Conversational repair in speakers with autism spectrum disorder

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.

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.

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.