Abstract
Pragmatic language difficulties, including unusual filler usage, are common among children with Autism Spectrum Disorder (ASD). This study investigated “um” and “uh” usage in children with ASD and typically developing (TD) controls. We analyzed transcribed Autism Diagnostic Observation Schedule (ADOS) sessions for 182 children (117 ASD, 65 TD), aged 4 to 15. Although the groups did not differ in “uh” usage, the ASD group used fewer “ums” than the TD group. This held true after controlling for age, sex, and IQ. Within ASD, social affect and pragmatic language scores did not predict filler usage; however, structural language scores predicted “um” usage. Lower “um” rates among children with ASD may reflect problems with planning or production rather than pragmatic language.
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Notes
From this point forward, “filler” will refer to only the words “um” and “uh”.
Irvine et al. (2016) and McGregor and Hadden (2020) did not specify whether immediate repeats were removed, so we assumed that any repeats were left as is. While Gorman et al. (2016) did remove repeats, they repeated all statistical analyses with repeats preserved and found no difference in the results obtained.
References
Adams, C. (2002). Practitioner Review: The assessment of language pragmatics. Journal of Child Psychology and Psychiatry, 43(8), 973–987. https://doi.org/10.1111/1469-7610.00226
Adams, J. R., Salem, A. C., MacFarlane, H., Ingham, R., Bedrick, S. D., Fombonne, E., Dolata, J. K., Hill, A. P., & van Santen, J. (2021). A pseudo-value approach to analyze the semantic similarity of the speech of children with and without autism spectrum disorder. Frontiers in Psychology, 12, 3089. https://doi.org/10.3389/fpsyg.2021.668344
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Dolata, J. K., Suarez, S., Calamé, B., & Fombonne, E. (2022). Pragmatic language markers of autism diagnosis and severity. Research in Autism Spectrum Disorders, 94, 101970.
Baltaxe, C. A. M., & D’Angiola, N. (1992). Cohesion in the discourse interaction of autistic, specifically language-impaired, and normal children. Journal of Autism and Developmental Disorders, 22(1), 1–21. https://doi.org/10.1007/bf01046399
Barokova, M., & Tager-Flusberg, H. (2020). Commentary: Measuring language change through natural language samples. Journal of Autism and Developmental Disorders, 50(7), 2287–2306. https://doi.org/10.1007/s10803-018-3628-4
Bates, D., Mächler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 1–48. https://doi.org/10.18637/jss.v067.i01
Bishop, D. V. M. (2003). The children’s communication checklist, version 2 (CCC-2). Pearson.
Bishop, D. V. M. (2013). Children’s communication checklist (CCC-2). In F. R. Volkmar (Ed.), Encyclopedia of autism spectrum disorders (pp. 614–618). Springer. https://doi.org/10.1007/978-1-4419-1698-3_1929
Capps, L., Kehres, J., & Sigman, M. (1998). Conversational abilities among children with autism and children with developmental delays. Autism, 2(4), 325–344. https://doi.org/10.1177/1362361398024002
Clark, H. H., & Fox Tree, J. E. (2002). Using uh and um in spontaneous speaking. Cognition, 84(1), 73–111. https://doi.org/10.1016/S0010-0277(02)00017-3
Cureton, E. E. (1956). Rank-biserial correlation. Psychometrika, 21(3), 287–290. https://doi.org/10.1007/BF02289138
DaWalt, L. S., Usher, L. V., Greenberg, J. S., & Mailick, M. R. (2019). Friendships and social participation as markers of quality of life of adolescents and adults with fragile X syndrome and autism. Autism, 23(2), 383–393. https://doi.org/10.1177/1362361317709202
de Marchena, A., & Eigsti, I.-M. (2010). Conversational gestures in autism spectrum disorders: Asynchrony but not decreased frequency. Autism Research, 3(6), 311–322. https://doi.org/10.1002/aur.159
Engelhardt, P. E. (2019). Speaker versus listener-oriented disfluency. In F. R. Volkmar (Ed.), Encyclopedia of autism spectrum disorders (pp. 1–10). Springer. https://doi.org/10.1007/978-1-4614-6435-8_102369-1
Engelhardt, P. E., Alfridijanta, O., McMullon, M. E. G., & Corley, M. (2017). Speaker-versus listener-oriented disfluency: A re-examination of arguments and assumptions from autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(9), 2885–2898. https://doi.org/10.1007/s10803-017-3215-0
Finlayson, I. R., & Corley, M. (2012). Disfluency in dialogue: An intentional signal from the speaker? Psychonomic Bulletin & Review, 19(5), 921–928. https://doi.org/10.3758/s13423-012-0279-x
Fox Tree, J. E. (2001). Listeners’ uses of um and uh in speech comprehension. Memory & Cognition, 29(2), 320–326. https://doi.org/10.3758/BF03194926
Friedman, L., Sterling, A., DaWalt, L. S., & Mailick, M. R. (2019). Conversational language is a predictor of vocational independence and friendships in adults with ASD. Journal of Autism and Developmental Disorders, 49(10), 4294–4305. https://doi.org/10.1007/s10803-019-04147-1
Goodkind, A., Lee, M., Martin, G. E., Losh, M., & Bicknell, K. (2018). Detecting language impairments in autism: A computational analysis of semi-structured conversations with vector semantics. Proceedings of the Society for Computation in Linguistics, 1, 12–22. https://doi.org/10.7275/r56w988p
Gorman, K., Olson, L., Hill, A. P., Lunsford, R., Heeman, P. A., & van Santen, J. P. H. (2016). Uh and um in children with autism spectrum disorders or language impairment. Autism Research, 9(8), 854–865. https://doi.org/10.1002/aur.1578
Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(5), 693–705. https://doi.org/10.1007/s10803-008-0674-3
Halladay, A. K., Bishop, S., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., Messinger, D., Pelphrey, K., Sanders, S. J., Singer, A. T., Taylor, J. L., & Szatmari, P. (2015). Sex and gender differences in autism spectrum disorder: Summarizing evidence gaps and identifying emerging areas of priority. Molecular Autism, 6(1), 36. https://doi.org/10.1186/s13229-015-0019-y
Happé, F., & Frith, U. (2020). Annual Research Review: Looking back to look forward—Changes in the concept of autism and implications for future research. Journal of Child Psychology and Psychiatry, 61(3), 218–232. https://doi.org/10.1111/jcpp.13176
Irvine, C. A., Eigsti, I.-M., & Fein, D. A. (2016). Uh, Um, and Autism: Filler disfluencies as pragmatic markers in adolescents with optimal outcomes from autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(3), 1061–1070. https://doi.org/10.1007/s10803-015-2651-y
Kover, S. T., Davidson, M. M., Sindberg, H. A., & Weismer, S. E. (2014). Use of the ADOS for assessing spontaneous expressive language in young children with ASD: A comparison of sampling contexts. Journal of Speech Language and Hearing Research, 57(6), 2221–2313. https://doi.org/10.1044/2014_jslhr-l-13-0330
Lake, J. (2008). Listener vs. speaker-oriented speech: Studying the speech of individuals with autism [PhD Thesis].
Lake, J., Humphreys, K. R., & Cardy, S. (2011). Listener vs. Speaker-oriented aspects of speech: Studying the disfluencies of individuals with autism spectrum disorders. Psychonomic Bulletin & Review, 18(1), 135–140. https://doi.org/10.3758/s13423-010-0037-x
Landa, R. (2000). Social language use in Asperger syndrome and high-functioning autism. In A. M. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 125–155). The Guilford Press.
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000). The autism diagnostic observation schedule, generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223. https://doi.org/10.1023/A:1005592401947
Loveland, K. A., Tunalia, B., Mcevoy, R. E., & Kelley, M. L. (1989). Referential communication and response adequacy in autism and Down’s syndrome. Applied Psycholinguistics, 10(3), 301–313. https://doi.org/10.1017/s014271640000864x
Lunsford, R. (2012). Toward improving dialogue coordination in spoken dialogue systems [PhD Thesis]. https://doi.org/10.6083/M4707ZF2
Lunsford, R., Heeman, P., Black, L., & Santen, J. (2010). Autism and the use of fillers: Differences between “um” and “uh.” Proceedings of DiSS-LPSS Joint Workshop, 2010, 107–110.
MacFarlane, H., Gorman, K., Ingham, R., Presmanes Hill, A., Papadakis, K., Kiss, G., & van Santen, J. (2017). Quantitative analysis of disfluency in children with autism spectrum disorder or language impairment. PLoS ONE, 12(3), 1–20. https://doi.org/10.1371/journal.pone.0173936
McGregor, K. K., & Hadden, R. R. (2020). Brief Report: “Um” fillers distinguish children with and without ASD. Journal of Autism and Developmental Disorders, 50(5), 1816–1821. https://doi.org/10.1007/s10803-018-3736-1
Miller, J., & Iglesias, A. (2012). SALT: Systematic analysis of language transcripts [Research version]. SALT Software.
Parish-Morris, J., Liberman, M. Y., Cieri, C., Herrington, J. D., Yerys, B. E., Bateman, L., Donaher, J., Ferguson, E., Pandey, J., & Schultz, R. T. (2017). Linguistic camouflage in girls with autism spectrum disorder. Molecular Autism, 8(1), 48–60. https://doi.org/10.1186/s13229-017-0164-6
Paul, R., Orlovski, S. M., Marcinko, H. C., & Volkmar, F. (2009). Conversational behaviors in youth with high-functioning ASD and Asperger syndrome. Journal of Autism and Developmental Disorders, 39(1), 115–125. https://doi.org/10.1007/s10803-008-0607-1
Prud’hommeaux, E. T., Roark, B., Black, L. M., & Van Santen, J. (2011). Classification of atypical language in autism. (pp. 88–96).
Prud’hommeaux, E. T., Van Santen, J., & Gliner, D. (2017). Vector space models for evaluating semantic fluency in autism. (pp. 32–37). https://doi.org/10.18653/v1/p17-2006
R Core Team. (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing.
Rouhizadeh, M., Sproat, R. W., & Santen, J. P. H. van. (2015). Similarity measures for quantifying restrictive and repetitive behavior in conversations of autistic children. In: Proceedings of the 2nd workshop on computational linguistics and clinical psychology: From linguistic signal to clinical reality, (pp. 117–123). https://doi.org/10.3115/v1/w15-1214
Rutter, M., Bailey, A., & Lord, C. (2003). Social communication questionnaire (SCQ). Western Psychological Services.
Salem, A. C., MacFarlane, H., Adams, J. R., Lawley, G. O., Dolata, J. K., Bedrick, S., & Fombonne, E. (2021). Evaluating atypical language in autism using automated language measures. Scientific Reports, 11(1), 10968. https://doi.org/10.1038/s41598-021-90304-5
Sattler, J. M., & Dumont, R. (2004). Assessment of children: WISC-IV and WPPSI-III supplement. Jerome M. Sattler.
Semel, E., Wiig, E., & Secord, W. (2004). Clinical evaluation of language fundamentals preschool (2nd ed.). Psychological Corporation.
Song, A., Cola, M., Plate, S., Petrulla, V., Yankowitz, L., Pandey, J., Schultz, R. T., & Parish-Morris, J. (2020). Natural language markers of social phenotype in girls with autism. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.13348
Tager-Flusberg, H., & Caronna, E. (2007). Language disorders: Autism and other pervasive developmental disorders. Language, Communication, and Literacy: Pathologies and Treatments, 54(3), 469–481. https://doi.org/10.1016/j.pcl.2007.02.011
Tager-Flusberg, H., & Kasari, C. (2013). Minimally verbal school-aged children with autism spectrum disorder: The neglected end of the spectrum. Autism Research, 6(6), 468–478. https://doi.org/10.1002/aur.1329
Tager-Flusberg, H., Paul, R., & Lord, C. (2005). Language and communication in autism. Handbook of autism and pervasive developmental disorders: Diagnosis, development, neurobiology, and behavior (3rd ed., Vol. 1, pp. 335–364). Wiley.
van Santen, J. P. H., Sproat, R. W., & Presmanes Hill, A. (2013). Quantifying repetitive speech in autism spectrum disorders and language impairment. Autism Research, 6(5), 372–383. https://doi.org/10.1002/aur.1301
Volden, J., Coolican, J., Garon, N., White, J., & Bryson, S. (2008). Brief Report: Pragmatic language in autism spectrum disorder: Relationships to measures of ability and disability. Journal of Autism and Childhood Schizophrenia, 39(2), 388. https://doi.org/10.1007/s10803-008-0618-y
Volden, J., & Phillips, L. (2010). Measuring pragmatic language in speakers with autism spectrum disorders: Comparing the children’s communication checklist–2 and the test of pragmatic language. American Journal of Speech-Language Pathology, 19(3), 204–212. https://doi.org/10.1044/1058-0360(2010/09-0011)
Wechsler, D. (2002). WPPSI-III: Wechsler preschool and primary scale of intelligence (3rd ed.). Psychological Corporation.
Wechsler, D. (2003). WISC-IV: Wechsler intelligence scale for children. Psychological Corporation.
Wendt, H. W. (1972). Dealing with a common problem in Social science: A simplified rank-biserial coefficient of correlation based on the U statistic. European Journal of Social Psychology, 2(4), 463–465. https://doi.org/10.1002/ejsp.2420020412
Wieling, M., Grieve, J., Bouma, G., Fruehwald, J., Coleman, J., & Liberman, M. (2016). Variation and change in the use of hesitation markers in Germanic languages. Language Dynamics and Change, 6(2), 199–234. https://doi.org/10.1163/22105832-00602001
Wittke, K., Mastergeorge, A. M., Ozonoff, S., Rogers, S. J., & Naigles, L. R. (2017). Grammatical language impairment in autism spectrum disorder: Exploring language phenotypes beyond standardized testing. Frontiers in Psychology, 8, 532. https://doi.org/10.3389/fpsyg.2017.00532
Wood-Downie, H., Wong, B., Kovshoff, H., Mandy, W., Hull, L., & Hadwin, J. A. (2021). Sex/gender differences in camouflaging in children and adolescents with autism. Journal of Autism and Developmental Disorders, 51(4), 1353–1364. https://doi.org/10.1007/s10803-020-04615-z
Young, E. C., Diehl, J. J., Morris, D., Hyman, S. L., & Bennetto, L. (2005). The use of two language tests to identify pragmatic language problems in children with autism spectrum disorders. Language, Speech, and Hearing Services in Schools, 36(1), 62–72. https://doi.org/10.1044/0161-1461(2005/006)
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This work was supported by the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health under Award R01DC012033 (PI: Dr. E. Fombonne).
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GOL, SB, and EF designed the study. GOL performed the statistical analysis and interpretation and wrote the manuscript. EF and SB assisted in the analysis and interpretation. SB, EF, and JKD provided expertise and guidance for the methodology and analysis. ACS and HM generated the ADOS transcripts. EF, HM, JKD, and ACS edited the manuscript. All authors contributed to the manuscript and approved its content.
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Lawley, G.O., Bedrick, S., MacFarlane, H. et al. “Um” and “Uh” Usage Patterns in Children with Autism: Associations with Measures of Structural and Pragmatic Language Ability. J Autism Dev Disord 53, 2986–2997 (2023). https://doi.org/10.1007/s10803-022-05565-4
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DOI: https://doi.org/10.1007/s10803-022-05565-4