Conventions for unconventional language: Revisiting a framework for spoken language features in autism

Abstract

Background and aims Autism has long been characterized by a range of spoken language features, including, for instance: the tendency to repeat words and phrases, the use of invented words, and “pedantic” language. These observations have been the source of considerable disagreement in both the theoretical and applied realms. Despite persistent professional interest in these language features, there has been little consensus around terminology, definitions and developmental/clinical interpretation. Main contribution This review paper updates and expands an existing framework for unconventional language in autism to include a broader range of non-generative (echolalia and self-repetition) and generative (idiosyncratic phrases, neologisms and pedantic language) features often observed in the language of individuals on the autism spectrum. For each aspect of the framework, we review the various definitions and measurement approaches, and we provide a summary of individual and contextual correlates. We also propose some transitional language features that may bridge non-generative and generative domains (e.g., mitigated echolalia and gestalt language). Conclusions This updated framework offers a unified taxonomy and nomenclature that can facilitate further investigation and interpretation of unconventional language in autism. Implications There are important implications of this work for our understanding of the complex interplay between autism and language development. Equally important are the clinical ramifications that will guide evidence-based practice in assessment and intervention for individuals on the autism spectrum.

●Repeat after me? Both Children with and without Autism Commonly Align Their Language with That of Their Caregivers

“…The child's response in (1) is clearly an instance of alignment, but in the autism literature such responses are generally viewed as linguistically non-generative, questionably functional, and targets for elimination in therapy (Luyster et al, 2022;Neely et al, 2016;Stiegler, 2015). The primary purpose of the current study is to address this paradox.…”

“…If indeed perspective-taking and theory of mind (ToM) development are the core functions of linguistic alignment, and if perspective-taking and ToM are closely related to social interaction, we might expect that children with ASD, who are characterized by challenges in social interactions (American Psychiatric Association, 2013), would find linguistic alignment challenging. And yet, ASD is also characterized by frequent echolalia (American Psychiatric Association, 2013;Luyster et al, 2022;Stiegler, 2015;Tager-Flusberg & Calkins, 1990), in which children are reported to repeat-sometimes verbatim-what their parents or teachers just said:…”

Echolalia from a transdiagnostic perspective

“…Immediate and delayed echolalia can further be classified by how exact they are in their repetition, whether they be exact repetitions ( Prizant & Duchan, 1981 ) or slightly changed (i.e., mitigated; Roberts, 1989 ). In a recent theoretical review, Luyster and colleagues ( 2022 ) encourage consideration of immediate and delayed echolalia as forms of nongenerative speech and mitigated echolalia as transitional speech, both laying the groundwork for generative forms of speech, including idiosyncratic language (e.g., neologisms, idiosyncratic phrasing) and pedantic language commonly observed in autism. Other terms used to describe echolalia in autism are defined in Table 1 .…”

“…Echolalia can be used as a way for individuals with limited self-generated language to communicate functionally ( Gernsbacher et al, 2016 ); however, echolalia in some forms has been reported to negatively impact one's quality of life, contributing to lower social acceptance and reduced vocational and independent living opportunities ( Paul et al, 2005 ). Despite echolalia being recently reviewed in several diagnostic-specific outlets, including reviews of echolalia in aphasia (e.g., Ota et al, 2020 ; Torres-Prioris & Berthier, 2020 ) and autism (e.g., Cohn et al, 2022 ; Gernsbacher et al, 2016 ; Luyster et al, 2022 ), no research to date has reviewed echolalia from a transdiagnostic perspective. Critically, given the prevalence of echolalia in clinical groups and the number of publications in the past decade exploring echolalia, a literature review that consolidates the findings from a transdiagnostic perspective and provides transdiagnostic clinical recommendations is warranted.…”

“…Potential advantages of a transdiagnostic approach to psychopathological phenomena include increased efficiency of training and dissemination of evidence-based practices, improved clinical fit for clinicians, and potential improvements in clinician and client satisfaction ( Marchette & Weisz, 2017 ). In this narrative review, we adopt a transdiagnostic framework to understand the commonalities and key differences of echolalia within and across clinical and non-clinical groups through a neurobehavioral lens, as recommended by recent echolalia reviews ( Luyster et al, 2022 ). Through this approach, we are better able to inform empirically supported treatment recommendations, clinical assessment protocols, and highlight future areas for research.…”