Conversations with autistic children: contingent relationships between features of adult input and children's response adequacy

Validity and reliability of the Persian version of the WH-Question comprehension test in children With autism

Questions form essential components of everyday speech; therefore, it is appropriate to evaluate children with autism to understand what they are asking during the daily conversation. A proper tool is required to assess questions formed through interrogative pronouns (what are commonly known as Wh-questions). The present study investigates the validity and reliability of the WH-Question comprehension test in children with autism. A sample of 52 neurotypical children were recruited from nursery and primary schools, and a sample of 28 children with autism were recruited from different centers for children with autism. The WH-Comprehension test was translated into Persian according to the international test commission (ITC) guideline. The reliability of the test was determined by test-retest and Cronbach's alpha approach. The face validity of the Persian version of the "WH-Comprehension test" was confirmed. The CVR for the test was equal to 0.85%, and the CVI was equal to 0.89%. Furthermore, the Intraclass Correlation Coefficient (ICC) for the total score was equal to 0.95, and Cronbach's Alpha Coefficient was calculated as 0.92. The results indicate that the translated WH-Comprehension test has acceptable validity and reliability within the sampled Persian groups and can be a helpful research tool.

Robot dramas may improve joint attention of Chinese-speaking low-functioning children with autism: stepped wedge trials

INTRODUCTION

Children with autism spectrum disorder (ASD), especially those with low cognitive functioning, have deficits in joint attention. Previous research has found that these children are interested in engaging with social robots.

PURPOSE

In the present study, we designed a robot drama intervention for promoting responses to joint attention abilities (RJA) of children with low-functioning autism (IQs < 70).

MATERIALS AND METHODS

Using a stepped wedge design, Chinese-speaking children aged six to eight were randomly assigned to three tiers (N = 18). Children of all three tiers had comparable autism severity, language and cognitive function, and joint attention abilities. Tier 1 first received intervention, followed by Tiers 2 and 3. They watched six dramas in which social robots demonstrated RJA behaviours.

RESULTS

The RJA of children of all tiers improved after intervention and such improvement was maintained over time. Despite initiation of joint attention (IJA) not being explicitly taught, IJA of all children was found to improve after intervention.

CONCLUSIONS

It was, therefore, concluded that a robot drama could enhance the joint attention of children with low-functioning ASD.Implications for rehabilitationIn comparison to typically developing children, children with autism spectrum disorder (ASD), especially those with low cognitive functioning, have deficits in joint attention.Robot-based drama intervention program was developed to promote responses to joint attention (RJA) abilities of children with low-functioning autism (IQs < 70).Modelling RJA in robot dramas can promote RJA abilities in these children.An improvement in RJA also yielded an increase in the initiation of joint attention (IJA) abilities.Children with low-functioning autism might be able to extract the initiation of joint attention skills from the drama, even though these behaviours were not explicitly taught.

A robot or a dumper truck? Facilitating play-based social learning across neurotypes

Structured abstract Background & aims

How can non-autistic adults facilitate social learning with children on the spectrum? A new theoretical understanding of autism is currently emerging that has made this question more relevant than ever. At the intersection of two growing research areas in the field of autism, the borderland that separates the experience of social interaction between neurotypes is increasingly mapped out. By integrating anthropological research on autistic sociality and the neurocognitive framework of predictive processing, this paper explores the question: If autistic people experience the world in a fundamentally different way, what is a meaningful strategy for supporting them in developing their socialities?

Methods

The paper reports an in-depth analysis of a 2-min sequence in which a non-autistic adult facilitates a collaboration game between three autistic children (8-12 years). The data comes from a participatory research project that develops a new pedagogical approach to social learning based on open-ended construction play. The analytical strategy is informed by conversation analysis.

Results

We find that the facilitation supports the children in accomplishing social interaction and collaboration, but it also in several instances gives rise to misunderstandings between the children. Whereas the facilitator aims to support the children's direct verbal communication about the construction task, we observe that the children use a broad repertoire of non-direct communication strategies that enables them to coordinate and align their shared process. We find that the children's actions with their hands in the construction task count as turns in the communication. Regarding the play-based learning environment, we find that the children are engaged in the shared construction task and that they competently navigate social tension when it arises without the facilitator's help.

Conclusion

We conclude that the misunderstandings between the children created by the facilitation from a non-autistic adult emerge from a discrepancy of attention in the situation. The facilitator focuses on the words, but the children focus on the task. Even though this discrepancy is not necessarily a result of different neurotypes, we find that it emerges from the social dynamics of facilitation by non-autistic adults that is key in many social intervention settings. Furthermore, we conclude that the play-based learning environment enables the facilitator to support the children without directly instructing them in their social behavior. This appears to give the children an opportunity to acquire complex social experiences through their collaboration.

Implications

The interaction dynamics in the data clip is shaped by the non-autistic adult's expectations of the children's interaction. This made us wonder whether we can establish a learning environment that begins from the learners' perspectives instead. The analysis caused us to change the facilitation strategy that we employ in our project. It is our hope that our approach will inspire reflection and curiosity in researchers and practitioners who develop social interventions targeting autistic people.

Understanding indirect requests for information in high-functioning autism

Few works have addressed the processing of indirect requests in High-Functioning Autism (HFA), and results are conflicting. Some studies report HFA individuals’ difficulties in indirect requests comprehension; others suggest that it might be preserved in HFA. Furthermore, the role of Theory of Mind in understanding indirect requests is an open issue. The goal of this work is twofold: first, assessing whether comprehension of indirect requests for information is preserved in HFA; second, exploring whether mind-reading skills predict this ability. We tested a group of (n = 14; 9–12 years) HFA children and two groups of younger (n = 19; 5–6 years) and older (n = 28; 9–12 years) typically developing (TD) children in a semi-structured task involving direct, indirect and highly indirect requests for information. Results suggested that HFA can understand indirect and highly indirect requests, as well as TD children. Yet, while Theory of Mind skills seem to enhance older TD children understanding, this is not the case for HFA children. Therefore, interestingly, they could rely on different interpretative strategies.

Should Echolalia Be Considered a Phonic Stereotypy? A Narrative Review

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) defines echolalia as a pathological, parrotlike, and apparently senseless repetition (echoing) of a word or phrase just uttered by another person and classifies this condition among the “restrictive and repetitive behaviours” of Autism Spectrum Disorder (ASD). The authors reviewed the existing literature on echolalia and its role in the development of children with ASD. Current conceptualizations include echolalia among repetitive behaviors and stereotypies and thus interpret this symptom as lacking any communicative significance, with negative effects on learning and sensory processing. Echoic behaviors, however, have been described in neurotypical infants and children as having a substantial effect on the consequent development of language and communication. Relevant research has documented a functional role of echolalia in ASD children as well since it facilitates the acquisition of verbal competencies and affords a higher degree of semantic generalization. This developmental function could be restricted to specific contexts. Considering echolalia as stereotypy and treating it as a disturbing symptom could impair the development of ASD-specific learning and communication processes. In light of this evidence, the authors propose a different conceptualization of echolalia and suggest that this symptom be considered among atypical communication patterns in children with ASD, with implications for treatment and prognosis.

Who is a better teacher for children with autism? Comparison of learning outcomes between robot-based and human-based interventions in gestural production and recognition

BACKGROUND

Individuals with autism spectrum disorder (ASD) tend to show deficits in engaging with humans. Previous findings have shown that robot-based training improves the gestural recognition and production of children with ASD. It is not known whether social robots perform better than human therapists in teaching children with ASD.

AIMS

The present study aims to compare the learning outcomes in children with ASD and intellectual disabilities from robot-based intervention on gestural use to those from human-based intervention.

METHODS AND PROCEDURES

Children aged six to 12 with low-functioning autism were randomly assigned to the robot group (N = 12) and human group (N = 11). In both groups, human experimenters or social robots engaged in daily life conversations and demonstrated to children 14 intransitive gestures in a highly-structured and standardized intervention protocol.

OUTCOMES AND RESULTS

Children with ASD in the human group were as likely to recognize gestures and produce them accurately as those in the robot group in both training and new conversations. Their learning outcomes maintained for at least two weeks.

CONCLUSIONS AND IMPLICATIONS

The social cues found in the human-based intervention might not influence gestural learning. It does not matter who serves as teaching agents when the lessons are highly structured.

Wh - Question answering in children with intellectual disability

This study investigated the ability of students with intellectual disability (ID) (n = 39) to answer questions beginning with different wh- question words presented in two referential conditions (i.e., with and without a picture). It also investigated participants' ability to answer questions that were more concrete (i.e., who, what, where) or abstract (i.e., when, why, how). Across conditions, the rank ordering of correct responses for each question word was: what, who, where, how, why, when. Logistic regression analysis revealed no overall statistical significance between the probability of answering questions correctly across referential conditions. Participants answered 89% of concrete and 56% of abstract questions correctly across both referential conditions, and logistic regression analysis revealed a statistically significant difference between the probability of answering concrete and abstract questions. The results of this study point to the importance of learning more about ways to support students with ID with answering wh- questions.

Conversational Abilities Among Children with Autism and Children with Developmental Delays

While it is widely recognized that autism undercuts conversational ability, there has been little systematic examination of the involvement of children with autism in informal conversational interaction. This study compares the behaviour of 15 children with autism and 15 children with developmental delays matched on language ability within the context of a semi-structured conversation. Children with autism more often failed to respond to questions and comments, less often offered new, relevant contributions, and produced fewer narratives of personal experience. In contrast to prior research findings, groups did not differ with respect to use of gesture: several children with autism enhanced their communication through dramatization and pointing. Discussion focuses on the nature of pragmatic impairment in autism; factors underlying the development of conversational ability, including theory of mind; and practices that may promote communicative competence.

Rethinking language in autism

In this article, we invite a rethinking of traditional perspectives of language in autism. We advocate a theoretical reappraisal that offers a corrective to the dominant and largely tacitly held view that language, in its essence, is a referential system and a reflection of the individual's cognition. Drawing on scholarship in Conversation Analysis and linguistic anthropology, we present a multidimensional view of language, showing how it also functions as interactional accomplishment, social action, and mode of experience. From such a multidimensional perspective, we revisit data presented by other researchers that include instances of prototypical features of autistic speech, giving them a somewhat different-at times complementary, at times alternative-interpretation. In doing so, we demonstrate that there is much at stake in the view of language that we as researchers bring to our analysis of autistic speech. Ultimately, we argue that adopting a multidimensional view of language has wide ranging implications, deepening our understanding of autism's core features and developmental trajectory.

Responses to Wh-, Yes/No-, A-not-A, and choice questions in Taiwanese children with high-functioning autism spectrum disorder

The present study investigated the hypothesis that children with high-functioning autism spectrum disorder (HFASD) have a greater difficulty in responding to Wh- than Yes/No questions across languages. Conversations between Taiwanese children and their mothers were investigated and the children's response adequacy to maternal questions in a semi-structured setting were examined. Twelve Taiwanese children with HFASD, ranging in age from 7.1 to 14.9 years old, were compared with 12 typically developing (TD) children matched on age, sex, IQ and mean length of utterance in syllable (MLUs). Compared to TD children, HFASD children produced more inadequate or inappropriate responses to Wh- and Yes/No questions than to A-not-A and Choice questions. Taiwanese HFASD children share a greater difficulty in responding to maternal Wh-questions with their Japanese counterparts and do not show a relative ease in responding to Yes/No questions, while A-not-A and Choice questions were easier to respond to for the Taiwanese children.

The case for multimodal analysis of atypical interaction: questions, answers and gaze in play involving a child with autism

Conversation analysis (CA) continues to accrue interest within clinical linguistics as a methodology that can enable elucidation of structural and sequential orderliness in interactions involving participants who produce ostensibly disordered communication behaviours. However, it can be challenging to apply CA to re-examine clinical phenomena that have initially been defined in terms of linguistics, as a logical starting point for analysis may be to focus primarily on the organisation of language ("talk") in such interactions. In this article, we argue that CA's methodological power can only be fully exploited in this research context when a multimodal analytic orientation is adopted, where due consideration is given to participants' co-ordinated use of multiple semiotic resources including, but not limited to, talk (e.g., gaze, embodied action, object use and so forth). To evidence this argument, a two-layered analysis of unusual question-answer sequences in a play episode involving a child with autism is presented. It is thereby demonstrated that only when the scope of enquiry is broadened to include gaze and other embodied action can an account be generated of orderliness within these sequences. This finding has important implications for CA's application as a research methodology within clinical linguistics.

Do Japanese children with high-functioning autism spectrum disorder respond differently to Wh-questions and Yes/No-questions?

The present study compared 12 Japanese children with high-functioning autism spectrum disorder (HFASD), ranging in age from 7.3-14.8 years, with 12 typically developing (TD) children matched for age, gender, and vocabulary. The means of full-scale IQ and verbal-IQ of the children with HFASD were 95.92 (SD = 15.30) and 98.00 (SD = 18.44), respectively. Children responded to questions from their mothers in conversations collected under a semi-structured setting, and the responses of both groups were examined from the viewpoint of adequacy. Compared to TD children, HFASD children produced more inadequate responses to Wh-questions than to Yes/No questions. To both types of questions, HFASD children produced more inappropriate responses than TD children. The findings suggest that parents of HFASD children should consider the influence of the question format on these children's response inadequacies.

Measuring pragmatic language in speakers with autism spectrum disorders: Comparing the children's communication checklist--2 and the test of pragmatic language

PURPOSE

To compare the Children's Communication Checklist-2 (CCC-2), a parent report instrument, with the Test of Pragmatic Language (TOPL), a test administered to the child, on the ability to identify pragmatic language impairment in speakers with autism spectrum disorders (ASD) who had age-appropriate structural language skills.

METHOD

Sixteen rigorously diagnosed children with ASD were matched to 16 typically developing children on age, nonverbal IQ, and structural language skill. Both groups were given the TOPL, and their parents completed the CCC-2.

RESULTS

The CCC-2 identified 13 of the 16 children with ASD as pragmatically impaired, while the TOPL identified only 9. Neither test identified any of the children in the control group as having pragmatic language impairment.

CONCLUSIONS

In these children with ASD, who displayed age-appropriate structural language skills, the CCC-2 identified pragmatic language impairment better than the TOPL. Clinically, this can be useful in documenting the presence of language dysfunction when traditional standardized language assessments would not reveal communication problems.

Using question words or asking yes/no questions: failure and success in clarifying the intentions of a boy with high-functioning autism

This paper examined the processes that resulted in an adult failing to comprehend the intentions of a boy with high-functioning autism. In a dyadic conversation between an adult and a young boy, the adult used questions to elicit clarification of intentions. The boy's responses were examined frame-by-frame using videotape microanalysis. Two causes of adult misunderstanding were formulaic use of words that confused the listener and directional gaze away from the listener. Questions that used interrogatives often failed to clarify the intention of the boy and yes/no questions appeared suitable to clarify his intention. However, success or failure to clarify an intention was not based solely on differences in the question format. Differences in question content may also have been relevant. Yes/no questions were mainly used to ask about specific actions. On the other hand, interrogative questions were used to handle cognitive or meta-cognitive matters.

Beyond pragmatics: morphosyntactic development in autism

Language acquisition research in autism has traditionally focused on high-level pragmatic deficits. Few studies have examined grammatical abilities in autism, with mixed findings. The present study addresses this gap in the literature by providing a detailed investigation of syntactic and higher-level discourse abilities in verbal children with autism, age 5 years. Findings indicate clear language difficulties that go beyond what would be expected based on developmental level; specifically, syntactic delays, impairments in discourse management and increased production of non-meaningful words (jargon). The present study indicates a highly specific pattern of language impairments, and importantly, syntactic delays, in a group of children with autism carefully matched on lexical level and non-verbal mental age with children with developmental delays and typical development.

Brief Report: The Relationship between Discourse Deficits and Autism Symptomatology

This study investigated the relationship between discourse deficits to a broader range of other symptoms in 57 children with autism. We hypothesized that autism symptomatology, as measured by the Autism Diagnostic Observation Schedule (ADOS), would be related to the children's difficulty in maintaining an ongoing topic of discourse. Children provided a natural language sample while interacting with one parent. These language samples were coded for the child's use of off-topic or noncontingent utterances. Results showed significant relationships between overall diagnostic symptomatology, and more specifically, deficits in communication as measured by the ADOS-G, and noncontingent discourse. The findings provide diagnostic validity to the ADOS-G and highlight in greater detail the significant communication impairment in autism.

Teaching children with autism to answer novel wh-questions by utilizing a multiple exemplar strategy

This study investigated the transfer and maintenance of question-answering skills in five children diagnosed with autism. A multiple baseline design across classes of questions (i.e., what, where, who and why) was applied for each child. Question-answer exemplars were selected within each class, and each class was trained separately in consecutive order. The dependent variable was the proportion of appropriate answers (i.e., complete sentences) to novel questions within each class, on first trial. The results showed that all children became able to answer novel questions with complete sentences within each of the classes that were trained, and they showed transfer of these skills across persons, settings and time. The findings support the use of analogous question-answer exemplars in order to facilitate response-transfer to novel questions. It is also suggested that this type of transfer is more likely to occur if the answers trained are in full sentence and there is a structural correspondence between the question and the answer in each single exemplar and across exemplars within a class of questions.

Does teaching theory of mind have an effect on the ability to develop conversation in children with autism?

The present research examined whether teaching children with autism to pass tasks that assess mental state understanding had any positive effects on communication. Two aspects of communication previously shown to be deficient in children with autism were considered. These are conversational ability, in particular the ability to expand on conversation, and the use of mental state terms in speech. Results showed that no discernible improvement was seen on either measure of communication following mental state teaching. Discussion centers on real versus superficial changes in understanding mental states as a result of teaching.

The development of contingent discourse ability in autistic children

This study investigated communicative competence in autistic children. Six autistic boys were matched to six children with Down syndrome on age and language level. For each child four samples of spontaneous speech over the course of 1 year were analysed. Child utterances were coded for adjacency, contingency and various categories of contingent discourse that either did or did not add new information. Autistic children wer found to be more non-contingent, and to show no developmental change in their contingent discourse, especially in categories of contingent discourse that added new information.

The effects of two levels of linguistic constraint on echolalia and generative language production in children with autism

The effects of specific types of adult antecedent utterances (high vs. low constraint) on the verbal behaviors produced by three subjects with autism were examined. Adult utterance types were differentiated in terms of the amount of control the adults exhibited in their verbal interactions with the subjects during a free play setting. Videotaped interactions were analyzed and coded according to a predetermined categorical system. The results of this investigation suggest that the level of linguistic constraint exerted on the child interactants during naturalistic play sessions affected their communicative output. The overall findings suggest that (a) adult high constraint utterances elicited more verbal utterances in general, as well as a majority of the subjects' echolalia; (b) adult low constraint utterances elicited more subject high constraint utterances; and (c) the degree of constraint of adult utterances did not appear to influence the mean lengths of subjects' utterances. The results are discussed in terms of their implications for educational interventions, and suggestions are made for future research concerning the dynamics of echolalia in interactive contexts.

A longitudinal study of language acquisition in autistic and Down syndrome children

Findings from a longitudinal study of language acquisition in a group of autistic children are presented. Six autistic subjects and six children with Down syndrome, matched on age and MLU at the start of the study, were followed over a period of between 12 and 26 months. Language samples were collected in the children's homes while they interacted with their mothers. Samples of 100 spontaneous child utterances from the transcripts were analyzed using the following measures: MLU, Index of Productive Syntax, lexical diversity, and form class distribution. The results indicate that the majority of these autistic children followed the same general developmental path as the Down syndrome children in this study, and normal children reported in the literature, in the acquisition of grammatical and lexical aspects of language, and confirm previous findings suggesting that autism does not involve a fundamental impairment in formal aspects of language.

Memory impairments and communication in relatively able autistic children

Autistic people have specific memory difficulties. The effects of these difficulties on communication in relatively able autistic children and learning impaired controls were assessed in three experiments. The experiments tested the ability to: (1) carry out instructions; (2) ask questions without repetition; and (3) answer questions about past activities. When specific memory skills were required autistic children's communication was impaired relative to controls. When the need to use these skills was eliminated from the tasks the autistic children performed as well as controls. Some practical and theoretical implications of the findings are discussed.