Assessing Language Skills in Children Aged 4 to 6 Years with Autism Spectrum Disorder: A Prospective Study

Background/Objectives: Language impairments are highly prevalent in children with Au-tism Spectrum Disorder (ASD). In preschoolers (3-6 years), language development predicts future social outcomes. Despite the availability of standardized tests for typically develop-ing children, few studies have specifically examined language impairments in preschool-aged children with ASD using these tools. This study aimed to comprehensively assess re-ceptive and expressive lexicon, receptive comprehension, phonology and articulation using standardized tools, and to evaluate their feasibility. A secondary goal was to compare the results obtained with standardized tests to those from developmental batteries and hetero-assessments (caregiver reports). Methods: Forty-seven children with ASD aged 4 to 6 years participated. Assessments in-cluded standardized language tests, developmental batteries and hetero-assessments. The dichotomous Rasch model evaluated feasibility and item performance of standardized tests. Concordance across methods was analyzed via Pearson correlations and stepwise linear re-gression. Results: Standardized assessments were feasible for most participants despite wide variabil-ity in language abilities. Partial but non-equivalent concordance was found among assess-ment methods, each providing complementary insights into language profiles. Conclusions: Combining multiple assessment methods is crucial to capture the complexity of language development in children with ASD. Standardized tests can be adapted and pro-vide more precise profiles than developmental batteries or hetero-assessments alone. A mul-timodal approach is essential to accurately identify language strengths and therapeutic tar-gets in preschool-aged children with ASD.