Trastorno Especifico Del Lenguaje Y Autismo

INT J LANG COMMUN DISORD, MARCH–APRIL VOL.

2011,

46, NO. 2, 127–137

Discussion Co-morbidity of autism and SLI: kinds, kin and complexity
Bruce Tomblin
Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA

(Received 3 October 2010; accepted 15 December 2010) Abstract
There has been a long-standing interest in the relationship between specific languageimpairment (SLI) and autism spectrum disorder (ASD). In the last decade Tager-Flusberg and colleagues have proposed that this relationship consists of a partial overlap between the two. Therefore, among children with ASD there exists a subgroup who have SLI and ASD which has been called ‘ALI’. Tager-Flusberg’s laboratory has presented several papers showing similar language profiles and brain structureabnormalities in both SLI and ALI. Others (Bishop, Whitehouse, Botting, Williams) have been less convinced that these ALI children have both ASD and SLI. Although they generally agree that the two groups are grossly similar, careful inspection of the data shows that there are differences. I will argue that many of the problems in this debate stem from a view of SLI that represents a particular kind oflanguage learner and therefore a particular and unique profile can be assumed. I argue for recognizing that SLI is not likely to be a unique kind of language learner. Many of the features reported to be characteristic of SLI are also found in other forms of neurodevelopmental disorders. Other features are the outgrowth of studying clinically identified children with SLI and thus the profile appearsto reflect biases and practices in the clinical service system. As a result it may be more reasonable to conclude that there is a large group of children with ASD who have poor language skills. The question then remains why are there so many children with ASD who also have poor language? There are several factors that collectively are strong candidates for answers to this question. Keywords: autismspectrum disorders (ASD), specific language impairment (SLI), co-morbidity.

Introduction Recently, there have been several papers published regarding the relationship of the language and communication problems of children with autism and autism spectrum disorder (ASD) and children with specific language impairment (SLI). The basic question that has been raised concerns whether there is an excessof SLI within children with ASD? For the practising clinician this question may appear to be a bit esoteric. Within the day-to-day practice of a speech– language clinician, each client is largely viewed as a unique entity. As such, clinical work is much more about the particular and the individual than it is about generalities and groups. The clinician is concerned most about the welfare of eachperson served and as such promoting effective communication in each client. Research is often quite the opposite. In this enterprise generalities concerning patterns and principles are the focus. Individuals are important insofar as they provide information about these patterns; however, the general-

ities are the most important. This results in what could be viewed as a disparity of purposebetween the clinic and research, even clinical research. One of these debates in clinical research concerns how we group or organize the types of clinical conditions that we treat and the relationships among these. The issue concerning the relationship of SLI and ASD is one of these kinds of questions and will be the subject of this paper. Therefore, we need to ask why these issues may be importantfor clinical practice. My best answer to this is that within the clinic and in research laboratories we must assume that the individual differences in the language and communication of our clients are largely systematic. Thus, it is not simply by chance that some children differ from others with respect to language and communication nor is it by chance that some children will be more similar to...