Abstract
The present study aims to investigate pragmatic and language abilities, in general, in individuals with autism spectrum disorder (ASD). ASD is not primarily a language disorder and language impairments or delays are no longer considered core characteristics of the condition. Instead, ASD mainly affects pragmatic abilities. In the current study, three high-functioning Greek-speaking individuals with ASD (ages 9, 11, and 15) were tested using picture-based tasks from the diagnostic evaluation of language variation (DELV). The results showed variations in their performance and developmental differences. The younger participant faced challenges in morphosyntactic abilities, possibly related to a comorbid language disorder rather than ASD-specific difficulties. The findings are discussed in light of three theoretical perspectives: theory of mind, executive functions, and weak central cohesion.
TopIntroduction
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by a vast variety of symptoms and a rather early onset (symptoms are visible in children younger than 2 years old). Its core features (i.e., the ones globally present and required for an ASD diagnosis) are deficits in communicative abilities and restricted/repetitive behaviors regarding interests and/or activities (Hodges et al., 2020); however, there are plenty of additional symptoms that may or may not be present in a person with ASD. The disorder is divided in three levels, based on the severity of its symptoms and the support needs of the individuals; level 1 refers to high-functioning individuals requiring only some level of additional support in the areas described above; level 2 concerns individuals with more substantial support needs; finally, level 3 includes individuals with severe symptoms that interfere with various areas of everyday life and require very substantial support (Weitlauf et al., 2014).
ASD is not a language disorder, which means that it does not primarily affect language and language impairments or delays are no longer considered a core characteristic of the disorder, nor a necessary symptom for an ASD diagnosis (Peristeri et al., 2017; Surian et al., 1996); however, autism does frequently affect language, in direct or indirect ways. Specifically, language acquisition in individuals with ASD is often delayed, regresses or, in some cases, language skills never develop (Tager-Flusberg, 2016; Pickles et al., 2022). Generally, individuals with ASD can (a) be verbal and have high language abilities, (b) have low language abilities, mostly communicating through simple phrases or a few words and (c) be non-verbal (Syriopoulou-Delli et al., 2016; Vogindroukas et al., 2022). When verbal, high-functioning individuals are concerned, autism seems to affect specific aspects of language less directly. The linguistic level more frequently and more noticeably affected by the disorder is the level of pragmatics, which is a core issue in individuals with ASD (Syriopoulou-Delli et al., 2016). Nevertheless, it is important to note that that co-occurrence of ASD and other language disorders is frequent (Schaeffer et al., 2023).
Pragmatic aspects reportedly affected by the disorder include the ability of compliance with communication rules and the Gricean maxims (Asada et al., 2022; Surian et al., 1996). A short inspection of the Gricean maxims reveals that people with ASD tend to present difficulties specifically in (a) distinguishing truthful from non-truthful utterances, (b) providing the quantity of information needed while avoiding unnecessary details, (c) holding a conversation without deviating from the topic and (d) organizing their thoughts and, subsequently, their speech (for more information on the Cooperative Principle and the Gricean maxims; Grice, 1975 & 1989). Other related pragmatic deficits associated with ASD include a tendency to interpret utterances in a literal way (which, in turn, limits the ability of understanding or coding implicatures), deviation from politeness (especially its typical or “negative” aspect; for more details on politeness forms, Brown & Levinson, 1987), difficulty in distinguishing between old and new information and impaired ability of telling a coherent and well-flowing story (Ferretti et al., 2018; Nuske & Bavin, 2011). Nevertheless, the results are not consistently in accordance (Schaeffer et al., 2023). It should be noted that, apart from pragmatic deficits, other linguistic impairments tend to also be present in the speech of individuals with ASD; for instance, in narrative tasks, deviations such as avoidance of long and syntactically complex utterances, morphosyntactic errors, limited speech fluency and repetitions have been reported (Kuijper et al., 2017).
Key Terms in this Chapter
Language Disorder: In this instance, we are primarily discussing Developmental Language Disorder, a situation where children encounter challenges in appropriately acquiring, comprehending and employing language during their developmental stage. Primary issues are often identified in vocabulary and morphosyntax, which can consequently impact their social communication abilities.
Autism Spectrum Disorder: Autism Spectrum Disorder (ASD) is a complex neurological condition characterized by challenges in social interaction, communication and repetitive behaviors. It varies widely in symptoms and severity, affecting social skills, communication abilities and adaptability. ASD is diagnosed based on specific behaviors observed in early childhood, with interventions and support tailored to each individual's needs and strengths.
High-Functioning Individuals: High-functioning individuals with ASD are those who exhibit relatively good cognitive, language and adaptive skills despite having ASD. They often fall under Level 1 in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) classification. These individuals may excel in certain areas while still facing challenges in social communication and other aspects typical of ASD.
Question Asking: Question asking is the act of using language to inquire, seek information, or elicit a response from others. It involves forming sentences or phrases designed to prompt someone else to provide answers, explanations, or details on a particular topic or subject. Question asking is a crucial aspect of communication, enabling individuals to gather information, engage in conversations and facilitate the exchange of ideas.
Pragmatic Abilities: Pragmatic abilities involve using language effectively in social situations, encompassing understanding implied meanings, taking turns in conversation and adapting communication to social norms. narrative abilities can be considered a part of pragmatic abilities.
Comorbidity: Comorbidity refers to the presence of two or more distinct disorders in an individual at the same time. These conditions can coexist and interact, influencing each other's symptoms, progression and treatment. Comorbidity is a common phenomenon in various fields of medicine and psychology, highlighting the interconnectedness and complexity of disorders.
Narrative Abilities: Narrative abilities involve the skill to create, understand and convey coherent and meaningful stories or accounts. This includes organizing information, using appropriate sequencing, maintaining listener engagement and adapting the narrative style to the context and the audience. Since narratives are a form of communication that occurs within a social context, they fall under the broader umbrella of pragmatic abilities, which encompass various aspects of effective communication in social interactions.
Communicative Roles: Communicative roles involve the functions individuals take on during communication, such as speaking, listening, asking questions, explaining and persuading, to convey information and achieve goals in social contexts.