Facing phonological complexity as an autistic adult: An exploratory study

Background and aims

While it has been suggested that phonology is relatively spared in autism, some studies have shown that many autistic children and adolescents exhibit severe phonological impairment, of which syllabic complexity is a reliable index. However, although autism is a lifelong disorder, no such evidence exists for adults. The aim of the present study is to bridge this knowledge gap by investigating how autistic adults deal with phonological complexity.

Method

Phonological abilities were assessed in 48 autistic adults aged 18 to 56 years and 50 controls matched on age and sex/gender. A linguistically motivated Nonword Repetition (NWR) task manipulating syllabic complexity, LITMUS-QU(Quasi Universal)-FR(ench)-NWR-Adults, was used to distinguish participants with and without a phonological impairment. In addition to the NWR task, additional tests were conducted to examine potential factors influencing phonological performance. These measures included morphosyntax, vocabulary, nonverbal IQ (NVIQ), short-term memory, working memory, and autism severity, providing a comprehensive understanding of variables affecting phonological abilities in autistic adults.

Results

Global performance on NWR was significantly lower and spanned a wider range in the autism group than that in the control group. By looking at individual results across the structures and substructures included in NWR, which presented varying degrees of syllabic complexity, it was possible to uncover great variability among autistic individuals with a phonologicalimpairment. Phonological proficiency appeared to be related to morphosyntax rather than to lexical knowledge and nonverbal cognition, including memory. Moreover, phonological skills did not correlate with autism severity.

Conclusions

This study represents a first step towards understanding how to characterize phonological skills in autistic adults. Our findings indicate that syllabic complexity prompts diverse behaviors among autistic individuals with impaired phonology. Further research is required to gain insight into the cause(s) underlying the detected difficulties.

Speech sound error patterns may signal language disorder in Swedish preschool children with autism

BACKGROUND

Within cohorts of children with autism spectrum disorder (ASD) there is considerable variation in terms of language ability. In the past, it was believed that children with ASD either had delayed articulation and phonology skills or excelled in those areas compared to other language domains. Very little is known about speech sound ability in relation to language ability and non-verbal ability in Swedish preschool children with ASD.

AIM

The current study aimed to describe language variation in a group of 4-6-year-old children with ASD, focusing on in-depth analyses of speech sound error patterns with and without non-phonological language disorder and concomitant non-verbal delays.

METHOD & PROCEDURES

We examined and analysed the speech sound skills (including consonant inventory, percentage of correct consonants and speech sound error patterns) in relation to receptive language skills in a sample of preschool children who had screened positive for ASD in a population-based screening at 2.5 years of age. Seventy-three children diagnosed with ASD participated and were divided into subgroups based on their receptive language (i.e., non-phonological language) and non-verbal abilities.

OUTCOMES & RESULTS

The subgroup division revealed that 29 children (40%) had language delay/disorder without concurrent non-verbal general cognitive delay (ALD), 27 children (37%) had language delay/disorder with non-verbal general cognitive delay (AGD), and 17 children (23%) had language and non-verbal abilities within the normal range (ALN). Results revealed that children with ALD and children with AGD both had atypical speech sound error patterns significantly more often than the children with ALN.

CONCLUSIONS & IMPLICATIONS

This study showed that many children who had screened positive for ASD before age 3 years - with or without non-verbal general cognitive delays - had deficits in language as well as in speech sound ability. However, individual differences were considerable. Our results point to speech sound error patterns as a potential clinical marker for language problems (disorder/delay) in preschool children with ASD.

WHAT THIS PAPER ADDS

What is already known on the subject Children with autism spectrum disorder (ASD) have deficits in social communication, restricted interests and repetitive behaviour. They show very considerable variation in both receptive and expressive language abilities. Previously, articulation and phonology were viewed as either delayed in children with ASD or superior compared with other (non-phonological) language domains. What this paper adds to existing knowledge Children with ASD and language disorders also have problems with speech sound error patterns. What are the potential or actual clinical implications of this work? About 75% of children with ASD experience language delays/disorders, as well as speech sound problems, related to speech sound error patterns. Understanding/acknowledging these phonological patterns and their implications can help in the diagnosis and intervention of speech sound disorders in children with ASD. Direct intervention targeting phonology might lead to language gains, but more research is needed.

Auditory Challenges and Listening Effort in School-Age Children With Autism: Insights From Pupillary Dynamics During Speech-in-Noise Perception

PURPOSE

This study aimed to investigate challenges in speech-in-noise (SiN) processing faced by school-age children with autism spectrum conditions (ASCs) and their impact on listening effort.

METHOD

Participants, including 23 Mandarin-speaking children with ASCs and 19 age-matched neurotypical (NT) peers, underwent sentence recognition tests in both quiet and noisy conditions, with a speech-shaped steady-state noise masker presented at 0-dB signal-to-noise ratio in the noisy condition. Recognition accuracy rates and task-evoked pupil responses were compared to assess behavioral performance and listening effort during auditory tasks.

RESULTS

No main effect of group was found on accuracy rates. Instead, significant effects emerged for autistic trait scores, listening conditions, and their interaction, indicating that higher trait scores were associated with poorer performance in noise. Pupillometric data revealed significantly larger and earlier peak dilations, along with more varied pupillary dynamics in the ASC group relative to the NT group, especially under noisy conditions. Importantly, the ASC group's peak dilation in quiet mirrored that of the NT group in noise. However, the ASC group consistently exhibited reduced mean dilations than the NT group.

CONCLUSIONS

Pupillary responses suggest a different resource allocation pattern in ASCs: An initial sharper and larger dilation may signal an intense, narrowed resource allocation, likely linked to heightened arousal, engagement, and cognitive load, whereas a subsequent faster tail-off may indicate a greater decrease in resource availability and engagement, or a quicker release of arousal and cognitive load. The presence of noise further accentuates this pattern. This highlights the unique SiN processing challenges children with ASCs may face, underscoring the importance of a nuanced, individual-centric approach for interventions and support.

Production of Mandarin consonant aspiration and monophthongs in children with Autism Spectrum Disorder

Impaired speech sound production adds difficulties to social communication in children with Autism Spectrum Disorder (ASD), while a limited attempt has been made to figure out the speech sound production among Mandarin-speaking children with ASD. The current study conducted both auditory-perceptual scoring and quantitative acoustic analysis of speech sound imitated by 27 Mandarin-speaking children with ASD (3.33-7.00 years) and 30 chronological-age-matched typically developing (TD) children. Auditory-perceptual scoring showed significantly lower scores for aspirated/unaspirated consonants and monophthongs in children with ASD. Moreover, the correlation between the developmental age of language and production accuracy in children with ASD emphasised the importance of language assessment. The quantitative acoustic analysis further indicated that the ASD group produced a much shorter voice onset time for aspirated consonants and showed a reduced vowel space than the TD group. Early interventions focusing on these production patterns should be introduced to improve the speech sound production in Mandarin-speaking children with ASD.

Describing (pre)linguistic oral productions in 3- to 5-year-old autistic children: A cluster analysis

LAY ABSTRACT

For most autistic children, spoken language emergence and development happen after the age of 3. Once they start developing and using spoken language, some eventually manage to reach typical levels of language abilities, while others remain minimally speaking into adulthood. It is therefore difficult to consider young autistic preschoolers as a homogeneous group in terms of spoken language levels. In our study, we breakdown a representative and inclusive group of children on the spectrum aged from 3 to 5 into five subgroups that correspond to different linguistic profiles. To do so, we qualitatively described children's (pre)verbal productions elicited during interactions with a parent and with an experimenter. We then used a type of statistical analysis called cluster analysis to group together the children that had a similar expressive (pre)linguistic behavior. Using this analysis, we were able to delineate five linguistic profiles with qualitatively different patterns of vocal production. Two of these profiles are composed of speaking children; the three others are composed of non- or minimally speaking children. Our findings show that traditional binary division of speaking versus nonspeaking autistic children is not precise enough to describe the heterogeneity of early spoken language in young autistic children. They also support the use of qualitative descriptions of vocal productions and speech to accurately document children's level of language, which could, in turn, help design very finely tailored language intervention specific to each child.

Diagnosis and Treatment of Childhood Apraxia of Speech Among Children With Autism: Narrative Review and Clinical Recommendations

PURPOSE

Treatment for children with autism spectrum disorder (ASD) and low verbal ability is a largely neglected area of study. Existing research focuses on language abilities; however, a subset of children with ASD also has speech sound disorders (SSDs). The purpose of this tutorial is to provide clinicians with evidence-based recommendations to guide speech assessment and treatment among children with ASD, low verbal ability, and suspected childhood apraxia of speech (CAS).

METHOD

Multifaceted search procedures were used to identify studies that have assessed or treated speech sound production among children with ASD. A narrative review and synthesis of the literature is followed by practical clinical recommendations based on best available evidence.

CONCLUSIONS

It is critically important to consider all possible hindrances to the development of functional communication ability for children with ASD. Speech sound production has been identified as a key predictor of expressive language outcomes, yet there are very few studies that address assessment and treatment of SSDs among children with ASD. Less is known about the presentation of CAS among children with ASD and low verbal ability. More research is needed to determine whether existing speech assessment and treatment methods are appropriate for children with ASD, if modifications are needed, or if new methods should be designed.

Neural coding of formant-exaggerated speech and nonspeech in children with and without autism spectrum disorders

The presence of vowel exaggeration in infant-directed speech (IDS) may adapt to the age-appropriate demands in speech and language acquisition. Previous studies have provided behavioral evidence of atypical auditory processing towards IDS in children with autism spectrum disorders (ASD), while the underlying neurophysiological mechanisms remain unknown. This event-related potential (ERP) study investigated the neural coding of formant-exaggerated speech and nonspeech in 24 4- to 11-year-old children with ASD and 24 typically-developing (TD) peers. The EEG data were recorded using an alternating block design, in which each stimulus type (exaggerated/non-exaggerated sound) was presented with equal probability. ERP waveform analysis revealed an enhanced P1 for vowel formant exaggeration in the TD group but not in the ASD group. This speech-specific atypical processing in ASD was not found for the nonspeech stimuli which showed similar P1 enhancement in both ASD and TD groups. Moreover, the time-frequency analysis indicated that children with ASD showed differences in neural synchronization in the delta-theta bands for processing acoustic formant changes embedded in nonspeech. Collectively, the results add substantiating neurophysiological evidence (i.e., a lack of neural enhancement effect of vowel exaggeration) for atypical auditory processing of IDS in children with ASD, which may exert a negative effect on phonetic encoding and language learning. LAY SUMMARY: Atypical responses to motherese might act as a potential early marker of risk for children with ASD. This study investigated the neural responses to such socially relevant stimuli in the ASD brain, and the results suggested a lack of neural enhancement responding to the motherese even in individuals without intellectual disability.

Phonological acquisition and development in Putonghua-speaking children with Autism Spectrum Disorders

Poor phonological development adversely affects language development and interpersonal communication abilities in children with Autism Spectrum Disorders (ASD). However, the characteristics of phonological development in children with ASD who speak Putonghua (the official standard spoken form of modern Mandarin Chinese) remain largely unknown. This study aims to investigate phonological acquisition and development among Putonghua-speaking children with ASD. Data were collected from participants recruited in Shanghai, China. Two experiments were conducted. In experiment I, phonological acquisition was compared between 16 children with ASD aged 3-6 years and 16 age-matched typically developing (TD) children. In experiment II, phonological acquisition was compared between 26 children with ASD over 6 years old and 26 receptive-language-age-matched TD children. Picture naming was applied to measure participants' phonology - the 21 initials, 36 finals and four tones of Putonghua. Paired-samples t-tests and Fisher's exact tests were applied. In experiment I, scores on initials, finals, tones and total phonology of children with ASD aged 3-6 years were significantly lower than those of age-matched TD children. The pronunciation accuracy rates for initials such as/x, t^h, l/, finals such as/jaʊ, joʊ, wo/ and Tone 3 (the low-rising tone) in the ASD group were significantly lower than in the TD group. In experiment II, there was no significant difference in overall phonological developmental level between children with ASD over 6 years old and receptive-language-age-matched TD children. Phonological development of Putonghua-speaking children with ASD was significantly lower than that of age-matched TD children but closer to that of receptive-language-age-matched TD children. Further, participants with ASD showed atypical development sequences in both initials and finals.

Development and evaluation of a 3-D virtual pronunciation tutor for children with autism spectrum disorders

The deficit in speech sound production in some children with autism spectrum disorder (ASD) adds to their communication barriers. The 3-D virtual environments have been implemented to improve their communication abilities. However, there were no previous studies on the use of a 3-D virtual pronunciation tutor designed specifically to train pronunciation for children with ASD. To fill this research gap, the current study developed and evaluated a 3-D virtual tutor which served as a multimodal and real-data-driven speech production tutor to present both places and manners of Mandarin articulation. Using an eye-tracking technique (RED 5 Eye Tracker), Experiment 1 objectively investigated children’s gauged attention distribution online while learning with our computer-assisted 3-D virtual tutor in comparison to a real human face (HF) tutor. Eye-tracking results indicated most participants showed more interests in the visual speech cues of the 3-D tutor, and paid some degree of absolute attention to the additional visual speech information of both articulatory movements and airflow changes. To further compare treatment outcomes, training performance was evaluated in Experiment 2 with the ASD learners divided into two groups, with one group learning from the HF tutor and the other from the 3-D tutor (HF group vs. 3-D group). Both groups showed improvement with the help of computer-based training in the post-intervention test based on the calculation of a 5-point Likert scale. However, the 3-D group showed much higher gains in producing Mandarin stop and affricate consonants, and apical vowels. We conclude that our 3-D virtual imitation intervention system provides an effective approach of audiovisual pronunciation training for children with ASD.