Verbal fluency and autism: Reframing current data through the lens of monotropism.

The purpose of this study was to reexamine research that used verbal fluency tasks to reinforce assumed deficits in word knowledge and retrieval in the autistic population. We identified seventeen articles that compared the performance of autistic and non-autistic people on verbal fluency measures and provided an interpretation of the observed performance. In this narrative review, we summarize many components of these studies, including a comprehensive account of how authors framed their research findings. Overall, results of the studies showed variation both between and within groups in terms of total number of correct words, how many subsequent words fell into subcategories, and how frequently participants switched between subcategories. Despite wide variation in findings across studies, authors consistently interpreted results as revealing or reinforcing autistic deficits. To contrast the deficit narrative, we offer an alternative interpretation of findings by considering how they could provide support for the autistic-led theory of monotropism. This alternative interpretation accounts for the inconsistencies in findings between studies, since wide individual variation in performance is an expected feature of the monotropic theory. We use our review as an exercise in reframing a body of literature from a neurodiversity-affirming perspective. We propose this as a case example and model for how autism research and clinical practice can move away from the consistent narrative of autism deficits that has pervaded our field for decades. Accordingly, we offer suggestions for future research and clinical practice.

Analysis of Noun Phrase Ambiguity in Narratives Reveals Differences in Referential Establishment But Not Cohesion for Older Autistic Children.

PURPOSE: Stories told by autistic narrators often contain relatively frequent use of ambiguous references. However, it remains unclear whether this ambiguity is driven by ambiguous character establishment (e.g., "Once upon a time, she/the girl…") and/or ambiguous cohesion (e.g., "Two girls lived in a castle. She/The girl…"). In this study, we directly compared rates of each type of ambiguity within and between narratives told by autistic and non-autistic children, to determine which type of ambiguity is relatively more common in narratives told by autistic children. METHOD: Thirty-three 10- to 17-year-old autistic participants (n = 17) and non-autistic peers (n = 16), who were not statistically different in age, standardized language scores, and IQ scores (p > .8 for all), watched two short animated videos alone and then described the videos' events to two listeners who were openly unfamiliar with the videos. We transcribed video recordings of narratives and coded all referential noun phrases (NPs) as either clear or ambiguous. We further categorized ambiguous NPs as either ineffective introduction or ineffective cohesion. RESULTS: Autistic children produced significantly higher rates of ambiguous establishment than non-autistic peers, whereas between-group comparisons' rates of ambiguous cohesion were not statistically significant. CONCLUSIONS: Older children on the autism spectrum show differences in the way they introduce characters, selecting NP types that are only appropriate when their listener is already familiar with the referent. In contrast, once they have introduced characters, they show cohesive skills that are comparable to those of non-autistic peers. Findings support theories arguing that autistic children show differences in their application of social pragmatic principles (listener/context-specific pragmatic rules), whereas their use of linguistic pragmatics (context-independent rules) is similar to that of non-autistic peers.

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

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.

Like, it's important: The frequency and use of the discourse marker like in older autistic children.

Background & Aims: Discourse markers, such as well or like, serve a variety of functions to support conversational reciprocity: filling pauses, aiding word-finding, and modulating turn-taking by holding the conversational floor. Previous research shows that autistic individuals use discourse markers less frequently than non-autistic (NonAu) peers; however, the discourse marker like has not been included in that research, despite its ubiquitous use by NonAu individuals, and despite the fact that like serves important pragmatic functions that are not encoded by any other discourse marker. Specifically, like signals to the listener that the content of upcoming speech is 1) Important/new; 2) Loose/approximate; 3) Reformulative; or 4) Quotative. The current study addresses this gap in the literature by comparing the frequency of discourse marker like use between older autistic and non-autistic children as well as exploring patterns of usage between the four like functions. Methods: Twenty-one 10-to-17-year-old children on the autism spectrum and 20 NonAu peers-statistically matched on age, sex, IQ and language scores-engaged in a semi-structured interview with a researcher. Uses of discourse-marker like were identified from written transcripts of interviews and each use was categorized into one of the four functions. Results: There were no significant differences in like frequencies between groups, nor were there differences in relative proportions of functions used by each group. Conclusions: Research consistently indicates that autistic individuals use discourse markers significantly less often than their NonAu counterparts, but the findings from our study suggest that this pattern does not persist to all such markers. This group of older autistic children use like as often as their peers and use it to signify similar information about upcoming speech to their listener.

Comparing Frequency of Listener Responses Between Adolescents with and Without ASD During Conversation.

In conversation, the listener plays an active role in conversation success, specifically by providing listener feedback which signals comprehension and interest. Previous work has shown that frequency of feedback positively correlates with conversation success. Because individuals with ASD are known to struggle with various conversational skills, e.g., turn-taking and commenting, this study examines their use of listener feedback by comparing the frequency of feedback produced by 20 adolescents with ASD and 23 neurotypical (NT) adolescents. We coded verbal and nonverbal listener feedback during the time when participants were listening in a semi-structured interview with a research assistant. Results show that ASD participants produced significantly fewer instances of listener feedback than NT adolescents, which likely contributes to difficulties with social interactions.

Structural and Contextual Cues in Third-Person Pronoun Interpretation by Children with Autism Spectrum Disorder and Their Neurotypical Peers.

This study investigates the use of structural and discourse contextual cues in the interpretation of third-person pronouns by children and adolescents with autism and their neurotypical peers. Results show that referent-biasing contextual information influences pronominal interpretation and modulates looking patterns in both groups compared to a context-neutral condition. These results go against the predictions of Weak Central Coherence and the notion that pragmatics in general is impaired in ASD, since the ASD group was able to use details in discourse context to influence the pronominal interpretation process. However, although discourse context influenced looking patterns in both groups, the groups nevertheless diverged in the nature of these patterns, suggesting that behavioral differences may emerge in more complicated discourse tasks.

Personal Pronoun Errors in Form versus Meaning Produced by Children with and without Autism Spectrum Disorder.

The current study investigates whether the types of pronominal errors children with autism spectrum disorder (ASD) make are different from those of their TD peers at similar stages of language development. A recent review about language acquisition in ASD argues that these children show relative deficits in assigning/extending lexical meaning alongside relative strengths in morpho-syntax (Naigles & Tek, 2017). Pronouns provide an ideal test case for this argument because they are marked both for grammatical features (case) and features that reflect qualities of the referent itself (gender and number) or the referent's role in conversation (person). The form-meaning hypothesis predicts that children with ASD should struggle more with these latter features. The current study tests this hypothesis with data from a caregiver report, completed by caregivers of 151 children with and without ASD. Reported pronominal errors were categorized as meaning or form and compared across groups. In accordance with the form-meaning hypothesis, a higher proportion of children with ASD make meaning errors than they do form errors, and significantly more of them make meaning errors than TD children do.

Cross-Modal Coordination of Face-Directed Gaze and Emotional Speech Production in School-Aged Children and Adolescents with ASD.

Autism spectrum disorder involves persistent difficulties in social communication. Although these difficulties affect both verbal and nonverbal communication, there are no quantitative behavioral studies to date investigating the cross-modal coordination of verbal and nonverbal communication in autism. The objective of the present study was to characterize the dynamic relation between speech production and facial expression in children with autism and to establish how face-directed gaze modulates this cross-modal coordination. In a dynamic mimicry task, experiment participants watched and repeated neutral and emotional spoken sentences with accompanying facial expressions. Analysis of audio and motion capture data quantified cross-modal coordination between simultaneous speech production and facial expression. Whereas neurotypical children produced emotional sentences with strong cross-modal coordination and produced neutral sentences with weak cross-modal coordination, autistic children produced similar levels of cross-modal coordination for both neutral and emotional sentences. An eyetracking analysis revealed that cross-modal coordination of speech production and facial expression was greater when the neurotypical child spent more time looking at the face, but weaker when the autistic child spent more time looking at the face. In sum, social communication difficulties in autism spectrum disorder may involve deficits in cross-modal coordination. This finding may inform how autistic individuals are perceived in their daily conversations.

Perceptions of self and other: Social judgments and gaze patterns to videos of adolescents with and without autism spectrum disorder.

Neurotypical adults often form negative first impressions of individuals with autism spectrum disorder and are less interested in engaging with them socially. In contrast, individuals with autism spectrum disorder actively seek out the company of others who share their diagnosis. It is not clear, however, whether individuals with autism spectrum disorder form more positive first impressions of autistic peers when diagnosis is not explicitly shared. We asked adolescents with and without autism spectrum disorder to watch brief video clips of adolescents with and without autism spectrum disorder and answer questions about their impressions of the individuals in the videos. Questions were related to participants' perceptions of the social skills of the individuals in the video, as well as their own willingness to interact with that person. We also measured gaze patterns to the faces, eyes, and mouths of adolescents in the video stimuli. Both participant groups spent less time gazing at videos of autistic adolescents. Regardless of diagnostic group, all participants provided more negative judgments of autistic than neurotypical adolescents in the videos. These data indicate that, without being explicitly informed of a shared diagnosis, adolescents with autism spectrum disorder form negative first impressions of autistic adolescents that are similar to, or lower than, those formed by neurotypical peers.

Motion-Capture Patterns of Voluntarily Mimicked Dynamic Facial Expressions in Children and Adolescents With and Without ASD.

Research shows that neurotypical individuals struggle to interpret the emotional facial expressions of people with Autism Spectrum Disorder (ASD). The current study uses motion-capture to objectively quantify differences between the movement patterns of emotional facial expressions of individuals with and without ASD. Participants volitionally mimicked emotional expressions while wearing facial markers. Recorded marker movement was grouped by expression valence and intensity. We used Growth Curve Analysis to test whether movement patterns were predictable by expression type and participant group. Results show significant interactions between expression type and group, and little effect of emotion valence on ASD expressions. Together, results support perceptions that expressions of individuals with ASD are different from-and more ambiguous than-those of neurotypical individuals'.

I Think We're Alone Now: Solitary Social Behaviors in Adolescents with Autism Spectrum Disorder.

Research into emotional responsiveness in Autism Spectrum Disorder (ASD) has yielded mixed findings. Some studies report uniform, flat and emotionless expressions in ASD; others describe highly variable expressions that are as or even more intense than those of typically developing (TD) individuals. Variability in findings is likely due to differences in study design: some studies have examined posed (i.e., not spontaneous expressions) and others have examined spontaneous expressions in social contexts, during which individuals with ASD-by nature of the disorder-are likely to behave differently than their TD peers. To determine whether (and how) spontaneous facial expressions and other emotional responses are different from TD individuals, we video-recorded the spontaneous responses of children and adolescents with and without ASD (between the ages of 10 and 17 years) as they watched emotionally evocative videos in a non-social context. Researchers coded facial expressions for intensity, and noted the presence of laughter and other responsive vocalizations. Adolescents with ASD displayed more intense, frequent and varied spontaneous facial expressions than their TD peers. They also produced significantly more emotional vocalizations, including laughter. Individuals with ASD may display their emotions more frequently and more intensely than TD individuals when they are unencumbered by social pressure. Differences in the interpretation of the social setting and/or understanding of emotional display rules may also contribute to differences in emotional behaviors between groups.

Mixed metaphors: Electrophysiological brain responses to (un)expected concrete and abstract prepositional phrases.

Languages around the world use spatial terminology, like prepositions, to describe non-spatial, abstract concepts, including time (e.g., in the moment). The Metaphoric Mapping Theory explains this pattern by positing that a universal human cognitive process underlies it, whereby abstract concepts are conceptualized via the application of concrete, three-dimensional space onto abstract domains. The alternative view is that the use of spatial propositions in abstract phrases is idiomatic, and thus does not trigger metaphoric mapping. In the current study, event-related potentials (ERPs) were used to examine the time-course of neural processing of concrete and abstract phrases consisting of the prepositions in or on followed by congruent and incongruent nouns (e.g., in the bowl/plate and in the moment/mend). ERPs were recorded from the onset of reference nouns in 28 adult participants using a 128-channel electrode net. Results show that congruency has differential effects on neural measures, depending on whether the noun is concrete or abstract. Incongruent reference nouns in concrete phrases (e.g., on the bowl) elicited a significant central negativity (an N400 effect), while incongruent reference nouns in abstract phrases (e.g., on the moment) did not. These results suggest that spatially incongruent concrete nouns are semantically unexpected (N400 effect). A P600 effect, which might indicate rechecking, reanalysis and/or reconstruction, was predicted for incongruent abstract nouns, but was not observed, possibly due to the variability in abstract stimuli. Findings cast doubt on accounts claiming that abstract uses of prepositions are cognitively and metaphorically linked to their spatial sense during natural, on-line processing.