Conversational capacities of individuals with autism spectrum disorders

People with autism spectrum disorder (ASD) are reported to have persistent difficulties with social interactions which may manifest as deficits in reciprocal conversation. Problems related to syntax and paralinguistic aspects of communication are well documented but pragmatic impairments are central to problems with conversation. Pragmatics include presupposition and discourse management which involves initiation, turn-taking, topic maintenance, topic shifts, and the reciprocal sharing of relevant information during conversations.

This thesis focuses on three interrelated broad issues relevant to conversational abilities of individuals with ASD. The first issue is related to the nature of conversational abilities in individuals with ASD. Exploration of this issue involved a systematic literature review examining studies that compared the pragmatic capacities of individuals with ASD during conversation with individuals who were typically developing or had other disabilities. These studies were analysed to examine the nature of pragmatic differences in ASD and the extent to which these differences are unique to ASD, as well as commonalities that may exist with other disability groups. Key findings were that operational definitions of variables were inconsistent and measurement instruments differed across the studies examined, thus analysis was complex and problematic. In particular, much of the research did not involve analysis of naturalistic conversational exchange. There were consistent findings but, overall, fewer than expected differences were found between the groups examined. Compared to other diagnostic groups and typically developing peers, individuals with ASD appeared to experience differential difficulties related to topic shift and topic preservation. Overall, groups with ASD provided fewer novel on-topic contributions and tended to perseverate more but the other commonly reported characteristics, such as eye-gaze and the number of turns taken, were either contradictory or not as pronounced as might be expected. This review was one of the first systematic attempts to distill and analyse the available research in order to determine the magnitude and nature of pragmatic difficulties during conversation.

Drawing on this review, the second area of focus related to conversational partner perceptions of behaviours that are potentially problematic in communication with persons with ASD. While a number of areas of difference in conversational abilities have been identified in research, this was the first study to examine the extent to which these differences were perceived as problematic for conversational partners. Key findings were behaviours that were reported to occur frequently were not necessarily regarded as problematic by conversation partners. In addition, some conversationally related behaviours that have been the subject of extensive research interest (e.g., starting conversations abruptly and inappropriate eye contact) were not generally perceived as problematic by partners. Overall, neurotypical conversation partners reported behaviours as more problematic than conversation partners with ASD. The nature of the relationship to the person with ASD also appeared to have an impact on the types of conversational behaviours that were considered problematic.

The final focus of the thesis was on interventions to address conversational abilities of children with ASD. Two promising strategies, scripts and the use of an iPad app, were combined to attempt to teach children with ASD to discriminate between on-topic and offtopic comments and maintain a topic during conversational exchanges. The first study indicated that a commercial app using scripts could be successfully used to teach a student to identify and apply on-topic responses during a conversational exchange. In the second study, the intervention did not yield positive results and additional teaching strategies were required, with mixed results. These two studies appear to be the first to evaluate the use of a commercially available iPad app to teach conversational skills to students with ASD and highlighted the importance of replication of research.

The studies in this thesis add to the existing research on the conversational capacities of individuals with ASD and how partners perceive the impact of specific capacities on conversational exchange. In addition, insight is offered into the effectiveness of promising interventions.