Neurodevelopmental disorders and family quality of life: emerging trends and future research directions.

Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are the most prevalent neurodevelopmental disorders. There is a growing body of literature investigating factors affecting quality of life in families (FQoL) with a child with these disorders. However, there are no studies that trace their knowledge anatomy. Thus, we conducted a scientometric analysis to describe this literature, detect certain variables that could be related to FQoL, and identify tendencies and open questions for future research. A literature search in the Web of Science, PubMed, and Scopus was run and identified 3281 publications published between 1975 and 2022. The results suggest an increase in the quantity of publications on FQoL in ASD and ADHD over the last few years (14% and 12%, respectively). For both research fields, the USA published the highest number of documents, showing that the production related to ADHD and FQoL is concentrated in just a few countries. Thematic analysis revealed several clusters, considering quality of life and children as core themes that are still setting trend lines. Moreover, it would be worthwhile to describe and analyze FQoL not only during the childhood of children with ASD and ADHD but also during their adolescence. IMPACT: Although the relationship between family quality of life and neurodevelopmental disorders could be considered novel, there is a growing interest from an interdisciplinary perspective. Family quality of life should be monitored not only during the childhood of children with ASD and ADHD, but also during their adolescence and adulthood. The analysis of the family quality of life in first-degree relatives and its relationship with protective factors (e.g., resilience and social support) should be explored in future studies.

Toddlers at Elevated Likelihood for Autism: Exploring Sensory and Language Treatment Predictors.

Baseline child characteristics may predict treatment outcomes in children with or at elevated likelihood of developing autism (EL-ASD). Little is known about the role of child sensory and language features on treatment outcome. Participants were randomly assigned to a parent-mediated intervention or control condition. Analyses explored the relationship between baseline child sensory and language characteristics and changes in ASD symptoms over approximately 9 months. Higher baseline sensory hyporeactivity was significantly related to less improvement in social communication (SC) for the treatment group only. More baseline atypical vocalizations were significantly related to less improvement on SC across treatment and control groups. This work provides an initial framework to encourage the tailoring of interventions for EL-ASD children, suggesting sensory reactivity and atypical vocalizations may be useful behaviors to consider in treatment planning.

Measuring feelings about choices and risks: The Berlin Emotional Responses to Risk Instrument (BERRI).

We introduce a brief instrument specifically validated for measuring positive and negative feelings about risks-the Berlin Emotional Responses to Risk Instrument (BERRI). Based on seven studies involving diverse adults from three countries (n = 2120), the BERRI was found to robustly estimate anticipatory affective reactions derived from subjective evaluations of positive (i.e., assured, hopeful, and relieved) and negative emotions (i.e., anxious, afraid, and worried). The brief BERRI outperformed a 14-item assessment, uniquely tracking costs/benefits associated with cancer screening among men and women (Studies 1 and 2). Predictive validity was further documented in paradigmatic risky choice studies wherein options varied over probabilities and severities across six contexts (health, social, financial, technological, ethical, and environmental; Study 3). Studies 4-6, conducted during the Ebola epidemic and COVID-19 pandemic, indicated BERRI responses were sensitive to subtle effects caused by emotion-related framing manipulations presented in different cultures and languages (the United States, Spain, and Poland). Study 7 indicated BERRI responses remained stable for 2 weeks. Although the BERRI can provide an estimate of overall affect, choices were generally better explained by the unique influences of positive and negative affect. Overall, results suggest the novel, brief instrument can be an efficient tool for high-stakes research on decision making and risk communication.

Duration of the patient interval in breast cancer and factors associated with longer delays in low-and middle-income countries: A systematic review with meta-analysis.

OBJECTIVE: Breast cancer survival is lower in low- and middle-income countries (LMICs) partially due to many women being diagnosed with late-stage disease. The patient interval refers to the time elapsed between the detection of symptoms and the first consultation with a healthcare provider and is considered one of the core indicators for early diagnosis and treatment. The goal of the current research was to conduct a meta-analysis of the duration of the patient interval in LMICs and investigate the socio-demographic and socio-cultural factors related to longer delays in presentation. METHODS: We conducted a systematic review with meta-analysis (pre-registered protocol CRD42020200752). We searched seven information sources (2009-2022) and included 50 articles reporting the duration of patient intervals for 18,014 breast cancer patients residing in LMICs. RESULTS: The longest patient intervals were reported in studies from the Middle East (3-4 months), followed by South-East Asia (2 months), Africa (1-2 months), Latin America (1 month), and Eastern Europe (1 month). Older age, not being married, lower socio-economic status, illiteracy, low knowledge about cancer, disregarding symptoms or not attributing them to cancer, fear, negative beliefs about cancer, and low social support were related to longer delays across most regions. Longer delays were also related to use of alternative medicine in the Middle East, South-East Asia, and Africa and distrust in the healthcare system in Eastern Europe. CONCLUSIONS: There is large variation in the duration of patient intervals across LMICs in different geographical regions. Patient intervals should be reduced and, for this purpose, it is important to explore their determinants taking into account the social, cultural, and economic context.

Linguistic and motor profiles in preschool and school-age children with an older sibling with autism spectrum disorder.

This study examines receptive-expressive language, gross-fine motor skills, and IQ abilities in 78 children, 43 children with an older sibling with autism spectrum disorder (Sibs-ASD) and 35 children with an older sibling with typical development, ranging from 4 to 11 years of age. Depending on age, both groups were divided in preschool and school groups. The results show that more than 76% of Sibs-ASD performed at least one language and/or motor skill under 25th percentile. Significant differences were described at preschool stage in three aspects: grammatical comprehension, ball skills, and global motor skills. At school age, significant differences were found in two aspects: expressive language, and ball skills. Some differences seem to decrease over time; meanwhile others seem to increase; and others remain stable. Thus, it seems that vulnerability continues in unaffected Sibs-ASD and suggest that this population may benefit from continued screening and monitoring into the preschool and school-age stages.

Vocalisation Repertoire at the End of the First Year of Life: An Exploratory Comparison of Rett Syndrome and Typical Development.

Rett syndrome (RTT) is a rare, late detected developmental disorder associated with severe deficits in the speech-language domain. Despite a few reports about atypicalities in the speech-language development of infants and toddlers with RTT, a detailed analysis of the pre-linguistic vocalisation repertoire of infants with RTT is yet missing. Based on home video recordings, we analysed the vocalisations between 9 and 11 months of age of three female infants with typical RTT and compared them to three age-matched typically developing (TD) female controls. The video material of the infants had a total duration of 424 min with 1655 infant vocalisations. For each month, we (1) calculated the infants' canonical babbling ratios with CBRUTTER, i.e., the ratio of number of utterances containing canonical syllables to total number of utterances, and (2) classified their pre-linguistic vocalisations in three non-canonical and four canonical vocalisation subtypes. All infants achieved the milestone of canonical babbling at 9 months of age according to their canonical babbling ratios, i.e. CBRUTTER ≥ 0.15. We revealed overall lower CBRsUTTER and a lower proportion of canonical pre-linguistic vocalisations consisting of well-formed sounds that could serve as parts of target-language words for the RTT group compared to the TD group. Further studies with more data from individuals with RTT are needed to study the atypicalities in the pre-linguistic vocalisation repertoire which may portend the later deficits in spoken language that are characteristic features of RTT.

The patient, diagnostic, and treatment intervals in adult patients with cancer from high- and lower-income countries: A systematic review and meta-analysis.

BACKGROUND: Longer time intervals to diagnosis and treatment are associated with worse survival for various types of cancer. The patient, diagnostic, and treatment intervals are considered core indicators for early diagnosis and treatment. This review estimated the median duration of these intervals for various types of cancer and compared it across high- and lower-income countries. METHODS AND FINDINGS: We conducted a systematic review with meta-analysis (prospectively registered protocol CRD42020200752). Three databases (MEDLINE, Embase, and Web of Science) and information sources including grey literature (Google Scholar, OpenGrey, EThOS, ProQuest Dissertations & Theses) were searched. Eligible articles were published during 2009 to 2022 and reported the duration of the following intervals in adult patients diagnosed with primary symptomatic cancer: patient interval (from the onset of symptoms to first presentation to a healthcare professional), diagnostic interval (from first presentation to diagnosis), and treatment interval (from diagnosis to treatment start). Interval duration was recorded in days and study medians were combined in a pooled estimate with 95% confidence intervals (CIs). The methodological quality of studies was assessed using the Aarhus checklist. A total of 410 articles representing 68 countries and reporting on 5,537,594 patients were included. The majority of articles reported data from high-income countries (n = 294, 72%), with 116 (28%) reporting data from lower-income countries. Pooled meta-analytic estimates were possible for 38 types of cancer. The majority of studies were conducted on patients with breast, lung, colorectal, and head and neck cancer. In studies from high-income countries, pooled median patient intervals generally did not exceed a month for most cancers. However, in studies from lower-income countries, patient intervals were consistently 1.5 to 4 times longer for almost all cancer sites. The majority of data on the diagnostic and treatment intervals came from high-income countries. Across both high- and lower-income countries, the longest diagnostic intervals were observed for hematological (71 days [95% CI 52 to 85], e.g., myelomas (83 days [47 to 145])), genitourinary (58 days [50 to 77], e.g., prostate (85 days [57 to 112])), and digestive/gastrointestinal (57 days [45 to 67], e.g., colorectal (63 days [48 to 78])) cancers. Similarly, the longest treatment intervals were observed for genitourinary (57 days [45 to 66], e.g., prostate (75 days [61 to 87])) and gynecological (46 days [38 to 54], e.g., cervical (69 days [45 to 108]) cancers. In studies from high-income countries, the implementation of cancer-directed policies was associated with shorter patient and diagnostic intervals for several cancers. This review included a large number of studies conducted worldwide but is limited by survivor bias and the inherent complexity and many possible biases in the measurement of time points and intervals in the cancer treatment pathway. In addition, the subintervals that compose the diagnostic interval (e.g., primary care interval, referral to diagnosis interval) were not considered. CONCLUSIONS: These results identify the cancers where diagnosis and treatment initiation may take the longest and reveal the extent of global disparities in early diagnosis and treatment. Efforts should be made to reduce help-seeking times for cancer symptoms in lower-income countries. Estimates for the diagnostic and treatment intervals came mostly from high-income countries that have powerful health information systems in place to record such information.

Anticipated help-seeking for cancer symptoms before and after the coronavirus pandemic: results from the Onco-barometer population survey in Spain.

BACKGROUND: The patient interval-the time patients wait before consulting their physician after noticing cancer symptoms-contributes to diagnostic delays. We compared anticipated help-seeking times for cancer symptoms and perceived barriers to help-seeking before and after the coronavirus pandemic. METHODS: Two waves (pre-Coronavirus: February 2020, N = 3269; and post-Coronavirus: August 2020, N = 1500) of the Spanish Onco-barometer population survey were compared. The international ABC instrument was administered. Pre-post comparisons were performed using multiple logistic and Poisson regression models. RESULTS: There was a consistent and significant increase in anticipated times to help-seeking for 12 of 13 cancer symptoms, with the largest increases for breast changes (OR = 1.54, 95% CI 1.22-1-96) and unexplained bleeding (OR = 1.50, 1.26-1.79). Respondents were more likely to report barriers to help-seeking in the post wave, most notably worry about what the doctor may find (OR = 1.58, 1.35-1.84) and worry about wasting the doctor's time (OR = 1.48, 1.25-1.74). Women and older individuals were the most affected. CONCLUSIONS: Participants reported longer waiting times to help-seeking for cancer symptoms after the pandemic. There is an urgent need for public interventions encouraging people to consult their physicians with symptoms suggestive of cancer and counteracting the main barriers perceived during the pandemic situation.

Can Parental Body Dissatisfaction Predict That of Children? A Study on Body Dissatisfaction, Body Mass Index, and Desire to Diet in Children Aged 9-11 and Their Families.

Body image has been associated with self-care and the assumption of either healthy habits or poor diets and eating disorders. As a vital element in the formation of a positive body image, the role of the family in childhood has been highlighted by a few studies. This study aimed to assess whether children's body dissatisfaction could be predicted by their parents' body dissatisfaction, body mass index (BMI), and approach to change. The sample consisted of 581 participants (366 parents and 215 children). The following instruments were used: anthropometric data, the Brief Scale of Body Dissatisfaction for Children, the IMAGE questionnaire (approach to change and drive for muscularity subscales), and the Eating Disorder Inventory-2 (body dissatisfaction and drive for thinness subscales). The results indicated that 19% of children, 22.8% of mothers, and 70.2% of fathers were overweight or obese. The multiple regression models developed for boys and girls explained 60 and 57% of the variance in body dissatisfaction, respectively. Several variables attributable to the mother (higher approach to change, higher drive for thinness, and higher BMI) and to the boys themselves (drive for muscularity, approach to change, and having a high BMI percentile) predicted a higher level of body dissatisfaction. For girls, only variables regarding themselves (approach to change, age, and BMI percentile) explained their body dissatisfaction. Relationships with the traits of the father were not detected for both models. The influence of sociocultural factors on the construction of gender and the negative consequences of mothers' dieting for aesthetic purposes, on the development of children's body image, are discussed.

Parental Risk Literacy is Related to Quality of Life in Spanish Families of Children with Autism Spectrum Disorder.

Families of children with autism spectrum disorder (ASD) often experience much more negative perceptions of their family quality of life (FQoL). To investigate key factors that may shape these experiences, we conducted a case-control study of sixty-one Spanish families (29 with a child with ASD) using a broad psychosocial assessment (e.g., ASD severity, social support, demographics), including the first direct test of the relationship between FQoL and parental risk literacy (i.e., the ability to evaluate and understand risk, as measured by numeracy). Results revealed that numeracy was associated with differences in perceived FQoL among families of children with ASD (R2 = .10), a finding that held across several models statistically controlling for the influence of other variables. Findings suggest that parental risk literacy skills may generally be associated with differences in decision making vulnerabilities (e.g., risk evaluation and interpretation) that influence family outcomes including FQoL.

Recognizing a Heart Attack: Patients' Knowledge of Cardiovascular Risk Factors and Its Relation to Prehospital Decision Delay in Acute Coronary Syndrome.

In acute coronary syndromes (ACSs), longer decision delay - the time patients wait before seeking medical attention after symptoms have started - increases the risk of complications and death. However, many patients wait much longer than recommended and research is needed investigating how patient decision delay can be reduced. In a cross-sectional study of 120 ACS survivors, we investigated the relationship between knowledge of cardiovascular risk factors and decision delay. Several days after the onset of a cardiac event, patients completed a questionnaire measuring demographics, decision delay, objective knowledge of cardiovascular risks factors and of ACS symptoms, and subjective perceptions of symptoms during the cardiac episode. Relevant clinical data were extracted from patients' medical records. In a multiple linear regression analysis, controlling for demographic and clinical factors, objective knowledge of cardiovascular risk factors and ACS symptoms, and subjective attributions of symptoms to a cardiac cause were related to shorter decision delays. Among patients with relatively high knowledge of risk factors, only 5% waited more than 1 h to seek help, compared to 22% among patients with relatively low knowledge. These results suggest that knowledge of the factors that increase the risk of developing cardiovascular disease could play a role in patient decision making during an acute cardiac event. We discuss methodological issues and potential underlying mechanisms related to decision heuristics and biases, which can inform future research.

Psychosocial markers of pre-hospital decision delay and psychological distress in acute coronary syndrome patients.

Objectives Both pre-hospital decision delay - the time patients wait before seeking medical attention after symptoms have started - and high psychological distress after the cardiac episode predict poor prognosis of patients with acute coronary syndromes (ACS). We aimed to identify psychosocial markers of these prognostic factors. Design A cross-sectional study of 102 consecutive, clinically stable ACS survivors. Methods Participants completed a questionnaire measuring pre-hospital decision delay, psychological distress, and several known psychosocial factors related to cardiovascular health: type D personality, resilience, social support, and concerns during the cardiac event. Multiple linear regression and mediation analyses were conducted. Results Type D personality and fewer concerns about the serious consequences of delaying help-seeking were related to more psychological distress post-ACS, and these relationships were mediated by longer pre-hospital decision delay. In contrast, resilience was related to lower psychological distress. Social support and social concerns about help-seeking were not related to the outcome variables. Conclusions Type D personality may be a risk factor for more delayed help-seeking for an ACS and higher psychological distress after the cardiac event. Resilience, in contrast, emerged as a potential protective factor of patients' mental health after the cardiac event. Pre-hospital decision delay was related to thinking about serious consequences (e.g., complications, protecting one's family) but not about social concerns (e.g., wasting other people's time) during the cardiac episode. Statement of Contribution What is already known on this subject? Longer pre-hospital decision delay, that is waiting longer to seek medical attention after symptoms have started, predicts poor prognosis of acute coronary syndrome patients. High psychological distress post-ACS, such as the development of anxiety and/or depression, also predicts poor prognosis of these patients. What does this study adds? This study identifies several psychosocial markers of longer prehospital decision delay and high psychological distress post-ACS. Prehospital decision delay was related to thinking about serious consequences (e.g., complications, protecting one's family) but not about social concerns (e.g., wasting other people's time) during the cardiac episode. Type D personality and fewer concerns about the serious consequences of delaying help-seeking were related to more psychological distress, and these relationships were mediated by longer prehospital decision delay. Resilience was related to lower psychological distress post-ACS.

Siblings of children with autism spectrum disorders: social support and family quality of life.

PURPOSE: Autism spectrum disorder (ASD) often has a significant impact on all family members, including parents and siblings of the person who suffers the disorder. This case-control study explores potential factors that help explain the impact of having an older sibling with ASD on several developmental domains, and to test whether these factors could explain their satisfaction on family quality of life (FQoL). METHODS: A total of 78 unaffected siblings of children with ASD (Sibs-ASD) and siblings of children with typical development (Sibs-TD) from 6 to 12 years old were evaluated. RESULTS: Our analyses show significant differences between groups in motor skills, severity of autistic traits, satisfaction on FQoL, and social support (ps < .05). Moreover, social support acts as positive factor protecting from the negative effect of having a sibling with ASD on satisfaction of FQoL (R2 = .32). CONCLUSIONS: Our findings highlight the variability in the developmental abilities of the unaffected school-age children with familiar risk factors and emphasize the need for supervising development of all Sibs-ASD over different time points. Social support may be a critical aspect to consider in interventions for improving the satisfaction on FQoL.

Numeracy and Risk Literacy: What Have We Learned so Far?

Numerical skills are essential to make informed decisions in our daily life. Unfortunately, many people lack basic numeracy, which limits their ability to accurately interpret risks (i.e., risk literacy). In this paper, we provide an overview of research investigating the role of numeracy in two prominent domains, where most research was concentrated, health and finance. We summarize what has been learned so far in these domains and suggest promising venues for future research. We conclude that it is important to conduct interventions to improve numeracy in less numerate individuals and to help them make informed decisions and achieve better life outcomes.

Canonical Babbling: A Marker for Earlier Identification of Late Detected Developmental Disorders?

PURPOSE OF REVIEW: To summarize findings about the emergence and characteristics of canonical babbling in children with late detected developmental disorders (LDDDs), such as autism spectrum disorder, Rett syndrome, and fragile X syndrome. In particular, we ask whether infants' vocal development in the first year of life contains any markers that may contribute to earlier detection of these disorders. RECENT FINDINGS: Only a handful studies have investigated canonical babbling in infants with LDDDs. With divergent research paradigms and definitions applied, findings on the onset and characteristics of canonical babbling are inconsistent and difficult to compare. Infants with LDDDs showed reduced likelihood to produce canonical babbling vocalizations. If achieved, this milestone was more likely to be reached beyond the critical time window of 5-10 months. SUMMARY: Canonical babbling appears promising as a potential marker for early detection of infants at risk for developmental disorders. In-depth studies on babbling characteristics in LDDDs are warranted.

Timing of Parents' Concerns Related to Autism Spectrum Disorder and its Diagnosis: A Mediation Analysis.

Parents are the first to indicate concerns about their child's development in up to 80% of children with autism spectrum disorder (ASD). They often notice symptoms related to ASD around the first two years, but the average age of diagnosis is 3.5 years old. This study examined the relationships between parents' early concerns and the time lag between suspicion and diagnosis. Forty-eight Spanish-speaking families were enrolled in this study. Parents were asked about early signs that made them think that their child could possibly have ASD. Mediation analyses showed that the child's age at suspicion mediated between sibling status and the time lag between suspicion and a formal diagnosis (ß = -.53, p < .01). Having another child with typical development accelerated parents' detection of ASD signs (ß = -.62, p < .001). The number of social-communication concerns that parents detected mediated this relationship (ß = -.28, p < .01). Parents who reported more social-communication concerns perceived these signs earlier, but have to cope with a longer time lag until diagnosis than those who reported more concerns related to restrictive and repetitive behaviors and interests, or other developmental concerns. Moreover, this relationship between concerns of ASD and the diagnoses was explained by the child's age. Training pediatricians on how to respond to parent questions and concerns could reduce the time lag between parents' concerns and diagnosis of ASD.

Language and motor skills in siblings of children with autism spectrum disorder: A meta-analytic review.

Children with autism spectrum disorder (ASD) show significant linguistic and motor impairments compared to children with typical development (TD). Findings from studies of siblings of children with ASD show similarities to conclusions from studies of children with ASD. The current meta-analysis reviewed studies reporting linguistic and/or motor skills in siblings of children with ASD compared to siblings of children with TD. Thirty-four studies published between 1994 and 2016 met all inclusion criteria. We compared three different age groups (12 months or younger, 13 to 24 months, and 25 to 36 months). At 12 months, compared to siblings of children with TD, siblings of children with ASD had worse receptive language (d = -.43, 95% CI [-.53, -.33]) and expressive language skills (d = -.40, 95% CI [-.57, -.23]), and these effects were sustained at 24 and 36 months. Similar, albeit smaller differences in fine motor skills were detected at 12 months (d = -.22, 95% CI [-.39, -.04]), and these differences were larger at 36 months (d = -.36, 95% CI [-.54, -.17]). There were differences in gross motor skills at 12 months (d = -.22, 95% CI [-.40, -.04]), but only a few studies were available at later ages. Compared to siblings of children with TD, infants who have siblings with ASD have worse linguistic and motor skills. These differences are detectable as early as when infants are 12 months old and seem to be sustained until they are 3 years old. Differences in language skills are larger than those in motor skills, especially during the first year. Autism Res 2017, 10: 1737-1750. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We reviewed studies reporting linguistic and/or motor skills in siblings of children with autism spectrum disorder (ASD) compared to those in siblings of children with typical development. The results showed that as a group, those infants who have siblings with ASD have less advanced linguistic and motor skills. These differences are detectable when infants are 12 months old and seem to be sustained until they are 3 years old. Differences in language skills are larger than those in motor skills.

Infants at-risk for autism spectrum disorder: Patterns of vocalizations at 14 months.

Differences in the early development of children are crucial for early detection of autism spectrum disorder (ASD). Previous studies have shown large differences between children later diagnosed with ASD and their typically developing peers in the early use of canonical vocalizations (i.e., vocalizations that include well-formed consonant-vowel syllables) and the use of vocalizations for communicative purposes. In this prospective study, we examined the extent to which infant vocalizations at 14 months would predict Autism Diagnostic Observation Schedule (ADOS) diagnostic symptom groups, that is, Autism, Spectrum, and Non-ASD, for 82 community-identified at-risk infants at 23 months. Thirty-minute video samples were coded with the intention to categorize and quantify speech (canonical/noncanonical and directed/nondirected) and nonspeech vocalizations (atypical, distress, and pleasure vocalizations). Our results revealed that more canonical directed (OR = 1.039, P = .036), and fewer noncanonical directed (OR=.607, P = .002) and noncanonical nondirected (OR = 1.200, P = .049) vocalizations were associated with a greater likelihood of being in the Non-ASD group versus the Autism group, with no variables significantly predicting Autism versus Spectrum group membership. Despite some statistically significant findings, models performed poorly in classifying children into correct ASD symptom group at age 23 months based on vocalizations at 14 months. Thus, the utility of infant vocalizations alone for predicting toddler clinical outcomes among infants initially identified at an elevated risk for ASD appears limited; however, considering the structure and function of early vocalizations combined with other early developmental and behavioral features may improve the confidence for clinicians in making an early diagnosis of ASD. Autism Res 2017, 10: 1372-1383. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

[Language comprehension disorders in non-verbal children with autism spectrum disorders and their implications in the family quality of life]. / Dificultades de comprensión del lenguaje en niños no verbales con trastornos del espectro autista y sus implicaciones en la calidad de vida familiar.

INTRODUCTION: Language widely varies in children with autism spectrum disorders (ASD). Evidence, however, suggests that these children understand language worse than their peers with typical development, showing a delay in acquisition of receptive vocabulary. Research relating quality of life (QOL) and language is limited. AIMS: To increase our knowledge about structural aspects of language in children with ASD, and to determine the effects of deficits in understanding in children with ASD in their families' QOL. SUBJECTS AND METHODS: We analyzed language comprehension in 26 non-verbal children with ASD (mean: 9.8 years) and 26 children with typical development (mean: 3.9 years) matched for age vocabulary, using standardized measures of receptive language. RESULTS: We found that levels of receptive vocabulary, auditory comprehension, and grammar comprehension in children with ASD are lower than typical levels for their age, and significantly differ from those in children with typical development. Parents of children with ASD also report severe communication problems in their children and lack of social support. Family QOL is influenced by language problems of children with ASD. CONCLUSIONS: There is a significant relationship between receptive language skills in children with ASD and perceptions of QOL in their families. These results can have important implications for designing clinical interventions.

TITLE: Dificultades de comprension del lenguaje en niños no verbales con trastornos del espectro autista y sus implicaciones en la calidad de vida familiar.Introduccion. El nivel de comprension del lenguaje en niños con trastornos del espectro autista (TEA) varia ampliamente. Sin embargo, la evidencia sugiere que estos niños comprenden el lenguaje peor que los de su misma edad con desarrollo tipico, y muestran retraso en el vocabulario receptivo. La investigacion que relaciona calidad de vida y lenguaje es muy escasa. Objetivos. Profundizar en la comprension de aspectos estructurales del lenguaje en niños con TEA y conocer la influencia de los deficits en comprension del lenguaje en niños con TEA en las percepciones sobre calidad de vida en sus familias. Sujetos y metodos. Analizamos la comprension verbal en 26 niños no verbales con TEA (media: 9,8 años) y en 26 niños con desarrollo tipico (media: 3,9 años) igualados en edad de vocabulario, utilizando medidas estandarizadas de lenguaje receptivo. Resultados. Hemos comprobado que el nivel de vocabulario receptivo, comprension auditiva y comprension gramatical en los niños con TEA esta por debajo del que corresponde a su edad, y difiere significativamente de aquel en niños con desarrollo tipico. Asimismo, los padres de niños con TEA informan de graves problemas de comunicacion en sus hijos y falta de apoyo social. La calidad de vida familiar se ve afectada por los problemas linguisticos de los niños con TEA. Conclusiones. Encontramos una importante relacion entre las habilidades de lenguaje receptivo en los niños con TEA y las percepciones sobre la calidad de vida en sus familias. Estos resultados pueden tener importantes implicaciones en el diseño de intervenciones clinicas.