Pragmatic Language Difficulties Research Articles

Pragmatic performance, its relationship with symptom severity, and early clinical predictors of pragmatics in 5 ~ 6-year-old children with autism spectrum disorder

BackgroundPragmatic language refers to using spoken language to convey messages effectively across diverse social communication contexts. However, minimal longitudinal research has focused on defining early predictors of pragmatic development in children with autism spectrum disorder (ASD).MethodsIn the present study, 71 children with ASD and 38 age- and gender- matched 24- to 30-month-old typically developing (TD) children were enrolled. Social-communication, language, and parent‒child interaction measures were collected for the ASD group at baseline. Three years later, all subjects were assessed for pragmatic ability via the Chinese version of the Language Use Inventory (LUI-Mandarin). First, the differences in pragmatic performance between the ASD and TD groups at follow-up were analyzed. Second, pragmatic performance was correlated with autism symptomatology at follow-up, as well as the structural language difficulties and joint engagement (JE) levels at baseline in the ASD group. Furthermore, hierarchical multiple regression analyses and machine learning techniques were performed to explore the effects of early potential predictors of pragmatic development in the ASD group.ResultsFirst, our results revealed that performance was significantly lower in the ASD than in the TD group with respect to the LUI-Mandarin total scores and subscale scores (except for subscale C). Second, correlation analysis revealed that more severe symptoms of ASD at follow-up were associated with lower LUI-Mandarin total scores and better language performance on the Gesell Developmental Schedules (GDS). Additionally, increased proportions of supported JE (SJE) states were associated with higher LUI-Mandarin total scores. In contrast, increased proportions of unengaged (UE) states were associated with lower LUI-Mandarin total scores in the ASD group. Third, hierarchical multiple regression analyses and machine learning techniques indicated that the proportions of SJE during parent‒child interactions, as well as the degree of social symptoms and structural language impairments, were significant contributors to pragmatic development for the ASD group in the prediction models.ConclusionIn summary, our findings suggest that pragmatic language difficulties are present in children with ASD as early as preschool age. Additionally, given the close correlation between the LUI-Mandarin score and symptom severity on the ADOS/ADI-R, the LUI-Mandarin might be a good way to triage children who need to wait a long time for a more extensive evaluation. Furthermore, this study provides new insights into potential targets for pragmatic interventions, and interventions can be designed to promote SJE between caregivers and children in future work.

Sex Differences in the Broad Autism Phenotype: Insights from the Australian Biobank.

Examining sub-threshold autistic traits in non-autistic first-degree relatives of individuals on the autism spectrum, known as the Broad Autism Phenotype (BAP), could provide new insights into the associations and familial aggregation of autistic traits. This study was a retrospective cross-sectional study of parents (n = 1008), probands with autism (n = 613), and unaffected siblings (n = 221) of probands with autism. BAP traits were examined by the BAP Questionnaire and Communication Checklist-Adult in parents, Autism Developmental Observation Scale-Second edition in probands, and Social Responsiveness Scale in siblings. Multivariable linear regression analyses were used to investigate the associations of parental BAP traits on autistic traits in probands and unaffected sibling BAP traits. Fathers showed significantly increased aloofness, pragmatic language difficulties, and social engagement problems compared to mothers. Female siblings showed increased difficulties with social cognition compared to male siblings. Adjusted models of the regression analyses showed that all BAP traits in fathers were significantly associated with BAP trait expression in probands with autism. Additionally, all of mother's BAP traits were significantly associated with unaffected siblings' BAP trait expression while only fathers' aloofness and rigidity traits were inversely associated with siblings' BAP trait expression. Finally, there were significant inverse interactions noted between parent's BAP traits and their children's BAP trait expression. This study demonstrated differences in how males and females express BAP traits and also identified differences in parent-child associations by sex, with fathers having a greater effect on their proband children's expression of BAP traits than mothers.

Analysis of Language Developmental Supporters for Multicultural Family’s Perception and Demand on IT-based Pragmatic Language Intervention

Objectives: This survey study investigated the perception of supporters of language development for multicultural families (the supporters) in regards to the pragmatic language difficulties of multicultural children, the importance of intervention, and the demand for an IT-based pragmatic language intervention program. Methods: Among a total of 300 supporters across the country, 159 completed questionnaires, which were used for the analysis. The questionnaire consisted of the respondents’ background information; experience of pragmatic language intervention; perception of pragmatic language difficulties of multicultural children and importance of intervention, and demands of IT-based pragmatic language intervention program. Results: The supporters with 4 years or more of experience reported the children to have greater pragmatic language difficulties compared with those with those with less than 4 years of experience. No statistically significant differences were found in the perceptions of the importance of pragmatic language intervention for multicultural children. The supporters indicated that the most useful IT-based pragmatic language intervention program would be ‘materials offer type’, followed by ‘pragmatic-language-intervention-related parent education type’, and ‘evaluation type’ respectively. Also, the respondents indicated that ‘pragmatic-language-intervention-related parent education type’ would be the most useful for the parents followed by ‘problem solving type’, and ‘learning type’ in the order listed. Conclusion: The supporters were highly aware of the pragmatic language difficulties of multicultural children and the importance of intervention, and the survey results indicated that they needed active support. The results of this study can be used as basic data when a follow-up study is conducted to develop an IT-based pragmatic language intervention program.

Assessing pragmatic language difficulties using the Revised Children's Communication Checklist-2. Exploratory structural equation modeling and associations with restricted and repetitive behaviors.

In this paper, we investigated the psychometric properties of the Child Communication Checklist-Revised (CCC-R) for the first time with an English-speaking sample. We used a confirmatory application of exploratory structural equation modeling (ESEM) to re-evaluate the CCC-R's psychometric properties. We found strong support for its use as an assessment for pragmatic and structural language. Our second main aim was to explore associations between pragmatic and structural language and restricted and repetitive behaviors (RRBs), two hallmark characteristics of autism. We used the CCC-R and Repetitive Behavior Questionnaire (RBQ-2) to investigate these associations in a diverse non-clinical sample of children, taking a transdiagnostic approach. We intentionally excluded autism and other neurodevelopmental diagnoses to test, (1) the CCC-R in a broad sample and (2) the association between pragmatic language and RRB in children not already selected for that association. The sample comprised two groups of children, one was community sampled (n = 123) and the other (n = 143) included children with non-specific behavioral, emotional and/or cognitive difficulties referred to an assessment unit by schools. We found clear associations between pragmatic language difficulties and RRBs in both groups. Regression analysis showed that pragmatic language was the only significant contributor to RRBs even after Grammatical-Semantic score, age, sex, and socioeconomic status were controlled. The pattern was the same for both recruitment groups. However, the effects were stronger for the school-referred group which also had more pragmatic difficulties, grammatical-semantic difficulties and RRBs. A robust link between pragmatic language and RRBs, established in autism, has continuity across the broader non-clinical population.

Assessing Psychological Implications in Children with Delayed Verbal Communication and Vocabulary Development: A Systematic Review

Background: Delayed verbal communication and vocabulary development can significantly impact children's emotional well-being, social interactions, and overall psychological development. This systematic review aims to synthesize existing research on the psychological effects associated with these delays, focusing on how they affect children's emotional health, social skills, and cognitive functioning. Methodology: This review systematically analyzed studies that investigated the psychological consequences of delayed verbal communication and vocabulary development in children. The studies included were diverse in design, including cross-sectional, longitudinal, and mixed-method approaches. Key measures across studies included assessments of depressive and anxiety symptoms, social-emotional functioning, language skills, and cognitive abilities. The analysis synthesized findings from a range of populations, including children with developmental language disorders (DLD), specific language impairment (SLI), and autistic spectrum disorders (ASD). Results: The review found that children with delayed verbal communication and vocabulary development are at increased risk for a variety of psychological issues. These include higher levels of anxiety and depression, difficulties in social interactions, and cognitive challenges. Specifically, children with DLD and SLI were more likely to experience emotional difficulties, such as depressive symptoms and anxiety, compared to their peers. Pragmatic language difficulties were found to be particularly associated with later psychotic experiences and depressive symptoms. Peer problems, bullying, and socioemotional challenges were prominent among youth with language impairments. Additionally, deficits in higher-order language skills and cognitive abilities were linked to greater emotional and social difficulties. Conclusion: The psychological impacts of delayed verbal communication and vocabulary development are profound, affecting children's emotional well-being, social interactions, and cognitive development. Interventions should address both language difficulties and associated emotional and social challenges.

Endophenotyping social cognition in the broader autism phenotype.

Relatives of individuals with autism spectrum disorder (ASD) may display milder social traits of the broader autism phenotype (BAP) providing potential endophenotypic markers of genetic risk for ASD. We performed a case-control comparison to quantify social cognition and pragmatic language difficulties in the BAP (n = 25 cases; n = 33 controls) using the Faux Pas test (FPT) and the Goldman-Eisler Cartoon task. Using deep phenotyping we then examined patterns of inheritance of social cognition in two large multiplex families and the spectrum of performance in 32 additional families (159 members; n = 51 ASD, n = 87 BAP, n = 21 unaffected). BAP individuals showed significantly poorer FPT performance and reduced verbal fluency with the absence of a compression effect in social discourse compared to controls. In multiplex families, we observed reduced FPT performance in 89% of autistic family members, 63% of BAP relatives and 50% of unaffected relatives. Across all affected families, there was a graded spectrum of difficulties, with ASD individuals showing the most severe FPT difficulties, followed by the BAP and unaffected relatives compared to community controls. We conclude that relatives of probands show an inherited pattern of graded difficulties in social cognition with atypical faux pas detection in social discourse providing a novel candidate endophenotype for ASD.

An Exploratory Study of Pragmatic Language Use Across Contexts With the Pragmatic Rating Scale-School Age Among Autistic Boys and Boys With Fragile X Syndrome Plus Autism.

Autistic boys and boys with co-occurring fragile X syndrome and autism spectrum disorder (FXS + ASD) demonstrate similar pragmatic language difficulties. The Pragmatic Rating Scale-School Age (PRS-SA) captures ecologically valid metrics of pragmatic language impairments in these populations. It is traditionally scored based on the Autism Diagnostic Observation Schedule (ADOS), which may limit the use of the PRS-SA more broadly in research and clinical contexts. This study evaluated the feasibility of the PRS-SA based on a shorter, semistructured conversational context compared to the ADOS in school-age autistic boys (n = 16) and boys with FXS + ASD (n = 16), matched on ASD traits. Differences across ADOS and conversational contexts and associations with ASD-related social difficulties were evaluated. Findings revealed differences in PRS-SA scores between ADOS and conversational contexts, but only for the FXS + ASD group. Limited associations were observed between PRS-SA scores and ASD traits. Results from this study indicate the feasibility of using the PRS-SA in a shorter conversational context than the ADOS to assess pragmatic language among autistic boys. For boys with FXS + ASD, contextual differences warrant careful consideration in future work.

Pragmatic language and associations with externalizing behaviors in autistic individuals and those who have lost the autism diagnosis

BackgroundPragmatic language weaknesses, a core feature of autism spectrum disorder (ASD), are implicated in externalizing behavior disorders (Gremillion & Martel, 2014). Particularly in a clinical setting, these co-occurring externalizing disorders are very common in autism; rates of Attentional Deficit-Hyperactive Disorder (ADHD) and Oppositional Defiant Disorder (ODD) are as high as 83% (ADHD) and 73% (ODD; Joshi et al., 2010). It is possible that pragmatic language weaknesses impact the ability to effectively communicate one’s needs, which may lead autistic children to utilize externalizing behaviors in order to achieve a desired outcome (Ketelaars et al., 2010; Rodas et al., 2017). MethodsThe aim of the current study is to investigate the relationship between pragmatic language, assessed via multiple modalities, and externalizing behaviors, assessed by parent interview, in youth with autistic (n = 33) or neurotypical (NT; n = 34) developmental histories, along with youth diagnosed with autism, who lost the diagnosis (LAD) by adolescence (n = 31). ResultsThe autism group had significantly more pragmatic language difficulties, and more externalizing behaviors and disorders; ADHD symptoms were particularly more prevalent, while LAD and NT groups did not differ. Challenges in pragmatic language abilities were associated with more externalizing symptoms when controlling for other facts that typically influence such symptoms, including nonverbal cognition, structural language, executive functioning, and autistic characteristics, but did not remain when age was included in the model. ConclusionsWe discuss the mechanisms underlying difficult-to-manage externalizing behaviors and implications for interventions and long-term outcomes for youth with and without a history of autism.

Technology assisted language intervention (TALI) for children who are deaf/hard of hearing: promising impact on pragmatic skills

ABSTRACT Children who are deaf and hard of hearing (DHH) often demonstrate pragmatic language difficulties which can impact academic and social outcomes. This randomized control trial for DHH children, ages 3–12 years, explored the Technology-Assisted Language Intervention (TALI), incorporating augmentative and alternative communication technology (AAC) into traditional speech/language therapy, compared to treatment-as-usual (TAU) to determine impact on pragmatics. Pragmatic outcome measures included parent reported Pragmatics Profile of the CELF-5 (for children age ≥5 years) and CELF-P Descriptive Pragmatics Profile (for children <5 years) in addition to parent reported Social and Communication domains of the Vineland Adaptive Behavior Scales,Third Edition (VABS). Over 24 weeks, children ≥5 years in the TALI made significantly more progress (increase in raw scores) on the Pragmatics Profile compared to children in TAU (12.7 points vs. −6.0 points; p = 0.04) and also showed significant gains on two of the three subscales. For children ≥5 years, no significant VABS changes were seen in either intervention group. For children <5 years, there were no statistically significant differences in growth on the CELF-P total pragmatics raw score or on any subdomain. However, children in TALI had significant increases in the mean VABS Communication (86.7–99.1) and Social domain standard scores (91.8–97.4;p = 0.01), while gains for children in TAU on the Communication and Social domain standard scores were not statistically significant. These promising results support the need for additional research exploring the effectiveness of AAC supported speech/language therapy to enhance DHH children’s pragmatic language skills. Trial registration: ClinicalTrials.gov identifier: NCT02998164.

Do comorbid symptoms discriminate between autism spectrum disorder, ADHD and nonverbal learning disability?

Characterizing the functioning of individuals with neurodevelopmental disorders is crucial to their diagnosis. Research has found that children with different neurodevelopmental disorders, including autism spectrum disorders (ASD), attention deficit and hyperactivity disorder (ADHD), and nonverbal learning disability (NLD), may have comorbid symptoms of anxiety and depression, and problems with pragmatic language. The main aim of the present study was to identify any differences in the above-mentioned comorbid symptoms associated with these clinical profiles. A second aim was to establish how well signs of pragmatic language difficulties could discriminate between the three clinical profiles, in terms of their diagnostic power. For this purpose, 107 participants from 8 to 16 years old with a diagnosis of ASD, ADHD or NLD were compared with a group of typically-developing children. Self-reports on symptoms of anxiety and depression, and parents’ reports on social and communication problems were analyzed. Our findings confirmed that symptoms of anxiety and depression, and problems with pragmatic language are associated with different neurodevelopmental disorders, but not in the same way. In terms of diagnostic power, we found that pragmatic language difficulties clearly discriminated children with ASD, ADHD or NLD from typically-developing children. Importantly, pragmatic language difficulties also discriminated adequately between ASD and NLD. Our findings are discussed in terms of the value of considering comorbid symptoms to obtain a more accurate diagnosis of neurodevelopmental disorders.

"Um" and "Uh" Usage Patterns in Children with Autism: Associations with Measures of Structural and Pragmatic Language Ability.

Pragmatic language difficulties, including unusual filler usage, are common among children with Autism Spectrum Disorder (ASD). This study investigated "um" and "uh" usage in children with ASD and typically developing (TD) controls. We analyzed transcribed Autism Diagnostic Observation Schedule (ADOS)sessions for 182 children (117 ASD, 65 TD), aged 4 to 15. Although the groups did not differ in "uh" usage, the ASD group used fewer "ums" than the TD group. This held true after controlling for age, sex, and IQ. Within ASD, social affect and pragmatic language scores did not predict filler usage; however, structural language scores predicted "um" usage. Lower "um" rates among children with ASD may reflect problems with planning or production rather than pragmatic language.

Pragmatic language markers of autism diagnosis and severity

PurposeAssessment of pragmatic language difficulties is limited with conventional tests but can be performed with informant reports. We evaluated the performance of a parent-completed language scale in differentiating autism from typical development (TD) and another neurodevelopmental disorder. Specifically, we aimed to gauge the respective values of structural and pragmatic language scores for diagnostic discrimination and for predicting severity of social impairment in autistic children. Method174 children aged 7–17 (101 with autism, 45 with ADHD, 28 with TD) were evaluated with the ADOS-2 and an abbreviated version of the WISC. Parents completed the Children’s Communication Checklist, 2nd Edition (CCC-2) and the Social Responsiveness Scale. CCC-2 mean differences across diagnostic groups were tested with analysis of variance and covariance. Multiple linear regression was used to compare the structural and pragmatic CCC-2 scores in predicting autism symptom severity. ResultsBoth structural and pragmatic language scores discriminated between the three diagnostic groups, with stronger effects for the pragmatic scores. Pragmatic scores remained robust predictors of ADHD and ASD diagnoses even after accounting for cognitive and structural linguistic differences. Among autistic children, social impairment severity was associated with pragmatic, but not structural, language profiles. ConclusionsIn order to characterize pragmatic language, easy to administer parent questionnaires such as the CCC-2 may support clinicians who are considering an autism diagnosis and needing to evaluate and monitor social communication.

A Longitudinal Study of Parent-Child Interactions and Language Outcomes in Fragile X Syndrome and Other Neurodevelopmental Disorders.

Difficulties with pragmatic language (i.e., language in social contexts, such as conversational ability) are a noted characteristic of the language profiles of both fragile X syndrome (FXS) and autism spectrum disorder (ASD), conditions which show significant phenotypic overlap. Understanding the origins and developmental course of pragmatic language problems in FXS and other developmental conditions associated with language impairment is a critical step for the development of targeted interventions to promote communicative competence across the lifespan. This study examined pragmatic language in the context of parent-child interactions in school-age children with FXS (who did and did not meet ASD criteria on the ADOS; n = 85), idiopathic ASD (n = 32), Down syndrome (DS; n = 38), and typical development (TD; n = 39), and their parents. Parent-child communicative interactions were examined across multiple contexts, across groups, and in relationship to pragmatic language outcomes assessed 2 years later. Results showed both overlapping and divergent patterns across the FXS-ASD and idiopathic ASD child and parent groups, and also highlighted key differences in pragmatic profiles based on situational context, with more pragmatic language difficulties occurring for both ASD groups in less structured interactions. Differences in parental language styles during parent-child interactions were associated with child language outcomes, likely reflecting the complex interplay of discourse style inherent to a parent, with the inevitable influence of child characteristics on parent language as well. Together, findings help delineate the dynamic and multifactorial nature of impaired pragmatic skills among children with FXS and other neurodevelopmental disorders associated with language impairment, with potential implications for the development of targeted interventions for pragmatic communication skills.

The FMR1 Premutation Phenotype and Mother-Youth Synchrony in Fragile X Syndrome

A subset of mothers who carry the FMR1 premutation may express a unique phenotype. The relationship between the FMR1 phenotype and mother-child interaction in families with fragile X-associated disorders has not been well characterized, despite the importance of high-quality mother-child interaction for child development. This study examined the association between the FMR1 phenotype and the quality of interactions between mothers and their adolescent/young adult sons with fragile X syndrome. Mother-youth synchrony was coded from a dyadic interaction. Maternal anxiety and depression symptoms, executive function deficits, and pragmatic language difficulties were evaluated. Results indicated that pragmatic language was associated with mother-youth synchrony. These findings highlight the importance of family-centered intervention practices for families with fragile X-associated disorders.

The Role of Working Memory in the Processing of Scalar Implicatures of Patients With Schizophrenia Spectrum and Other Psychotic Disorders

A number of studies have demonstrated pragmatic language difficulties in people with Schizophrenia Spectrum and Other Psychotic Disorders. However, research about how people with schizophrenia spectrum and other psychotic disorders understand scalar implicatures (SIs) is surprisingly rare, since SIs have generated much of the most recent literature. Scalar implicatures are pragmatic inferences, based on linguistic expressions like some, must, or, which are part of a scale of informativeness (e.g., some/many/all). Logically, the less informative expressions imply the more informative ones, but pragmatically people usually infer that the presence of a less informative term implies that the more informative term was not applicable. In one of the few existing studies with people with schizophrenia spectrum and other psychotic disorders, Wampers et al. (2018) observed that in general, people with schizophrenia spectrum and other psychotic disorders were less likely to derive SIs than controls. The current study has three main aims. First, we want to replicate the original finding with the scalar terms some-all. Second, we want to investigate how these patients deal with different scalar terms, that is, we want to investigate if scalar diversity is also observed in this clinical group. Third, we investigate the role of working memory, often seen as another important mechanism to enable inferring SIs. Twenty-one individuals with a psychotic disorder and 21 matched controls answered 54 under-informative statements, in which seven different pairs of scalar terms were used. In addition, working memory capacity was measured. Patients with schizophrenia spectrum and other psychotic disorders did not make more logical interpretations when processing quantifiers, disconfirming Wampers et al. (2018). However, certain scalar scales elicited more pragmatic interpretations than others, which is in line with the scalar diversity hypothesis. Additionally, we observed only partial evidence for the role of working memory. Only for the scalar scale and-or, a significant effect of working memory was observed. The implications of these results for patients with schizophrenia spectrum and other psychotic disorders are discussed, but also the role of working memory for pragmatic inferences, as well as the place of SIs in experimental pragmatics.

Maternal Pragmatic Language Difficulties in the FMR1 Premutation and the Broad Autism Phenotype: Associations with Individual and Family Outcomes.

Broader phenotypes associated with genetic liability, including mild difficulties with pragmatic language skills, have been documented in mothers of children with autism spectrum disorder (ASD) and mothers of children with fragile X syndrome (FXS). This study investigated the relationship between pragmatic difficulties and indicators of maternal well-being and family functioning. Pragmatic difficulty was associated with loneliness in mothers of children with ASD or FXS, and with depression, decreased life satisfaction, and poorer family relationship quality in mothers of children with FXS only. Results inform subtle maternal pragmatic language difficulties as a risk factor that that may contribute to reduced health and well-being, informing tailored support services to better meet the unique needs of families of children with ASD or FXS.

Age differences in broader autism phenotype traits from young adulthood to older adulthood.

Much of past research has been dedicated to refining the operationalization and correlates of the broader autism phenotype (BAP) and less on how the BAP differs by socio-demographic characteristics, like age-particularly after midlife. This gap is important because other nonclinical trait-like characteristics (e.g., personality) have shown considerable age differences, leading to work assessing the malleability of psychological characteristics and improving outcomes for individuals and their significant others. In the current study, we examined cross-sectional age differences in the BAP in a large sample of adults ranging in age from 18 to 85. We recruited a sample of 2966 adults ranging in age from 18 to 85 (Mage = 36.53, SD = 12.61; 58.9% Female; 1.1% with an ASD diagnosis) recruited from an online survey service. We found that total BAP scores were higher in younger adults and lower among older adults. These differences were particularly true for pragmatic language difficulties, with this component of the BAP showing the most dramatic age differences. Aloofness showed similar negative associations with age, albeit much smaller. Rigidity was not significantly associated with age. The results are consistent with other research showing an abatement of symptoms among individuals with autism spectrum disorders (ASDs) across early life and theories predicting changes in other psychological characteristics (e.g., personality). The results are discussed in the context of the malleability of ASD and BAP traits across life, the clinical implications of these changes, and the origins and consequences for lifespan differences in BAP. LAY SUMMARY: Little is known about how subclinical autistic-like traits among middle-aged and older adults compare to younger adults. We found that these subclinical traits were highest in young adults and lowest in older adults. Knowing how these traits differ by age can provide researchers and clinicians with a sense of how much these traits might change across life, if the traits might be sensitive to interventions, and when in development it might be best to intervene.

Linking Peer-Mediated Interventions to Address Conversational Difficulties in Adolescents With Autism

PurposeAdolescents with autism spectrum disorder (ASD) commonly experience an array of pragmatic language difficulties that can interfere with their ability to engage in reciprocal or balanced conversations with their peers. Difficulties with the use of language during peer encounters can contribute to these students' social isolation even when in inclusive settings. Increasingly, researchers have identified effective approaches for teaching conversational skills to individuals with ASD, but there are few demonstrations of effective interventions in high school settings. Peer-mediated intervention (PMI) is one approach that can embody research-based recommendations for teaching conversational skills (e.g., direct instruction, teaching in natural settings, use of peer partners). This clinical focus article describes effective PMI strategies for improving the social conversations of high school students with ASD based on our (the authors') emerging research.ConclusionsUsingFey's (1986)classification scheme, the article begins with an illustration of different conversational profiles of adolescents with ASD and associated goals for intervention. Next, key components of our PMI approach are described, followed by detailed illustrations of three research-based intervention strategies that speech-language pathologists can use to address different conversational goals. Emphasis is placed on strategies for teaching students with ASD target skills and training peers to support conversation. Outcomes and clinical reflections of our intervention research are described. Finally, the article ends with a discussion of additional considerations for speech-language pathologists regarding implementation and generalization.Supplemental Materialhttps://doi.org/10.23641/asha.13308470

Función ejecutiva, lenguaje pragmático y perfiles psicopatológicos según la CBCL en niños con trastornos del neurodesarrollo y antecedentes familiares de esquizofrenia

Introducción: La escala CBCL de Achenbach completada por padres evalúa un amplio rango de problemas conductuales y emocionales de inicio en la infancia. Sus subescalas “retraimiento-depresión” y principalmente “problemas de pensamiento” se han propuesto como medida de detección de riesgo de psicosis en adolescentes. Dentro de los posibles endofenotipos de la esquizofrenia se plantean la disfunción ejecutiva y la alteración en el lenguaje pragmático. Objetivos: Identificar mediante ambas subescalas de la CBCL un subgrupo de niños y adolescentes con puntuaciones elevadas entre los pacientes que consultan en psiquiatría infantil por trastornos del neurodesarrollo y que tienen antecedentes familiares de esquizofrenia. Material y métodos: Los padres completan la escala CBCL de Achenbach, CCC-Childrens Communication Checklist- (evaluación del lenguaje pragmático) y BRIEF-2 (evaluación conductual de la función ejecutiva).Resultados: Se incluyeron 21 niños (16 niños: 5 niñas). Edad media 11,4 años. Los diagnósticos principales fueron TDAH (66,7%), trastorno de aprendizaje (9,5%) y TEA (9,5%). Las dos subescalas de la CBCL “retraimiento-depresión” y “problemas de pensamiento” discriminan dos grupos, uno con afectación (n=11) con puntuaciones por encima del Pc70 y otro sin afectación (n=10) con puntuaciones inferiores al Pc70. Los casos con afectación mostraron más dificultades en el lenguaje pragmático y función ejecutiva que los del grupo sin afectación.Conclusiones: Realizar una evaluación dimensional más completa de la psicopatología, como la que ofrece la CBCL, en niños con trastornos del neurodesarrollo y antecedentes familiares de esquizofrenia puede ayudar a describir mejor las dificultades premórbidas e identificar casos susceptibles de seguimiento longitudinal e intervención precoz.

Assessment of implicit language and theory of mind in multiple sclerosis.

Increasing evidence suggests that social cognition, especially theory of mind (ToM), is impaired in individuals with multiple sclerosis (MS). ToM appears to be a determining factor for social functioning, but research has shown a connection between ToM and pragmatic language disorders among people with neurological or psychiatric disorders. Yet, pragmatic language remains a domain rarely referenced in MS. We investigated the effect of MS in terms of the ability for making inferences via pragmatic understanding and ToM. We included 21 individuals with MS and 21 healthy controls matched for age, education and linguistic skills who performed verbal tasks involving pragmatic language (Implicit Information Management Test, Narrative Discourse Task), ToM (Test of Social Faux Pas) and a visual task of making inferences (Visual Inferences Test). Performance was significantly lower for individuals with MS than controls in the Test of Social Faux Pas (total score), but performance in pragmatic tasks did not differ. Performance was significantly lower for MS individuals for logical inference on the Implicit Information Management Test and pragmatic inference on the Visual Inferences Test. Additionally, for the MS group, the total score on the Implicit Information Management Test was correlated with the faux pas test total score and hits. Even with lack of marked cognitive decline and disability in individuals with MS and lack of differences between groups in pragmatic tasks, the MS group showed lower performance in making inferences and interpreting implicit and social situations. This study highlights the link between pragmatic language and ToM difficulties in MS.