Abstract
Personal pronouns, such as 'I' and 'you', require a speaker/listener to continuously re-map their reciprocal relation to their referent, depending on who is saying the pronoun. This process, called 'deictic shifting', may underlie the incorrect production of these pronouns, or 'pronoun reversals', such as referring to oneself with the pronoun 'you', which has been reported in children with autism. The underlying neural basis of deictic shifting, however, is not understood, nor has the processing of pronouns been studied in adults with autism. The present study compared the brain activation pattern and functional connectivity (synchronization of activation across brain areas) of adults with high-functioning autism and control participants using functional magnetic resonance imaging in a linguistic perspective-taking task that required deictic shifting. The results revealed significantly diminished frontal (right anterior insula) to posterior (precuneus) functional connectivity during deictic shifting in the autism group, as well as reliably slower and less accurate behavioural responses. A comparison of two types of deictic shifting revealed that the functional connectivity between the right anterior insula and precuneus was lower in autism while answering a question that contained the pronoun 'you', querying something about the participant's view, but not when answering a query about someone else's view. In addition to the functional connectivity between the right anterior insula and precuneus being lower in autism, activation in each region was atypical, suggesting over reliance on individual regions as a potential compensation for the lower level of collaborative interregional processing. These findings indicate that deictic shifting constitutes a challenge for adults with high-functioning autism, particularly when reference to one's self is involved, and that the functional collaboration of two critical nodes, right anterior insula and precuneus, may play a critical role for deictic shifting by supporting an attention shift between oneself and others.
Highlights
Participants with high-functioning autism showed reliably slower and less accurate responses than the control group for the items requiring a deictic shift (SHIFT) compared with items using a fixed label (FIXED). These slower and less accurate responses of the autism group were accompanied by lower functional connectivity between the right anterior insula and precuneus only for the SHIFT condition
Further analyses indicated that underconnectivity between the right anterior insula and precuneus was observed when transforming ‘you’ to ‘I’ (SHIFTTO-SELF), but not when transforming ‘I’ to ‘you’ (SHIFT-TOOTHER), and that activation in the precuneus did not change between these two conditions in the autism group, but was significantly lower for the SHIFT-TO-SELF than the SHIFT-TOOTHER conditions in the control group
Pronoun reversals are described as idiosyncratic language impairment in autism, but the findings suggest that they may characterize an atypical understanding of the social world because deictic shifting is embedded in understanding the self- and other-relationship, which requires the recognition of the self-stance relative to the other’s existence
Summary
Personal pronouns, such as ‘I’ and ‘you’, require a speaker/listener to continuously re-map their reciprocal relation to their referent, depending on who is saying the pronoun. This process, called ‘deictic shifting’, may underlie the incorrect production of these pronouns, or ‘pronoun reversals’, such as referring to oneself with the pronoun ‘you’, which has been reported in children with autism. As described in Leo Kanner’s seminal documentation of autism above, children with autism sometimes incorrectly refer to themselves by using the second-person pronoun, ‘you’, instead of the first-person pronoun, ‘I’, by repeating the pronoun they heard someone else use when referring to them Such atypical production of personal pronouns, called ‘pronoun reversals’, has long been recognized as a common impairment in autism
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