Strategic scoring in autism (Girolamo et al., 2024)

<b>Purpose: </b>Despite the clinical utility of sentence production and sentence repetition to identify language impairment in autism, little is known about the extent to which these tasks are sensitive to potential language variation. One promising method is strategic scoring, which has good clinical utility for identifying language impairment in nonautistic school-age children across variants of English. This report applies strategic scoring to analyze sentence repetition and sentence production in autistic adolescents and adults.<b>Method:</b> Thirty-one diverse autistic adolescents and adults with language impairment (ALI; <i>n</i> = 15) and without language impairment (ASD; <i>n</i> = 16) completed the Formulated Sentences and Recalling Sentences subtests of the Clinical Evaluation of Language Fundamentals–Fifth Edition. Descriptive analyses and regression evaluated effects of scoring condition, group, and scoring condition by group on outcomes, as well as group differences in finiteness marking across utterances and morphosyntactic structures.<b>Results: </b>Strategic and unmodified item-level scores were essentially constant on both subtests and significantly lower in the ALI than the ASD group. Only group predicted item-level scores. Group differences were limited to: percent grammatical utterances on Formulated Sentences and percent production of overt structures combined on Sentence Repetition (ALI &lt; ASD).<b>Discussion:</b> Findings support the feasibility of strategic scoring for sentence production and sentence repetition to identify language impairment and indicate that potential language variation in finiteness marking did not confound outcomes in this sample. To better understand the clinical utility of strategic scoring, replication with a larger sample varying in age and comparisons with dialect-sensitive measures are needed.<b>Supplemental Material S1. </b>Cross-linguistic autism studies published in English employing sentence repetition and sentence production tasks.Girolamo, T., Ghali, S., &amp; Larson, C. (2024). Sentence production and sentence repetition in autistic adolescents and young adults: Linguistic sensitivity to finiteness marking.<i> Journal of Speech, Language, and Hearing, 67</i>(7), 2297–2315. https://doi.org/10.1044/2024_JSLHR-24-00028<br>