Level of sense-making in children with autistic disorder and intellectual disability: Patterns of delay and deviance in development

The present study examined levels of sense-making in relation to adaptive functioning and autism symptomatology in low-functioning children with autistic disorder. Thirty-six children with autistic disorder and intellectual disability were compared with 27 children with intellectual disability and 33 typically developing children with a comparable nonverbal mental age (2–5 years). Level of sense-making was measured with the ComFor. Delays and deviant behaviors were assessed by using the Vineland Screener 0–6-NL and the Diagnostic Interview for Social and Communication Disorders. Levels of sense-making were substantially lower in the group with autistic disorder. At nonsymbolic levels of sense-making, children with autistic disorder and intellectual disability were much lower functioning in terms of social and communicative adaptive behavior than the children in the comparison groups with the same level of sense-making. Within the autism group, lower levels of sense-making were associated with more severe autism symptomatology in the domains of social interaction, communication, and imagination.

► Difficulties in sense-making are pervasive in children with AD and ID.
► Level of sense-making is an important underlying factor for adaptive delays.
► Lower levels of sense-making are associated with more severe autism symptomatology.
► Interventions need to be adjusted to the level of sense-making.