Expressive pragmatic skills in pre-school children with and without Down's syndrome: parental perceptions

Pragmatic and Conversational Features of Arabic-Speaking Adolescents With Autism Spectrum Disorder: Examining Performance and Caregivers' Perceptions

Purpose This study investigates the features of pragmatic and conversational skills in the language of Arabic-speaking adolescents with autism spectrum disorder (ASD) by comparing them with typically developing (TD) Arabic-speaking adolescents in Saudi Arabia. It aims to identify the differences in the pragmatic skills of the two groups and the perception of those skills by caregivers, with respect to four main pragmatic areas: discourse management, communicative function, conversational repair, and presupposition abilities. Method Data for this study were collected from 15 Saudi adolescents with ASD and a control group of 15 TD adolescents, matched for gender and language abilities. All the participants were in the normal IQ range. The caregivers of the adolescents with ASD and TD adolescents also participated in this study. Data were collected on the adolescents' performances using the Yale in vivo Pragmatic Protocol. In addition, the Pragmatics Profile of Everyday Communication Skills (PPECS) was used to collect data on the caregivers' perceptions of the adolescents' abilities. The combination of tools in this study allows for a unique comparison between actual performance and caregivers' perceptions. Results As expected, both the adolescents' performances and the caregivers' perceptions reflected an overall deficit in the pragmatic and conversational skills of adolescents with ASD. However, we also identified an inconsistency between the caregivers' estimation of the participant's pragmatic abilities and the actual abilities demonstrated by the adolescents. In particular, TD adolescents performed significantly better than adolescents with ASD in the pragmatic areas of turn-taking, topic maintenance, and topic initiation, but the caregivers did not detect differences between the two groups in these discourse management abilities. Conclusions This study has important implications for both ASD interventions and assessment. It provides a comprehensive assessment approach for measuring pragmatic skills, including both direct (participants' performances) and indirect (caregivers' perceptions) measures. Future research may benefit from adopting the combined approach used in this study to explore pragmatics in ASD. Differences between caregivers' perceptions and the performances of individuals with ASD should be considered, as well as the influence of various factors on their communication.

Longitudinal analysis of communication repair skills across three neurodevelopmental disabilities

BACKGROUND

This study is a longitudinal follow-up to prior work examining the important pragmatic skill of communication repair (i.e., the ability to respond effectively to a request for clarification of an unclear message) across three neurodevelopmental disabilities in which language skills are impaired: fragile X syndrome with and without autism spectrum disorder (FXS-ASD; FXS-O), idiopathic ASD (ASD-O), Down syndrome (DS) and controls with typical development (TD). Prior work examining communication repair skills at younger ages indicated impairments in boys with FXS-ASD and ASD-O, with females performing comparably with each other across groups.

AIMS

To characterize communication repair skills in young individuals with FXS-ASD, FXS-O, ASD-O, DS and TD, across groups and over development. A secondary aim included documenting sex differences in FXS (with and without ASD) and DS.

METHODS & PROCEDURES

Sixty young individuals with FXS-ASD (49 males, 11 females), 38 with FXS-O (13 males, 25 females), 38 with ASD-O (males only), 42 with DS (21 males, 21 females) and 41 with TD (21 males, 20 females) participated in the study, with a subsample reported on here who were retested at a second time point 2.7 years later on average. Participants completed a structured, picture-based task designed to assess the ability to repair breakdowns in communication. Participants' responses were compared across groups and sexes at the second time point, and interpreted with respect to previously published (Time 1) findings.

OUTCOMES & RESULTS

Key findings included that, with age, male groups (including those with FXS-ASD and ASD-O, who showed difficulty at Time 1) performed more comparably, decreasing their use of inappropriate responses, in spite of relatively little change observed in general cognitive or structural language abilities in the clinical groups. However, girls with FXS and DS became more non-responsive with age, and differences between boys and girls with FXS-ASD emerged over time as well.

CONCLUSIONS & IMPLICATIONS

Findings suggest that impairments in a critical pragmatic skill-the ability to repair communication breakdown-show significant change with age across three neurodevelopmental disabilities, with important sex-specific patterns. These developments were often observed in spite of a relative plateau in cognitive and language growth, suggesting that repair skills may be more malleable and therefore an excellent target for intervention. Findings not only inform the nature of pragmatic impairment across groups but also can importantly inform clinical practice, suggesting that clinicians should monitor pragmatic skills such as repairs throughout development and also consider the role of sex in clinical efforts.

Specificity: A Phenotypic Comparison of Communication-Relevant Domains Between Youth With Down Syndrome and Fragile X Syndrome

Despite the shared presence of an intellectual disability (ID), there is a growing literature documenting important phenotypic differences between Down syndrome (DS) and fragile X syndrome (FXS). These conclusions, however, are based on a synthesis across studies, each of which typically includes only measures of a limited number of constructs, and with differing participant characteristics. Firmer conclusions regarding specific phenotypes require a single comprehensive multi-domain assessment of participants with the syndrome groups being well matched on chronological age (CA) and cognitive functioning. The current study was designed to fill this gap by assessing several important cognitive and behavioral domains relevant to communication, such as: structural language skills, false belief understanding, as well as pragmatics and behavioral difficulties, in 30 adolescents of both sexes with DS and 39 males with FXS, matched on CA and nonverbal (NV) cognition. After statistically controlling for NV cognition, we did not find significant syndrome differences in expressive and receptive structural language or false belief understanding. In contrast, participants with DS displayed less stereotyped language and fewer behavioral difficulties compared to males with FXS. Within-syndrome associations among the targeted domains are described. Finally, females with DS were less impaired than males with DS in almost all structural language domains, whereas no significant sex-related differences were observed in NV cognition, false belief understanding, pragmatics, or behavior. Clinical and methodological implications of the findings are discussed.

A Multi-Method Investigation of Pragmatic Development in Individuals With Down Syndrome

This longitudinal study examined pragmatic language in boys and girls with Down syndrome (DS) at up to three time points, using parent report, standardized and direct assessments. We also explored relationships among theory of mind, executive function, nonverbal mental age, receptive and expressive vocabulary, grammatical complexity, and pragmatic competence. Controlling for cognitive and language abilities, children with DS demonstrated greater difficulty than younger typically developing controls on parent report and standardized assessments, but only girls with DS differed on direct assessments. Further, pragmatic skills of individuals with DS developed at a delayed rate relative to controls. Some sex-specific patterns of pragmatic impairments emerged. Theory of mind and executive function both correlated with pragmatic competence. Clinical and theoretical implications are discussed.

Management of swallowing and communication difficulties in Down syndrome: A survey of speech-language pathologists

PURPOSE

To explore speech pathology services for people with Down syndrome across the lifespan.

METHOD

Speech-language pathologists (SLPs) working in Australia were invited to complete an online survey, which enquired about the speech pathology services they had provided to client/s with Down syndrome in the past 12 months. The data were analysed using descriptive statistics.

RESULT

A total of 390 SLPs completed the survey; 62% reported seeing a client with Down syndrome in the past 12 months. Most commonly, SLPs provided assessment and individual intervention for communication with varying levels of family involvement. The areas of dysphagia and/or communication addressed by SLPs, or in need of more services differed according to the age of the person with Down syndrome. SLPs reported a number of reasons why services were restricted.

CONCLUSION

There is a need to re-assess the way that SLPs currently provide services to people with Down syndrome. More research is needed to develop and evaluate treatment approaches that can be used to better address the needs of this population.

Communicative performance of children with Down syndrome in two different situations

BACKGROUND

analysis of the pragmatic aspects of language in children with Down syndrome.

AIM

to verify the influence of environmental and contextual variables in the pragmatic aspects of language of Down syndrome (DS) children when interacting with their caregivers and therapist, and to compare their performance in both situations.

METHOD

participants were 15 children with DS with ages ranging from 4 to 6.11 years. Data were obtained through anamnesis, the protocol of functional communicative profile, and a socioeconomic questionnaire. Data obtained from both interaction situations (with the caregiver and with the therapist) were compared, and submitted to statistical analysis.

RESULTS

Caregiver's socioeconomic and educational levels were the variables that most had an influence on the pragmatic aspects of the child in both interaction situations. Children presented proportional rates of functional communication when compared to the data obtained for their caregivers and the communicative functions more frequently used by them were recognition of others, comment and performative. Comparisons between the interaction situations indicated no statistically significant differences concerning the children's communicative performance.

CONCLUSION

caregivers' socioeconomic and educational levels might be considered risk factors for the development of the pragmatic aspects of language in children with DS and special attention should be given to these families during the speech-language therapeutic process. Independently of the interlocutor, these children were able to initiate and maintain communication, using communicative means and functions in a similar fashion.

Emergência dos esquemas simbólicos em crianças com síndrome de Down, prematuros muito baixo peso e crianças com desenvolvimento típico

OBJETIVO: verificar a emergência dos esquemas simbólicos simples e combinados e seus respectivos subtipos em 20 crianças prematuras muito baixo peso, 20 crianças com síndrome de Down e 20 crianças com desenvolvimento típico. MÉTODOS: todos os sujeitos foram acompanhados mensalmente durante seis meses, a partir da avaliação inicial em que estavam localizados no final da quinta fase do período sensório-motor. Para tanto, foi utilizado o Protocolo para Observação do Desenvolvimento Cognitivo e da Linguagem Expressiva - versão revisada (PODCLE-r). Os dados foram analisados de forma quantitativa e qualitativa. RESULTADOS: os resultados revelaram que os esquemas simbólicos simples e combinados emergiram de forma semelhante para todos os grupos, embora se tenha observado ritmo de desenvolvimento mais lento para as crianças prematuras muito baixo peso e crianças com síndrome de Down, quando comparadas às crianças com desenvolvimento típico. A análise qualitativa, referente à diversidade e complexidade dos esquemas simbólicos produzidos, mostrou que as crianças prematuras muito baixo peso apresentaram pior desempenho quando comparadas às crianças com síndrome de Down e às com desenvolvimento típico, apresentando também dificuldades específicas quanto ao uso de esquemas simbólicos aplicados a objetos não-figurativos, ou seja, quanto à construção da representação por meio de significantes arbitrários. CONCLUSÃO: estes dados reforçam a importância de se acompanhar a emergência e o desenvolvimento dos esquemas simbólicos simples e combinados nessas crianças, com o objetivo de monitorar e estimular esse desenvolvimento, com vistas a minimizar os efeitos da defasagem cognitiva e a favorecer o desenvolvimento da linguagem.

Education and children with Down syndrome: neuroscience, development, and intervention

Of the recent advances in education-related research in Down syndrome, the characterization of the Down syndrome behavioral phenotype has become a potentially critical tool for shaping education and intervention in this population. This article briefly reviews the literature on brain-behavior connections in Down syndrome and identifies aspects of the Down syndrome behavioral phenotype that are potentially relevant to educators. Potential challenges to etiologically informed educational planning are discussed.

Language phenotypes and intervention planning: bridging research and practice

This paper focuses on the communication and language phenotypes associated with three genetic disorders: Down syndrome, Williams syndrome, and fragile X syndrome. It is argued that there is empirical evidence that these disorders predispose children to specific profiles of strength and weakness in some areas of speech, language, and communication, and that intervention planning for children with each syndrome may take an approach informed by these profiles. Issues related to within-group variability, shared outcomes among syndromes, and the need for empirical validation for syndrome-specific recommendations are discussed.

Predicting longitudinal change in language production and comprehension in individuals with Down syndrome: hierarchical linear modeling

Longitudinal change in syntax comprehension and production skill, measured four times across a 6-year period, was modeled in 31 individuals with Down syndrome who were between the ages of 5 and 20 years at the start of the study. Hierarchical Linear Modeling was used to fit individual linear growth curves to the measures of syntax comprehension (TACL-R) and mean length of spontaneous utterances obtained in 12-min narrative tasks (MLU-S), yielding two parameters for each participant's comprehension and production: performance at study start and growth trajectory. Predictor variables were obtained by fitting linear growth curves to each individual's concurrent measures of nonverbal visual cognition (Pattern Analysis subtest of the Stanford-Binet), visual short-term memory (Bead Memory subtest), and auditory short-term memory (digit span), yielding two individual predictor parameters for each measure: performance at study start and growth trajectory. Chronological age at study start (grand-mean centered), sex, and hearing status were also taken as predictors. The best-fitting HLM model of the comprehension parameters uses age at study start, visual short-term memory, and auditory short-term memory as predictors of initial status and age at study start as a predictor of growth trajectory. The model accounted for 90% of the variance in intercept parameters, 79% of the variance in slope parameters, and 24% of the variance at level 1. The some predictors were significant predictors of initial status in the best model for production, with no measures predicting slope. The model accounted for 81% of the intercept variance and 43% of the level 1 variance. When comprehension parameters are added to the predictor set, the best model, accounting for 94% of the intercept and 22% of the slope variance, uses only comprehension at study start as a predictor of initial status and comprehension slope as a predictor of production slope. These results reflect the fact that expressive language acquisition continues in adolescence and is predicted by syntax comprehension and its growth trajectory.