Language Use Differs Between Boys with Both Autism and FXS and Autism Alone, Study Shows

Adolescent autistic boys who also have fragile X syndrome converse differently when it comes to certain aspects of language than autistic boys without the disease, a study suggests.

This study, which examined demonstrative and personal pronoun use, adds to the knowledge of language issues in these adolescent populations and can help guide the development of intervention targets for school-age children with these disorders.

The study, “The use of demonstratives and personal pronouns in fragile X syndrome and autism spectrum disorder,” was published in Clinical Linguistics & Phonetics.

The use of demonstratives (i.e., the words “this,” “that,” “these,” “those,” “here,” and “there”) plays a crucial role in language and conversation. Using demonstratives in daily speech is necessary for social development and successful daily interactions.

Demonstrative use is impaired in idiopathic (of unknown cause) autism spectrum disorder beyond early childhood. However, it is unclear whether these issues are related to the severity of autism spectrum disorder or overall language ability.

Like demonstratives, personal pronouns are an early developing component of language. Individuals with autism spectrum disorder commonly make mistakes in the use of personal pronouns in speech. This has been linked to problems with communication for those with the disorder.

Because fragile X syndrome often occurs alongside autism spectrum disorder, it is likely that the use of demonstratives and personal pronouns is impaired in fragile X syndrome as well. However, whether demonstrative or pronoun use is affected in individuals with both fragile X syndrome and autism spectrum disorder is not known.

“Given the critical role that demonstratives and personal pronouns play in language development, understanding these impairments in fragile X syndrome and idiopathic autism spectrum disorder can help create intervention targets during the school-age years,” the researchers wrote.

These researchers from the University of Wisconsin examined how the co-occurrence of fragile X with autism spectrum disorder affects demonstrative and personal pronoun use. To do so, they compared demonstrative and personal pronoun use during conversation in teen boys with only autism spectrum disorder with teen boys who had both fragile X syndrome and autism spectrum disorder of matched severity.

They examined the mean length of utterance — a measure of linguistic productivity in children — as well as the relationship among grammatical ability, autism spectrum disorder severity, and IQ scores in the production of these skills.

Their findings indicate that adolescent boys with both fragile X syndrome and autism spectrum disorder use pronouns at a similar rate in conversation as those with matched idiopathic autism spectrum disorder.

On the other hand, the participants differed regarding the use of demonstratives, in that adolescent boys with both conditions produced greater proportions of concrete and appropriate demonstratives, and more demonstratives overall than the group with autism spectrum disorder alone.

Grammatical complexity was related to several aspects of demonstrative and personal pronoun production in participants with autism spectrum disorder. The increased mean length of utterance (i.e., increased linguistic productivity) was related to higher demonstrative and personal pronoun use as well as fewer errors in demonstratives, first- and third-person personal pronouns, and fewer omitted personal pronouns.

However, language productivity, measured by the mean length of utterance, in boys with both fragile X syndrome and autism spectrum disorder was only related to demonstrative and personal pronoun use. Errors in the use of demonstratives or personal pronouns were not related to mean length utterance in fragile X syndrome and autism spectrum disorder as they were in idiopathic autism spectrum disorder alone.

This indicates that language ability may not play the same role in these referencing skills for both groups.

There was no noticeable link between IQ scores and demonstrative or personal pronoun use in either group, suggesting that intellectual ability may not be an important factor in the use of these aspects of language.

In addition, the researchers did not find any links between disorder severity and demonstrative and personal pronoun production for the boys with autism spectrum disorder. However, more severe autism spectrum disorder was linked to an increased proportion of omitted personal pronouns and a lower total number of personal pronouns for the boys with fragile X syndrome and autism spectrum disorder.

“Better understanding of demonstrative and personal pronoun strengths and challenges in these populations and in this age range can help inform intervention targets throughout the school-age years, as demonstratives and personal pronouns are critical for language development, social referencing, and communication success,” the researchers said.

This study has several limitations. The sample sizes were small for both groups, and the only measure for grammatical complexity was mean length of utterance.

The same studies also should be performed with adolescent girls as well as in larger groups and with more measures of grammatical complexity. The researchers recommend that future work include standardized or experimental tasks targeting demonstrative and personal pronoun production as well as comprehension.