Can Narrative Skills Improve in Autism Spectrum Disorder? A Preliminary Study with Verbally Fluent Adolescents Receiving the Cognitive Pragmatic Treatment

Autism spectrum disorder (ASD) is a neurodevelopmental condition affecting social and communicative skills, including narrative ability, namely the description of real-life or fictive accounts of temporally and causally related events. With this study, we aimed to determine whether a communicative-pragmatic training, i.e., the version for adolescents of the Cognitive-Pragmatic Treatment, is effective in improving the narrative skills of 16 verbally fluent adolescents with ASD. We used a multilevel approach to assess pre- and post-training narrative production skills. Discourse analysis focused on micro- (i.e., mean length of utterance, complete sentences, omissions of morphosyntactic information) and macrolinguistic measures (i.e., cohesion, coherence errors, lexical informativeness). Results revealed a significant improvement in mean length of utterance and complete sentences and a decrease in cohesion errors. No significant change was found in the other narrative measures investigated. Our findings suggest that a pragmatically oriented training may be useful in improving grammatical efficiency in narrative production

Social-pragmatic contextual comprehension in Italian preschool and school-aged children: A study using the Pragma test

Efficient communication requires the interplay of linguistic, cognitive and social skills, including the ability to make contextual inferences and to understand others’ intentions and emotions. The capacity to effectively use language in specific contexts (i.e., pragmatic ability) develops with age, and an assessment of this ability is important for understanding both typical and atypical development. The Pragma test was originally developed and validated on Finnish children to assess social-pragmatic comprehension. The present study utilizes a slightly adapted version of the Pragma test, translated into Italian, and presents the results of the test given to 110 typically developing Italian children (4–8 years of age). The Italian version of the Pragma test shows content and concurrent validity, interrater reliability, and internal consistency, and it proves to be sensitive in detecting an age-dependent pattern of performance, across pre-school and school age children, in the pragmatic parameters investigated. The present study has ramifications for clinical contexts, as data for typical pragmatic development enables identification of strengths and weaknesses in the pragmatic performance in clinical populations. Finally, the results indicate that the Pragma test is relevant to both Finnish and Italian cultural contexts, thus providing the opportunity to make cross-cultural comparisons

The fuzzy boundaries of the social (pragmatic) communication disorder (SPCD): Why the picture is still so confusing?

Introduction: Since the introduction of Social (Pragmatic) Communication Disorder (SPCD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) in 2013, a debate has arisen in the scientific community about its usefulness in differential diagnosis for other clinical categories such as Autism Spectrum Disorder (ASD) and Specific Language Impairment (SLI). Indeed, SPCD criteria share a common deficit in communication and pragmatic skills with these diagnostic entities. Available assessment tools seem scarce and not sensitive enough to clarify diagnostic criteria and clinical boundaries. This study aims to review the existing literature on diagnostic screening for SPCD to highlight confounding variables in the domains examined, overlap with other diagnostic entities, and lack of specificity of available assessment tools in identifying the core deficits of the disorder. Methods: The search strategy was defined by combining the following keywords: “social pragmatic communication disorder,” “DSM-5,” “differential diagnosis,” and “child.” The search was performed in three databases: Medline (PubMed), Scopus, and Web of Science. All studies published between 2013 and April 2023, written in English, and with a major focus on SPCD were included in the review. Results: After the screening for the eligibility, 18 studies were included in the review. Most of these studies aimed to investigate the differential diagnosis between SPCD and other diagnostic categories (e.g., specific language impairment and autism spectrum disorder). Of these researches, only 6 were ad hoc experimental studies, while the others were based on previously collected databases. Conclusions: SPCD seems to have its own peculiarities and characteristics, indicating its clinical relevance, as emphasized by the DSM-5. However, the lack of specific instruments and a number of confounding variables make it difficult to identify and differentiate SPCD from other diagnostic entities. Further research is needed to overcome the lack of specific clinical instruments and lack of empirical studies

Sincere, deceitful, and ironic communicative acts and the role of the theory of mind in childhood

Abstract The aim of the study is to investigate the relationship among age, first- and second-order Theory of Mind and the increasing ability of children to understand and produce different kinds of communicative acts — sincere, ironic, and deceitful communicative acts — expressed through linguistic and extralinguistic expressive means. To communicate means to modify an interlocutor’s mental states (Grice, 1989), and pragmatics studies the inferential processes that are necessary to fill the gap, which often exists in human communication, between the literal meaning of a speaker’s utterance and what the speaker intends to communicate to the interlocutor. We administered brief video-clip stories showing different kinds of pragmatic phenomena — sincere, ironic, and deceitful communicative acts — and first- and second-order ToM tasks, to 120 children, ranging in age from 3 to 8 years. The results showed the existence of a trend of difficulty in children’s ability to deal with both linguistic and extralinguistic pragmatic tasks, from the simplest to the most difficult: sincere, deceitful, and ironic communicative acts. A hierarchical regression analysis indicated that age plays a significant role in explaining children’s performance on each pragmatic task. Furthermore, the hierarchical regression analysis revealed that first-order ToM has a causal role in explaining children’s performance in handling sincere and deceitful speech acts, but not irony. We did not detect any specific role for second-order ToM. Finally, ToM only partially explains the observed increasing trend of difficulty in children’s pragmatic performance: the variance in pragmatic performance explained by ToM increases between sincere and deceitful communicative acts, but not between deceit and irony. The role of inferential ability in explaining the improvement in children’s performance across the pragmatic tasks investigated is discussed