Differential Diagnosis between Autism Spectrum Disorder and Hyperlexia in a Jordanian Sample

Abstract

This study investigated whether children with Autism Spectrum Disorder (ASD) and children with Hyperlexia (HLX) differ in social interaction and pragmatic language, repetitive behaviors, sensory processing, and the decoding–comprehension gap. A comparative cross-sectional design was employed involving 80 children aged 4–10 years; 40 children diagnosed with ASD and 40 children with HLX recruited from specialized centers in Amman, Jordan. Data were collected using the Social Responsiveness Scale–Second Edition (SRS-2), Repetitive Behavior Scale–Revised (RBS-R), Short Sensory Profile (SSP), and standardized assessments of decoding, reading comprehension, and listening comprehension, from which decoding–comprehension discrepancy scores were calculated. Group differences were examined. The findings demonstrated that children with ASD continued to obtain significantly higher scores across all SRS-2 domains than children with HLX, with the largest adjusted effects observed for Social Communication. Also, the group of children with ASD demonstrated significantly higher levels of repetitive behavior on all sub-scales of the RBS-R, especially in the subscale of Sameness Behavior  along with significantly higher levels of sensory processing problems in all SSP measures, especially Auditory Filtering. In contrast, children with HLX demonstrated significantly stronger decoding performance and significantly larger decoding–reading  and decoding–listening  discrepancy scores than children with ASD..