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Cited by 170Autism Spectrum Disorder ResearchLanguage Development and DisordersChild Nutrition and Feeding Issues

Autism and diagnostic substitution: evidence from a study of adults with a history of developmental language disorder

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Bishop, Dorothy V M, Whitehouse, Andrew J O, Watt, Helen J, Line, Elizabeth A·2008·Developmental Medicine & Child Neurology
DOI 10.1111/j.1469-8749.2008.02057.x
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Abstract

Rates of diagnosis of autism have risen since 1980, raising the question of whether some children who previously had other diagnoses are now being diagnosed with autism. We applied contemporary diagnostic criteria for autism to adults with a history of developmental language disorder, to discover whether diagnostic substitution has taken place. A total of 38 adults (aged 15–31y; 31 males, seven females) who had participated in studies of developmental language disorder during childhood were given the Autism Diagnostic Observation Schedule ‐ Generic. Their parents completed the Autism Diagnostic Interview ‐ Revised, which relies largely on symptoms present at age 4 to 5 years to diagnose autism. Eight individuals met criteria for autism on both instruments, and a further four met criteria for milder forms of autistic spectrum disorder. Most individuals with autism had been identified with pragmatic impairments in childhood. Some children who would nowadays be diagnosed unambiguously with autistic disorder had been diagnosed with developmental language disorder in the past. This finding has implications for our understanding of the epidemiology of autism.

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  • 34% of a sample of 38 adults with DLD diagnoses were found to meet autism criteria.

    “34% of a sample of 38 adults with DLD diagnoses were found to meet autism criteria (Bishop et al., 2008).”

    From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Bishop et al., 2008

    The Results (page not provided) report that 13 of 38 participants—approximately 34%—met the broader criterion for ASD or autism on both instruments. Only eight met the paper’s strict criterion for autism, so describing all 34% as meeting autism criteria omits an important distinction. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • In adults diagnosed with developmental language disorder in childhood (n=38), 8 out of 38 meet strict autism criteria.

    “8 out of 38 participants diagnosed with a developmental language disorder in childhood meet strict autism criteria”

    From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Bishop et al. (2008)

  • In the same population, a further 5 meet criteria for broader ASD/PDD-NOS.

    “a further 5 meet criteria for broader ASD/PDD-NOS”

    From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Bishop et al. (2008)

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Research works printed but not linked: 23

  1. Williams JG, Higgins JPT, Brayne CEG. Systematic review of prevalence studies of autism spectrum disorders. Arch Dis Child 2006; 91: 8-15.
  2. Rutter M. Incidence of autism spectrum disorders: changes over time and their meaning. Acta Paediatr 2005; 94: 2-15.
  3. Bishop DVM. Autism, Asperger's syndrome and semantic- pragmatic disorder: where are the boundaries? Br J Disord Commun 1989; 24: 107-21.
  4. Bishop DVM, Norbury CF. Exploring the borderlands of autistic disorder and specific language impairment: a study using standardised diagnostic instruments. J Child Psychol Psychiatry 2002; 43: 917-29.
  5. Boucher J. SPD as a distinct diagnostic entity: logical considerations and directions for future research. Int J Lang Commun Disord 1998; 33: 71-81.
  6. Botting N. Semantic-pragmatic disorder (SPD) as a distinct diagnostic entity: making sense of the boundaries. Int J Lang Commun Disord 1998; 33: 87-90.
  7. Brook SL, Bowler DM. Autism by another name? Semantic and pragmatic impairments in children. J Autism Dev Disord 1992; 22: 61-81.
  8. Bishop DVM, Rosenbloom L. Classification of childhood language disorders. In: W. Yule, Rutter M, eds. Language development and disorders. Clinics in Developmental Medicine No. 101/102. London: Mac Keith Press, 1987: 16-41.
  9. Rapin I, Allen D. Developmental language disorders: nosologic considerations. In: Kirk U, ed. Neuropsychology of language, reading, and spelling. New York: Academic Press, 1983: 155-84.
  10. Bishop DVM. Development of the Children's Communication Checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children. J Child Psychol Psychiatry 1998; 39: 879-91.
  11. Conti-Ramsden G, Crutchley A, Botting N. The extent to which psychometric tests differentiate subgroups of children with SLI. J Speech Lang Hear Res 1997; 40: 765-77.
  12. Lord C, Risi S, Lambrecht L, et al. The Autism Diagnostic Observation Schedule -Generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord 2000; 30: 205-23.
  13. Lord C, Rutter M, LeCouteur A. Autism Diagnostic Interview - Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 1994; 24: 659-85.
  14. Baird G, Simonoff E, Pickles A, et al. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet 2006; 368: 210-15.
  15. Jick H, Kaye JA. Epidemiology and possible causes of autism. Pharmacotherapy 2003; 23: 1524-30.
  16. Shattuck PT. The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education. Pediatrics 2006; 117: 1028-37.
  17. Conti-Ramsden G, Simkin Z, Botting N. The prevalence of autistic spectrum disorders in adolescents with a history of specific language impairment (SLI). J Child Psychol Psychiatry 2006; 47: 621-28.
  18. Howlin P, Mawhood L, Rutter M. Autism and developmental receptive language disorder -a comparative follow-up in early adult life. II. Social, behavioural, and psychiatric outcomes. J Child Psychol Psychiatry 2000; 41: 561-78.
  19. Clegg J, Hollis C, Mawhood L, Rutter M. Development language disorders -a follow-up in later life. Cognitive, language and psychosocial outcomes. J Child Psychol Psychiatry 2005; 46: 128-49.
  20. Gernsbacher MA, Dawson M, Goldsmith HH. Three reasons not to believe in an autism epidemic. Curr Dir Psychol Sci 2005; 14: 55-58.
  21. Wing L. The autistic spectrum. Lancet 1997; 350: 1761-66.
  22. Bishop DVM, Adams C. Conversational characteristics of children with semantic-pragmatic disorder II. What features lead to a judgement of inappropriacy? Br J Disord Commun 1989; 24: 241-63.
  23. Bishop DVM, Hartley J, Weir F. Why and when do some language impaired children seem talkative? J Autism Dev Disord 1994; 24: 177-97. 344 Developmental Medicine & Child Neurology 2008, 50: 341-345 *North American usage: mental retardation. 14698749, 2008, 5, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2008.02057.x, Wiley Online Library on [18/08/2026]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

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Authors
Bishop, D. V. M., Whitehouse, A. J. O., Watt, H. J., & Line, E. A.
Affiliations
University of Oxford (GB)
ORCID
Venue
Developmental Medicine & Child Neurology
Publisher
Wiley
Published
2008-03-31
Volume
50
Issue
5
Pages
341-345
ISSN
  • 0012-1622 (ISSN-L)
  • 1469-8749
DOI
10.1111/j.1469-8749.2008.02057.x
OpenAlex
W1981373405
Cited by
170
References
1
Citations by year
2026: 3 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 11 · 2020: 7 · 2019: 4 · 2018: 7 · 2017: 9 · 2016: 13 · 2015: 17 · 2014: 8 · 2013: 14 · 2012: 13
FWCI
8.47
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Developmental Medicine & Child Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
Funders
Wellcome Trust (082498/Z/07/Z, 082498)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
autism spectrum disorder, specific language impairment, pragmatic impairment, autism epidemiology, autistic adults, language disorders in children
MeSH terms
Adolescent, Adult, Autistic Disorder, Developmental Disabilities, Female, Humans, Interview, Psychological, Language Development Disorders, Male, Psychiatric Status Rating Scales, Psychometrics, Retrospective Studies

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