Idiom Comprehension Deficits in High-Functioning Autism Spectrum Disorder Using a Korean Autism Social Language Task

Idiom and proverb processing in autism: a systematic review and meta-analysis

Figurative language processing impairments in autism have been widely demonstrated, and have been considered a defining feature of autism. Studies in this area often consider different types of figurative language together, and less attention has been paid to identifying the factors that might contribute to difficulties in processing specific types of figurative language. Here we present a preregistered systematic review and meta-analysis of studies assessing the comprehension of idioms and proverbs in autism spectrum disorder (ASD) as compared to typically developing (TD) individuals. Idioms are widely used multi-word figurative expressions, which are understood by using contextual information. Proverbs are a related type of fixed, figurative, formulaic expression in a sentential form, typically linked with wisdom. Idioms and proverbs represent forms of figurative language which are more conventionalized and frequently opaquer than metaphors, pointing to a unique way that they are processed in conversational contexts. Our analysis encompassed a total of 11 studies from 10 papers (involving 235 autistic and 224 TD individuals), which met our inclusion criteria (the ASD and TD groups were matched on both chronological age and intelligence). The analysis of accuracy data revealed a group difference favouring the TD over the ASD group, with a medium effect size, and no indication of a publication bias. Participants’ age was unrelated to the magnitude of group differences, but there was a trend for smaller group differences in the case of participants with higher (verbal) intelligence. We discuss these findings with reference to theories related to the nature of figurative language impairments in autism.

Aberrant Neural Activation Underlying Idiom Comprehension in Korean Children with High Functioning Autism Spectrum Disorder

PURPOSE

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication impairments and repetitive behaviors or restricted interests. Impaired pragmatic language comprehension is a universal feature in individuals with ASD. However, the underlying neural basis of pragmatic language is poorly understood. In the present study, we examined neural activation patterns associated with impaired pragmatic language comprehension in ASD, compared to typically developing children (TDC).

MATERIALS AND METHODS

Functional magnetic resonance imaging (fMRI) was applied to 15 children with ASD and 18 TDC using the Korean pragmatic language task.

RESULTS

Children with ASD were less accurate than TDC at comprehending idioms, particularly when they were required to interpret idioms with mismatched images (mismatched condition). Children with ASD also showed different patterns of neural activity than TDC in all three conditions (neutral, matched, and mismatched). Specifically, children with ASD showed decreased activation in the right inferior frontal gyrus (IFG) (Brodmann area 47) in the mismatched condition, compared with TDC (IFG; t(31)=3.17, p<0.001).

CONCLUSION

These results suggest that children with ASD face difficulties in comprehending pragmatic expressions and apply different pragmatic language processes at the neural level.

Assessing social-pragmatic inferencing skills in children with autism spectrum disorder

By utilizing the Pragma test this study investigated how sixteen five- to ten-year-old children with autism spectrum disorder (ASD) and sixteen typically developing (TD) children comprehended contextually challenging scenarios demanding 1) contextual inference with theory of mind (ToM), 2) contextual inference without ToM, 3) relevant use of language, 4) recognition of feelings, and 5) understanding false beliefs. The study also compared children's ability to explain their own correct answers. In addition, this study evaluated the sensitivity of three different methods for discriminating the children with ASD from the TD children: 1) the Pragma test, 2) the Social Interaction Deviance Composite (SIDC) of Children's Communication Checklist-2 (CCC-2), and 3) the Theory of Mind subtest of the Developmental Neuropsychological Assessment, Second edition (NEPSY-II). The results showed that children with ASD differed from TD children in questions demanding context utilization. However, the demand of mind-reading in utterance interpretation increased the difference between groups. Compared to TD children, children with ASD had more difficulties in explaining how they had used context to arrive at the correct answer. The discrimination power for detecting children with ASD from TD children was excellent in the Pragma test, good in the SIDC CCC-2 and fair in the Theory of Mind subtest of NEPSY-II. This study showed that by using contextually sensitive materials, such as the Pragma test, it is possible to detect the social-pragmatic inferencing difficulties of high-functioning children with ASD in structured test situations and not only in real-life situations or by using parental reports.

Figurative language comprehension in individuals with autism spectrum disorder: A meta-analytic review

We present a meta-analysis of studies that compare figurative language comprehension in individuals with autism spectrum disorder and in typically developing controls who were matched based on chronological age or/and language ability. A total of 41 studies and 45 independent effect sizes were included based on predetermined inclusion criteria. Group matching strategy, age, types of figurative language, and cross-linguistic differences were examined as predictors that might explain heterogeneity in effect sizes. Overall, individuals with autism spectrum disorder showed poorer comprehension of figurative language than their typically developing peers (Hedges' g = -0.57). A meta-regression analysis showed that group matching strategy and types of figurative language were significantly related to differences in effect sizes, whereas chronological age and cross-linguistic differences were not. Differences between the autism spectrum disorder and typically developing groups were small and nonsignificant when the groups were matched based on the language ability. Metaphors were more difficult to comprehend for individuals with autism spectrum disorder compared with typically developing controls than were irony and sarcasm. Our findings highlight the critical role of core language skills in figurative language comprehension. Interventions and educational programmes designed to improve social communication skills in individuals with autism spectrum disorder may beneficially target core language skills in addition to social skills.

Can You Play with Fire and Not Hurt Yourself? A Comparative Study in Figurative Language Comprehension between Individuals with and without Autism Spectrum Disorder

Individuals with High functioning autism (HFA) are distinguished by relative preservation of linguistic and cognitive skills. However, problems with pragmatic language skills have been consistently reported across the autistic spectrum, even when structural language is intact. Our main goal was to investigate how highly verbal individuals with autism process figurative language and whether manipulation of the stimuli presentation modality had an impact on the processing. We were interested in the extent to which visual context, e.g., an image corresponding either to the literal meaning or the figurative meaning of the expression may facilitate responses to such expressions. Participants with HFA and their typically developing peers (matched on intelligence and language level) completed a cross-modal sentence-picture matching task for figurative expressions and their target figurative meaning represented in images. We expected that the individuals with autism would have difficulties in appreciating the non-literal nature of idioms and metaphors, despite intact structural language skills. Analyses of accuracy and reaction times showed clearly that the participants with autism performed at a lower level than their typically developing peers. Moreover, the modality in which the stimuli were presented was an important variable in task performance for the more transparent expressions. The individuals with autism displayed higher error rates and greater reaction latencies in the auditory modality compared to the visual stimulus presentation modality, implying more difficulty. Performance differed depending on type of expression. Participants had more difficulty understanding the culturally-based expressions, but not expressions grounded in human experience (biological idioms). This research highlights the importance of stimulus presentation modality and that this can lead to differences in figurative language comprehension between typically and atypically developing individuals. The current study also contributes to current debates on the role of structural language in figurative language comprehension in autism.