Comprehension of Yes/No- and Wh-questions Across Autism Spectrum Conditions

Abstract

Understanding questions is key for successful communication. Although deficits in communication are the hallmark of Autism Spectrum Conditions (ASC), how both yes/no-questions and wh-questions are understood by children with ASC has been poorly investigated in Spanish. Nevertheless, questions play an important role in ASC diagnostic tests and neurocognitive assessments. Although there is a widespread assumption of visual support easing linguistic production and comprehension, it has not been extensively investigated in question comprehension research.

The aim of this thesis is to contribute to a more comprehensive picture of language impairments in ASC by targeting questions as a specific and neglected dimension of language in ASC. Specific research questions concern the impact of syntactic differences in question type, syntactic complexity and other linguistic, cognitive and age factors on question comprehension. Finally, the role of visual support as a facilitator of question comprehension is investigated.

34 children with ASC–ID (autism without intellectual disability, mean age = 9.99) were recruited and matched on VMA (verbal mental age) with 34 TD (typically developing) participants (mean age = 8.85). 14 individuals with ASC+ID (autism with intellectual disability, mean age = 12.95) were also recruited. These were compared to 7 ID (intellectual disability) participants without ASC (mean age = 12.86). The task design of the experiment used narratives to control the context in which yes/no-questions and different types of wh-questions (namely wh-questions in simple and complex sentences, long-distance wh-questions in complex sentences and local wh-questions in complex sentences) were asked. Participants responded immediately after having been exposed to

narratives with either visual support or audio support only. Participants’ ability to answer questions about these narratives was assessed as a measure of their question comprehension.

Significant results showed that both ASC and TD groups had greater difficulties in wh-questions than yes/no-questions. Compared to TD, ASC–ID also had lower wh- question comprehension. In addition, the ASC+ID group showed a lower level of question comprehension in yes/no-questions and in wh-questions compared to the ASC– ID and ID groups. All wh-questions in complex sentences and local wh-questions in complex sentences were more difficult for the ASC–ID group in comparison to the TD group. The ASC+ID group underperformed in all types of wh-question comprehension in comparison to the ASC–ID participants and had greater difficulties to comprehend local wh-questions in complex sentences compared to the ID group.

Visual support aided question comprehension both in ASC and in TD. In between- group comparisons significantly greater question comprehension difficulties in tasks with visual support in the ASC–ID relative to the TD group remained. The ASC+ID group scored significantly lower in both visual and non-visual tasks in comparison to both ASC– ID and ID groups. VMA and VIQ (verbal intelligence quotient) correlated with yes/no- question comprehension in TD and in ASC–ID participants. In TD individuals, there was a correlation with these variables and wh-question comprehension. In the ID group, working memory and VIQ had a positive relation with the comprehension of some types of wh-questions.

These results provide novel evidence for a question comprehension impairment in ASC with and without ID, which specifically centers on wh-questions. As age and cognitive factors were more related to question comprehension in TD and ID groups than in ASC, different underlying cognitive mechanisms might be at work in ASC. At a practical level, this thesis incites reflection on the roles of question types both in diagnostic assessments and interventions.

La comprensió de les preguntes és essencial per a la comunicació. Tot i que els dèficits en la comunicació són característics de les Condicions de l’Espectre Autista (CEA), la comprensió de les preguntes sí/no i de les preguntes qu- ha estat poc investigada en castellà. Tampoc s’ha estudiat l’impacte del suport visual, encara que es pressuposa que és beneficiós.

L’objectiu d’aquest estudi és demostrar com el tipus de pregunta, la complexitat sintàctica i altres factors lingüístics, cognitius i d’edat així com també el suport visual poden influenciar la comprensió d’estructures interrogatives. Amb aquesta finalitat, es van seleccionar 34 persones amb CEA–DI (autisme sense discapacitat intel·lectual, edat mitjana = 9,99), 34 persones amb DT (desenvolupament típic) edat mitjana = 8,85), 14 individus amb CEA+DI (autisme amb discapacitat intel·lectual, edat mitjana = 12,95) i 7 participants amb DI (discapacitat intel·lectual) sense CEA (edat mitjana = 12,86). Es va relacionar el grup amb CEA–DI i el grup amb DT segons l’edat verbal mental.

Tant els grups amb CEA com amb DT van tenir més dificultats en la comprensió de les preguntes qu- que en les preguntes sí/no. Comparativament, el grup amb DT respecte del grup amb CEA–DI va mostrar un nivell de comprensió significativament menor de les preguntes qu-. El grup amb CEA+DI va mostrar un dèficit més elevat tant en les preguntes sí/no com en les qu- en comparació amb els grups amb CEA–DI i DI. Totes les preguntes qu- en frases complexes i les preguntes qu- locals en aquestes frases van ser significativament més difícils per al grup amb CEA–DI que per al grup amb DT. El suport visual va afavorir la comprensió de preguntes tant de les persones amb CEA, com del grup amb DT. Altres factors lingüístics, cognitius o d’edat mostren escasses correlacions i complexes amb la comprensió de preguntes, en el CEA. Aquests resultats demostren dèficits en la comprensió de preguntes en tot l’espectre autista, fins i tot en absència de discapacitat intel·lectual.