Analysis of a Repetitive Language Coding System: Comparisons between Fragile X Syndrome, Autism, and Down Syndrome

Abstract

Expressive language sampling (ELS) is a frequently used tool for language analysis, as it can be used across widely ranging cognitive and language abilities. ELS can also evaluate pragmatic language, including excessive self-repetition, which is challenging to assess with traditional standardized assessments. This study explored how a well-established ELS protocol can assess three types of linguistic self-repetition in three neurodevelopmental disabilities: fragile X syndrome (FXS), autism spectrum disorder (ASD), and Down syndrome (DS). We examined its ability to differentiate between these disorders, the relationships between repetitive language and other participant characteristics, and initial construct validity. We found that the groups with FXS and ASD differed significantly on each of the three repetitive language measure, and that the group with DS differed from either ASD or FXS on two. Cognitive ability was significantly related to phrase repetition in the group with ASD. When the groups were combined, there was evidence of convergent and divergent validity. This study extends previous research on ELS and supports its use as a means to characterize pragmatic language. It also provides information about the relationships between repetitive language and other phenotypic characteristics.

Consistency and reliability of automated language measures across expressive language samples in autism

“…The sample for the current study was drawn from a larger sample of native English‐speaking individuals with ASD, FXS, and DS, aged between six and 23 years, who were recruited as part of a multi‐site study evaluating the utility of expressive language sampling (ELS) as a source of outcome measures (Abbeduto et al, 2020; Hoffmann et al, 2022; Thurman et al, 2021). A total of 13 participants with ASD were reported by their caregivers to speak a language in addition to English; but only one participant was described as fluent in their other language.…”

Communication in fragile X syndrome: Patterns and implications for assessment and intervention

“…This repetition is found in several forms, including immediate repetition of a specific word or phrase (e.g., "She's gonna be a statue, gonna be a statue"), repetition of a specific conversational device that does not add information to the conversation (e.g., "Right on"), or repeatedly returning to a specific topic of conversation (Murphy and Abbeduto, 2007). There is evidence that this is a key phenotypic element to FXS, as it is found regardless of non-verbal cognitive or language ability and in both males and females with FXS (Martin et al, 2018;Hoffmann et al, 2022). Interestingly, levels of self-repetition have distinguished groups with FXS and ASD, with FXS showing higher levels of topic and phrase repetition and ASD showing higher rates of conversational device repetition (Hilvert et al, 2020;Hoffmann et al, 2022).…”

“…There is evidence that this is a key phenotypic element to FXS, as it is found regardless of non-verbal cognitive or language ability and in both males and females with FXS (Martin et al, 2018;Hoffmann et al, 2022). Interestingly, levels of self-repetition have distinguished groups with FXS and ASD, with FXS showing higher levels of topic and phrase repetition and ASD showing higher rates of conversational device repetition (Hilvert et al, 2020;Hoffmann et al, 2022).…”

“…For individuals regularly using two-to-three-word phrases, an expressive language sampling (ELS) protocol has been developed and shows strong psychometrics in its use in FXS (Berry-Kravis et al, 2013a;Abbeduto et al, 2020;Shaffer et al, 2020). It has been shown to differentiate between diagnoses, and to be able to characterize syntax, vocabulary, and pragmatics in FXS and other populations with varying levels of language ability (Abbeduto et al, 2020;Shaffer et al, 2020;Hoffmann et al, 2022).…”

“…The benefit to incorporating a book into this intervention is that it also continues to build on the print awareness and narrative structure needed for literacy (Justice et al, 2009). These practices that have focused on educating caregivers in communication techniques have also been proven effective when delivered via telehealth, opening up additional possibilities for families who may have trouble finding a provider familiar with them nearby (McDuffie et al, 2016a(McDuffie et al, ,b, 2018Bullard et al, 2017;Abbeduto et al, 2020;Shaffer et al, 2020;Hoffmann et al, 2022).…”