The communicative use of pointing in autism: developmental profile and factors related to change.

PURPOSE: To describe different longitudinal profiles in communicative abilities and symptoms severity in early autism.

METHODS

Five children with autism, aged from 3;3 to 4;10 years at baseline, were tested for production and comprehension of imperative and declarative pointing at about 4-month intervals. Concurrently with these sessions, children were evaluated in terms of cognitive and communicative abilities, and symptoms severity.

RESULTS

Four subjects showed a mild to severe retardation in communicative and linguistic abilities. For production, all children exhibited the imperative pointing and only one the declarative pointing. For comprehension, two subjects showed the same profile as in production ('only imperative' and 'first imperative-later declarative', respectively). One child did not show any clear comprehension of the pointing gestures produced by the experimenter, and one child was able to understand both pointing in the same session. Childhood autism rating scale (CARS) global scores tended to decrease across sessions for all subjects and different individual profiles were identified.

DISCUSSION: Declarative or experience-sharing pointing emerged later in one child only; it remained absent in four children as production, and in two children as comprehension. A preliminary conclusion based on CARS rating, is that autism involves a symptomatology that may decrease across time even if children differ in the decreasing profile relative to specific scores.