Pragmatic Language Skills Research Articles

Assessing language skills in adolescents with autism spectrum disorder

Language abilities in adolescents with autism spectrum disorders (ASDs) are variable and can be challenging to ascertain with confidence. This study aimed to compare and evaluate different forms of language assessment: standardized language testing, narrative analysis and parent/teacher reports. 14 adolescents with ASD and 14 typically developing adolescents matched on age, gender and nonverbal ability were assessed using a number of standardized assessments for receptive and expressive language skills, a standardized narrative test, two experimental narrative assessments and a parent/teacher report measure of pragmatics. The findings were that, although adolescents with ASD scored within the normal range on expressive and receptive language, their performance on narrative tasks revealed difficulties with both structural and evaluative language. It should be noted that both teachers and parents rated the pragmatic language skills of the young people with ASD as significantly lower than those of the typically developing group but parents were more likely than teachers to additionally identify difficulties in speech and syntax. The implications of these results for professionals in terms of assessing the language skills of adolescents with ASD and for the planning of appropriate intervention are discussed.

Revisión de intervenciones para mejorar las habilidades pragmáticas en niños y niñas con problemas de conducta y atención

Revisión de intervenciones para mejorar las habilidades pragmáticas en niños y niñas con problemas de conducta y atención

Development and Standardization of a Test for Pragmatic Language Skills in Egyptian Arabic: The Egyptian Arabic Pragmatic Language Test (EAPLT)

Objective: The aim of this study was to standardize an Egyptian Arabic Pragmatic Language Test (EAPLT) using linguistically and socially suitable questions and pictures in order to be able to address specific deficits in this language domain. Participants and Methods: Questions and pictures were designed for the EAPLT to assess 3 pragmatic language subsets: pragmatic skills, functions, and factors. Ten expert phoniatricians were asked to review the EAPLT and complete a questionnaire to assess the validity of the test items. The EAPLT was applied in 120 typically developing Arabic-speaking Egyptian children (64 females and 56 males) randomly selected by inclusion and exclusion criteria in the age range between 2 years, 1 month, 1 day and 9 years, 12 months, 31 days. Children’s scores were used to calculate the means and standard deviations and the 5th and 95th percentiles to determine the age of the pragmatic skills acquisition. Results: All experts have mostly agreed that the EAPLT gives a general idea about children’s pragmatic language development. Test-retest reliability analysis proved the high reliability and internal consistency of the EAPLT subsets. A statistically significant correlation was found between the test subsets and age. Conclusion: The EAPLT is a valid and reliable Egyptian Arabic test that can be applied in order to detect a pragmatic language delay.

Using Language Sample Analysis to Assess Pragmatic Skills in School-Age Children and Adolescents

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, addition of social (pragmatic) communication disorder has underscored the need for development and refinement of clinical tools to accurately identify pragmatic language deficits in clinical populations. One of the 4 required social (pragmatic) communication disorder diagnostic criteria is difficulty following rules for conversation and storytelling. As such, language sample collection and analysis is an important assessment tool for identification of this disorder. This tutorial describes a language sampling protocol and reviews analysis techniques for the purpose of documenting pragmatic language skills in school-age populations.

An exploration of sarcasm detection in children with Attention Deficit Hyperactivity Disorder

The present research explored the ability of children with ADHD to distinguish between sarcasm and sincerity. Twenty-two children with a clinical diagnosis of ADHD were compared with 22 age and verbal IQ matched typically developing children using the Social Inference–Minimal Test from The Awareness of Social Inference Test (TASIT, McDonald, Flanagan, & Rollins, 2002). This test assesses an individual’s ability to interpret naturalistic social interactions containing sincerity, simple sarcasm and paradoxical sarcasm. Children with ADHD demonstrated specific deficits in comprehending paradoxical sarcasm and they performed significantly less accurately than the typically developing children. While there were no significant differences between the children with ADHD and the typically developing children in their ability to comprehend sarcasm based on the speaker’s intentions and beliefs, the children with ADHD were found to be significantly less accurate when basing their decision on the feelings of the speaker, but also on what the speaker had said. Results are discussed in light of difficulties in their understanding of complex cues of social interactions, and non-literal language being symptomatic of children with a clinical diagnosis of ADHD. The importance of pragmatic language skills in their ability to detect social and emotional information is highlighted.

Pragmatic Language Outcomes of Children With Attention Deficit Hyperactivity Disorder After Therapist- and Parent-Delivered Play-Based Interventions: Two One-Group Pretest-Posttest Studies With a Longitudinal Component.

The pragmatic language outcomes of children with attention deficit hyperactivity disorder (ADHD) were explored across two feasibility studies. Five children with ADHD (ages 6-11 yr), their parents, and 5 typically developing peers completed an assessment 18 mo after a therapist-delivered intervention (Study 1). Participants then completed a parent-delivered intervention (Study 2). Blinded ratings of peer-to-peer play interactions documented changes in children's pragmatic language 18 mo after the Study 1 intervention and before, immediately after, and 1 mo after the Study 2 intervention. Nonparametric statistics and Cohen's d were used to measure change. Children's pragmatic language outcomes were maintained 18 mo after the therapist-delivered intervention and significantly improved from before to 1 mo after the parent-delivered intervention. Interventions involving occupational therapist and speech-language pathologist collaboration, play, and parent and peer involvement may facilitate children's pragmatic language skills.

Speaker-Versus Listener-Oriented Disfluency: A Re-examination of Arguments and Assumptions from Autism Spectrum Disorder

We re-evaluate conclusions about disfluency production in high-functioning forms of autism spectrum disorder (HFA). Previous studies examined individuals with HFA to address a theoretical question regarding speaker- and listener-oriented disfluencies. Individuals with HFA tend to be self-centric and have poor pragmatic language skills, and should be less likely to produce listener-oriented disfluency. However, previous studies did not account for individual differences variables that affect disfluency. We show that both matched and unmatched controls produce fewer repairs than individuals with HFA. For silent pauses, there was no difference between matched controls and HFA, but both groups produced more than unmatched controls. These results identify limitations in prior research and shed light on the relationship between autism spectrum disorders and disfluent speech.

Retrospectively Assessed Early Motor and Current Pragmatic Language Skills in Autistic and Neurotypical Children.

Autistic individuals often struggle developmentally, even in areas that are not explicit diagnostic criteria, such as motor skills. This study explored the relation between early motor skills, assessed retrospectively, and current pragmatic language skills. Caregivers of neurotypical and autistic children, matched on gender and age, completed assessments of their child's early motor development and current language abilities. Early motor skills were correlated with later pragmatic language skills, and autistic children exhibited fewer motor skills than neurotypical children. In fact, motor skills were a better predictor of an autism spectrum diagnosis than were scores on a measure of current pragmatic language. These results highlight the important role of motor skills in autism spectrum disorders.

Lapbooks: Adding Creativity to Literature-Based Intervention

Contextualized language intervention (CLI) is a treatment approach that seeks to target multiple language skills in the context of meaningful, functional, and curriculum-based activities. For school-age children, literature-based language intervention is a type of CLI that can simultaneously target a variety of semantic, syntactic, and pragmatic language skills, while also supporting the core curriculum. This tutorial demonstrates how to design lapbooks (collections of mini-books, pockets, and foldables laid out in a standard file folder) to organize and creatively display the language learning activities completed for each literature unit. Links to a series of instructional videos are also provided via the author's YouTube channel ( https://www.youtube.com/channel/UCne6IbEwEf8eWVyJxHPXvPw ).

Signaling of noncomprehension in communication breakdowns in fragile X syndrome, Down syndrome, and autism spectrum disorder

The ability to indicate a failure to understand a message is a critical pragmatic (social) language skill for managing communication breakdowns and supporting successful communicative exchanges. The current study examined the ability to signal noncomprehension across different types of confusing message conditions in children and adolescents with fragile X syndrome (FXS), Down syndrome (DS), autism spectrum disorder (ASD), and typical development (TD). Controlling for nonverbal mental age and receptive vocabulary skills, youth with comorbid FXS and ASD and those with DS were less likely than TD controls to signal noncomprehension of confusing messages. Youth with FXS without ASD and those with idiopathic ASD did not differ from controls. No sex differences were detected in any group. Findings contribute to current knowledge of pragmatic profiles in different forms of genetically-based neurodevelopmental disorders associated with intellectual disability, and the role of sex in the expression of such profiles. Learning outcomesUpon completion of this article, readers will have learned about: (1) the social-communicative profiles of youth with FXS, DS, and ASD, (2) the importance of signaling noncomprehension in response to a confusing message, and (3) the similarities and differences in noncomprehension signaling in youth with FXS (with and without ASD), DS, idiopathic ASD, and TD.

Developmental trajectories of structural and pragmatic language skills in school-aged children with Williams syndrome.

This study aimed to compare developmental courses of structural and pragmatic language skills in school-aged children with Williams syndrome (WS) and children with idiopathic intellectual disability (IID). Comparison of these language trajectories could highlight syndrome-specific developmental features. Twelve monolingual Dutch-speaking children with WS aged 5.10 to 13.3 years were assessed by means of standardised structural language tests measuring receptive and expressive vocabulary and sentence comprehension and production. Pragmatic language was evaluated by means of an expressive referential communication task and a retelling test. All of these language abilities were re-evaluated with the same measures after a period of 18 to 24 months. Performance was compared to 12 children with IID pairwise matched for chronological age (CA) and non-verbal fluid reasoning (Gf) at Time 1. Non-verbal mental age (NVMA) was taken into account when delineating developmental trajectories. Children with WS outperformed children with IID on expressive vocabulary development. In contrast, sentence comprehension was significantly poorer than in children with IID at the second time point. Increased variability and rather poor performance on pragmatic language tasks were demonstrated in the WS group. Irrelevant and off-topic extraneous information transfer continued to be a syndrome-specific characteristic of children with WS. The data provide new insights into diverging developmental trajectories across language domains. Expressive structural language skills tend to progress more rapidly than receptive language skills in children with WS causing more distinctive language profiles over time. Some children with WS seem to benefit from the growth in expressive structural language abilities to enhance their expressive pragmatic language skills, while in some others these abilities remain challenging. This study highlights the need for continued follow-up of language challenges in WS and for a dynamic and individualised interventional approach.

Parental report on socio-communicative behaviours in children with 22q11.2 deletion syndrome

ABSTRACTBackground Children with 22q11.2 deletion syndrome (22q11.2DS) are reported to have socio-communicative impairments. Although many of these children are diagnosed with intellectual disability (ID) and/or autism spectrum disorder (ASD), these populations are seldom used as control groups. Hence, information regarding syndrome-specific socio-communicative challenges is lacking.Method Parental concerns regarding everyday communication were investigated by means of the Children’s Communication Checklist-2-NL (Geurts, 2007). Twenty children with 22q11.2DS (chronological age: 6 years–13 years 3 months) were compared to 21 children with idiopathic ID and 23 children with idiopathic ID and comorbid ASD. All groups were matched for fluid intelligence (Gf), chronological age, and core language scores.Results Neglect or inadequate use of context information was more prevalent in children with 22q11.2DS than in children with idiopathic ID. Nonverbal communication seemed less impaired than in children with idiopathic ID + ASD.Conclusion Pragmatic language skills and developmental trajectories in children with 22q11.2DS merit further investigation.

Shakespeare and autism: an exploratory evaluation of the Hunter Heartbeat Method

ABSTRACTThis preliminary report describes the Hunter Heartbeat Method, a drama-based social skills intervention designed to improve the social interaction, pragmatic language, and facial-emotion recognition skills of individuals with autism spectrum disorder. Fourteen children with autism spectrum disorder were recruited for the first-ever systematic implementation of this drama-based intervention. Piloting of post-test measures indicated that the participants’ scores increased across time on measures of social skills, communication, and pragmatic language. Furthermore, the Penn Facial Recognition's facial emotion recognition task, a computer-based facial emotion task, detected change in skill across time. Importantly, the intervention was acceptable to participants and parents and feasible to implement. The preliminary results need to be replicated with a larger number of participants and within a more controlled design. However, these findings indicate that Hunter Heartbeat Method shows promise in improving the social and communicative functioning of children with autism spectrum disorder.

Study of pragmatic language ability in children with hearing loss

Abstract Pragmatic language refers to how language is used socially to achieve some purpose in communication. Pragmatic language impairment can be a disorder by itself, or as a sign of other accompanying disorders. Hearing-impaired children show less clear pragmatic communication functions. Knowledge of pragmatic abilities in children with hearing loss (HL) is lacking relative to that of children with normal hearing (NH). The aim of this study was to examine the pragmatic language ability in Arabic-speaking children with sensorineural hearing loss in order to apply a proper intervention program to guard against the effect of early pragmatic language skill disorders on later academic and social abilities. Twenty-seven children with HL were subjected to pragmatic language assessment using the Arabic version of the Test of Pragmatic Language, 2nd edition and both the Observational Rating Scale and the Pragmatic Profile subtests of the Clinical Evaluation of Language Fundamental, 4th edition. The results obtained were compared with the results of 27 age-matched and sex-matched NH children. The results of this study revealed significantly lower pragmatic abilities in children with HL compared with children with NH. Male children were significantly more impaired compared with female children. There were significant correlations between the pragmatic variables and the degree of HL, speech discrimination ability, and the duration of auditory deprivation. HL children had significantly lower pragmatic skills compared with NH children, with greater affection correlated with increasing severity of HL and the duration of auditory deprivation. The higher susceptibility to pragmatic impairment in this category of children as well as the importance of pragmatic skills for further social communicative and academic careers should be considered in their rehabilitative plan.

Story Goodness in Adolescents With Autism Spectrum Disorder (ASD) and in Optimal Outcomes From ASD.

This study examined narrative quality of adolescents with autism spectrum disorder (ASD) using a well-studied "story goodness" coding system. Narrative samples were analyzed for distinct aspects of story goodness and rated by naïve readers on dimensions of story goodness, accuracy, cohesiveness, and oddness. Adolescents with high-functioning ASD were compared with adolescents with typical development (TD; n = 15 per group). A second study compared narratives from adolescents across three groups: ASD, TD, and youths with "optimal outcomes," who were diagnosed with ASD early in development but no longer meet criteria for ASD and have typical behavioral functioning. In both studies, the ASD group's narratives had lower composite quality scores compared with peers with typical development. In Study 2, narratives from the optimal outcomes group were intermediate in scores and did not differ significantly from those of either other group. However, naïve raters were able to detect qualitative narrative differences across groups. Findings indicate that pragmatic deficits in ASD are salient and could have clinical relevance. Furthermore, results indicate subtle differences in pragmatic language skills for individuals with optimal outcomes despite otherwise typical language skills in other domains. These results highlight the need for clinical interventions tailored to the specific deficits of these populations.

Cognitive Impairment and Rehabilitation Strategies After Traumatic Brain Injury.

Traumatic brain injury (TBI) is among the significant causes of morbidity and mortality in the present world. Around 1.6 million persons sustain TBI, whereas 200,000 die annually in India, thus highlighting the rising need for appropriate cognitive rehabilitation strategies. This literature review assesses the current knowledge of various cognitive rehabilitation training strategies. The entire spectrum of TBI severity; mild to severe, is associated with cognitive deficits of varying degree. Cognitive insufficiency is more prevalent and longer lasting in TBI persons than in the general population. A multidisciplinary approach with neuropsychiatric evaluation is warranted. Attention process training and tasks for attention deficits, compensatory strategies and errorless learning training for memory deficits, pragmatic language skills and social behavior guidance for cognitive-communication disorder, meta-cognitive strategy, and problem-solving training for executive disorder are the mainstay of therapy for cognitive deficits in persons with TBI. Cognitive impairments following TBI are common and vary widely. Different cognitive rehabilitation techniques and combinations in addition to pharmacotherapy are helpful in addressing various cognitive deficits.

Social communication in autism spectrum disorder not improved by Theory of Mind interventions.

Social communication in autism spectrum disorder not improved by Theory of Mind interventions.

A longitudinal investigation of childhood communication ability and adolescent psychotic experiences in a community sample

BackgroundSome childhood speech and language impairments precede psychosis but it is not clear whether they also precede adolescent psychotic experiences and whether this association is specific to psychotic experiences. MethodsPragmatic language and expressive speech and language (parent-assessed using the Children's Communication Checklist) at age 9 and psychotic experiences and depression at ages 12 and 18 were investigated in 7659 participants from the Avon Longitudinal Study of Parents and Children. Associations were investigated using multivariate modelling. ResultsPoorer pragmatic language at 9years was associated with psychotic experiences at both ages (12years OR 1.22, 95% CI 1.11, 1.34; 18years OR 1.25, 95% CI 1.10, 1.41) but only with depression at 18years (OR 1.10, 95% CI 1.00, 1.22). Poorer expressive speech and language ability was not associated with psychotic experiences or depression at either age. There was evidence that pragmatic language was specifically associated with psychotic experiences at age 12 but no evidence that the strength of any of the associations changed over time. ConclusionsDeficits in pragmatic language precede early and late adolescent psychotic experiences and early adolescent depression. Interventions aimed at helping children improve pragmatic language skills may reduce the incidence of adolescent psychopathology and associated psychological disorder and dysfunction later in life.

Clinical Assessment of Pragmatics (CAPs): A Validation Study of a Video-Based Test of Pragmatic Language in Adolescent Students

The purpose of this study was to examine the validity and reliability of a novel new video-based approach to assessing pragmatic language, namely the Clinical Assessment of Pragmatics (CAPs). This study included students with Language Impairment (LI), High-Functioning Autism (ASD) and non-disabled students. Thirty participants, ages 14 to 16 years old, were administered 3 pragmatic judgment and 3 pragmatic performance subtests comprised of 10 items each for a total of 60 test items. Expert opinion was solicited for the purpose of obtaining content validity. Study results revealed that this instrument provides a valid and reliable comprehensive measure of pragmatic language skills. Both test-retest and interrater reliability were found to be strong. Experts rated the CAPs highly for both content and clarity. Concurrent validity was obtained on three of the CAPs subtests and was found to correlate to three existing pragmatic language instruments and measures (the Clinical Assessment of Spoken Language – Pragmatic Judgment subtest, the Test of Pragmatic Language and the Social Language Development Test, adolescent). CAPs is a tool which is both valid and reliable and can be used as a means of determining whether school-aged students present with deficits in pragmatic language skills, specifically, high-functioning autism or specific language impairment.

A preliminary report of the narrative abilities and verb production among Mandarin-speaking individuals with traumatic brain injury

A preliminary report of the narrative abilities and verb production among Mandarin-speaking individuals with traumatic brain injury