文法障害を主徴とする特異的言語障害を合併した成人自閉スペクトラム症の1例

An adult case of autism spectrum disorder with grammatical specific language impairment

　幼少期に言語発達の遅れはあったが，学童期以降は顕著な問題を認めず，青年期に自閉スペクトラム症(ASD)と診断された成人例．言語性IQは正常範囲内だったが，言語聴覚士との会話の中で意思疎通が困難な場面が認められたことから，発達性の言語障害を評価する構文検査(格助詞の補完課題と文の理解課題)を実施した．その結果，格助詞の補完課題(特にかき混ぜ語順文)で大幅な低下を示した．この結果は文法障害を主徴とする特異的言語障害(G-SLI)の特徴によく一致した．同様の検査を，ASDと診断された成人例10例にも行ったが，本例のような大幅な低下を示す例はなかった．以上より，本例はASDにG-SLIが合併した1例と考えられた．言語性IQが正常範囲内でも，コミュニケーションに問題が認められる場合は，コミュニケーション以前の言語機能に問題がないか詳細を調べる必要がある．そのうえで，障害特性に合った援助・訓練が求められる．

　We reported on an adult male with autism spectrum disorder(ASD) and grammatical specific language impairment(G-SLI). The case had language delay in his infancy, but since school age, he has had no subjective language problems. His verbal IQ in WAIS-III was 97 when admitted to our hospital. However, he sometimes showed communication difficulties in conversation with his speech-language-hearing therapist. We then conducted a syntactic examination on him including the production of case particles and the comprehension of sentences with various syntactic complexities. In the production task, we asked him to fill in the blanks with case particles in order to complete a sentence describing a picture. His score for this task was exceptionally low. When the sentences were presented with the basic word order, his score was good. However, when they were in a scrambled order, his score was rather poor. These features concur with those of G-SLI. We also conducted the test on 10 adults with ASD. None of them showed the same features. Hence, we concluded that the case had G-SLI in addition to ASD. Thus, it is important to check for language disability in case of communication difficulties, and not to make a hasty judgment assuming that it is caused by ASD.