Pragmatic competence of children with autism spectrum disorder. Impact of theory of mind, verbal working memory, ADHD symptoms, and structural language

Abstract

The primary aim of this study is to increase the existing knowledge about the pragmatic skills of children with autism spectrum disorders (ASD). Specifically, the study has two objectives. The first is to provide a profile of characteristics based on The Children's Communication Checklist (CCC-2) pragmatics scales (inappropriate initiation, stereotyped language, use of context, nonverbal communication, and general pragmatics) and narrative task indicators. To this end, children with ASD will be compared to children with typical development (TD), controlling the effects of sex and structural language (speech, syntax, semantics, coherence). The second objective is to analyze whether theory of mind (ToM), verbal working memory, ADHD symptoms, and structural language can predict pragmatic competence in children with ASD without intellectual disability (ID). The results showed worse performance in the group with ASD on the majority of the pragmatic aspects evaluated. In addition, the application of ToM skills and structural language were significant predictors of the pragmatic skills of the children with ASD. These findings reinforce the importance of focusing intervention programs on mentalist abilities through experiences in real social scenarios, along with strengthening structural language components.

Theory of Mind Profiles in Children With Autism Spectrum Disorder: Adaptive/Social Skills and Pragmatic Competence

“…This group also showed significantly less mastery of daily living skills and poorer adaptive skills than the "Higher ToM abilities" profile, which showed less widespread impairment. Our results corroborate previous findings that have linked the prevalence of ToM in ASD to the degree of autistic symptoms (Lerner et al, 2011;Hoogenhout and Malcolm-Smith, 2017) or to pragmatic and social competence (Tager-Flusberg, 2001;Mazza et al, 2017;Baixauli et al, 2019).…”

Structural and Pragmatic Language Impairments in Children Evaluated for Autism Spectrum Disorder (ASD)

“…Kuijper et al (2017) reported a mean (SD) Structural Language Score in the ASD group of 20.4 (9.0), and a mean (SD) General Pragmatic Score of 37.4 (13.1), both of which are higher (indicating larger deficits) compared with the present sample. In a more recent study, Baixauli-Fortea et al (2019) report a mean (SD) Structural Language Score in the ASD group of 19.0 (9.4), which is close to the observed value in the present sample. There are, however, important differences between these two and the present study; smaller sample sizes (n = 36 and n = 52), the inclusion of only participants with normal range cognitive abilities, as well as a more limited age range under study (6-12 and 7-11 years), which may limit comparability.…”

“…The overall extent and profile of structural language deficits did not differ between children with and without an ASD diagnosis, and is consistent with the language profile reported from previous studies in school-aged children with ASD, as reviewed by Boucher (2012). Further, the observed extent of deficits is comparable to previous studies in school-aged children with ASD (Helland et al 2012;Kuijper et al 2017;Baixauli-Fortea et al 2019). Clinicians and researchers have long been aware of the high comorbidity between ASD and other NDDs (Lord et al 2018), as well as their potential impact on specific aspects of language and communication.…”

Comparing Early Pragmatics in Typically Developing Children and Children with Neurodevelopmental Disorders

“…A medium to large correlation has been found in TD children (Matthews et al, 2018 ; Wilson & Bishop, 2021 ). There is also a growing evidence supporting that structural language deficits were common and associated with reduced pragmatic competence in children with LI and ASD (Baixauli-Fortea et al, 2019 ; Greenslade et al, 2019 ; Levinson et al, 2020 ; Reindal et al, 2021 ). Subsequent studies should focus on the interactions between the two domains and compare how the reciprocal relationships are manifested in children with or without neurodevelopmental disorders.…”