Loukusa Soile, Mäkinen Leena, Kuusikko-Gauffin Sanna, Ebeling Hanna, Leinonen Eeva
Research Unit of Logopedics, PO Box 1000, 90014 University of Oulu, Finland.
Faculty of Medicine, Institute of Clinical Medicine, Department of Child Psychiatry, Oulu University Hospital, University of Oulu, PO Box. 26, 90029 Oulu, Finland.
J Commun Disord. 2018 May-Jun;73:91-105. doi: 10.1016/j.jcomdis.2018.01.006. Epub 2018 Feb 2.
By utilizing the Pragma test this study investigated how sixteen five- to ten-year-old children with autism spectrum disorder (ASD) and sixteen typically developing (TD) children comprehended contextually challenging scenarios demanding 1) contextual inference with theory of mind (ToM), 2) contextual inference without ToM, 3) relevant use of language, 4) recognition of feelings, and 5) understanding false beliefs. The study also compared children's ability to explain their own correct answers. In addition, this study evaluated the sensitivity of three different methods for discriminating the children with ASD from the TD children: 1) the Pragma test, 2) the Social Interaction Deviance Composite (SIDC) of Children's Communication Checklist-2 (CCC-2), and 3) the Theory of Mind subtest of the Developmental Neuropsychological Assessment, Second edition (NEPSY-II). The results showed that children with ASD differed from TD children in questions demanding context utilization. However, the demand of mind-reading in utterance interpretation increased the difference between groups. Compared to TD children, children with ASD had more difficulties in explaining how they had used context to arrive at the correct answer. The discrimination power for detecting children with ASD from TD children was excellent in the Pragma test, good in the SIDC CCC-2 and fair in the Theory of Mind subtest of NEPSY-II. This study showed that by using contextually sensitive materials, such as the Pragma test, it is possible to detect the social-pragmatic inferencing difficulties of high-functioning children with ASD in structured test situations and not only in real-life situations or by using parental reports.
通过运用语用测试，本研究调查了16名5至10岁的自闭症谱系障碍（ASD）儿童和16名发育正常（TD）的儿童如何理解具有情境挑战性的场景，这些场景要求：1）运用心理理论（ToM）进行情境推理；2）不运用ToM进行情境推理；3）语言的相关运用；4）情感识别；5）理解错误信念。该研究还比较了儿童解释自己正确答案的能力。此外，本研究评估了三种不同方法区分ASD儿童和TD儿童的敏感性：1）语用测试；2）儿童沟通清单-2（CCC-2）的社会互动偏差综合量表（SIDC）；3）发育神经心理评估第二版（NEPSY-II）的心理理论子测试。结果表明，在需要情境运用的问题上，ASD儿童与TD儿童存在差异。然而，话语解释中对读心术的要求增加了两组之间的差异。与TD儿童相比，ASD儿童在解释如何利用情境得出正确答案方面存在更多困难。在语用测试中，从TD儿童中检测出ASD儿童的鉴别力极佳，在SIDC CCC-2中鉴别力良好，在NEPSY-II的心理理论子测试中鉴别力一般。本研究表明，通过使用情境敏感材料，如语用测试，有可能在结构化测试情境中检测出自闭症谱系障碍高功能儿童的社会语用推理困难，而不仅仅是在现实生活情境中或通过家长报告来检测。
