Pragmatic Language in Autism: An Overview

  • Yan Grace Lam


Pragmatics concerns with the acquisition of knowledge necessary for the appropriate and effective use of language in everyday social contexts. It is well known that pragmatic deficits are symptomatic of children with Autism Spectrum Disorders, but little is known about how they are related to the cardinal features of the disorders.

In this chapter, studies on pragmatic behaviors specific to Autism Spectrum Disorders were reviewed. Issues pertaining to methodologies and interpretation of findings were addressed. Findings from previous studies were discussed in relation to the prevalent cognitive impairments and brain anomalies observed in Autism Spectrum Disorders. Future efforts should be directed to define the domain of inquiry as well as to develop tools that can detect pragmatic skills at different developmental stage.


Autism Spectrum Disorder Emotion Perception Weak Central Coherence Pragmatic Language Brain Anomaly 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Abell F, Krams M, Ashburner J, Passinghan R, Friston K, Frackowiak R, et al. The neuroanatomy of autism: a voxel-based whole brain analysis of structural scans. Neuroreport. 1999;10:1647–51.PubMedCrossRefGoogle Scholar
  2. Alexander MP, Benson DF, Stuss DT. Frontal lobes and language. Brain Lang. 1989;37:656–91.PubMedCrossRefGoogle Scholar
  3. Baron-Cohen S, Ring HS, Bullmore ET, Wheelwright S, Ashwin C, Williams SCR. The amygdala theory of autism. Neurosci Biobehav Rev. 2000;24:355–64.PubMedCrossRefGoogle Scholar
  4. Bartak L, Rutter M, Cox AA. A comparative study of infantile autism and specific developmental receptive language disorder. Br J Psychiatry. 1975;126:127–45.PubMedCrossRefGoogle Scholar
  5. Beisler JM, Tsai CY, Von KD. Comparisons between autistic and nonautistic children on the test for auditory comprehension of language. J Autism Dev Disord. 1987;17:95–102.PubMedCrossRefGoogle Scholar
  6. Bihrle AM, Brownell HH, Powelson JA, Gardner H. Comprehension of humorous and non-humorous materials by left and right brain-damaged patients. Brain Cogn. 1986;5:399–411.PubMedCrossRefGoogle Scholar
  7. Bishop D. Development of the children’s communication checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children. J Child Psychol Psychiatry. 1998;39:879–91.PubMedCrossRefGoogle Scholar
  8. Bishop DVM. The children’s communication checklist. 2nd ed. London: The Psychological Corporation Limited; 2003.Google Scholar
  9. Buitelaar JK, van-der-Wees M, Swabb-Barneveld H, Van-der-Gaag RJ. Theory of mind and emotion-recognition functioning in autistic spectrum disorders and in psychiatric control and normal children. Dev Psychopathol. 1999;11:39–58.PubMedCrossRefGoogle Scholar
  10. Cantwell D, Baker I, Rutter M. A comparative study of infantile autism and specific developmental receptive language disorder: IV. Analysis of syntax language and language function. J Child Psychol Psychiatry. 1978;19:351–62.PubMedCrossRefGoogle Scholar
  11. Carper RA, Courchesne E. Inverse correlation between frontal lobe and cerebellum sizes in children with autism. Brain. 2000;123:836–44.PubMedCrossRefGoogle Scholar
  12. Carrow-Woolfolk E. Comprehensive assessment of spoken language. Circle Pines: American Guidance Service; 1999.Google Scholar
  13. Carter R. Mapping the mind. London: Phoenix; 1998.Google Scholar
  14. Courchesne E, Yeung CR, Press GA, Hesselink JR, Jernigan TL. Hypoplasia of cerebellar vermal lobules VI and VII in autism. N Engl J Med. 1988;318:1349–54.PubMedCrossRefGoogle Scholar
  15. Damasio AR, Maurer RG. Neurological model for childhood autism. Arch Neurol. 1978;35:777–86.PubMedCrossRefGoogle Scholar
  16. De Villiers J, Fine J, Ginsberg G, Vaccarella L, Szatmari P. Brief report: a scale for rating conversational impairment in autism spectrum disorder. J Autism Dev Disord. 2007;37:1375–80.PubMedCrossRefGoogle Scholar
  17. Denckla MB. The neuropsychology of social-emotional learning disabilities. Arch Neurol. 1983;40:461–2.PubMedCrossRefGoogle Scholar
  18. Eisenmajer R, Prior M. Cognitive linguistic correlates of “theory of mind” ability in autistic children. Br J Dev Psychol. 1991;9:351–64.CrossRefGoogle Scholar
  19. Fuster JM. The prefrontal cortex of the primate: a synopsis. Psychobiology. 2000;28:125–31.Google Scholar
  20. Gagnon L, Mottron L, Joanette Y. Questioning the validity of the semantic-pragmatic syndrome diagnosis. Autism. 1997;1:37–55.CrossRefGoogle Scholar
  21. Gedye A. Frontal lobe seizures in autism. Med Hypotheses. 1991;34:174–82.PubMedCrossRefGoogle Scholar
  22. Hale CM, Tager-Flusberg H. The relationship between theory of mind and discourse development. Autism. 2005;9:157–78.PubMedCrossRefGoogle Scholar
  23. Happe F. Autism: cognitive deficit or cognitive style? Trends Cogn Sci. 1999;3:216–22.PubMedCrossRefGoogle Scholar
  24. Happe F, Frith U. The neuropsychology of autism. Brain. 1996;119:1377–400.PubMedCrossRefGoogle Scholar
  25. Joanette Y, Goulet P, Hannequin D. Right hemisphere and verbal communication. New York: Springer; 1990.CrossRefGoogle Scholar
  26. Joseph R. Neuropsychology, neuropsychiatry, and clinical neuroscience. 2nd ed. Baltimore: Williams & Wilkins; 1996.Google Scholar
  27. Joseph RM, McGrath LM, Tager-Flusberg H. Executive dysfunction and its relation to language ability in verbal school-age children with autism. Dev Neuropsychol. 2005;27:361–78.PubMedCrossRefGoogle Scholar
  28. Lam YG. The relationship of pragmatic language deficits and cognitive impairments in high-functioning autism. Unpublished doctoral thesis. Hong Kong: University of Hong Kong.Google Scholar
  29. Lam YG, Yeung SSS. Towards a convergent account of pragmatic language deficits in children with high-functioning autism: depicting the phenotype using the pragmatic rating scale. Res Autism Spectrum Disord. 2012;6(2):792–7.CrossRefGoogle Scholar
  30. Landa R. Social language use in Asperger’s syndrome and high-functioning autism. In: Klin A, Volkmar FR, Sparrow SS, editors. Asperger syndrome. New York: Guilford Press; 2000. p. 159–71.Google Scholar
  31. Landa RJ, Goldberg MC. Language, social, and executive functions in high-functioning autism: a continuum of performance. J Autism Dev Disord. 2005;35:557–73.PubMedCrossRefGoogle Scholar
  32. Landa R, Piven J, Wzorek MM, Gayle JO, Chase GA, Folstein SE. Social language use in parents of autistic individuals. Psychol Med. 1992;22:245–54.PubMedCrossRefGoogle Scholar
  33. Loveland K, Landry S, Hughes S, Hall S, McEvoy R. Speech acts and the pragmatic deficits in autism. J Speech Hear Res. 1988;31:593–604.PubMedGoogle Scholar
  34. Martin I, McDonald S. Weak coherence, no theory of mind, or executive dysfunction? Solving the puzzle of pragmatic language disorders. Brain Lang. 2003;85:451–66.PubMedCrossRefGoogle Scholar
  35. McAlonan GM, Daly E, Kumari V, Critchley HD, van Amelsvoort T, Suckling J, et al. Brain anatomy and sensorimotor gating in Asperger’s syndrome. Brain. 2002;125:1594–606.PubMedCrossRefGoogle Scholar
  36. McDonald S. Differential pragmatic language loss after closed head injury: ability to comprehend conversational implicature. Appl Psycholinguist. 1992;13:295–312.CrossRefGoogle Scholar
  37. McDonald S. Pragmatic language skills after closed head injury: ability to meet the informational needs of the listener. Brain Lang. 1993;44:28–46.PubMedCrossRefGoogle Scholar
  38. McDonald S, Pearce S. The “dice” game: a new test of pragmatic language skills after closed-head injury. Brain Inj. 1995;9:255–71.PubMedCrossRefGoogle Scholar
  39. McDonald S, Van-Sommers P. Pragmatic language skills after closed head injury: ability to negotiate requests. Cogn Neuropsychol. 1993;10:297–315.CrossRefGoogle Scholar
  40. Mesibov GB, Adams LW, Klinger LG. Understanding the disorder. New York: Plenum; 1997.Google Scholar
  41. Molloy R, Brownell HH, Gardner H. Discourse comprehension by right hemisphere stroke patients: deficits in prediction and revision. In: Joanette Y, Brownell HH, editors. Discourse ability and brain damage: theoretical and empirical perspectives. New York: Springer; 1990. p. 113–30.CrossRefGoogle Scholar
  42. Murphy DGM, Critchley HD, Schmitz N, McAlonan GM. Asperger syndrome: a proton magnetic resonance spectroscopy study of brain. Arch Gen Psychiatry. 2002;59:885–91.PubMedCrossRefGoogle Scholar
  43. Norbury CF, Bishop DM. Narrative skills of children with communication impairments. Int J Lang Commun Disord. 2003;38(3):287–313.PubMedCrossRefGoogle Scholar
  44. Novoa OP, Ardila A. Linguistic abilities in patients with prefrontal damage. Brain Lang. 1987;30:206–25.PubMedCrossRefGoogle Scholar
  45. Ozonoff S. Executive function in autism. In: Schopler E, Mesibov GB, editors. Learning and cognition in autism. New York: Plenum; 1995.Google Scholar
  46. Ozonoff S, Miller JN. Teaching theory of mind: a new approach to social skills training for individuals with autism. J Autism Dev Disord. 1995;25:415–33.PubMedCrossRefGoogle Scholar
  47. Ozonoff S, Miller JN. An exploration of right-hemisphere contributions to the pragmatic impairments of autism. Brain Lang. 1996;52:411–34.PubMedCrossRefGoogle Scholar
  48. Paul R. Communication. In: Cohen DJ, Donnellan A, editors. Handbook of autism and pervasive developmental disorders. New York: Wiley; 1987. p. 61–84.Google Scholar
  49. Paul R. Language disorders from infancy through adolescence: assessment and intervention. St. Louise: Mosby; 1995.Google Scholar
  50. Paul R, Orlovski, Marcinko HC, Volkmar F. Conversational behaviors in youth with high-functioning ASD. J Autism Dev Disord. 2009;39:115–25.PubMedCrossRefGoogle Scholar
  51. Pennington BF, Ozonoff S. Executive functions and developmental psychopathology. J Child Psychol Psychiatry. 1996;37:51–87.PubMedCrossRefGoogle Scholar
  52. Phelps-Terasaki D, Phelps-Gunn T. Test of pragmatic language (ToPL). San Antonio: Pearson; 1992.Google Scholar
  53. Philofsky A, Fidler DJ, Hepburn S. Pragmatic language profiles of school-age children with autism spectrum disorders and Williams syndrome. Am J Speech Lang Pathol. 2007;16:368–80.PubMedCrossRefGoogle Scholar
  54. Piven J, Arndt S, Bailey J, Andreasen N. Regional brain enlargement in autism: an MRI study. J Am Acad Child Adolesc Psychiatry. 1996;35:530–6.PubMedCrossRefGoogle Scholar
  55. Piven J, Palmer P, Landa R, Santangelo S, Jacobi D, Childress D. Personality and language characteristics in parents from multiple-incidence autism families. Am J Med Genet. 1997;74:398–411.PubMedCrossRefGoogle Scholar
  56. Ramondo N, Milech D. The nature and specificity of the language coding deficit in autistic children. Br J Psychol. 1984;75:95–103.PubMedCrossRefGoogle Scholar
  57. Rapin I. Developmental dysphasia and autism in pre-school children: characteristics and subtypes. London: AFASIC; 1987.Google Scholar
  58. Reichow B, Salamack S, Paul R, Volkmar FR, Klin A. Pragmatic assessment in autism spectrum disorders: a comparison of a standard measure with parent report. Commun Disord Q. 2008;29:169–76.PubMedCrossRefGoogle Scholar
  59. Rolls ET. On the brain and emotion. Behav Brain Sci. 2000;23:219–33.CrossRefGoogle Scholar
  60. Rumsey JM, Hanahan AP. Getting it “right”: performance of high-functioning autistic adults on a right hemisphere battery. J Clin Exp Neuropsychol. 1990;12:81.Google Scholar
  61. Russell R, Grizzle KL. Assessing child and adolescent pragmatic language competencies: toward evidence-based assessments. Clin Child Fam Psychol Rev. 2008;11:59–73.PubMedCrossRefGoogle Scholar
  62. Shields JR. Semantic-pragmatic disorder: a right hemisphere syndrome? Br J Disord Commun. 1991;26:383–92.PubMedCrossRefGoogle Scholar
  63. Shields J, Varley R, Broks P, Simpson A. Hemispheric function in developmental language disorders and high-level autism. Dev Med Child Neurol. 1996a;38:473–86.PubMedCrossRefGoogle Scholar
  64. Shields J, Varley R, Broks P, Simpson A. Social cognition in developmental language disorders and high-level autism. Dev Med Child Neurol. 1996b;38:487–95.PubMedCrossRefGoogle Scholar
  65. Strong CJ. The strong narrative assessment procedure. Madison: Thinking Publications; 1998.Google Scholar
  66. Tager-Flusberg H. On the nature of linguistic functioning in early infantile autism. J Autism Dev Disord. 1981;11:45–56.PubMedCrossRefGoogle Scholar
  67. Tager-Flusberg H. A psycholinguistic perspective on language development in the autistic child. In: Dawson G, editor. Autism: nature, diagnosis, and treatment. New York: Guilford; 1989. p. 92–115.Google Scholar
  68. Tager-Flusberg H. Semantic processing in the free recall of autistic children: further evidence for a cognitive deficit. Br J Dev Psychol. 1991;9:417–30.CrossRefGoogle Scholar
  69. Tager-Flusberg H. Autistic children’s talk about psychological states: deficits in the early acquisition of a theory of mind. Child Dev. 1992;63:161–72.PubMedCrossRefGoogle Scholar
  70. Tager-Flusberg H. What language reveals about the understanding of minds in children with autism. In: Baron-Cohen S, Tager-Flusberg H, Cohen DJ, editors. Understanding other minds: perspectives from autism. Oxford: Oxford University Press; 1993.Google Scholar
  71. Tager-Flusberg H. The relationship between language and social cognition: lessons from autism. In: Levy Y, editor. Other children, other languages: issues in the theory of language acquisition. Hillsdale: Erlbaum; 1994. p. 359–81.Google Scholar
  72. Tager-Flusberg H. Language and understanding minds: connections in autism. In: Baron-Cohen S, Tager-Flusberg H, Cohen DJ, editors. Understanding other minds: perspectives from developmental cognitive neuroscience. Oxford: Oxford University Press; 2000. p. 124–49.Google Scholar
  73. Tager-Flusberg H, Anderson M. The development of contingent discourse ability in autistic children. J Child Psychol Psychiatry. 1991;32:1123–34.PubMedCrossRefGoogle Scholar
  74. Tager-Flusberg H, Sullivan K. Predicting and explaining behavior: a comparison of autistic, mentally retarded and normal children. J Child Psychol Psychiatry. 1994a;35:1059–75.PubMedCrossRefGoogle Scholar
  75. Tager-Flusberg H, Sullivan K. A second look at second-order belief attribution in autism. J Autism Dev Disord. 1994b;24:577–86.PubMedCrossRefGoogle Scholar
  76. Tager-Flusberg H, Sullivan K. Attributing mental states to story characters: a comparison of narratives produced by autistic and mentally retarded individuals. Appl Psycholinguist. 1995;16:241–56.CrossRefGoogle Scholar
  77. Tanaka Y. Exploring the language pragmatics disabilities in autism spectrum disorders. Japan Psychol Rev. 2007;50:54–63.Google Scholar
  78. Temple CM. The brain: an introduction to human brain and behavior. London: Penguin; 1993.Google Scholar
  79. Thompson L. Children talking: the development of pragmatic competence. Clevedon: Multilingual Matters; 1997.Google Scholar
  80. Verte S, Geurts HM, Roeyers H, Rosseel Y, Oosterlaan J, Sergeant JA. Can the children’s communication checklist differentiate autism spectrum subtypes? Autism. 2006;10:266–87.PubMedCrossRefGoogle Scholar
  81. Volden J, Lord C. Neologisms and idiosyncratic language in autistic speakers. J Autism Dev Disord. 1991;21:109–30.PubMedCrossRefGoogle Scholar
  82. Volden J, Philips L. Measuring pragmatic language in speakers with autism spectrum disorders: comparing the children’s communication checklist-2 and the test of pragmatic language. Am J Speech Lang Pathol. 2010;19:204–12.PubMedCrossRefGoogle Scholar
  83. Volden J, Mulcahy RF, Holdgrafer G. Pragmatic language disorder and perspective taking in autistic speakers. Appl Psycholinguist. 1997;18:181–98.CrossRefGoogle Scholar
  84. Waterhouse L, Fein D. Language skills in developmentally disabled children. Brain Lang. 1982;15:307–33.PubMedCrossRefGoogle Scholar
  85. Wetherby AM, Prutting CA. Profiles of communicative and cognitive-social abilities in autistic children. J Speech Hear Res. 1984;27:364–77.PubMedGoogle Scholar
  86. Weylman ST, Brownell HH, Gardner H. “It’s not you mean, not what you say”: pragmatic language use in brain-damaged patients. In: Plum F, editor. Language, communication, and the brain. New York: Raven; 1988. p. 229–43.Google Scholar
  87. Young E, Diehl J, Morris D, Hyman S, Bennetto L. The use of two language tests to identify pragmatic language problems in children with autism spectrum disorders. Language Speech and Hearing Services in Schools. 2005;36:62–72.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Psychological StudiesHong Kong Institute of EducationTaipo, New TerritoriesHong Kong

Personalised recommendations