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Conduct disordered children show severe language deficits
A startling study reports that two-thirds of male children
diagnosed with conduct disorder (CD) exhibit pragmatic
language impairments and other behavioral features ' "similar
in nature and degree to those of children with autism."
Jane Gilmour and colleagues evaluated 142 children
referred to a clinic with a diagnosis of either autism spectrum
disorder or conduct disorder, comparing them to a group of
typically developing children. In addition, the researchers
evaluated 54 children excluded from elementary schools due to
conduct problems. The researchers focused on male children
with CD, who outnumber CD females by a ratio of nine to one.
Parents and teachers rated the children using the Children's
Communication Checklist. In both CD groups, the researchers
say, two-thirds of the children exhibited marked defects in
pragmatic language, regardless of IQ. Pragmatic language
involves skills that allow an individual to communicate in a way
that is appropriate to a social situation-for instance, proper
initiation of conversation, use of contextual clues, ability to
gauge a listener's interest, and ability to maintain rapport.
The deficits seen in the CD children, the researchers say,
were comparable to those seen in children with autism, a
neurodevelopmental disorder that causes severe deficits in
language and social skills. "Our data show that a subset of
children presenting as CD actually have an unidentified autism
spectrum disorder," they say. "There are still further children
with CD who do not reach a formal autism spectrum disorder
diagnosis but who nonetheless have pragmatic problems."
Gilmour et al. conclude, "The results indicate that a
significant minority of children with disruptive behavior in the
community have significant, previously unidentified social
communication difficulties." They note that other studies have
shown an overlap between autistic deficits and conduct
problems; one study by Speltz et al., for instance, found that
preschool boys with oppositional defiant disorder had poorer
vocabularies for describing emotional states than typical
children did, even when the researchers controlled for general
vocabulary knowledge and test-taking behavior. Gilmour et al.
say it also is interesting that both autism and CD affect far more
boys than girls.
The researchers say their findings suggest that the
educational interventions used for children with autism-
interventions aimed at reducing language and social disorders
stemming from neurological deficits-are likely to be more
effective than current interventions for CD, which have proven
disappointing.
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"Social communication deficits in conduct disorder: a clinical
and community survey," J. Gilmour, B. Hill, M. Place, and D. H.
Skuse, Journal of Child Psychology and Psychiatry, Vol. 45,
No. 5, 2004, 967-78. Address: Jane Gilmour, Sub-
Department of Clinical Health Psychology, University College
London, Gower Street, London WCIE 6BT, UK.
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