Vol. 10, No. 3, 2004 Page 1&2

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.


"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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