Early joint attention abilities measured by the ADOS‐2 predict subsequent expressive language development in minimally verbal autistic children

Abstract Background Most preschool autistic children exhibit substantial language delays, yet only ∼25% remain minimally verbal (MV) throughout life. Developing expressive language is crucial for improving outcomes. This study examined early predictors of later expressive language growth in MV preschool autistic children. Methods Data from 99 MV autistic children (mean age 27.7 months at diagnosis) who completed ADOS‐2 assessments at diagnosis and 12–24 months later were analyzed. Children were stratified into three groups according to their language abilities at follow‐up (MV, one‐word, and phrases). Logistic regression was used to determine whether baseline ADOS‐2 calibrated severity scores (CSS), non‐verbal cognitive abilities, or Joint Attention (JA), derived from six ADOS‐2 items, enabled prediction of expressive language abilities at follow‐up. Results Children who successfully developed expressive language (one‐word/phrases) had significantly lower baseline ADOS‐2 social affect CSS and JA scores, but did not differ in their non‐verbal cognitive abilities or ADOS‐2 restricted and repetitive behaviors CSS. Gains in JA were significantly larger in children who developed expressive language. Conclusion MV preschoolers with better social abilities at diagnosis, specifically JA, were more likely to develop expressive language within 1–2 years. Joint attention scores derived from the ADOS‐2 offer an easily accessible and widely available measure with important prognostic value for MV children.