Specific Language Impairment in Children with High-Functioning Autism Spectrum Disorder

By Pamela Lim (Inquiries, 2018, VOL. 10 NO. 05)

Autism Spectrum Disorders (ASD) are among the most common neurodevelopmental disorders. According to the Centers for Disease Control and Prevention (CDC), studies in Asia, Europe, and North America have identified individuals with ASD with an average prevalence of about 1% (CDC, 2015). ASDs are typically diagnosed in early childhood, often at or before preschool age.

However, there is no specific genetic test or clinical procedure for diagnosis. Diagnosis is based mainly on documented core impairments related to social interaction, communication, as well as restricted and repetitive behavior (American Psychiatric Association, 2013). In addition to impairments in the core symptom areas, many individuals with ASD also have impaired cognitive skills, atypical sensory behaviors, or other complex medical and psychiatric symptoms and conditions, such as seizure disorders, motor impairments, hyperactivity, anxiety, and self-injury/aggression. According to the DSM-5, individuals who meet the specified criteria are given the diagnosis of "autism spectrum disorder (ASD)" with one of three levels of severity. Level of severity is defined in terms of the amount of support needed in the area of social communication and with restricted, repetitive behaviors. The DSM-5 also recognizes severity may vary by context and fluctuate over time. Severity ratings are used for descriptive purposes only and not to diagnose or determine eligibility for services (APA, 2013).

Abnormal use of language (pragmatics), particularly in social communication and social interaction is the most striking feature of autism (Belkadi, 2006). However, the difficulties individuals with autism have with speech and language are very heterogeneous and could be contributed by a number of different factors (Gabig, 2011). Furthermore, individuals with autism frequently have deficits in paying attention to auditory information (Mody et al., 2013). They have to be trained to pay attention to sounds. Even when they are paying attention, they have difficulty in decoding what sounds mean and in matching them to words or thoughts.

Children with autism, especially those who require moderate to high level of support, often have difficulties with articulation (Gabig, 2011). This could be part of a broader problem of difficulty with oral-motor function. On the other hand, research has shown individuals with autism are better with paying attention and appreciating visual materials (Mody et al., 2013; Gabig, 2011). Therefore, the visual route is one way of getting access to their minds and giving them a way of expressing themselves.

Language Processing in the ASD Brain. Children with ASD can differ extensively in the extent of communication impairment. Up to fifty per cent of children with ASD are unable to speak throughout life (Groen, Zwiers, Van der Gaag, & Buitelaar, 2008). However, there is a subgroup who can communicate within the normal range of function.

There is also a subgroup of children with ASD who show deficits in certain aspects of language. They could be having problems in one or more of the following aspects: auditory processing, vocabulary production, perception of phonemes (the building blocks of words), higher-order semantics, syntax, pragmatics, or prosody (Rescorla & Safyer, 2013). Semantics refers to the meaning of words and this is the most common linguistic deficit in children and adolescents with ASD. Syntax means the language rules for combining words into phrases and sentences, and for understanding the relationship among words. Pragmatics is the implied meaning underlying a sentence, such as irony or satire. Prosody is the pitch, tone, rhythm, or intonation of a sentence (Groen et al., 2008). Some of these children would often communicate with reduced length sentences.

Research has shown impairment can occur in both the comprehension and production of language, however, there is greater impairment in comprehension (Belkadi, 2006; Hudry et al., 2010). These children have demonstrated reduced brain activation in prefrontal and temporal brain regions under scenarios that involve irony (Groen et al., 2008). They can also be impaired in their understanding of nonverbal cues from others. These nonverbal cues include discerning intentions and making rapid intuitive judgments of social context. Children with ASD who are high-functioning, are found to particularly have difficulty in recognizing negative facial expressions (Chapman & Baron-Cohen, 2006).

There are obvious differences in the brain structures between neurotypical children and children with ASD (Dawson, 2008). Functional imaging studies have found reduced activation in Broca’s area in contrast to Wernicke’s area. The reduced activation in Broca’s area could indicate a deficit in integrating the meaning of words within sentences, hence, impeding comprehension. The left lateralization, or specialization, of language processing seen in neurotypical children can also be reversed in children with ASD (Hodge et al., 2010). They are found to have larger language areas in the right cerebral cortex.

Children with Specific Language Impairment. Children with specific language impairment (SLI) show a significant deficit in spoken and written language that cannot be attributed to neurological damage, hearing impairment, or intellectual disability (Webster & Shevell, 2004). SLI is more prevalent than autism and affects approximately seven percent of all children. It is a longstanding condition with adverse effects on the child’s academic and social standing. Diagnosis is based on behavioral evaluation and research has shown that cause of the impairment is likely to have a genetic basis. Children with SLI is a heterogeneous group, and exhibit deficits in comprehension and/or production across any of the five language domains (i.e., phonology, morphology, syntax, semantics, pragmatics). Language disorders may persist across the lifespan, and symptoms may change over time. They exhibit problems in their ability to use grammatical morphemes, verbal inflection and rapid auditory processing. Some have impairment in one specific area, others might display problems in all the different areas. There would also be children who do not have spoken language disorder, but struggle with reading and written expression (Webster & Shevell, 2004).

For these children with SLI, there are usually deficits in morphological awareness (e.g., derivational morphemes, such as prefixes and suffixes, including inflectional morphology, such as plural, present progressive, and past tense markers). They would omit the use of function morphemes long after age-matched children with typical language development show consistent production of these elements (Dockrell, Ricketts, Palikara, Charman, & Lindsay, 2012). Errors occurred most often on verbs (especially verb endings, auxiliary verbs, and past tense marking of regular and irregular forms), function words (e.g., articles and prepositions), and pronouns. These errors occur more frequently as a result of omission rather than misuse. However, occurrence of both error types may be inconsistent. They would have problems judging grammaticality—identifying and correcting grammatical errors and identifying parts of speech. As a result, they have problems comprehending and using complex syntactic structures (Dockrell et al., 2012). It is also common to find them struggling with curriculum-related expository discourse production, and comprehending morphologically complex words that are common in academic subjects, especially at the higher levels.

Research has shown that children with SLI display abnormalities in neurodevelopment of their fronto-corticocerebellar circuits (Hodge et al., 2010). These circuits manage motor control and the processing of language, cognition, working memory, and attention. Neuroimaging studies have also shown brain structure and function abnormalities in Broca’s area, specifically the inferior frontal gyrus (IFG) language-association cortex (Hodge et al., 2010). As a result, language comprehension and processing in children with SLI are comparatively slower and less mature than age-matched children who are developmentally normal in their language functions.

Вариант 8

Задание 1. Напишите академическое эссе на русском языке (темы на выбор предложены в приложении 1).

Задание 2. Оформите результаты вашего диссертационного исследования 1) в виде научных тезисов на русском языке (требования представлены в приложении 2) в виде речи на защите диссертации.

Задание 3. Подготовьте обращение к широкой аудитории на русском языке, убеждающее в необходимости толерантного отношения к больным ВИЧ-инфекцией. Составьте тезисы данного материала на английском языке для его представления в виде презентации.

Задание 4. Составьте электронное письмо на русском и английском языках коллеге по работе и подтвердите свое участие в деловой встрече, уточните время и дату встречи. Следуйте формальной структуре электронного письма и используйте клишированные формулы.

Задание 5. Прочитайте научно-популярную статью на английском языке. Распределите абзацы текста по смысловым разделам: введение, описание эксперимента, научные выводы и перспективы дальнейшего исследования. На основе статьи создайте тезисный доклад для выступления, используя стандартные речевые клише.