We report the first study on pronoun use by an under-studied research population, children with autism spectrum disorder (ASD) exposed to American Sign Language from birth by their deaf parents. Personal pronouns cause difficulties for hearing children with ASD, who sometimes reverse or avoid them. Unlike speech pronouns, sign pronouns are indexical points to self and other. Despite this transparency, we find evidence from an elicitation task and parental report that signing children with ASD avoid sign pronouns in favor of names. An analysis of spontaneous usage showed that all children demonstrated the ability to point, but only children with better-developed sign language produced pronouns. Differences in language abilities and self-representation may explain these phenomena in sign and speech.
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Exceptions are the ASL signs we and our (Meier 1990).
As is conventional, we denote ASL signs with their English translations in small caps.
The linguistic status of personal pronouns in ASL and other signed languages has been a matter of continuing controversy (Cormier et al. 2013; McBurney 2002; Meier 1990; Meier and Lillo-Martin 2010). However, ASL unequivocally has points to self and points to addressee; for the purpose of this paper we label these points as first- and second-person pronouns.
Signed English is a system of manual signs that follows English grammar and thus is not considered an independent language.
We use non-parametric tests throughout this paper because assumptions of normality are violated.
We use Cohen’s d as a measure of effect size when comparing two means; a value greater than 0.8 typically represents a large effect.
A sign that functions as a unique name for a person, often invented by Deaf parents (Supalla 1992).
We also analyzed whether the group differences were significant in terms of who responded with names and who did not (rather than who produced pronouns and who did not), since some children produced both in their answer. The group difference was again significant under this criterion for both the first-person task (Fisher’s Exact Test, p < .05, one-tailed) and the second-person task (Fisher’s Exact Test, p < .0001, one-tailed).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Asendorpf, J. B. (2002). Self-awareness, other-awareness, and secondary representation. In A. N. Meltzoff & W. Prinz (Eds.), The imitative mind: development, evolution, and brain bases. Cambridge studies in cognitive perceptual development (pp. 63–73). New York: Cambridge University Press.
Baron-Cohen, S. (1989). Perceptual role taking and protodeclarative pointing in autism. British Journal of Developmental Psychology, 7, 113–127.
Bates, E., & Dick, F. (2002). Language, gesture, and the developing brain. Developmental Psychobiology, 40, 293–310.
Beykirch, H. L., Holcomb, T. A., & Harrington, J. F. (1990). Iconicity and sign vocabulary acquisition. American Annals of the Deaf, 135, 306–311.
Bischof-Kohler, D. (1994). Self-objectification and other-oriented emotions: Self-recognition, empathy, and prosocial behavior in the second year. Zeitschrift Fur Psychologie, 202, 349–377.
Brown, L., Sherbenou, R. J., & Johnsen, S. K. (2010). Test of Nonverbal Intelligence (4th ed.). Austin, TX: Pro-Ed.
Camaioni, L., Perucchini, P., Muratori, F., & Milone, A. (1997). A longitudinal examination of the communicative gestures deficit in young children with autism. Journal of Autism and Developmental Disorders, 27, 715–725.
Camaioni, L., Perucchini, P., Muratori, F., Parrinini, B., & Cesari, A. (2003). The communicative use of pointing in autism: Developmental profile and factors related to change. European Psychiatry, 18, 6–12.
Carmody, D. P., & Lewis, M. (2012). Self representation in children with and without autism spectrum disorders. Child Psychiatry and Human Development, 43, 227–237.
Casey, S. (2003). Relationships between gestures and signed languages: Indicating participants in action. In A. Baker, B. van den Bogaerde, & O. Crasborn (Eds.), Cross-linguistic perspectives in sign language research: Selected papers from TISLR 2000 (pp. 95–117). Hamburg: Signum.
Charney, R. (1980). Pronoun errors in autistic children: Support for a social explanation. International Journal of Language & Communication Disorders, 15, 39–43.
Chiat, S. (1982). If I were you and you were me: The analysis of pronouns in a pronoun-reversing child. Journal of Child Language, 9, 359–379.
Clark, E. V. (1978). From gesture to word: On the natural history of deixis in language acquisition. In J. S. Bruner & A. Garton (Eds.), Human growth and development: Wolfson College lectures 1976 (pp. 85–120). Oxford: Oxford University Press.
Cormier, K., Schembri, A., & Woll, B. (2013). Pronouns and pointing in sign languages. Lingua, 137, 230–247.
Enns, C. J., Zimmer, K., Boudreault, P., Rabu, S., & Broszeit, C. (2013). American Sign Language: Receptive Skills Test. Winnipeg, MB: Northern Signs Research Inc.
Evans, K. E., & Demuth, K. (2012). Individual differences in pronoun reversal: Evidence from two longitudinal case studies. Journal of Child Language, 39, 162–191.
Hatzopoulou, M. (2010). Acquisition of reference to self and others in Greek Sign Language (Stockholm University, 2008). Sign Language & Linguistics, 13, 83–91.
Hoza, J. (2011). The discourse and politeness functions of HEY and WELL in American Sign Language. In C. B. Roy (Ed.), Discourse in signed languages (pp. 69–95). Washington, DC: Gallaudet University Press.
Jackson, C. A. (1989). Language acquisition in two modalities: The role of nonlinguistic cues in linguistic mastery. Sign Language Studies, 62, 1–22.
Johnston, T. (2013). Towards a comparative semiotics of pointing actions in signed andspoken languages. Gesture, 13, 109–142.
Jordan, R. (1989). An experimental comparison of the understanding and use of speaker-addressee personal pronouns in autistic children. British Journal of Disorders of Communication, 24, 169–179.
Jure, R., Rapin, I., & Tuchman, R. (1991). Hearing-impaired autistic children. Developmental Medicine and Child Neurology, 33, 1062–1072.
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.
Klima, E. S., & Bellugi, U. (1979). The signs of language. Cambridge, MA: Harvard University Press.
Konstantareas, M. M., Oxman, J., & Webster, C. D. (1982). The representational and information-processing foundations of linguistic functioning in autistic children. Neurolinguistics, 11, 93–123.
Lee, A., Hobson, R. P., & Chiat, S. (1994). I, you, me, and autism: An experimental study. Journal of Autism and Developmental Disorders, 24, 155–176.
Lewis, M., & Brooks-Gunn, J. (1979). Social cognition and the acquisition of self. New York: Plenum Press.
Lewis, M., & Ramsay, D. (2004). Development of self-recognition, personal pronoun use, and pretend play during the 2nd year. Child Development, 75, 1821–1831.
Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism Diagnostic Observation Schedule, (ADOS-2) (2nd ed.). Torrance, CA: Western Psychological Services.
Mayberry, R. I., & Eichen, E. B. (1991). The long-lasting advantage of learning sign language in childhood: Another look at the critical period for language acquisition. Journal of Memory and Language, 30, 486–512.
Mayberry, R. I., Lock, E., & Kazmi, H. (2002). Development: Linguistic ability and early language exposure. Nature, 417, 38.
McBurney, S. (2002). Pronominal reference in signed and spoken language: Are grammatical categories modality-dependent? In R. P. Meier, K. Cormier, & D. Quinto-Pozos (Eds.), Modality and structure in signed and spoken languages (pp. 329–369). Cambridge: Cambridge University Press.
Meier, R. P. (1982). Icons, analogues and morphemes: The acquisition of verb agreement in ASL (Doctoral Dissertation). San Diego: University of California.
Meier, R. P. (1987). Elicited imitation of verb agreement in American Sign Language: Iconically or morphologically determined? Journal of Memory and Language, 26(3), 362–376.
Meier, R. P. (1990). Person deixis in American Sign Language. In S. D. Fischer & P. Siple (Eds.), Theoretical issues in sign language research: Linguistics (Vol. 1, pp. 175–190). Chicago: University of Chicago Press.
Meier, R. P. (2002). The acquisition of verb agreement: Pointing out arguments for the linguistic status of agreement in signed languages. In G. Morgan & B. Woll (Eds.), Directions in sign language acquisition (pp. 115–141). Amsterdam: John Benjamins.
Meier, R. P., & Lillo-Martin, D. (2010). Does spatial make it special? On the grammar of pointing signs in American Sign Language. In D. B. Gerdts, J. Moore, & M. Polinsky (Eds.), Hypothesis A/hypothesis B: Linguistic explorations in honor of David M. Perlmutter (pp. 345–360). Cambridge, MA: MIT Press.
Meinzen-Derr, J., Wiley, S., Bishop, S., Manning-Courtney, P., Choo, D. I., & Murray, D. (2014). Autism spectrum disorders in 24 children who are deaf or hard of hearing. International Journal of Pediatric Otorhinolaryngology, 78, 112–118.
Morgan, G., Barriere, I., & Woll, B. (2006). The influence of typology and modality on the acquisition of verb agreement morphology in British Sign Language. First Language, 26, 19–43.
Newport, E. L., & Meier, R. P. (1985). The acquisition of American Sign Language. In D. I. Slobin (Ed.), The crosslinguistic study of language acquisition. The data (Vol. 1, pp. 881–938). Hillsdale, NJ: Erlbaum.
Ohta, M. (1987). Cognitive disorders of infantile autism: A study employing the WISC, spatial relationship conceptualization, and gesture imitations. Journal of Autism and Developmental Disorders, 17, 45–62.
Oshima-Takane, Y. (1992). Analysis of pronominal errors: A case-study. Journal of Child Language, 19, 111–131.
Oshima-Takane, Y., & Benaroya, S. (1989). An alternative view of pronominal errors in autistic children. Journal of Autism and Developmental Disorders, 19, 73–85.
Padden, C. (1983). Interaction of morphology and syntax in American Sign Language (Doctoral Dissertation). San Diego: University of California.
Petitto, L. A. (1983). From gesture to symbol: The relationship between form and meaning in the acquisition of personal pronouns in American Sign Language. Papers and Reports on Child Language Development, 22, 100–107.
Petitto, L. A. (1987). On the autonomy of language and gesture: Evidence from the acquisition of personal pronouns in American Sign Language. Cognition, 27, 1–52.
Pizzuto, E. (1990). The early development of deixis in American Sign Language: What is the point? In V. Volterra & C. Erting (Eds.), From gesture to language in hearing and deaf children (pp. 142–162). Washington, DC: Gallaudet University Press.
Ritvo, E. R., Ritvo, R., Freeman, B. J., & Mason-Brothers, A. (1994). Clinical characteristics of mild autism in adults. Comprehensive Psychiatry, 35, 149–156.
Rogers, S. J., & Pennington, B. F. (1991). A theoretical approach to the deficits in infantile autism. Development and Psychopathology, 3, 137–162.
Roper, L., Arnold, P., & Monteiro, B. (2003). Co-occurrence of autism and deafness: Diagnostic considerations. Autism, 7, 245–253.
Rutter, M., Bailey, A., & Lord, C. (2003). Social Communication Questionnaire. Los Angeles: Western Psychological Services.
Schick, B., de Villiers, P., de Villiers, J., & Hoffmeister, R. (2007). Language and theory of mind: A study of deaf children. Child Development, 78, 376–396.
Schiff-Myers, N. B. (1983). From pronoun reversals to correct pronoun usage: A case study of a normally developing child. Journal of Speech and Hearing Disorders, 48, 394–402.
Schlosser, R. W., & Wendt, O. (2008). Effects of augmentative and alternative communication intervention on speech production in children with autism: A systematic review. American Journal of Speech-Language Pathology, 17, 212.
Shield, A., & Meier, R. P. (2012). Palm reversal errors in native-signing children with autism. Journal of Communication Disorders, 45, 439–454.
Smiley, P. A., Chang, L. K., & Allhoff, A. K. (2011). Can Toddy give me an orange? Parent input and young children’s production of I and You. Language Learning and Development, 7, 77–106.
Smith, I. M. (1998). Gesture imitation in autism I: Nonsymbolic postures and sequences. Cognitive Neuropsychology, 15, 747–770.
Supalla, S. J. (1992). The book of name signs: Naming in American Sign Language. San Diego, CA: DawnSignPress.
Tager-Flusberg, H. (1994). Dissociations in form and function in the acquisition of language by autistic children. In H. Tager-Flusberg (Ed.), Constraints on language acquisition: Studies of atypical children (pp. 175–194). Hillsdale, NJ: Lawrence Erlbaum Associates.
Tager-Flusberg, H., & Kasari, C. (2013). Minimally verbal school-aged children with autism spectrum disorder: The neglected end of the spectrum. Autism Research, 6, 468–478.
Thompson, R. L., Vinson, D. P., & Vigliocco, G. (2009). The link between form and meaning in American Sign Language: Lexical processing effects. Journal of Experimental Psychology: Learning, Memory, and Cognition, 35, 550–557.
Vinson, D. P., Cormier, K., Denmark, T., Schembri, A., & Vigliocco, G. (2008). The British Sign Language (BSL) norms for age of acquisition, familiarity, and iconicity. Behavioral Research Methods, 40, 1079–1087.
Whiten, A., & Brown, J. (1998). Imitation and the reading of other minds: Perspectives from the study of autism, normal children and non-human primates. In S. Bråten (Ed.), Intersubjective communication and emotion in early ontogeny (pp. 260–280). Cambridge: Cambridge University Press.
The authors thank J. Pyers and R. Hoffmeister for help with the study design, S. Butler Koestler and D. Mood for conducting the ADOS evaluations, B. Makofske for evaluating clinical impression, T. Sampson and M. Gandhi for coding data, A. Marks for taking photos, F. Ramont for modeling signs, and the schools, parents, administrators, teachers, and children who made this research possible. This study was supported by a postdoctoral fellowship to the first author from the National Institute on Deafness and Other Communication Disorders (Grant Number #F32-DC011219) and a research enhancement grant from the Autism Science Foundation to the first author.
Modifications to the ADOS-2 Administered to Deaf Participants
In order to administer the ADOS-2 to children who are deaf and communicate using ASL, several modifications were made. The test authors (Lord et al. 2012) clearly indicate that the ADOS-2 is not intended to be used with children with hearing loss. However, the ADOS-2 is commonly used in clinical practice among professionals trained in working with children who are deaf or hard of hearing, in order to gather information regarding social communication and behavior in a semi-structured format. Currently, there are no published best-practice guidelines regarding appropriate modifications to the ADOS-2 when used with this population. For the purposes of this study, modifications were made based on the examiner’s clinical experience. Where possible, every effort was made to adhere as closely as possible to standardized test procedures. Otherwise, modifications that were made were intended to be consistent across subjects. The following describes the modifications that were made regarding (1) module selection; (2) task selection and administration; and (3) scoring.
In order to administer the ADOS-2, a module based on the child’s language level must be chosen. It is standard practice in choosing a module to count signs as gestures rather than words. However, doing so would underestimate the language ability of deaf, signing children. Therefore, for the purposes of this study, children’s use of ASL signs was considered equivalent to spoken language and was not scored as being gestures (e.g., two to three signs paired together were considered equivalent to spoken “phrase speech”; combining two thoughts through complex signed phrases was considered equivalent to “fluent speech”). Module selection was therefore based on the examinee’s fluency in sign language (e.g., an examinee communicating only in sign language using complex signed phrases was administered a Module 3, rather than a Module 1 as would be indicated if signs were considered equivalent to gestures).
Due to differences between the modalities of sign and speech, it was also necessary to modify several tasks. Directions for all tasks were translated into ASL. The Response to Name task was administered with modifications. The examiner first presented the examinee’s name sign within their peripheral vision (three times). If the examinee did not respond, attention-getting procedures not involving touch that are typically used within Deaf culture were administered (e.g., tapping on the ground, waving within the individual’s line of sight). If the examinee did not respond, standardized directions for attempting to get the examinee’s attention first by implying they would be tickled and then by tickling them were administered (either by the examiner or a parent, if available).
An effort was made to adhere to standardized procedures for administering Joint Attention. Modifications to standardized statements included using the sign see or look + a head turn, without the directional element of that sign, during initial presses. The sign see was then paired with a point on the last press.
Demonstration Task was modified by fingerspelling elements of directions rather than using signs which were iconic in nature and/or providing an alternative task such as making a bowl of cereal. When it was necessary to administer Anticipation of Social Routine to older children with limited language, the peekaboo task was modified to be more age-appropriate. Signed instructions for Functional Symbolic Imitation were modified incorporating appropriate ASL classifiers to maintain the task’s intention (e.g., airplane + 5 handshape in a forward, flying motion).
Modifications to codes and scoring algorithms were also necessary. For the purpose of this paper, only modified codes are reported and only modifications affecting scoring algorithms are reported in the chart (Table 6).
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Shield, A., Meier, R.P. & Tager-Flusberg, H. The Use of Sign Language Pronouns by Native-Signing Children with Autism. J Autism Dev Disord 45, 2128–2145 (2015). https://doi.org/10.1007/s10803-015-2377-x
- Sign language
- Autism spectrum disorder
- Language development