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Autism Spectrum Disorder: A Review of the Research

Gina R. Buonagura

Long Island University

EDS 600: Introduction to the Study of the Exceptional Child

Professor Gaglio

June 17, 2024

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Overview of Autism

Autism Spectrum Disorder (ASD) is a neurological disorder that affects many

individuals. The Individuals with Disabilities Education Act defines autism as “a developmental

disability that significantly affects a person’s ability to communicate and use nonverbal cues''

(Grandin, T., 2007). According to the National Institute of Mental Health, “Autism spectrum

disorder (ASD) is a neurological and developmental disorder that affects how people interact

with others, communicate, learn, and behave” (U.S. Department of Health and Human Services).

Already, we have two different definitions of what ASD is, although they may have some

commonalities such as it being a neurological disorder. According to the book Childhood Autism

Spectrum Disorder: Evidence-Based Assessment and Intervention, there is Childhood Autism,

Atypical Autism, and an “autism-like” classification called Asperger Syndrome. The authors

define childhood autism as “the presence of impaired development before the age of three years;

which includes deficits in three areas of reciprocal social interaction, communication, and

restricted, repetitive patterns of behavior” and atypical autism as “atypical development that is

present after three years of age, with a lack of impairment in the three areas required for a

diagnosis of childhood autism.” Asperger syndrome “has similar characteristics to childhood

autism, including deficits in reciprocal social interaction and repetitive stereotyped behaviors;

however, a diagnosis of Asperger Syndrome does not require deficits in social communication”

(Kendorsi and Fisher, 2018, 4-5). Autism is known to be a “spectrum” disorder because there is a

vast variation in the type and severity of symptoms that people may experience, as we can see

from the varying definitions.

Now that we have some definitions of what Autism is, let’s talk about the causes and

prevalence of the disorder. It seems that since the year 2000, prevalence rates of ASD have “been
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on an increasing trend” (Kendorsi and Fisher, 2018, 6). This could be due to a number of factors,

although “no single cause of autism has been found” (Grandin, 2007). While there is not a

known cause for autism, there are several risk factors that may increase the likelihood of

developing ASD. According to the National Institute of Mental Health, these risk factors include

“having an older sibling with ASD, having older parents, having certain genetic conditions (such

as Down syndrome or Fragile X syndrome), and having a very low birth weight” (U.S.

Department of Health and Human Services). In terms of who is more likely to be diagnosed with

ASD, it has been found that “boys are 4.5 times more likely to be diagnosed than girls, and white

children are more likely to be diagnosed than African American and Hispanic children”

(Kendorsi and Fisher, 2018, 6). While the reasons for the increase in the prevalence of ASD are

unclear, there are several hypotheses. These include “an increase in awareness, more specific

diagnostic criteria, or a true increase in ASD… policies for screening during pediatric well visits,

as well as changes in risk factors such as parental age, maternal obesity, and in vitro fertilization”

(Kendorsi and Fisher, 2018, 7). It should also be noted that ASD tends to be comorbid with other

disorders, but most commonly is comorbid with intellectual disability. The other most common

disorders that can co-occur with ASD include social anxiety disorder, attention deficit

hyperactivity disorder, and oppositional defiant disorder. Some characteristics of autism,

according to The Puzzle of Autism, include “problems with processing and expressing language”,

as well as “difficulties with social interaction, communication, and academic work.” There are

also early indicators for children that may have autism, such as “lack of eye contact”, “lack of

attention to the same item or topic that another person is focusing on when interacting with that

person,” “lack of reciprocal conversion,” and “atypical sensory/motor processing” (Grandin,

2007).
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Characteristics of Autism

Autism spectrum disorder has a variety of characteristics. These characteristics are found

in the diagnostic criteria for autism spectrum disorder in the Diagnostic and Statistical Manual of

Mental Disorders, Fifth Edition (DSM-V-TR). The DSM-V-TR is used by psychiatrists and

psychologists and is their “most important resource for diagnosing mental health and

brain-related conditions.” This is because it provides clear, detailed definitions for a variety of

mental health and brain-related conditions, along with details and examples of signs and

symptoms for those conditions (Cleveland Clinic Medical Professional). Some of the

characteristics of ASD are difficulties with social interaction, problems with processing and

expressing language, and difficulties with communications. Now that we have identified some

characteristics, let’s find out more about them.

One characteristic of autism is difficulties with social interaction. “Difference and delay

in social development is at the absolute core of ASD” (Towle, 2013, 59). Soon after they are

born, a child’s social life usually begins with their parents or caregivers, since a behavior like

crying may result in them being picked up, rocked, and cuddled. Children’s social skills continue

to develop as they grow. Towle went on to say that children on the spectrum might have typical

development during their first year but start to lose them, and some children show deficits in

their development from the time they are born. In regards to social engagement and interest,

children with ASD “are known to go off on their own and pursue their own interests,” making it

important to keep an eye on how often a child spends more time alone than paying with other

children (Towle, 2013, 61). These children also may have atypical sensory interests or repetitive

behaviors that they devote their attention to. One of the most-well known symptoms of autism is

the lack of eye contact, which can be overstimulating for them. Another aspect of social
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interaction that is missing in children with ASD is the initiation of the interaction. These children

often do not approach their peers or ask to join in a game. They are also unlikely to respond to

those who try to initiate conversation, such as a parent or teacher calling out their name. Autistic

children are missing some of the key aspects for imitating others, like paying attention to watch

what they do and the motivation to want to imitate them. Finally, children with autism lack the

ability to take turns, which is due to them not understanding “the pacing and timing of it to the

same extent” (Towle, 2013, 81).

Another characteristic that could be a potential sign of autism is a deficit or problem with

processing and expressing language. A study was done that analyzed whether there were

commonalities in formal language profiles for children with autism spectrum disorder (ASD) and

Specific Language Impairment (SLI). This study had a sample size of 20 students each, of

similar ages and IQ, and they were divided into three groups: ASD, SLI, and Control. According

to this study, “Formal language impairment does not constitute a core symptom for diagnosis, but

a broad set of linguistic difficulties may be manifested in individuals with ASD, ranging from the

complete absence of language to difficulties with the lexical-semantic, grammatical, and

pragmatic components thereof” (Ramírez-Santana, et al., 2019). It goes on to say that some of

the similarities and differences between SLI and ASD have been found, making it clear that there

is overlap but each disability also has their own respective symptoms and diagnostic criteria. As

stated earlier, there were 60 participants total, and they were all enrolled in schools in the Island

of Tenerife, which is in Spain. Each of the autistic children in the study had received a formal

diagnosis of ASD by a board-certified psychiatrist experienced in evaluating ASD, and are

considered to be higher-functioning. This is important to note because the results of this study

might not apply to those who are lower on the spectrum. The test used in the study was the
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CELF-4 standardized test, which assesses language with scales for Spanish speakers in the

United States. The participants in the study completed the standardized test, which assessed

several variables of language, including receptive language, expressive language, concepts and

directions, and word associations. According to the results, “there are no significant differences

between the SLI and ASD groups, with effect sizes of practically zero, meaning that the first

hypothesis formulated in the present study could be rejected” (Ramírez-Santana, et al., 2019). In

the discussion section of this journal, we discover that “a sizable subgroup of children with ASD

also have additional difficulties with formal aspects of language, similar to those observed in

profiles of children with SLI: phonological difficulties, moderate vocabulary problems, and more

serious deficits in semantic and morphosyntactic components of language” (Ramírez-Santana, et

al., 2019).The hypotheses the researchers had at the beginning of the study could not be

confirmed at the end of the study. Finally, there were some limitations to this study. These

included “the possible heterogeneity of both groups has not been considered,” “as it was a

cross-sectional study, the evolution of the subjects of the sample is not shown,” and “the sample

is made up of only male children, therefore gender differences are not studied”

(Ramírez-Santana, et al., 2019). This study gave us some insight to the way that children with

autism may struggle with language, but it is important to remember that all children may present

these signs of deficits in language in a different way, and no two should be compared.

A third characteristic of children with ASD is difficulties with communication. Like the

other characteristics, difficulties with communication will be prominent by the time they are 3

years old. These deficits in communication might “create difficulties in conversing with others,

and the condition makes learning to communicate a greater challenge” (Llaneza, et al., 2010, 2).

The four diagnostic criteria that need to be be met in order to receive a diagnosis of autism
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spectrum disorder are: “reciprocal social actions are uniformly abnormal in some way; language

delays that occur in beginning language a well as in interactive conversation; repetitive or

restrictive behaviors, and special interests; diagnosis only occurs if behaviors are not better

accounted for by Rett Disorder or another Childhood Disintegrative Disorder” (Llaneza, et al.,

2010, 2-3). Did you know that about a third to half of people with ASD “do not develop enough

natural speech to meet their daily needs” (Llaneza, et al., 2010, 3). Individuals with

high-functioning autism might have less difficulties with language and a higher IQ, but they are

also less likely to be receptive to non-verbal cues or use emotional features in speech. Those that

work with the higher-functioning autistic individuals are able to see “consistent ‘autistic’

personalities” among these individuals. This includes the “‘aloof’ personality, wherein the child

avoids physical contact and eye contact… the ‘passive’ personality, in which the individual does

not avoid physical contact, but does not initiate interaction with others… the ‘Socially Extremely

Awkward Person,’ is less common, and described as an individual who initiates interactions with

others, but is often socially awkward resulting in others reacting inappropriately” (Llaneza, et al.,

2010, 4). One thing that children with autism struggle with is called the theory of mind, which is

when they can understand what others are thinking. Because they are unable to understand how

others feel, they may face obstacles such as “problems understanding and appreciating the

thoughts and feelings of others, determining the intention of others, and understanding how one’s

own behavior impacts others” (Llaneza, et al., 2010, 5).This is an essential part in managing

communication with others, and their lack of theory of mind can prevent them from

communicating effectively. There are ways to promote communication skills in children with

ASD. Role-playing and stimulation to provide these children with opportunities to work on

improving their communication skills and play with others cooperatively. When it comes to
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low-functioning children with autism, augmentative communication systems are used to teach

core communication skills. These devices are also used in the classroom. There might be some

genetic factors that could lead to a child having ASD, with “early studies of monozygotic twins

estimated the heritability of ASD to be more than 90% of the variance between ASD and

non-ASD individuals is due to genetic effects (Llaneza, et al., 2010, 8). Although science has

advanced drastically since autism has been considered a diagnosis, research has not been able to

find a gene that can be found in a large number of individuals with autism.

Autism spectrum disorder has a variety of signs, symptoms, and characteristics that can

vary in severity from person to person. In this section, we learned about three of these

characteristics: difficulties with social interaction, problems with processing and expressing

language, and difficulties with communications. Now that we have a better understanding of

what these characteristics look like in children with autism, we can use it to be mindful and

observant of children that we think should be referred for a diagnosis. As parents, caregivers, and

educators, we can use this information to help us gather evidence of a potential diagnosis of

autism. After gathering this information, the child could be brought in for a consultation with a

board-certified psychiatrist. With that in mind, just because children might present with these

characteristics, it might not result in a diagnosis of autism. To help build their social interaction,

language, and communication skills, autistic children should be given interventions and tools that

will help them. These include role-playing, stimulation, and augmentative communication

systems. We need to be able to do better with helping these children interact with their peers and

be able to effectively communicate.

Impact of Autism on Family Members

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A diagnosis of autism does not only impact the child who is diagnosed, but also on the

family members of that family. There have been several studies done to determine the impacts a

diagnosis of autism on family members. The results of the studies unveiled the impacts through

interviews of various family members, such as parents and siblings. In this section, I will be

sharing the results of three different studies that were conducted to determine the impact on

families.

In a Clinical Research Paper, Ashley L. Hartmann examines different impacts of autism

on families and theories that could help to strengthen the family unit. The conceptual framework

for this paper included the description of three theories- empowerment perspective, strengths

perspective, and family systems theory- since they applied to her research. In simple terms: the

empowerment perspective aims to empower families who are impacted by a diagnosis of autism

spectrum disorder; the strengths perspective is geared more toward the autistic individuals

strengths rather than their deficiencies, and family systems theory shifts the focus from a single

perspective to a family systems perspective. The research for this paper was done qualitatively

through the use of narrative interviews. There were 8 participants in this study, four parents and

four siblings of a child with autism, chosen using convenience sampling. As an incentive for

those participating in the study, a $10 Target gift card was provided to each person. There are no

names used in this paper, protecting the confidentiality of the participants. The data was

collected in a semi structured interview of ten questions. Each participant chose the location of

their interview. There were limitations with this process: the researcher has a sibling with autism,

there was a limited number of questions asked, and the small size of the study does not represent

generalization to the larger population. When participants were asked how their sibling’s autism

affected their relationship with their parents, they had a similar answer. They said that they
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“never felt ignored or neglected as a result of their siblings’ autism diagnosis” (Hartmann, A. L.,

2012, 33-34). In terms of siblings' feelings about an autism diagnosis, each reported that it might

have been a little difficult in the beginning, they found ways to connect and develop the

relationship on their own. As far as the participants who are parents of an autistic child, their

initial emotions about the diagnosis ranged from feeling relieved to more negative feelings. All

of the parent participants responded that they have learned patience from raising their child. A

diagnosis of autism has been found to lead to life changes, as well as affect other familial

relationships. Support systems help parents to cope and deal with the stressors of having a child

with autism. The findings in this study contradict current literature when it comes to siblings

feeling embarrassed and being ignored by parents when having a sibling with autism. Each

participant reported no feelings of embarrassment and that they thought their parents were doing

an excellent job dividing their time between the siblings. Supporting the current literature, this

study found that grandparents are an important support system and are always around to help.

There has been an increasing number of children being diagnosed with autism at an

earlier age in recent years. With the new diagnoses, there is little known about what types of

support these families receive. A study was conducted with these objectives in mind: “to

describe the demographic characteristics of preschoolers and their families; to discover parental

perceptions of the child’s difficulties; to identify the impact the child has on family life; to

outline the supports available to families and those they would like to have” (Cassidy, A., et al.,

2008, 116). The participants were 104 self-selected parents with a child under five at the time of

the interview, and each had been diagnosed recently at two community-based specialist clinics.

Of these families, 4 informants were fathers, 26 had both parents present, and 74 had the mother

as the only informant. Each parent was interviewed for 90 minutes in their homes, having to
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answer a mix of open and closed questions. There were also three scales used with some or all

participants: the Vineland Adaptive Behaviour Scale, the Gilliam Autism Rating Scale, and the

Questionnaire on Resources and Stress (QRS-F). Out of the 104 children with autism, 95 were

boys and 9 were girls. The most commonly mentioned difficulties were language (88; 85%), play

(77; 74%), and relating to others (74; 71%). Other difficulties mentioned were unusual interest in

toys/objects (64; 62%), unusual response to new things (64; 62%), adaptation to change (61;

59%), difficulty in imitating (46; 45%), unpleasant (43; 41%), and fear/nervousness (40; 39%)

(Cassidy, A., et al., 2008, 120). There were many problems that the participants indicated having

the most difficulty dealing with, including speech and communication, temper tantrums,

aggressive behaviors, non-compliance, need for routine, and lack of social interaction. When

asked about restrictions they experienced on socializing with their child, their responses were

that “29% they felt they could not enjoy outings together as a family; 27% could not take the

child to other people’s homes; 23% were not able to leave the child with a child under/babysitter

and 17% could not go shopping with the child” (Cassidy, A., et al., 2008, 121). Parents reported

that the support they received came from their family (61%), friends (32%), neighbors (12%) and

church members (6.6%), or none at all (33%). Finally, when they were asked about the

placement they want for their children, 72% wanted a mainstream placement with a learning

support assistant, 17% mentioned a special school, 6% said a special class within a mainstream

school, and 2% wanted a school meant for children with autism.

In a qualitative study of mothers’ perspectives, we gain some more insight on the impacts

of autism spectrum disorders on the families. The current rise in autism diagnoses each year is

predicted to be at about 36,500 each year. Since this increase is going to be affecting more

families, it is essential to understand the impacts of having children with autism on the family.
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The family’s function is likely going to be affected with all the challenges of dealing with the

child with ASD’s symptoms and their severity. Some common autism related family challenges

include “a sense of loss and depression, decreased opportunities for family vacations and fun

outings, changes in relationships resulting in loss of support, and personal and professional

sacrifices” (Nealy, C. E., et al., 2012, 188). The participants in this study were a convenience

sample of eight women who self-identify as mothers of children with ASD. They were all

English speakers, and did not include mothers of more than one child with a disability.

Information was gathered using family information forms and multiple response questions about

service utilization. After completing these forms and questions, each woman completed

semi-structured interviews in their home, each lasting from 20 to 45 minutes. The most

commonly reported interventions for the children included “school-based special education

resources, sensory integration therapy, dietary modifications, speech/language therapy,

occupational therapy, medication, and supplements'' (Nealy, C. E., et al., 2012, 192).

Additionally, four major themes- emotional impact, familial relationships impact, social impact,

and financial support- and three subthemes- stress, worry, and guilt- were identified. These

findings are consistent with the current literature that focuses on the impact of an autism

diagnosis on families.

There are several implications of the research studies discussed in this section. With the

increase of autism diagnoses in recent years, there needs to be more research done with a larger

number of participants, which would make the results more generalizable. Another area of

research that should be taken into consideration for future studies is future living arrangements

for children with autism. Would the parents of this child want them institutionalized? Would a

sibling or other family member take the child in if something were to happen to the parents? It
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would be beneficial to offer services to children with autism that are family-oriented and can

offer support to those children and their families. When children are being treated by service

providers, it is important to consider offering the parents and families some support as well.

They might be dealing with several emotions regarding their child/sibling’s diagnosis. There are

informal social supports that can lead to positive coping strategies for parents, such as learning

about autism and meeting other families impacted by ASD. Since autism can lead to financial

problems, there should be more research conducted to determine which resources and

interventions are the most cost efficient for these families.

Effectiveness of Interventions

As our knowledge of autism continues to grow, the amount of interventions available do

as well. With the new information, we are able to fine tune or come up with interventions that

will benefit a child with an autism diagnosis. There are processes to go through before deciding

which intervention would be best suited for each child. Some interventions are scientific-based

and validated, while others are not yet backed by scientific evidence. How do we know which

interventions to consider and use to help children with a diagnosis of autism? The results from

research studies may be able to provide some answers.

When considering interventions for children with a diagnosis of ASD, it should be taken

into account whether it has been proven to be effective. Interventions can only be validated by

conducting scientifically based research. It is important to note that there has been “a lack of

consensus on how to identify and evaluate scientifically valid and effective interventions”

(Lingren & Doobay, 2011, 9). There are several basic principles of effective ASD interventions,

including beginning intervention services before a definitive diagnosis if autism is being heavily

considered, providing extensive intervention, and ongoing measurement and documentation of

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the child’s progress toward their educational goals. In this analysis of interventions, each

treatment was placed into one of four categories: significant scientific evidence, promising or

emerging scientific evidence, limited scientific evidence, and not recommended. Of the

interventions studied, there were several that were supported by significant scientific evidence,

including Applied Behavior Analysis (ABA), Discrete Trial Training (DTT), Functional

Communication Training (FCT), Pivotal Response Training (PRT), and Antecedent-Based

Interventions. There are also several interventions that have been used in combination with these,

such as augmentative and alternative communication (AAC) devices, picture exchange

communication system (PECS), modeling, and visual support. This study also identified a few

interventions that are promising, such as developmental relationship-based treatment (also

known as floor time), play therapy, and supportive therapies (such as art therapy or pet/animal

therapy). Some of the interventions that have a limited amount of scientific evidence to back

them up include sensory integration (SI), auditory integration training (ATT), nutritional

supplements, gluten- and casein-free diet, and facilitated communication (FC). Finally, the

research done in this study showed that interventions like holding therapy, secretin, and chelation

for neurotoxicity are not recommended for use with autistic individuals.

Over the past couple of decades, there have been a plethora of therapies and interventions

being introduced to potentially help those with ASD improve their symptoms. In this next

research study, the studies were chosen based on if they were randomized controlled trials

(RCTs), controlled clinical trials (CCTs), or observational analytical studies. The results were

summarized descriptively and evidence tables were created. There were 101 studies included in

the review. In the summary of their findings, it can be seen that the effectiveness of discrete trial

learning was inconsistent across studies. There is limited and inconclusive evidence that discrete
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trial learning may be beneficial in helping with communication and social interaction. In regards

to developmental interventions, there were positive outcomes reported with milieu therapy and

no treatment in cognitive abilities. Environmental modification had positive results with

significant improvement to no vocational outcomes and cognitive performance. Integrative

programs, such as lego therapy, have been reported to produce improvements in social skills and

autism symptoms. Social skills development interventions, especially Social Stories, had

significant results with social interaction in the short term. The researchers' review of current

literature on the effects of interventions for ASD was contradicting across the studies. Each of

the interventions that were looked at in this research have little or inconsistent results across

studies.

Individuals with ASD might have symptoms that prevent them from learning effectively.

Social skills are an important aspect of a child’s life, and those with autism tend to have

difficulty with communication and social interaction. There are Social Skills Development

Programs that are aimed to teach these children social skills that might be missed in school. “The

primary focus of Social Skills Development Programs is to help children with ASD develop

improved awareness and understanding of other perspectives in order to improve conversation

skills, develop relationships with peers, play cooperatively, mediate conflict, develop self

regulation skills, and problem-solve” (Llaneza, et al., 2010, 5). The sessions are extremely

structured, with an assessment to start and progress reports to follow. These programs also

include activity-based lessons, which focuses on teachable moments in a real-life situation.

Social skills lessons are differentiated based on the age group they are being implemented for,

ensuring that they are not too complicated or too simple for those with ASD. As we have seen,

the interventions also need to be differentiated based on whether an individual is considered to be

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low- or high-functioning. Augmentative communication devices, such as the Picture Exchange

Communication System (PECS), can be used in school. With PECS, “picture symbols are used to

represent items that the student wants and the student is taught to request them” (Llaneza, et al.,

2010, 6). This is one example of a low-technology and effective intervention.

Now that we have some more information about what interventions are available, we can

use these studies to determine if they should be used or not. Since each child experiences

different symptoms and various severity, it’s possible that more than one intervention will be

used to benefit the child. To ensure that they are working, the interventions should be evaluated

on a regular basis and, if necessary adjusted. A limitation to be considered for future studies is

the classification criteria for the interventions. If the criteria is looking for something specific, it

could overlook interventions that don’t fit the criteria but could benefit a child with autism. Any

intervention approach can be researched and could show that children with autism are showing

signs of progress. It is still important to make sure that any intervention that is being considered

has some evidence of scientific support.

Conclusion

Autism spectrum disorder is a neurological and developmental disorder that has been

increasing in diagnoses in more recent years. This diagnosis is not one to be taken lightly, and

proper care must be given to children with autism. With this information, we are able to do a few

things. First, we can use the studies to identify symptoms of autism and refer children to a

psychiatrist for a consultation. If the consult leads to a diagnosis of autism, there are several steps

that we can now take. The first thing that can be done is finding an intervention or cohort of

interventions that will help these children improve some of the skills they are experiencing

deficits in. These interventions should have some evidence of effectiveness in treating children
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with ASD. The next thing that we can do is to research the intervention in question. With this

research, we should be able to determine whether it has been proven to effectively improve the

deficits in areas like communication and social skills. Finally, with the information we have at

our fingertips, we need to focus on providing support to the families of children with a diagnosis

of autism. The stress and emotional nature of having a child with autism in the family can be a

lot to handle by yourself. Sometimes, the diagnosis can cause a rift between family members and

the support they are given begins to decrease. To help negate this from happening, these families

should be provided with opportunities to seek professional help and talk to other families who

are experiencing similar situations. These supports can make all the difference for a family with

an autistic child.
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Works Cited

Cassidy, A., McConkey, R., Truesdale‐Kennedy, M., & Slevin, E. (2008). Preschoolers with

autism spectrum disorders: The impact on families and the supports available to them. Early

Child Development and Care, 178(2), 115–128. https://doi.org/10.1080/03004430701491721

Cleveland Clinic Medical Professional. (n.d.). DSM-5: What it is & what it Diagnoses.

Cleveland Clinic.

https://my.clevelandclinic.org/health/articles/24291-diagnostic-and-statistical-manual-dsm-5

Grandin, T. (2007). Autism from the Inside . Autism from the Inside.

Hartmann, A. L. (2012). (rep.). Autism and its Impact on Families (pp. 24–60). St. Paul,

Minnesota.

Kendorsi, J. G., & Fisher, A. G. (2018). Description and Diagnosis. In Childhood Autism

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Lindgren, S., & Doobay , A. (2011). (publication). Evidence-Based Interventions for Autism

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(2010). Communication, interventions, and scientific advances in autism: A commentary.

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Nealy, C. E., O’Hare, L., Powers, J. D., & Swick, D. C. (2012). The impact of autism spectrum

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Ospina, M. B., Krebs Seida, J., Clark, B., Karkhaneh, M., Hartling, L., Tjosvold, L.,

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Ramírez-Santana, G. M., Acosta-Rodgríguez, V. M., & Hernández-Expósito, S. (2019). A

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Language Impairment/Estudio Comparativo de Los Fenotipos Linguisticos En El Trastorno Del

Espectro A Utistay En El Trastorno Especifico delLenguaje., 31(4).

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