Hemispheric processing of idioms in schizophrenia and autism spectrum disorder

A leopard cannot change its spots: A novel pragmatic account of concretism in schizophrenia

Concretism is a well-known feature of schizophrenia, tracing back to the early descriptions of the disease and commonly associated with the literal interpretation of figurative expressions such as proverbs, metaphors, and idioms. However, figurative expressions are not all alike in terms of linguistic and pragmatic processes. Determining if some figurative types are more impaired than others and if the type of task affects the performance constitutes an open issue with implications for the description of the clinical profile and for treatment. We run a fine-grained assessment of figurative language comprehension by comparing 47 patients with schizophrenia and 39 controls in three figurative types (idioms, metaphors, proverbs) presented in two response formats (multiple-choice, verbal-explanation), considering also the role of cognitive and clinical variables and the impact on quality of life. Mixed-effects models analysis revealed that: i) patients performed worse than controls across figurative types and response formats, indicating a diffuse impairment; ii) there is an interplay of figurative type and response format, which makes verbal-explanation of proverbs especially challenging; iii) in patients, problems in figurative language are largely connected with formal thought disorder and global IQ. Moreover, multiple-choice of metaphors was associated with patients' quality of life. This study offers a novel account of concretism, framed in pragmatics and figurative language processing. Adopting this perspective allowed us to describe the nuances of concretism, which areas in the figurative domain are especially challenging for patients and which ones capture differences in functioning, in order to guide intervention programs and integration in society.

Gaze and Motor Traces of Language Processing: Evidence from Autism Spectrum Disorders in Comparison to Typical Controls

We investigated what strategies underlie figurative language processing in two groups of participants distinguished by the presence of a developmental deficit, highly-verbal participants with autism, and control participants without autism in two age ranges each. Individuals with autism spectrum disorder are characterised by impaired social interaction and communication. Even at the high end of the spectrum, where structural language is adequate, difficulties in comprehending non-literal aspects of language are widely attested. The exact causes of these problems are, however, still open to debate. In an interactive sentence-picture matching task participants selected the most suitable image representation of a non-literal figurative expression that matched the target meaning, while their eye-movements and hand movements were being tracked. Our results suggest that individuals with ASD have different processing patterns than typically developing peers when interpreting figurative language, even when they provide the correct answers. Both children with and without autism, and participants with autism display greater uncertainty and competition between alternatives when providing the answer, often reflected in also considering the literal interpretation of the expression against its target figurative meaning. We provide evidence that expression transparency and decomposability play a central role in figurative language processing across all groups.

The Understanding of Scalar Implicatures in Children With Autism Spectrum Disorder: Dichotomized Responses to Violations of Informativeness

This study investigated the understanding of underinformative sentences like "Some elephants have trunks" by children with autism spectrum disorder (ASD). The scalar term 'some' can be interpreted pragmatically, 'Not all elephants have trunks,' or logically, 'Some and possibly all elephants have trunks.' Literature indicates that adults with ASD show no real difficulty in interpreting scalar implicatures, i.e., they often interpret them pragmatically, as controls do. This contrasts with the traditional claim of difficulties of people with ASD in other pragmatic domains, and is more in line with the idea that pragmatic problems are not universal. The aim of this study was to: (a) gain insight in the ability of children with ASD to derive scalar implicatures, and (b) do this by assessing not only sensitivity to underinformativeness, but also different degrees of tolerance to violations of informativeness. We employed a classic statement-evaluation task, presenting optimal, logical false, and underinformative utterances. In Experiment 1, children had to express their judgment on a binary option 'I agree' vs. 'I disagree.' In Experiment 2, a ternary middle answer option 'I agree a bit' was also available. Sixty-six Flemish-speaking 10-year-old children were tested: 22 children with ASD, an IQ-matched group, and an age-matched group. In the binary judgment task, the ASD group gave more pragmatic answers than the other groups, which was significant in the mixed effects logistic regression analysis, although not in the non-parametric analysis. In the ternary judgment task, the children with ASD showed a dichotomized attitude toward the speaker's meaning, by tending to either fully agree or fully disagree with underinformative statements, in contrast with TD children, who preferred the middle option. Remarkably, the IQ-matched group exhibited the same pattern of results as the ASD group. Thanks to a fine-grained measure such as the ternary judgment task, this study highlighted a neglected aspect of the pragmatic profile of ASD, whose struggle with social communication seems to affect also the domain of informativeness. We discuss the implications of the dichotomized reaction toward violations of informativeness in terms of the potential role of ASD and of cognitive and verbal abilities.