Idiosyncratic Use of Language and Unusual References in Narratives of Optimal Outcome Children with a History of Autism Spectrum Disorders

Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010).

Objectives: The purpose of this study was to analyze narratives of individuals who have achieved “optimal outcomes” (OO) and contrast them with narratives of individuals with high-functioning autism (HFA) and typical development (TD), with a focus on idiosyncratic language and unusual references. Spontaneous narratives provide an especially sensitive method for investigating language abilities.

Methods: The “Tuesday” story from the Autism Diagnostic Observation Scale (ADOS) was collected from 45 participants (n= 15 per group), matched on age (M = 12.8, range = 9.9-15.6) and VIQ [M (SD)= 111.9 (16.4), 105.9 (15.9), and 114.0 (12.4) for OO, HFA, and TD, respectively, p = .26]. Narratives were analyzed by coders naïve to diagnosis. Idiosyncratic language was operationalized as unconventional use of language ("congregating around a human suburb"), overly formal or scripted language ("stay tuned for the sequel"), or use of neologisms (”electronical wires”). Unusual references were operationalized as odd specific references not apparent from the pictures (e.g., frogs named after Star Wars characters). The composite variable “idiosyncratic language/unusual references” was created to measure whether individuals in one group were more likely than another group to use either idiosyncratic language or make unusual references.

Results:  

Logisitical regression analyses were conducted to determine whether group membership (OO, HFA, TD) could predict the use of idiosyncratic language and unusual references in narratives. The HFA group was significantly more likely to use idiosyncratic language than the TD group (odds ratio, 18.76, Wald c² (1)= 5.962, p=.02). However, the OO group did not differ significantly from either the HFA or TD groups (p’s >.11). Specifically, 4/15 OO individuals, 8/15 HFA individuals, and 1/15 TD individuals displayed idiosyncratic language in their narratives.  There were no significant differences among groups in use of unusual references (p’s>.07). However, the OO group and HFA groups were more likely than the TD group to produce either idiosyncratic language or make unusual references [OO: odds ratio, 6.30, Wald c² (1)= 4.635, p=.03; HFA: odds ratio, 7.8, Wald c² (1)= 5.883, p=.02];  there was no significant difference between the OO and HFA groups (p=.80). Specifically, 9/15 OO and 10/15 HFA individuals did so, compared to only 3/15 TD individuals.

Conclusions:  

Despite achieving social and language skills within the average range, OO individuals are more likely than TD individuals to display idiosyncratic language or make odd specific references when producing narratives. These characteristics may transfer to and impact the quality of their conversations and social interactions with others. Furthermore, these results suggest that these pragmatic features of language may be more resistant to remediation.