Profiles of Language and Communication Skills in Autism

Wilkinson (1998) identifies a form/function dissociation of individuals with relation to communication in which deficits are realized in ability to apply language form to functional communication. She further identifies four interrelated systems of linguistic communication that ASD children struggle with (p.73):

Pragmatics- the social aspect of language such as body language and eye gaze in conjunction with appropriate verbal use.

Semantics- rules that govern word meanings and concepts

Phonology- rules that govern production of speech sounds (pronunciation/articulation)
Prosody- intonation, rhythm, stress

Syntax- rules that govern how words are put together to form sentences

Each system above is thought to develop in an interrelated way and in congruent fashion. However it ASD individuals are often assessed with difficulty in one or multiple of the 4 areas. Some autistic individuals develop with mutism (Lord & Paul, 1997 as cited in Shriberg, et al 2001) while some others develop more advanced verbal skills with functional communicating skills as seen with Asperger’s Syndrome (Miller-Kuhaneck, 2004; Mirenda, 2006).

Pragmatics: pragmatics is the social aspect of language that includes “eye gaze, gesture and social smiling along with skills of turn taking, choice of topic and relevance of contributions to conversation” (Wilkinson p.74). The concept of joint attention can be observed where there is an impaired ability of attention and intentional behaviors such as pointing and gestures used in social interactions. Pragmatic challenges are also witnessed in speech based conversations through turn taking, echolalia and relevant topics in a discussion (Miller-Kuhaneck, 2004; Wilkinson 1998).

Semantics: defined as unusual word use pattern with increased frequency of neologisms, echolalia and use of made up words. Semantics can often be delayed language skills seen in ASD children, however it can also be due in part to impaired pragmatics and joint attention (Wilkinson, p. 75). The delayed learned vocabulary skills can further challenge the conceptual and symbolic language and the relating it to functional communication.

Phonology: can be observed when looking at the prosody aspect of communication, or the intonation, stress and pitch. Some individuals struggle modulating rhythm or volume, while others with ASD have no deficits. More commonly, this can be observed with monotone or robot speech, or range from baby soft tone to very loud speech. The patterns vary to each individual, but are one avenue for further research. This research article also suggested that as language skills increase with alter development, prosody remains a continuous challenge.

Syntax: syntax itself is not impaired in ASD individuals, but rather features of communication such as pronoun reversal, echolalia, and pragmatics. Pronoun reversal (saying ‘you’ for ‘me’ and vice versa) is more evident in social conversation with the shifting of referents (p. 76) as compared to individual talk-applying formal skill to functional communication (Shriberg, et al 2001).

An impairment of language skills is evident from the form and function perspective. ASD individuals have intact functions of form (eye gaze, gesture), but struggle with the transition to functional communication in social situations. Individuals struggling with the most basic forms of communication may demonstrate the typical behavior often associated with ASD as coping strategies (outbursts, tantrums, hand flapping, withdrawal, etc).

The intensive early intervention approach strategy, with child initiated social goals would be most productive for the child. The child is able to identify the motivational factors that will drive his performance and offer him the best chance for success (Lynch, PPD 2009). The intervention could use a profiling approach to identify the weakness in the 4 systems described above to guide interventions.

Wilkinson, K. M. Profiles of Language and Communication Skills in Autism Mental Retardation and Developmental Disabilities 4: 73-79 (1998)