Is verbal reference impaired in autism spectrum disorder? A systematic review

Background and aims: Pragmatic language is a key difficulty in autism spectrum disorder. One such pragmatic skill is verbal reference, which allows the current entity of shared interest between speakers to be identified and thus enables fluid conversation. The aim of this review was to determine the extent to which studies have found that verbal reference is impaired in autism spectrum disorder. We organise the review in terms of the methodology used and the modality (production versus comprehension) in which proficiency with verbal reference was assessed. Evidence for the potential cognitive underpinnings of these skills is also reviewed. Main contribution and methods: To our knowledge, this is the first systematic review of verbal reference in autism spectrum disorder. PsychINFO and Web of Science were systematically screened using the combination of search terms outlined in this paper. Twenty-four studies met our inclusion criteria. Twenty-two of these examined production, whereby the methodology ranged from elicited conversation through to elicited narrative, the ‘director’ task and other referential communication paradigms. Three studies examined reference interpretation. (One study investigated both production and appropriacy judgement). Four studies examined the relationship between appropriate usage of verbal reference and formal language (lexico-syntactic ability). Two studies investigated whether reference production related to Theory of Mind or Executive Functioning. Conclusion and implications: Across a range of elicited production tasks, the predominant finding was that children and adults with autism spectrum disorder demonstrate a deficit in the production of appropriate verbal reference in comparison not only to typically developing groups, but also to groups with Developmental Language Disorder or Down syndrome. In contrast, the studies of reference interpretation which compared performance to typical control groups all found no between-group differences in this regard. To understand this cross-modality discrepancy, we need studies withthe same sample of individuals, whereby the task requirements for comprehension and production are as closely matched as possible. The field also requires the development of experimental manipulations which allow us to pinpoint precisely if and how each comprehension and/or production task requires mentalising and/or various components of executive functioning. Only through such detailed and controlled experimental work would it be possible to determine the precise location of impairments in verbal reference in autism spectrum disorder. A better understanding of this would contribute to the development of interventions

Content andForm Interactions in the Narratives of Children with Specific Language Impairment

This project investigated the relationship of content and form in the narratives of school-age children. Method: Two samples of children with specific language impairment (SLI) and their age-matched peers (British Columbia sample, M age 9;0, n = 26; Texas/Kansas sample, M age 7;6, n = 40) completed the Test of Narrative Language (TNL, Gillam & Pearson, 2004). The relative strength of content elaboration and grammatical accuracy was measured for each child using variables derived from the TNL scoring system (Study 1) and from analysis of the story texts (Study 2). Results: Both studies indicated that, compared to age peers, the children with SLI were more likely to produce stories of uneven strength, either stories with poor content that were grammatically quite accurate, or stories with elaborated content that were less grammatical. Conclusions: These findings suggest that school-age children with SLI may struggle with the cumulative load of creating a story that is both elaborate and grammatical. They also show that the absence of errors is not necessarily a sign of strength. Finally, they underscore the value of comparing individual differences in multiple linguistic domains, including the elaboration of content, grammatical accuracy, and syntactic complexity

Individual differences in children's pragmatic ability: a review of associations with formal language, social cognition, and executive functions

Children vary in their ability to use language in social contexts and this has important consequences for wellbeing. We review studies that test whether individual differences in pragmatic skill are associated with formal language ability, mentalising and executive functions in both typical and atypical development. The strongest and most consistent associations found were between pragmatic and formal language. Additional associations with mentalising were observed, particularly with discourse contingency and irony understanding. Fewer studies considered executive function and evidence is mixed. To make progress, high-quality studies of specific pragmatic skills are needed to test mechanistic models of development. We propose 6 goals for future research: 1) developing an empirically-based taxonomy of pragmatic skills; 2) establishing which skills matter most for everyday functioning; 3) testing specific hypotheses about information processing; 4) augmenting measures of individual differences; 5) considering a broader set of psychological associates; 6) employing statistical tools that model the nested structure of pragmatics and cognition