ASD Is Not DLI: Individuals With Autism and Individuals With Syntactic DLI Show Similar Performance Level in Syntactic Tasks, but Different Error Patterns

Sentence Production and Sentence Repetition in Autistic Adolescents and Young Adults: Linguistic Sensitivity to Finiteness Marking

PURPOSE

Despite the clinical utility of sentence production and sentence repetition to identify language impairment in autism, little is known about the extent to which these tasks are sensitive to potential language variation. One promising method is strategic scoring, which has good clinical utility for identifying language impairment in nonautistic school-age children across variants of English. This report applies strategic scoring to analyze sentence repetition and sentence production in autistic adolescents and adults.

METHOD

Thirty-one diverse autistic adolescents and adults with language impairment (ALI; n = 15) and without language impairment (ASD; n = 16) completed the Formulated Sentences and Recalling Sentences subtests of the Clinical Evaluation of Language Fundamentals-Fifth Edition. Descriptive analyses and regression evaluated effects of scoring condition, group, and scoring condition by group on outcomes, as well as group differences in finiteness marking across utterances and morphosyntactic structures.

RESULTS

Strategic and unmodified item-level scores were essentially constant on both subtests and significantly lower in the ALI than the ASD group. Only group predicted item-level scores. Group differences were limited to: percent grammatical utterances on Formulated Sentences and percent production of overt structures combined on Sentence Repetition (ALI < ASD).

DISCUSSION

Findings support the feasibility of strategic scoring for sentence production and sentence repetition to identify language impairment and indicate that potential language variation in finiteness marking did not confound outcomes in this sample. To better understand the clinical utility of strategic scoring, replication with a larger sample varying in age and comparisons with dialect-sensitive measures are needed.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25822336.

Reading comprehension differences between children with Autism Spectrum Disorder and low cognitive abilities and children with Autism Spectrum Disorder and intact cognitive skills: the roles of decoding, fluency and morphosyntax

Introduction

Reading comprehension is one of the most important skills learned in school and it has an important contribution to the academic success of children with Autism Spectrum Disorder (ASD). Though previous studies have investigated reading comprehension difficulties in ASD and highlighted factors that contribute to these difficulties, this evidence has mainly stemmed from children with ASD and intact cognitive skills. Also, much emphasis has been placed on the relation between reading comprehension and word recognition skills, while the role of other skills, including fluency and morphosyntax, remains underexplored. This study addresses these gaps by investigating reading comprehension in two groups of school-aged children with ASD, one with intact and one with low cognitive abilities, also exploring the roles of word decoding, fluency and morphosyntax in each group's reading comprehension performance.

Methods

The study recruited 16 children with ASD and low cognitive abilities, and 22 age-matched children with ASD and intact cognitive skills. The children were assessed on four reading subdomains, namely, decoding, fluency, morphosyntax, and reading comprehension.

Results

The children with ASD and low cognitive abilities scored significantly lower than their peers with intact cognitive abilities in all reading subdomains, except for decoding, verb production and compound word formation. Regression analyses showed that reading comprehension in the group with ASD and intact cognitive abilities was independently driven by their decoding and fluency skills, and to a lesser extent, by morphosyntax. On the other hand, the children with ASD and low cognitive abilities mainly drew on their decoding, and to a lesser extent, their morphosyntactic skills to perform in reading comprehension.

Discussion

The results suggest that reading comprehension was more strongly affected in the children with ASD and low cognitive abilities as compared to those with intact cognitive skills. About half of the children with ASD and intact cognitive skills also exhibited mild-to-moderate reading comprehension difficulties, further implying that ASD may influence reading comprehension regardless of cognitive functioning. Finally, strengths in decoding seemed to predominantly drive cognitively-impaired children's reading performance, while the group with ASD and intact cognitive skills mainly recruited fluency and metalinguistic lexical skills to cope with reading comprehension demands, further suggesting that metalinguistic awareness may be a viable way to enhance reading comprehension in ASD.

Sentence production and sentence repetition in autistic adolescents and young adults: Linguistic sensitivity to finiteness-marking

Purpose

Despite the clinical utility of sentence production and sentence repetition to identify language impairment in autism, little is known about the extent to which these tasks are sensitive to potential dialectal variation. One promising method is strategic scoring (Oetting et al., 2016), which has good clinical utility for identifying language impairment in nonautistic school-age children across dialects of English. This report applies strategic scoring to analyze sentence repetition and sentence production in autistic adolescents and adults.

Method

Thirty-one diverse autistic adolescents and adults with language impairment (ALI; n=15) and without language impairment (ASD; n=16) completed the Formulated Sentences and Recalling Sentences subtests of the Clinical Evaluation of Language Fundamentals-5th Ed (Wiig et al., 2013). Descriptive analyses and regression evaluated effects of scoring condition, group, and scoring condition by group on outcomes, as well as group differences in finiteness-marking across utterances and morphosyntactic structures.

Results

Strategic and unmodified item-level scores were essentially constant on both subtests and significantly lower in the ALI than the ASD group. Only group predicted item-level scores. Group differences were limited to: percent grammatical utterances on Formulated Sentences and percent production of overt structures combined on Sentence Repetition (ALI < ASD).

Discussion

Findings support the feasibility of strategic scoring for sentence production and sentence repetition to identify language impairment and indicate that potential dialectal variation in finiteness-marking did not confound outcomes in this sample. To better understand the clinical utility of strategic scoring, replication with a larger sample varying in age and comparisons with dialect-sensitive measures are needed.

Comprehension of Ditransitive Constructions in Mandarin-Speaking Children with Developmental Language Disorder and Children with Autism Spectrum Disorder Plus Language Impairment

This study examined and compared the comprehension of Mandarin ditransitive constructions in children with developmental language disorder (DLD) and children with autism spectrum disorder plus language impairment (ALI). Eighteen children with DLD, 17 children with ALI, and 27 age-matched typically developing (TDA) children, participated in a sentence-picture matching task on four patterns of Mandarin ditransitive constructions. Both children with DLD and children with ALI received significantly lower accuracy than TDA children in general and their most common errors were thematic role reversals. However, while children with ALI evinced a generalized deficit in all four patterns, only the comprehension of S1 (Subj. + Vgei + IO + DO) and S3 (Subj. + gei + IO + V + DO) was affected in children with DLD, with that of S2 (Subj. + V + DO + gei + IO) and S4 (Subj. + V + IO + DO) preserved in this population. Additionally, thematic role reversal errors were more dominant in children with DLD than in children with ALI who also committed a relatively higher proportion of Wrong Theme and No Recipient errors. It is concluded that the primary deficit of children with DLD lies in representing dependent relationships between the arguments and the verb as involved in thematic role assignment, but this is less critical in children with ALI, with their performance on the comprehension task possibly also related to other factors associated with the condition. To enhance the development of ditransitive constructions, intervention efforts for children with DLD and children with ALI could focus on strengthening the connection between each argument and its thematic role.

Morphosyntactic skills in Arabic-speaking children with autism spectrum disorder: Evidence from error patterns in the sentence repetition task

Background and aims

Although autism spectrum disorder (ASD) has not traditionally been associated with morphosyntactic impairments, some children with ASD manifest significant difficulties in this domain. Sentence Repetition (SRep) tasks are highly reliable tools for detecting morphosyntactic impairment in different languages and across various populations, including children with ASD. This study is among the first to evaluate morphosyntactic abilities of Palestinian-Arabic (PA) speaking children using a PA SRep task.

Methods

A total of 142 PA-speaking children, aged 5-11, participated in the study: 75 children with typical language development (TLD) and 67 children with ASD. The PA SRep task targeted morphosyntactic structures of varying complexity (simple subject-verb-object [SVO] sentences, biclausal sentences, wh-questions, relative clauses). Children's accuracy scores were assessed across these structures and error patterns encompassing morphosyntactic and pragmatic aspects were analyzed.

Results

Two subgroups of ASD emerged: 43% showed age-appropriate language skills (ASD  +  NL) pairing up with TLD peers, while 57% showed signs of morphosyntactic impairment (ASD  +  LI). Children in both groups exhibited a higher frequency of morphosyntactic errors than pragmatic ones. Children with ASD  +  LI showed difficulties with producing complex morphosyntactic structures, such as relative clauses and object wh-questions. Error analysis revealed that children in the ASD  +  LI group produced sentence fragments and simplified constructions when complex structures were targeted.

Conclusions

The current study extends the cross-linguistic evidence of the heterogeneity of morphosyntactic profiles in children with ASD to Arabic-speaking children. Error analysis indicates that poor morphosyntax, rather than pragmatics, challenges children's performance on the SRep task.

Implications

Our results emphasize the importance of comprehensive language assessment in children with ASD and underscore the need for tailored intervention plans targeting impaired morphosyntactic structures in some children with ASD.

Rhythmic Music Training's Effect on Syntactic Structure Processing among Malay Adolescents with Syntactic Specific Language Impairment

Background

Adolescents with syntactic specific language impairment (S-SLI) fail to comprehend which object questions. We hypothesised that rhythmic music training is more effective in treating this condition than conventional methods because music is often perceived as having a clear, isochronous beat or pulse. Thus, this study aims to investigate the effects of rhythmic music training on the syntactic structure processing of Malay which questions among native adolescents.

Methods

In this research study, the participants were three groups of Malay adolescents aged 13 years old-15 years old: i) adolescents with S-SLI with music training, ii) adolescents with S-SLI without music training and iii) typically developing adolescents. Before and after music training, the participants were given a sentence-picture matching task. Accuracy measures and reaction times were captured using E-Prime 2.0.

Results

The results indicated that with music training, the accuracy and reaction time associated with which object questions among the two SLI groups were significantly higher and lower, respectively.

Conclusion

The implications of using rhythmic music training in enhancing syntactic structure processing are also discussed.

Lexical and Morphosyntactic Profiles of Autistic Youth With Minimal or Low Spoken Language Skills

PURPOSE

Autistic youth who are minimally or low verbal are underrepresented in research leaving little to no evidence base for supporting them and their families. To date, few studies have examined the types of words and word combinations these individuals use. The purpose of this study was to take a strengths-based approach to outline descriptive profiles of autistic youth who use few words and elucidate the lexical and morphosyntactic features of their spoken language.

METHOD

We analyzed language samples from 49 autistic youth ages 6-21 years who used fewer than 200 words. Systematic Analysis of Language Transcripts was used to investigate the relationship between number of different words (NDW) and proportion of nouns and verbs (vs. other word classes), mean length of utterance in morphemes (MLUm), and the frequency of early developing morphosyntactic structures. We used linear regression to quantify the relationship between NDW and lexical and morphosyntactic features.

RESULTS

Proportion of nouns and verbs produced did not increase significantly in those with higher NDW. Conversely, MLUm and the frequency of early developing morphosyntactic structures increased significantly in those with higher NDW.

CONCLUSIONS

Youth with higher NDW did not produce more nouns and verbs, suggesting lexical profiles that are not aligned with spoken vocabulary level. Youth with higher NDW had higher MLUm and more early morphosyntactic forms, suggesting that morphosyntactic profiles align with spoken vocabulary level. We discuss the implications for improving clinical services related to spoken language.

Language in autism: domains, profiles and co-occurring conditions

This article reviews the current knowledge state on pragmatic and structural language abilities in autism and their potential relation to extralinguistic abilities and autistic traits. The focus is on questions regarding autism language profiles with varying degrees of (selective) impairment and with respect to potential comorbidity of autism and language impairment: Is language impairment in autism the co-occurrence of two distinct conditions (comorbidity), a consequence of autism itself (no comorbidity), or one possible combination from a series of neurodevelopmental properties (dimensional approach)? As for language profiles in autism, three main groups are identified, namely, (i) verbal autistic individuals without structural language impairment, (ii) verbal autistic individuals with structural language impairment, and (iii) minimally verbal autistic individuals. However, this tripartite distinction hides enormous linguistic heterogeneity. Regarding the nature of language impairment in autism, there is currently no model of how language difficulties may interact with autism characteristics and with various extralinguistic cognitive abilities. Building such a model requires carefully designed explorations that address specific aspects of language and extralinguistic cognition. This should lead to a fundamental increase in our understanding of language impairment in autism, thereby paving the way for a substantial contribution to the question of how to best characterize neurodevelopmental disorders.

Linguistic markers of autism spectrum conditions in narratives: A comprehensive analysis

Background & Aims: Narratives are regularly elicited as part of standardized assessments for autism spectrum conditions (ASC) such as the ADOS, but have rarely been utilized as linguistic data in their own right. We here aimed for a specific and comprehensive quantitative linguistic profile of such narratives across nominal, verbal, and clausal domains of grammatical organization, and error patterns. Methods: We manually transcribed and annotated narratives elicited from the ADOS from a sample of bilingual autistic Spanish-Catalan children (n = 18), matched with typically developing controls (n = 18) on vocabulary-based verbal IQ. Results: Results revealed fewer relative clauses and more frequent errors in referential specificity and non-relational content-word choice in ASC. Frequent error types are also discussed qualitatively. Conclusions & Implications: These findings, based on more finegrained linguistically defined variables, help to disentangle previous inconsistencies in the literature, and to better situate language changes in the spectrum of neurocognitive changes in this population.

A Comparative Study Across Methods to Identify Adolescents with Syntactic Specific Language Impairment

Background

Specific language impairment (SLI) is described as a heterogeneous deficit that causes difficulties in various aspects of language. We performed a comparative study of two methods of language assessment with the primary objective of determining the most effective approach for identifying adolescents with syntactic SLI and typical development (TD) in use.

Methods

A software-assisted method using E-Prime 2.0 was used to create an experiment. The participants were Malay adolescents aged 13 years old-15 years old. The conventional method was compared with the software-assisted method to assess the participants' comprehension and production performance. Data on reaction time (RT), scoring and no response (NR) were obtained from the adolescents.

Results

Based on the two methods, the findings on the selection of participants for the SLI and TD groups was different. The two methods produced similar results in terms of the selection of TD group and most participants in the syntactic SLI group except for two participants who failed in the conventional method but passed the test in the software-assisted method.

Conclusion

The descriptive evaluation of the findings suggested selecting software-assisted method as the alternative source because the provided information was detailed and this information enabled the researcher to identify the SLI group.

Language impairments in children with developmental language disorder and children with high-functioning autism plus language impairment: Evidence from Chinese negative sentences

There is controversy as to whether children with developmental language disorder (DLD) and those with high-functioning autism plus language impairment (HFA-LI) share similar language profiles. This study investigated the similarities and differences in the production of Chinese negative sentences by children with DLD and children with HFA-LI to provide evidence relevant to this controversy. The results reflect a general resemblance between the two groups in their lower-than-TDA (typically developing age-matched) performance. Both groups encountered difficulties in using negative markers, which suggests that they might be impaired in feature agreement. Slight differences were detected between the two groups. Specifically, children with DLD experienced difficulties with the agreement on the feature [+telic] and that on the feature [+dynamic], while children with HFA-LI had difficulties with the agreement on the feature [+dynamic] and that on the feature [−dynamic]. This study supports the idea of a common symptomatology for the two disorders. More importantly, it suggests that these two disorders, DLD and HFA-LI, are not altogether the same in terms of language impairment. This paper concludes that general labels should not be simply attached to any children with language disorders. Instead, atypical language is very worthy of further analysis in the categorization of language disorders.

Modern Foreign Approaches to the Assessment of Different Linguistic Levels in Children with Autism Spectrum Disorders

<p>The article presents an overview of studies on the problem of speech evaluation in childhood. We analyzed the material based on the model that describes 4 levels of language: phonetics and phonology, morphosyntax, semantics and pragmatics. The article contains the analysis of studies describing each level of language as well as existing approaches to its assessment, and reviews studies on language impairments in children with autism spectrum disorders. Additionally, the article contains a detailed analysis of existing foreign and Russian standardized methods for assessing speech development, showing which level of language organization (among each of the mentioned above methods) allows us to assess. It also describes the assessment procedures and evaluation. The review systematizes the available data on the approaches to atypical speech development in children with autism spectrum disorders.</p>

Lexical Semantic Knowledge of Children with ASD—a Review Study

Studies on the lexical semantic abilities of children with autism have yielded contradicting results. The aim of the current review was to explore studies that have specifically focused on the lexical semantic abilities of children with ASD and try to find an explanation for these contradictions. In the 32 studies reviewed, no single factor was found to affect lexical semantic skills, although children with broader linguistic impairment generally, but not universally, also showed impaired lexical semantic skills. The need for future studies with young ASD participants, with differing intellectual functioning, longitudinal studies, and studies assessing a wide range of language domains are discussed.

Sentence Repetition Tasks to Detect and Prevent Language Difficulties: A Scoping Review

Sentence repetition tasks (SRTs) have been widely used in language development research for decades. In recent years, there has been increasing interest in studying performance in SRTs as a clinical marker for language impairment. What are the characteristics of SRTs? For what purposes have SRTs been used? To what extent have they been used with young children, in different languages, and with different clinical populations? In order to answer these and other questions, we conducted a scoping review. Peer reviewed studies published in indexed scientific journals (2010–2021) were analyzed. A search in different databases yielded 258 studies. Research published in languages other than English or Spanish, adult samples, dissertations, case studies, artificial models, and theoretical publications were excluded. After this exclusion, 203 studies were analyzed. Our results show that most research using SRT were conducted with English monolingual speakers older than 5 years of age; studies with bilingual participants have mostly been published since 2016; and SRTs have been used with several non-typical populations. Research suggests that they are a reliable tool for identifying language difficulties and are specifically suitable for detecting developmental language disorder.

Brain mRNA Expression Associated with Cortical Volume Alterations in Autism Spectrum Disorder

Numerous studies report abnormal cerebral cortex volume (CCV) in autism spectrum disorder (ASD); however, genes related to CCV abnormalities in ASD remain largely unknown. Here, we identify genes associated with CCV alterations in ASD by performing spatial correlations between the gene expression of 6 donated brains and neuroimaging data from 1,404 ASD patients and 1,499 controls. Based on spatial correlations between gene expression and CCV differences from two independent meta-analyses and between gene expression and individual CCV distributions of 404 patients and 496 controls, we identify 417 genes associated with both CCV differences and individual CCV distributions. These genes are enriched for genetic association signals and genes downregulated in the ASD post-mortem brain. The expression patterns of these genes are correlated with brain activation patterns of language-related neural processes frequently impaired in ASD. These findings highlight a model whereby genetic risk impacts gene expression (downregulated), which leads to CCV alterations in ASD.

Developmental Language Disorder and Autism: Commonalities and Differences on Language

Language and communication deficits characterize both autism spectrum disorder and developmental language disorder, and the possibility of there being a common profile of these is a matter of tireless debate in the research community. This experimental study addresses the relation of these two developmental conditions in the critical topic of language. A total of 103 children (79 males, 24 females) participated in the present study. Specifically, the study’s sample consisted of 40 children with autism, 28 children with developmental language disorder, and 35 typically developing children between 6 and 12 years old. All children completed language and cognitive measures. The results showed that there is a subgroup inside the autism group of children who demonstrate language difficulties similar to children with developmental language disorder. Specifically, two different subgroups were derived from the autism group; those with language impairment and those without. Both autism and language-impaired groups scored lower than typically developing children on all language measures indicating a common pathology in language ability. The results of this study shed light on the relation between the two disorders, supporting the assumption of a subgroup with language impairment inside the autism spectrum disorder population. The common picture presented by the two developmental conditions highlights the need for further research in the field.

Coconuts and curtain cakes: The production of wh-questions in ASD

BACKGROUND AND AIMS

Children with autism spectrum disorders (ASD) have been found to exhibit difficulties in wh-question production. It is unclear whether these difficulties are pragmatic or syntactic in nature. The current study used a question elicitation task to assess the production of subject and object wh-questions of children with ASD in two different languages (Hebrew and French) wherein the syntactic structure of wh-questions is different, a fact that may contribute to better understanding of the underlying deficits affecting wh-question production. Crucially, beyond the general correct/error rate we also performed an in-depth analysis of error types, comparing syntactic to pragmatic errors and comparing the distribution of errors in the ASD group to that of children with typical development (TD) and children with Developmental Language Disorder (DLD).

RESULTS

Correct production rates were found to be similar for the ASD and DLD groups, but error analysis revealed important differences between the ASD groups in the two languages and the DLD group. The Hebrew- and French ASD groups were found to produce pragmatic errors, which were not found in children with DLD. The pragmatic errors were similar in the two ASD groups. Syntactic errors were affected by the structure of each language.

CONCLUSIONS

Our results have shown that although the two ASD groups come from different countries and speak different languages, the correct production rates and more importantly, the error types were very similar in the two ASD groups, and very different compared to TD children and children with DLD.Implications: Our results highlight the importance of creating research tasks that test different linguistic functions independently and strengthen the need for conducting fine-grained error analysis to differentiate between groups and gain insights into the deficits underlying each of them.

Comprehending reflexive and clitic constructions in children with autism spectrum disorder and developmental language disorder

BACKGROUND

It has been established that people with autism spectrum disorder (ASD) often have difficulties understanding spoken language. Understanding reflexive and clitic pronouns is vital to establishing reference-based inference, but it is as yet unclear whether such constructions pose specific difficulties for those with ASD. Pronoun interpretation seems be connected to the development of pragmatic abilities, and can therefore be considered a plausible marker in the differential diagnosis between ASD and developmental language disorder (DLD).

AIMS

To establish whether or not there are differences between ASD and DLD in relation to their understanding of pronoun constructions (both reflexive and clitic). The working hypothesis was that although no differences were expected between groups in relation to automatic (online) pronoun processing, the comprehension of reflexive pronouns would constitute a diagnostic marker between the group with ASD and language disorder and the DLD group.

METHODS & PROCEDURES

The study carried out two experiments with three clinical groups (two with ASD and different levels of language proficiency and one with DLD) and two control groups with typically developing people (with equivalent language levels), analysing their on- and offline processing in pronoun resolution tasks. The first experiment uses an online method (eye-tracking) to record pronoun processing in real time. The second uses an offline method to analyse comprehension accuracy.

OUTCOMES & RESULTS

The results of the two experiments indicated no differences in the way in which the clinical and control groups resolved the tasks, but a shorter reaction time was observed only in the age-matched control group in comparison with the ASD group without language disorder in the first experiment, perhaps due to the fact that processing pronouns involves a greater cognitive load among the latter group.

CONCLUSIONS & IMPLICATIONS

The comprehension of reflexive pronouns cannot be considered a diagnostic marker for distinguishing ASD from DLD. What this paper adds What is already known on the subject Previous studies have found that the performance of children with ASD in the comprehension of personal pronouns is equivalent to youngest control groups, but poorer regarding the interpretation of reflective pronouns. However, children with DLD do not usually have problems with the use of pronouns, which suggests that their pronoun processing is not affected. As pronoun interpretation seems be connected to the development of pragmatic abilities, it could be considered a plausible marker in the differential diagnosis between ASD and DLD. What this paper adds to existing knowledge This paper presents the results of two experiments involving pronoun processing by those with ASD (both with and without language disorder) and those with DLD. The design enables us to analyse the reflexive and clitic pronoun processing in people with ASD and DLD, regardless of their language proficiency. One experiment uses an eye-tracking methodology that allows us to obtain data about how the pronouns are processed in real time. It represents an attempt to identify language markers that may help distinguish between the two groups and adapt the interventions to the specific problems experienced by each one. What are the potential or actual clinical implications of this work? The results indicate that it is not possible to identify any specific impairment in pronoun processing among the clinical groups (ASD and DLD).

Identifying Language and Cognitive Profiles in Children With ASD via a Cluster Analysis Exploration: Implications for the New ICD-11

The new version of the International Classification of Diseases (ICD-11) mentions the existence of four different profiles in the verbal part of the Autism Spectrum Disorder (ASD), describing them as combinations of either spared or impaired functional language and intellectual abilities. The aim of the present study was to put ASD heterogeneity to the forefront by exploring whether clear profiles related to language and intellectual abilities emerge when investigation is extended to the entire spectrum, focusing on verbal children. Our study proposed a systematic investigation of both language (specifically, structural language abilities) and intellectual abilities (specifically, nonverbal cognitive abilities) in 51 6- to 12-year-old verbal children with ASD based on explicitly motivated measures. For structural language abilities, sentence repetition and nonword repetition tasks were selected; for nonverbal cognitive abilities, we chose Raven's Progressive Matrices, as well as Matrix Reasoning and Block Design from the Wechsler Scales. An integrative approach based on cluster analyses revealed five distinct profiles. Among these five profiles, all four logically possible combinations of structural language and nonverbal abilities mentioned in the ICD-11 were detected. Three profiles emerged among children with normal language abilities and two emerged among language-impaired children. Crucially, the existence of discrepant profiles of abilities suggests that children with ASD can display impaired language in presence of spared nonverbal intelligence or spared language in the presence of impaired nonverbal intelligence, reinforcing the hypothesis of the existence of a separate language module in the brain. Autism Res 2020, 13: 1155-1167. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The present work put Autism Spectrum Disorder heterogeneity to the forefront by exploring whether clear profiles related to language and cognitive abilities emerge when investigation is extended to the entire spectrum (focusing on verbal children). The use of explicitly motivated measures of both language and cognitive abilities and of an unsupervised machine learning approach, the cluster analysis, (a) confirmed the existence of all four logically possible profiles evoked in the new ICD-11, (b) evoked the existence of (at least) a fifth profile of language/cognitive abilities, and (c) reinforced the hypothesis of a language module in the brain.

Prerequisites of Third-Person Pronoun Use in Monolingual and Bilingual Children With Autism and Typical Language Development

The current study investigated the production of third-person subject and object pronouns in monolingual and bilingual children with High Functioning Autism (HFA) and typical language development (TLD). Furthermore, it evaluated the underlying linguistic and non-linguistic prerequisites of pronoun use, by assessing the role of morpho-syntactic skills, Theory of Mind (ToM) abilities, working memory and inhibition on pronoun use. A total of 85 children aged 4 to 9 years participated in four groups: 27 children with HFA [14 monolingual (monoHFA) and 13 bilingual (biHFA)], and 58 children with TLD [28 monolingual (monoTLD) and 30 bilingual (biTLD)]. All children spoke Hebrew and the bilingual children spoke Russian as their Heritage Language. Third-person subject and object pronouns were elicited in Hebrew. The results yielded no effect of bilingualism, and a robust effect of HFA on the use of pronouns. Bilingual Russian-Hebrew speaking children paired up with their monolingual Hebrew-speaking peers in pronominal use in Hebrew. Monolingual and bilingual children with TLD showed nearly ceiling performance on pronoun use. The facilitative effect of pronominal acquisition in Hebrew among bilingual children was attributed to similarities in the pronominal systems of the two languages of bilingual children. Age was found to be a predictive factor of pronoun use in children with TLD. Conversely, children with HFA had a lower rate of pronoun production compared to the TLD groups. Both third-person subject and object pronouns were largely predicted by morpho-syntactic abilities of children with HFA. In addition, subject pronoun use was predicted by ToM skills and working memory confirming that pronoun use is a complex phenomenon, which requires integration of multiple linguistic and non-linguistic components. To conclude, our findings suggest that morpho-syntactic development is a prerequisite for third-person subject and object pronoun use in children with HFA, and ToM and working memory are involved in third-person subject pronoun use. In addition, we show that pronoun use is not compromised by dual language exposure in children with TLD and with HFA.