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Pragmatic Language Impairment in Asperger’s and High-Functioning Autism


Pragmatic speech is language used to communicate and socialize (e.g., knowing what to say, how to say it, when to say it, and generally how to “act” around others during conversation). Many children with Asperger’s (AS) and High-Functioning Autism (HFA) have difficulty using language in various social situations – even though they may have large vocabularies and are able to speak in full sentences that are clearly articulated. These “special needs” children may say words clearly and use long, complex sentences with correct grammar, but still have a communication problem if they haven’t mastered the rules for social language known as pragmatics.

Children with pragmatic speech issues may embarrass their parents (albeit unintentionally because they lack social skills) by making what others view as rude comments. They may have little variety in language use, say inappropriate or unrelated things during conversations, or tell stories in a disorganized way.

Pragmatics involve 3 major communication skills:
  1. Changing language according to the needs of the listener or situation (e.g., talking differently to a baby than to a grown-up, speaking differently in a classroom than on a playground, giving background information to an unfamiliar listener, etc.)
  2. Following rules for conversations and storytelling (e.g., how close to stand to someone when speaking, how to use facial expressions and eye contact, how to use verbal and nonverbal signals, introducing topics of conversation, rephrasing when misunderstood, staying on topic, taking turns in conversation, etc.)
  3. Using language for different purposes (e.g., requesting, promising, informing, greeting, demanding, etc.)

All kids have pragmatic difficulties in some situations. But, if problems in social language use occur often and seem inappropriate considering your youngster's age, he or she may have a pragmatic disorder. Children with Pragmatic Language Disorder have particular trouble understanding the meaning of what others are saying, and they are challenged in using language appropriately to get their needs met and interact with peers.

Young people with the disorder often exhibit the following: 
  • aphasic speech (e.g., word search pauses, jargoning, word order errors, word category errors, verb tense errors)
  • delayed language development
  • difficulty explaining or describing an event
  • difficulty extracting the key points from a conversation or story
  • difficulty following conversations or stories
  • difficulty in distinguishing offensive remarks
  • difficulty in making and maintaining friendships and relationships because of delayed language development
  • difficulty in reading comprehension
  • difficulty understanding choices and making decisions
  • difficulty understanding contextual cues
  • difficulty understanding questions
  • difficulty understanding satire or jokes
  • difficulty with organizational skills
  • difficulty with pronouns or pronoun reversal
  • difficulty with reading body language
  • difficulty with verb tenses
  • stuttering or cluttering speech
  • tendency to be concrete or prefer facts to stories
  • tendency to get lost in the details
  • tendency to initiate conversations that are "off-topic" or "one-sided"
  • tendency to repeat words or phrases

Pragmatic disorders often coexist with other language problems (e.g., vocabulary development, grammar). In addition, pragmatic problems often lower social acceptance (e.g., peers may avoid having conversations with the affected child).

Pragmatic Language Skills Development—

Moms and dads can help their AS and HFA children to use language appropriately in social situations (i.e., pragmatics). Here are some general suggestions to help develop these skills:

1. As often as needed, encourage your child to rephrase or revise an unclear word or sentence. Provide an appropriate rephrase or revision by asking, "Did you mean _____?"

2. As often as possible, take full advantage of naturally occurring “teaching-situations” throughout the day. For instance, have your child practice (a) requesting necessary materials to complete a project, (b) greetings at the beginning of a day, (c) saying goodbye to friends, (d) asking siblings what they want to eat for lunch, and so on.

3. Demonstrate how nonverbal cues are important to communication (e.g., talk about what happens when a facial expression does not match the emotion expressed in a verbal message, such as using angry words while smiling).

4. Pretending to talk to different people in different situations is a great pragmatics exercise (i.e., role-playing different conversations). For instance, create a situation in which your child has to explain the same thing to several people, such as how to make a grilled cheese sandwich or play a particular game. Model how your child should talk to a peer versus a grown-up, or a sibling versus a stranger.

5. Teach storytelling skills. Provide visual cues (e.g., pictures, objects, etc.) or a story outline to help tell a story in sequence.

6. Teach the use of “persuasion.” For instance, ask your child what she would say to convince you to let her do something. Discuss different ways to present a message. For example, indirect (“I wish I could go next door to see my friend.”) versus direct (“Can I go next door and see my friend?”), or impolite (“I’m not going to eat those green beans!”) versus polite (“Can I please have something other than green beans for my vegetable?”).

7. When your child speaks, respond to his “intended” message rather than correcting his grammar or pronunciation. Also, provide an appropriate model in your own speech. For instance, if your child says, "That's how it doesn't work," you can respond with, "Correct. That's not how it works.”

Kids with pragmatic language impairment are often unable to vary their language use, to relate information or stories in an organized way, or to say appropriate and “on-topic” things during conversations. Pragmatic speech disorder can also be related to difficulties with grammar and vocabulary development. As kids get older and more social skills are demanded, peers may avoid conversation with the child experiencing pragmatic speech problems. As a result, these “special needs” kids have fewer friends, are less accepted in social situations, and may be bullied or teased by peers.

If you think your AS or HFA youngster may have a pragmatic speech problem, contact a local licensed speech pathologist for an evaluation.

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