Volden Joanne
Speech Pathology and Audiology, University of Alberta, Edmonton, Alberta, Canada.
Int J Lang Commun Disord. 2004 Apr-Jun;39(2):171-89. doi: 10.1080/13682820410001663252.
The ability to repair communicative breakdown is an important pragmatic language skill, yet very little is known about it in the population of children with autism spectrum disorder (ASD). Previous investigations have shown that people with ASD, across a variety of ages and language levels, recognized communicative breakdown and responded to requests for clarification (RQCLs) with a wide variety of repair strategies. No previous work has assessed the repair abilities of speakers with ASD when faced with a persistent communicative breakdown indicated by a stacked series of RQCLs.
The present paper aimed to determine whether school-aged, high-functioning children with ASD responded to a stacked series of RQCLs in a way similar to children matched for language age.
METHODS & PROCEDURES: Nine school-aged, high-functioning children with ASD were recruited and matched to nine control group children based on language level. During conversation, an unfamiliar examiner engineered 10 episodes of communicative breakdown. Each consisted of a stacked series of three RQCLs ('What?', 'I don't understand', 'Tell me another way'). Verbal and non-verbal responses to each RQCL were coded. Responses were analysed by a series of repeated measures analyses of variance with diagnostic group and RQCL type/position as independent variables and type of repair as the dependent variable.
OUTCOMES & RESULTS: Children with ASD were similar to language age-matched control children in responding to RQCLs and employing a variety of repair strategies. In addition, their pattern of responding over the series of RQCLs was very similar to the controls in varying the repair strategy by adding increasingly more information as the breakdown persisted, i.e. as the sequence of RQCLs progressed. Children with ASD, however, were significantly more likely than language age-matched controls to respond to an RQCL with an inappropriate response.
The ability to repair communicative breakdown successfully raises questions about some of the currently popular theories about the source and nature of social and communicative deficits in autism. In addition, the presence of significantly more inappropriate utterances in the group with ASD poses both theoretical and clinical challenges. In theoretical terms, several possible explanations are proposed, but future work will need to test these hypotheses. Clinically, it is important to focus on utterances that disrupt the conversational flow and that generate severe social penalties for the speaker with ASD.
修复沟通障碍的能力是一项重要的语用语言技能,但对于自闭症谱系障碍(ASD)儿童群体,人们对此知之甚少。先前的调查表明,不同年龄和语言水平的ASD患者能够识别沟通障碍,并使用多种修复策略回应澄清请求(RQCL)。此前没有研究评估过ASD患者在面对一系列连续的RQCL所表明的持续性沟通障碍时的修复能力。
本文旨在确定学龄期高功能ASD儿童对一系列连续的RQCL的反应是否与语言年龄匹配的儿童相似。
招募了9名学龄期高功能ASD儿童,并根据语言水平将其与9名对照组儿童进行匹配。在对话过程中,由一名不熟悉的考官制造10次沟通障碍场景。每次场景都包含一系列连续的三个RQCL(“什么?”“我不明白”“换种说法告诉我”)。对每个RQCL的言语和非言语反应进行编码。以诊断组和RQCL类型/位置作为自变量,修复类型作为因变量,通过一系列重复测量方差分析对反应进行分析。
ASD儿童在回应RQCL和采用多种修复策略方面与语言年龄匹配的对照组儿童相似。此外,在一系列RQCL中,随着障碍持续(即随着RQCL序列推进),他们通过增加越来越多的信息来改变修复策略的反应模式与对照组非常相似。然而,ASD儿童比语言年龄匹配的对照组更有可能以不恰当的反应回应RQCL。
成功修复沟通障碍的能力对目前一些关于自闭症社会和沟通缺陷的来源及本质的流行理论提出了质疑。此外,ASD组中明显更多的不恰当言语的出现带来了理论和临床方面的挑战。从理论角度提出了几种可能的解释,但未来的研究需要检验这些假设。在临床上,重要的是关注那些扰乱对话流程并给ASD患者带来严重社交惩罚的言语。