Wiig & Secord, 1989) and
the Test of Nonverbal Intelligence-Second Edition (Brown,
Sherbenou, & Johnsen, 1990). All ASD participants were
required to complete a questionnaire prior to commence-
ment of testing.
The Test of Language Competence-Expanded Edition
(TLC-E) (Wiig & Secord, 1989) provided the language
measures used to fulfil the three aims of the study. It is a
standardised test for the paediatric population and assesses
emerging metalinguistic competence in semantics, syntax,
and/or pragmatics. The test utilises a strategy approach to
language assessment based on the view that strategy
acquisition is central to the growth in communicative
competence and metalinguistic ability (Wiig & Secord,
1989).
Level 2 of TLC-E (Wiig & Secord, 1989) was used as it
is suitable for children aged 9 years, 0 months—18 years,
11 months. The children’s raw scores were converted to
Standard Scores as per instruction manual. Adult raw
scores were converted to Z-scores for the statistical
analyses. The TLC-E subtests are Ambiguous Sentences,
Listening Comprehension: Making Inferences, Oral
Expression: Recreating Sentences, and Figurative Lan-
guage. Examples of the four TLC-E subtests are presented
Appendix A.
The Test of Nonverbal Intelligence-Second Edition
(TONI-2) (Brown et al., 1990) was included in the test
battery to determine if nonverbal performance influenced

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verbal performance. The significance of nonverbal cogni-
tion was examined in each of the analyses undertaken to
achieve the stated research aims.
All ASD participants were requested to complete a
questionnaire prior to commencement of testing. The
questionnaire was completed by participants or parents/
carers. As well as providing identifying data, the ques-
tionnaire requested a retrospective history of language
development. This information allowed the researchers
to apply the methodology used in validation studies
(i.e., differentiating participants according to develop-
mental language history) to the current study. Questions
regarding the participant’s developmental history were
worded in a way to avoid parents/caregivers making
decisions regarding the appropriateness of the timing of
language onset. Judgments regarding delayed or normal
onset of language were made by an experienced speech
pathologist. DSM-IV (APA, 1994) language criterion (i.e.,
the use of single words by two years of age and the use of
communicative phrases by three years of age) was the
standard against which onset decisions were made. Where
needed, clarification of information provided in the ques-
tionnaire was sought at the initial assessment session.
Where language history could not be provided, this was
documented as unsure. Developmental language history
was not available for two child participants. For one child,
the parents were not able to recall developmental mile-
stones, and for the other, developmental history was not
available as the child did not live with his family of origin.
For the adults, the majority (53 %) had no access to
developmental histories.
Testing was undertaken at the University of Queensland,
in schools, or in the home of the participant. Each assess-
ment was administered in a distraction-free environment in
a standardised manner according to the instruction manual.
No response time-limits were placed on participants.
Results
Children
Group means and standard deviations for the child mea-
sures are shown in Table 3. For each measure, a Levene’s
test was carried out, and where necessary, appropriate
corrections for non-homogeneity were undertaken. For
determination of statistical significance, a conservative
level of p  .01 was utilised. This significance level was
chosen to account for possible Type 1 errors resulting from
the multiplicity of tests, while not increasing Type II error
rates. Student t tests indicated there was no significant
difference between the two groups on age (p  .01), and
no difference on nonverbal ability (p  .01).
1529
Table 3 Descriptive statistics of the child participants
Variable ASD (n = 20) Controls (n = 18) t Sig.
(2-tailed)
M SD M SD
TONI-2 100 18 113 16 2.258 .473
TLC-E
Amb Sent 5 3 10 3 4.267 .001***
List Comp 6 3 8 2 2.980 .005**
Oral Exp 5 2 10 3 6.699 .001***
Fig Lge 7 3 8 3 1.856 .072
ASD = Autism spectrum disorder; TONI-2 = Test of Nonverbal
Intelligence-2nd Edition; TLC-E = Test of Language Competence-
Expanded Edition; Amb Sent = Ambiguous Sentences; List
Comp = Listening Comprehension: Making Inferences; Oral Exp =
Oral Expression: Recreating Sentences; Fig Lge = Figurative
Language
**p  .01. ***p  .001
Children with ASD performed significantly less well
than their normally developing peers on Ambiguous Sen-
tences (p  .001), Listening Comprehension: Making
Inferences (p  .01), and Oral Expression: Recreating
Sentences (p  .001). There was no significant difference
between the two groups on Figurative Language (p  .01).
Using two years of age as the differential criterion as
stipulated by DSM-IV, children with ASD were grouped
according to developmental language history (onset of
language prior to two years of age (AS), onset after two
years of age (HFA), and those with uncertain develop-
mental language history). As shown in Table 4, the three
groups did not differ significantly on age (p  .01), non-
verbal intelligence (p  .01), or on any of the language
measures (p  .01 on all measures).
An agglomerative hierarchical cluster analysis was
undertaken with the child ASD participants. Current per-
formance on the four TLC-E subtests was used to deter-
mine an optimal classification. The hierarchical clustering
of the ASD child participants is shown in Fig. 1. The
purpose of the cluster analysis is to join cases together into
successively larger clusters, using some measure of simi-
larity or distance (StatSoft, 1984–2004). The rescaled dis-
tance refers to similarity in measures, and cases with a
similar rescaled distance cluster early. Greater distances at
which clusters combine denote greater heterogeneity
within the clusters. When a horizontal line joins two ver-
tical portions, it indicates fusion between two clusters of
cases.
The cluster analysis identified three subgroups of chil-
dren. These subgroups are descriptive only. Membership
within the subgroups is shown in Table 5. Scores are given
as within standard deviations from the control group
means. Performance between the subgroups ranged from
average to moderate-severe difficulties. Subgroup 3’s
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Table 4 Performance by children with ASD grouped according to performance was within the average range for Listening
developmental language history Comprehension: Making Inferences and Figurative Lan-
Variable Language Language Unsure Kruskall– guage, and mild-moderately impaired on Ambiguous
onset prior to onset after history Wallis test Sentences and Oral Expression: Recreating Sentences.
two years of two years of (n = 2) Subgroup 1 was characterised by moderate-severe diffi-
age (n = 10) age (n = 8)
culties on Ambiguous Sentences, Listening Comprehen-
M (SD) M (SD) M (SD) v2 p sion: Making Inferences, and Oral Expression: Recreating
(Asymp. Sentences, and mild-moderate difficulties on Figurative
Sig.
2-tailed) Language.
Chi-Square tests indicated that neither sex (v2 = 4.091,
Age 12; 5 (2; 4) 11; 4 (1; 11) 9; 2 (0.4) 4.729 .094 p = .129), nor developmental language history
TONI-2 103 (18) 99 (20) 91 (6) 1.302 .521 (v2 = 5.480, p = .242) were significant in the formation of
TLC-E the child subgroups. The Kruskal–Wallis test determined
Amb Sent 7 (4) 4 (1) 3 (0) 6.566 .038 neither age (v2 = 2.838, p = .242), TONI-2 performance
List Comp 7 (3) 5 (2) 3 (1) 4.702 .095 (v2 = 8.461, p = .015), nor Oral Expression: Recreating
Oral Exp 5 (2) 5 (3) 4 (1) .310 .856 Sentences (v2 = 4.401, p = .111) were significantly dif-
Fig Lge 8 (4) 6 (3) 4 (1) 3.669 .160 ferent between the subgroups. Significant differences were
ASD = Autism spectrum disorder; TONI-2 = Test of Nonverbal noted on Ambiguous Sentences (v2 = 12.847, p = .002),
Intelligence-2nd Edition; TLC-E = Test of Language Competence- Listening Comprehension: Making Inferences
Expanded Edition; Amb Sent = Ambiguous Sentences; List (v2 = 11.236, p = .004), and Figurative Language
Comp = Listening Comprehension: Making Inferences; Oral Exp = (v2 = 13.491, p = .001). As shown in Table 6, post-hoc
Oral Expression: Recreating Sentences; Fig Lge = Figurative
Language. Mann–Whitney U tests identified a significant difference
between subgroups 1 and 2 on Listening Comprehension:
performance was generally average for Ambiguous Sen- Making Inferences (p  .01) and between subgroups 1
tences, Listening Comprehension: Making Inferences, and and 3 on Ambiguous Sentences (p  .001) and Figurative
Figurative Language, but exhibited mild difficulties on Language (p  .001). All other differences between the
Oral Expression: Recreating Sentences. Subgroup 2’s subgroups were not significant (p  .01).

Fig. 1 Agglomerative
hierarchical cluster analysis of
the language performance ofthe
children with ASD. The four
subtest scores from the Test of
Language Competence-
Expanded Edition were used for
the analysis. Subgroup
membership is shown in Table
5.

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Table 5 Subgroups of child ASD participants based on performance on the TLC-E

ID Given Diag Lge Hist Amb Sent List Comp Oral Exp Fig Lge

Subgroup 1 (n = 11) ASC 7 AS Delayed 2.5 2.5 2.5 1.5

ASC 10 AS Delayed 2.5 2.5 2.5 2.5
ASC 19 ASD Unsure 2.5 2.5 2.5 1.0
ASC 11 AS Delayed 2.0 1.5 2.5 1.5
ASC 16 AS/ASD Delayed 2.5 1.5 2.5 1.5
ASC 5 AS Normal 2.5 2.0 2.0 2.0
ASC 12 AS Unsure 2.5 2.0 2.0 1.5
ASC 1 AS Normal 2.0 1.0 2.0 1.0
ASC 20 ASD Normal 2.0 2.0 2.5 1.0
ASC 14 AS/ASD Delayed 2.5 2.0 1.5 1.0
ASC 17 ASD Delayed 2.0 2.5 1.0 2.0
Subgroup 2 (n = 4) ASC 6 AS Normal 1.5 1.0 1.5 1.0
ASC 15 AS Normal 1.0 .5 2.0 1.0
ASC 8 AS Normal 2.5 +.5 2.5 1.0
ASC 18 ASD Delayed 2.0 .5 2.0 .0
Subgroup 3 (n = 5) ASC 2 ASD Normal +.5 1.0 2.0 +1.5
ASC 9 AS Normal 1.0 2.0 2.5 +1.0
ASC 3 AS Normal +1.0 +1.5 1.0 +2.0
ASC 4 AS Normal +1.0 +1.0 1.0 +.5
ASC 13 AS Delayed 1.0 +1.0 .0 +1.0
ASD = Autism spectrum disorder; TLC-E = Test of Language Competence-Expanded Edition; ASC = Autism spectrum child identification;
Given Diag = Independently determined diagnosis; Lge Hist = Developmental language history; Normal = Language onset prior to age two
years; Delayed = Language onset after age two years; Amb Sent = Ambiguous Sentences; List Comp = Listening Comprehension: Making
Inferences; Oral Exp = Oral Expression: Recreating Sentences; Fig Lge = Figurative Language; Deviations from the control group subtest
means are shown; + = above the mean; = below the mean; Scores written as .0 indicate no deviation from the control mean

Adults
Group means and standard deviations for the adult mea-
sures are shown in Table 7. For each measure, a Levene’s
test was carried out, and where necessary, appropriate
corrections for non-homogeneity were undertaken. Again,
a conservative level of p  .01 was utilised for determi-
nation of statistical significance, to account for possible
Type 1 errors resulting from the multiplicity of tests, but
without increasing Type II error rates. Student t tests
indicated there was no significant difference between the
two groups on age (p  .01), and no difference on non-
verbal ability (p  .01). Student t tests revealed signifi-
cant differences between the means of the two groups on
Oral Expression: Recreating Sentences (p  .01) and
Figurative Language (p  .01). There were no significant
differences between the two groups on Ambiguous Sen-
tences (p  .01) and Listening Comprehension: Making
Inferences (p  .01).
The ASD adults were grouped according to develop-
mental language history based on DSM-IV language cri-
terion (prior to two years of age (AS), after two years of
age (HFA), or uncertain of developmental history). As
shown in Table 8, the three groups did not differ signifi-
cantly on age (p  .01), nonverbal intelligence (p  .01),
or on any of the language measures (p  .01 on all
measures).
An agglomerative hierarchical cluster analysis was
undertaken with the adults with ASD. Current performance
on the four TLC-E subtests was used to determine an
optimal classification. The hierarchical clustering of the
ASD adults is shown in Fig. 2.
The analysis identified three subgroups of adults with
ASD. These subgroups are descriptive only. Membership
of the subgroups is shown in Table 9. Raw scores are
given as within standard deviations from the control
group means. Subgroup 1’s performance was character-
ised by generally average performance on Ambiguous
Sentences, and Listening Comprehension: Making Infer-
ences, and less skilled performance on Oral Expression:
Recreating Sentences and Figurative Language. Subgroup
2’s performance was strongest on Figurative Language
(mild difficulty-average), and moderate-severe difficulties
on the three remaining subtests. Subgroup 3 presented
with severe difficulties spread across all four TLC-E
subtests.

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Table 6 Differences between the ASD child subgroups on the three significant TLC-E subtests
Variable Subgroup 1/2 Subgroup 1/3 Subgroup 2/3
Z p Asymp. Sig. (2-tailed) Z p Asymp. Sig. (2-tailed) Z p Asymp. Sig. (2-tailed)

Amb Sent 1.717 .086 3.265 .001 *** 2.347 .019

List Comp 2.866 .004 ** 2.555 .011 .620 .535
Fig Lge 2.104 .035 3.177 .001 *** 2.470 .014
ASD = Autism spectrum disorder; TLC-E = Test of Language Competence-Expanded Edition; Amb Sent = Ambiguous Sentences; List
Comp = Listening Comprehension: Making Inferences; Fig Lge = Figurative Language; **p  .01. ***p  .001

Table 7 Descriptive statistics of the adult participants

Variable ASD (n = 17) Controls (n = 13) t Sig. (2-tailed)
M SD M SD

TONI 2 91 14 99 11 1.765 .857

TLC-E
Amb Sent # 39 25 11 32 5 2.256 .033
List Comp # 36 26 8 32 3 2.756 .011
Oral Exp # 78 60 12 73 6 3.392 .002**
Fig Lge # 36 24 10 33 4 3.274 .003**
ASD = Autism spectrum disorders; TONI-2 = Test of Nonverbal Intelligence-2nd Edition; TLC-E = Test of Language Competence-Expanded
Edition; Amb Sent = Ambiguous Sentences; List Comp = Listening Comprehension: Making Inferences; Oral Exp = Oral Expression: Rec-
reating Sentences; Fig Lge = Figurative Language; # = Maximum possible score. **p  .01

Table 8 Performance by adults with ASD grouped according to developmental language history
Variable Language onset after two years Uncertain developmental Language onset prior to Kruskall–Wallis test
of age (n = 7) Language history (n = 9) two years of age (n = 1)
M (SD) M (SD) M (SD) v2 p (Asymp. Sig. 2-tailed)

Age 31 (10) 38 (14) 29 1.388 .499

TONI-2 87 (17) 95 (10) 83 2.340 .310
TLC-E
Amb Sent 22 (11) 29 (10) 8 3.865 .145
List Comp 26 (8) 26 (9) 19 .754 .686
Oral Exp 57 (16) 64 (7) 51 1.489 .475
Fig Lge 21 (10) 28 (9) 16 2.670 .263
ASD = Autism spectrum disorder; TONI-2 = Test of Nonverbal Intelligence-2nd Edition; TLC-E = Test of Language Competence-Expanded
Edition; Amb Sent = Ambiguous Sentences; List Comp = Listening Comprehension: Making Inferences; Oral Exp = Oral Expression: Rec-
reating Sentences; Fig Lge = Figurative Language

Chi-Square tests indicated membership into the three
subgroups was not significantly influenced by language
history (v2 = 4.641, p = .326) or gender (v2 = .643,
p = .725). The Kruskal–Wallis test indicated there were
no significant differences between the subgroups on age
(v2 = 1.088, p = .580), and TONI-2 (v2 = 8.949,
p = .011). Significant differences between the subgroups
were found on Ambiguous Sentences (v2 = 13.018,
p = .001), Listening Comprehension: Making Inferences
(v2 = 12.557, p = .002), Oral Expression: Recreating
Sentences (v2 = 11.485, p = .003), and Figurative Lan-
guage (v2 = 10.089, p = .006). Table 10 displays the
results of post-hoc analyses using Mann–Whitney U tests.
Subgroups 1 and 2 differed significantly on Ambiguous
Sentences (p  .01) and Listening Comprehension:
Making Inferences (p  .01). Significant differences
between subgroups 1 and 3 were found on all four
TLC-E subtests (p  .01 on all measures). Subgroups 2
and 3 did not differ on any of the language measures
(p  .01).

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J Autism Dev Disord (2007) 37:1525–1538 1533

Fig. 2. Agglomerative
hierarchical cluster analysis of
the language performance of the
adults with ASD. The four
subtest scores from the Test of
Language Competence-
Expanded Edition were used for
the analysis. Subgroup
membership is shown in
Table 9.

Discussion skills. The findings support the study’s two predicted

hypotheses. Firstly, performance on a range of complex
The major focus in the present study was to examine the language tasks that emerge later in the developmental
performance of individuals with ASD on complex language process of language acquisition was less proficient in ASD

Table 9 Subgroups of ASD adult participants based on performance on the TLC-E

ID Given Diag Lge Hist Amb Sent List Comp Oral Exp Fig Lge

Subgroup 1 ASA 3 AS Unsure +1.0 +1.0 2.0 1.0

(n = 8) ASA 5 AS Unsure +1.0 +1.0 1.5 +.5
ASA 1 HFA Delayed +.5 +1.0 2.0 2.0
ASA 13 AS Unsure +1.5 .0 +.5 +1.0
ASA 14 AS Unsure +1.0 1.0 1.0 +.5
ASA 8 Autism Delayed +1.0 .0 +1.0 .5
ASA 7 AS Unsure 1.0 .0 .5 2.5
ASA 15 AS Delayed +.5 +1.0 .0 3.5
Subgroup 2 ASA 9 AS Unsure .5 5.5 3.0 1.0
(n = 4) ASA 10 AS Unsure 1.5 4.5 1.5 1.0
ASA 16 AS Unsure 1.5 2.0 2.0 1.5
ASA 11 AS Delayed 4.0 1.5 1.5 +.5
Subgroup 3 ASA 4 HFA Delayed 5.0 4.0 5.5 6.5
(n = 5) ASA 17 AS Delayed 4.0 4.5 6.0 5.5
ASA 2 AS Delayed 5.0 5.5 5.0 4.5
ASA 6 AS Normal 5.5 4.5 4.0 4.5
ASA 12 AS Unsure 5.5 7.0 3.0 7.0
ASD = Autism spectrum disorder; TLC-E = Test of Language Competence-Expanded Edition; ASA = Autism spectrum adult identification;
Given Diag = Independently determined diagnosis; Lge Hist = Developmental language history; Normal = Language onset prior to age two
years; Delayed = Language onset after age two years; Amb Sent = Ambiguous Sentences; List Comp = Listening Comprehension: Making
Inferences; Oral Exp = Oral Expression: Recreating Sentences; Fig Lge = Figurative Language; TLC-E raw scores were used to calculate the
ASD deviations from the control group subtest means; + = above the mean; = below the mean; Scores written as .0 indicate no deviation from
the control mean

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Table 10 Differences between the adult ASD subgroups on the four TLC-E subtests
Variable Subgroup 1/2 Subgroup 1/3
Z p Asymp. Sig. (2-tailed) Z p Asymp. Sig. (2-tailed)
Amb Sent 2.557 .008**
List Comp 2.756 .004**
Oral Exp 1.701 .089
Fig Lge .171 .933
ASD = Autism spectrum disorder; TLC-E = Test of Language Competence-Expanded Edition; Amb Sent = Ambiguous Sentences; List
Comp = Listening Comprehension: Making Inferences; Oral Exp = Oral Expression: Recreating Sentences; Fig Lge = Figurative Language;
**p  .01
than in typically developing peers. Secondly, subgroups
within ASD can be described based on current performance
on later-developing complex language tasks. While no
prediction was made regarding performance of individuals
with ASD grouped according to developmental language
history, the current findings suggest that developmental
language history may not be a significant factor in current
performance on complex language tasks.
Later-developing Complex Language Abilities in ASD
The language skills assessed by the TLC-E (Wiig &
Secord, 1989) require high-level cognitive-linguistic skill.
Both children and adults with ASD experienced difficulties
with the complex language tasks relative to their peers.
Children with ASD were less skilled on tasks of resolving
ambiguity, understanding inferential language, and using
linguistic flexibility to produce speech acts constrained by
a communicative situation. Adults with the diagnosis pre-
sented with difficulties in interpreting figurative language
and producing relevant speech acts. Cognitive skill alone
did not account for these difficulties, as both the children
and adults with ASD had similar nonverbal cognitive skills
to their normally developing peers.
Previous studies of autism spectrum presentations have
also identified difficulties with later-developing language
tasks. For example, difficulties with inferential language
(Dennis, Lazenby, & Lockyer, 2001; Koning & Magill-
Evans, 2001; Ozonoff & Miller, 1996), figurative language
(Dennis et al., 2001), and producing relevant speech acts
(Dennis et al., 2001; Losh & Capps, 2003; Ozonoff &
Miller, 1996) have all been described in the AS/HFA
population. The current findings support these claims.
Some inconsistencies are apparent however. Contrary to
our findings and those of Dennis et al., Gunter, Ghaziud-
din, and Ellis (2002) described inferential skills in AS/HFA
as being no different to controls. Further, Dennis et al.
described children younger than the child clinical group in
the current study as possessing some level of linguistic
flexibility for resolving ambiguity.
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J Autism Dev Disord (2007) 37:1525–1538
Subgroup 2/3
Z p Asymp. Sig. (2-tailed)
2.940 .002** 2.233 .026
2.965 .002** 1.126 .286
2.932 .002** 2.449 .014
2.936 .002** 2.470 .014
Performance of Individuals with ASD Grouped
According to Developmental Language History
The findings of the current study suggest that perfor-
mance on later-developing complex language tasks does
not differentiate groups of ASD individuals when
grouped according to developmental language history as
specified in DSM-IV (APA, 1994). However, while there
were non-significant differences for both the child and
adult groups, caution is required when interpreting the
results.
Consistent with the theoretical concerns previously
raised, the reliability and validity of diagnostic decisions
based on developmental milestones has been challenged
for three major reasons (Prior et al., 1998; Tager-Flusberg,
2003; Woodbury-Smith, Klin, & Volkmar, 2005). Firstly,
there are concerns that diagnostic decisions may be based
on unreliable retrospective recall of developmental mile-
stones leading to inaccurate diagnoses (Tager-Flusberg,
2003; Woodbury-Smith et al., 2005). Although the mean at
diagnosis for AS is 8 years (Attwood, 1998), some indi-
viduals are diagnosed in adulthood (Frith, 2003). In cases
where there is a lengthy period of time between early
childhood and age at diagnosis, the recall of developmental
milestones may be unreliable or unavailable. In the current
study, this limitation was evident, particularly with the
adult participants.
Secondly, the DSM-IV (APA, 1994) distinction between
AS and HFA may not consistently be applied in diagnostic
and clinical practice (Klin, Pauls, Schultz, & Volkmar,
2005). In the current study, there were examples of chil-
dren not using single words and not using communicative
phrases by age 3 years. According to DSM-IV criteria,
these children would be given the diagnosis of Autistic
Disorder. However, a number of children with these
reported milestones were given a diagnosis of AS.
Finally, the interpretation of reported milestones may
be inconsistent, leading to conflicting diagnoses (Tager-
Flusberg, 2003; Woodbury-Smith et al., 2005). Tager-
Flusberg (2003) for instance argued that DSM-IV’s
J Autism Dev Disord (2007) 37:1525–1538
(APA, 1994) language criterion (i.e., the use of single
words by two years of age and the use of communicative
phrases by three years of age) would be judged as
delayed onset if compared to normative data from typi-
cally developing children. In such a presentation, a
diagnosis of Autistic Disorder, not AS, could be given.
For these reasons, although developmental language
history was not a differentiating factor, interpreting the
findings as suggesting that complex language skills do
not differentiate individuals with ASD with differing
developmental language histories needs to be considered
with caution.
Subgroups within ASD Based on Performance
on Complex Language Tasks
The findings of the present study suggest individuals with
ASD exhibit a range of abilities on complex cognitive-
linguistic tasks, as assessed by the TLC-E (Wiig & Secord,
1989), where ability was not related to age, gender, or
nonverbal cognitive skills. Subgroups could be identified in
ASD where ability ranged from average/above average
through to moderate-severe impairments. Examples of
responses from individuals within the subgroups are found
in Appendix B
There are limitations to the study which are acknowl-
edged. Firstly, the study should be viewed as a pilot study
only, given the limited sample size. Replication with a far
larger cohort is warranted before generalisation to the
wider ASD population can be considered. Secondly,
non-significant results such as in the determination of
language differences between those with differing lan-
guage onset histories may reflect unreliable reporting
of histories. However, while the focus of diagnostic
debate remains on retrospective history, this issue will
continue.
Subtest
Ambiguous Sentences
An ambiguous sentence is read aloud without the use of intonation
to indicate meaning. The sentence is shown to the participant (P).
To obtain the full score, P must provide two different interpretations.
1535
Conclusions
Using similar methodologies but broadening the theoretical
perspective of previous research into the language skills in
AS and HFA, the results from the current study may extend
the clinical appreciation of the language difficulties asso-
ciated with ASD. The findings suggest that the language
difficulties experienced by children and adults with ASD
extend beyond semantic and syntactic skills as defined by
previous studies. In addition, subgroups within ASD are
evident, defined by their complex language skills. Finally,
developmental language history was found to be not sig-
nificant in language outcomes, but the reliability of our
findings can be challenged due to the reliance upon retro-
spective recall of developmental milestones.
The clinical implications of the findings suggest that
conceptualising AS and HFA as autistic disorders on a
spectrum may provide much clinically relevant information
about the range of language skills in the autistic presenta-
tion. Further, a reliance on accurate assessment of current
language performance, rather than a reliance on possibly
inaccurate recall of past language performance should
form the basis for intervention strategies and services. To
clinically appreciate the diversity of language skills in
ASD, comprehensive language assessments should be
undertaken on all individuals. Individualised education and
vocational support plans can then be determined, based on
individual strengths and weaknesses.
Acknowledgments The authors acknowledge the children, adults,
and their families who supported the study through their participation.
A special thanks to the Principal, St Augustine’s College, and the
students for their involvement.
Appendix A
TLC-E subtests and example items
Test item example
Target sentenc
The elephant was ready to lift.
Acceptable responses for full score
Ready to lift something.
Ready to be lifted.
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