Language, Communication, and Self-Awareness Among Individuals with Autism

Background: Individuals with Asperger’s syndrome/high-functioning autism (HFA) have clinically significant difficulties with communication despite (by definition) normal structural language abilities.  However, recent studies suggest that sub-clinical abnormalities in structural language that are difficult to detect using standardised language tests may be present among people with Asperger’s (e.g., Eigsti et al., 2007).   Individuals with HFA also have diminished self-awareness in at least some respects (e.g., Williams & Happé, 2010).

Objectives: To assess self- and other-reported estimates of language and communication skills among adults with HFA and matched comparison participants, using the “Communication Checklist – Self-report” (Bishop et al., 2009) and “Communication Checklist-Adult” (Whitehouse & Bishop, 2009), respectively. 

Methods: Forty five adults with HFA, as well as 45 typically developed comparison adults, matched for age, VIQ, and PIQ, will take part.  Ethical approval for the study has been granted and data collection has just started.  Participants are recruited from a database of participants who have taken part in our previous studies (and therefore have intelligence and diagnostic information already collected), ensuring recruitment will not be a barrier to the success of the study.

Participants will complete the Communication Checklist – Self-report (CC-SR), a 70-item questionnaire that assesses three domains of functioning: Structural language, pragmatic language, and social engagement.  A friend/relative of each participant will provide a report on the skills of the participant in each of these domains, using the Communication Checklist-Adult (CC-A).

Results: We make two specific predictions about the results of the study:

Firstly, we predict that, relative to comparison participants, adults with HFA will achieve significantly lower scores on the Structural Language subscale on both the CC-SR and the CC-A.  This will provide direct evidence of sub-clinical structural language anomalies among individuals who have otherwise normal verbal intelligence (all verbal IQs > 100).  

Secondly, there will be a significantly weaker association between self-reports of social-communication skills (on the CC-SR) and other-person reports of social-communication skills (on the CC-A) among individuals with ASD than among comparison participants.  Specifically, we predict that adults with ASD will consistently underestimate their difficulties with social-communication, as reflected by significantly lower scores on the Social Engagement and Pragmatic Language subscales of the CC-SR than on the equivalent subscales of the CC-A.  If confirmed, this would provide further evidence for a diminished self-awareness among individuals with ASD.

Conclusions: This study has the potential to inform our understanding of language, communication, and self-awareness among people with autism, topics of which are currently the focus of sustained research attention (see, for example, Hobson & Bowler, 2010)