Early Pragmatic Communication in Autism and Fragile X Syndrome

Autism and fragile X syndrome (FXS) are both associated with pragmatic communication difficulties, but the pattern of strengths and weaknesses varies. Early pragmatic communication skills include using communication for different functions, such as behavior regulation or establishing/maintaining joint attention. This study examines naturalistic samples of communication to assess pragmatic function variables in very young children with autism, FXS, and typical development (TD).

Using the Communication Complexity Scale, standardized communication samples were collected from children with autism (n = 10), FXS (n = 10), and TD (n = 10), matched on spoken word count. Patterns of overall communication and pragmatic functions are provided. The relationships between pragmatic communication and cognition, receptive language, expressive language, and autistic symptomatology were assessed. Group differences in the amount and complexity of the pragmatic functions of behavior regulation and joint attention were analyzed.

Descriptively different patterns of overall communication and pragmatic functions emerged between groups, with lower amounts of joint attention in the group with autism. Trends toward significant correlations between expressive language and both pragmatic functions in FXS as well as behavior regulation and cognition in the FXS and TD groups emerged. There were no significant group differences.

Findings highlight possible early differences in pragmatic communication between autism and FXS. Clinicians need to consider nuanced differences between groups.