Courtenay Frazier Abstract

2004 Elsevier Inc. All rights reserved. 

Contine reading Courtney Frazier’s Paper

Abstract
Inadequate language is a defining feature of the autism spectrum disorders (autism). Autism is a behaviorally and dimensionally defined developmental disorder of the immature brain that has a broad range of severity and many etiologies, with multiple genes involved. Early studies, which focused on the language of verbal children on the autistic spectrum, emphasized aberrant features of their speech such as unusual word choices, pronoun reversal, echolalia, incoherent discourse, unresponsiveness to questions, aberrant prosody, and lack of drive to communicate. Persistent lack of speech of some individuals was attributed to the severity of their autism and attendant mental retardation rather than possible inability to decode auditory language. Clinical study of unselected children with autism indicated that the language deficits of preschoolers fall into two broad types, perhaps with subtypes, those that involve reception and production of phonology (sounds of speech) and syntax (grammar), and those that do not but involve semantics (meaning) and pragmatics (communicative use of language,processing, and production of discourse). Except for the preschoolers’ universally deficient pragmatics and comprehension of speech, many of their language deficits parallel those of non-autistic preschoolers with developmental language disorders. There is now biological support for the clinical observation that young autistic children are language disordered as well as autistic. Recent electrophysiological studies disclose auditory input abnormalities in lateral temporal cortex even in verbal individuals on the autistic spectrum. Severe receptive deficits for phonology enhance the risk for epilepsy. Genetic studies indicate that linkage to chromosome 7q31–33 is limited to families with evidence for phonologic impairment as well as autism. Clearly, social and cognitive disorders alone provide an inadequate explanation for the range of language deficits in autism.
© 2002 Elsevier Science B.V. All rights reserved.

Abstract
Background: Traditionally, autism and specific language impairment (SLI) have been regarded as distinct disorders but, more recently, evidence has been put forward for a closer link between them: a common set of language problems, in particular receptive language difficulties and the existence of intermediate cases including pragmatic language impairment. The present study aimed to examine the prevalence of autism spectrum disorders in a large sample of adolescents with a history of SLI.

Method: The presence of autism spectrum disorders was examined in seventy-six 14-year-olds with a confirmed history of SLI. A variety of instruments were employed, including the Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS) and the Family History Interview (FHI).

Results: The prevalence of autism spectrum disorders in young people with SLI was found to be 3.9%, about 10 times what would be expected from the general population. In addition, a much larger number of young people with a history of SLI showed only some autism spectrum symptoms or showed them in a mild form.

Conclusions: Young people with SLI have an increased risk of autism. The magnitude of this risk is considerable. In addition, a larger proportion (a quarter of individuals) present with a number of behaviours consistent with autism spectrum disorders.

Gina Conti-Ramsden School of Psychological Sciences, University of Manchester, UK, Zoë Simkin School of Psychological Sciences, University of Manchester, UK, and Nicola Botting School of Psychological Sciences, University of Manchester, UK School of Psychological Sciences, University of Manchester, UK
Gina Conti-Ramsden, Human Communication and Deafness, School of Psychological Sciences, Humanities Devas Street Building, The University of Manchester, Oxford Road, Manchester M13 9PL, UK

Abstract
Inadequate language is a defining feature of the autism spectrum disorders (autism). Autism is a behaviorally and dimensionally defined developmental disorder of the immature brain that has a broad range of severity and many etiologies, with multiple genes involved. Early studies, which focused on the language of verbal children on the autistic spectrum, emphasized aberrant features of their speech such as unusual word choices, pronoun reversal, echolalia, incoherent discourse, unresponsiveness to questions, aberrant prosody, and lack of drive to communicate. Persistent lack of speech of some individuals was attributed to the severity of their autism and attendant mental retardation rather than possible inability to decode auditory language. Clinical study of unselected children with autism indicated that the language deficits of preschoolers fall into two broad types, perhaps with subtypes, those that involve reception and production of phonology (sounds of speech) and syntax (grammar), and those that do not but involve semantics (meaning) and pragmatics (communicative use of language,processing, and production of discourse). Except for the preschoolers’ universally deficient pragmatics and comprehension of speech, many of their language deficits parallel those of non-autistic preschoolers with developmental language disorders. There is now biological support for the clinical observation that young autistic children are language disordered as well as autistic. Recent electrophysiological studies disclose auditory input abnormalities in lateral temporal cortex even in verbal individuals on the autistic spectrum. Severe receptive deficits for phonology enhance the risk for epilepsy. Genetic studies indicate that linkage to chromosome 7q31–33 is limited to families with evidence for phonologic impairment as well as autism. Clearly, social and cognitive disorders alone provide an inadequate explanation for the range of language deficits in autism.
&copy 2002 Elsevier Science B.V. All rights reserved.

Continue reading Isabelle Rapin and Michelle Dunn’s Paper

There is a growing body of evidence supporting the many connections between cognitive competence and high-quality pretend play. This article defines the cluster of concepts related to pretend play and cognition and briefly synthesizes the latest research on the role of such play in children’s cognitive, social, and academic development. The article notes that there is a growing body of evidence to suggest that high-quality pretend play is an important facilitator of perspective taking and later abstract thought, that it may facilitate higher-level cognition, and that there are clear links between pretend play and social and linguistic competence. The article also notes that there is still a great need for research on the relationship between high-quality pretend play and development of specific academic skills. The article concludes with a discussion of the challenges and potential policy directions suggested by research findings.

Continue reading Doris Bergen’s paper

Autism is a developmental condition involving a triad of social impairments: in social relationships, communication, and imagination (Wing and Gould, 1979). Rapin and Allen (1987) commented that one subtype of developmental language disorder – ’semantic-pragmatic syndrome’ – was frequently seen, in a severe form, in verbal children with autism. In children with ’semantic-pragmatic’ disorder, the onset of language use is delayed, and when language emerges it is accompanied by echolalia, jargon and auditory inattention. When they are older, such children use superficially complex language with clear articulation but have difficulty with the use and understanding of language, interpreting over-literally and using language inappropriately in conversation. There has been debate as to whether semantic-pragmatic language disorder forms part of the disorders of the autistic spectrum.

Language has canonical components such as phonology, syntax and lexical semantics, but other non-componential, non-literal and context-bound aspects of language are involved in its use in social discourse. The exercise of these pragmatic language skills relies upon the integrity of broader cognitive functions concerned with the processing of social information. Language use also involves the broader skills of attention and drawing inferences.

The study of social cognition has been concerned both with the nature of social knowledge and with the nature of cognitive processes involved in the perception and interpretation of the social world (Ostrom 1984). It has been suggested that the social impairments found in autism are linked to an inability to mentalise, a lack of understanding of mental states: of a ‘theory of mind’ (Baron-Cohen 1989, Frith 1989).

Continue Reading Jane Shields,Rosemary Varley,Paul Broks and Adrian Simpson’s Paper from the Developmental Medicine and Child Neurology, 1996, 38, 487-495

The diagnostic criteria for autism have been refined and made more objective since Kanner first described the syndrome, so there is now reasonable consistency in how this diagnosis is applied. However, many children do not meet these criteria, yet show some of the features of autism. Where language development is impaired, such children tend to be classed as cases of developmental dysphasia (or specific language impairment) whereas those who learn to talk at the normal age may be diagnosed as having Asperger’s syndrome. It is argued that rather than thinking in terms of rigid diagnostic categories, we should recognise that the core syndrome of autism shades into other milder forms of disorder in which language or non-verbal behaviour may be disproportionately impaired.

Continue reading D. V. M. Bishop’s (Department of Psychology, University of Manchester) Paper

The majority of language assessment procedures available to speech therapists are concerned with the child’s ability to use grammar, vocabulary and phonology. In recent years there has been increasing recognition that many children who are reasonably competent in these areas may nevertheless have problems with semantics and pragmatics. Thus although their speech may be fluent and grammatically well formed, the content of what they say has an odd quality, and the way in which they use language in social interactions may be unusual. Several authors have suggested that this constitutes a specific subtype of language disorder, variously termed ’semantic-pragmatic syndrome’ (Rapin & Allen, 1983), ’semantic-pragmatic disorder’ Bishop & Rosenbloom, 1987) or ‘conversational disability’ (Conti-Ramsden & Gunn, 1986). Rapin (1987) includes the following in her characterisation of semantic-pragmatic syndrome speech fluent with adequate articulation; verbose; comprehension deficits for the meaning of verbal messages, notably questions; tendency to interpret messages quite literally; tendency to respond to one or two words in a sentence rather than to the entire message; incessant chatter, perseveration, use of or circumlocutions, semantic paraphasias and lack of semantic specificity; impairment in the ability to take turns and to maintain a topic in discourse.

Continue reading C. Adams (Centre of Audiology, Education of the Deaf and Speech Pathology, University of Manchester)
and D. V. M. Bishop’s (Department of Psychology, University of Manchester) paper

Part 1. Organizational Framework and Assessment Parameters

This paper describes an organizational framework for the assessment of pragmatic abilities in children. The framework addresses the areas of communicative intention, presupposition, and the social organization of discourse. For each area, assessment parameters are presented in coordination with a review of pertinent literature. Recent approaches to the study of child language have emerged from a renewed interest in pragmatics, the rules governing the use of language in a social context (Bates, 1976). This is in contrast to the focus during the past two decades on the structural aspects of language. It is now realized that in addition to learning the phonologic, semantic and syntactic rules of language, a child must also master the rules that underlie how language is used for the purpose of communication (Hymes, 1971). The acquisition of these rules requires a complex integration of linguistic, cognitive, and social knowledge.
The development of pragmatic skills in handicapped children has not received substantial attention despite the recognition by practitioners that there are children whose social interaction abilities cannot be directly tied to their linguistic skills (Bernard-Opitz, 1982; Blank, Gessner, & Esposito, 1979; Snyder, 1978; Spekman, 1981). Numerous clinical reports indicate that these children demonstrate major communication deficits which transcend their problems with form and content or which exist even in the presence of normal linguistic skills. The problems exhibited by these children illustrate that linguistic knowledge alone does not guarantee appropriate language use. There are also children who manifest poor social interaction abilities that can be accounted for by a primary linguistic deficit (Brinton & Fujiki, 1982; Fey & Leonard, 1983; Leonard, Camarata, Rowan, & Chapman, 1982) or cognitive deficit (Beveridge, 1976: Guralnick, 1978). However, most clinicians and special educators do not yet have an adequate framework for assessing pragmatic difficulties regardless of their foundation. Whereas the development of formalized pragmatic assessment instruments must await a clearer delineation of a normal developmental sequence, it is now possible to draw on empirical and theoretical literature to construct an organizational framework for analyzing performance in this area. Such a framework can aid the practitioner in fulfilling the two major objectives of assessment: (a) to determine the effectiveness of a child as a communicator, and (b) to provide recommendations regarding appropriate intervention strategies. The purpose of this paper is to present such a framework along with a discussion of the relevant behavioral dimensions that warrant attention in the assessment of pragmatic abilities. The construction of this framework is based, in part, on the pioneering work of others including Bates (1976) and Miller (1978). It is our intention that this assessment framework be viewed as an extension of existing diagnostic models. Without information about language structure and cognitive growth, it is difficult to arrive at a well-informed and accurate decision regarding the integrity of a child’s communication system.

Continue reading this paper by FROMA P. ROTH NANCY J. SPEKMAN University of Maryland, College Park

As the children’s commissioner for England says the lack of adequate education for autistic children is “shocking and appalling”, one mother describes her ordeal.

Joy Belson’s son Ashley committed suicide when he was 18 after suffering a number of learning difficulties, including Asperger’s, an autistic spectrum disorder.

Ashley felt he was “useless”, despite being bright and passing his GCSEs when he was 12 years old.

Mrs Belson, 62, who now lives in Carrickmacross, Ireland, was living in Birmingham at the time. She believes the education system let her son down badly.

‘Useless’

“Ashley was first expelled from school when he was about eight. We got him into a local school who worked very very hard with him, but eventually they felt that things were getting a little too disruptive,” she said.

That was when he was 11, so Mrs Belson began looking for specialist schools for her son. Ashley also suffered from Tourette Syndrome, attention deficit hyperactivity disorder (ADHD) and Semantic Pragmatic Disorder.

“We were bandied about between lots of schools, but they were not suitable for the problems he had got – they were for children who were badly behaved.

“We finally got him into a school in Chelmsley Wood. The headmaster there worked very very hard with him and he built up a good relationship with him. But when the Ofsted report came through the school was closed, and when it eventually re-opened the headmaster left.

“The new headmistress started taking in children bit by bit. Ashley was only there for a couple of weeks before they told us they couldn’t teach him because of the problems he had.

“The fact he’d passed his GCSEs for maths when he was 12 meant nothing to them.”

Mrs Belson was never able to find a school that was suitable for Ashley.

“They could cater for his intelligence but not his level of disruption, or they could cater for his disruptiveness but not for his intelligence – they could never do both.”

“My son was a lovely boy, and I’m not just saying that because I’m his mother, but he was very intelligent, and the system let him down very very badly.

“He would say repeatedly ‘I’m useless’.”

Ashley never returned to school after he was 13. Mrs Belson believes that being rejected from school was one factor leading to his suicide.

“I feel passionate about this because I know where these kids can go,” she said.

Source: with thanks BBC NEWS – Jacqueline Head