Prosody and Language Ability in Asperger's Syndrome and HighFunctioning Autism

1
Prosody and Language Ability in Asperger's
Syndrome and High-Functioning Autism
Joanne McCann1, Sue Peppé1, Fiona Gibbon1, Anne
OHare23 and Marion Rutherford2
1 Queen Margaret University College, Edinburgh
2 Royal Hospital for Sick Children, Edinburgh 3
Edinburgh University
RCSLT Conference 2006 Realising the Vision
2
Contents

• Background
• HFA and AS diagnostic criteria
• Prosody in HFA and AS
• Design
• Participants
• methods
• Results
• Discussion

3
The Autism Spectrum
Autism
Classic autism/ autism with learning
difficulties/ severe autism/ Kanners Autism
High-functioning
Wider phenotype
Aspergers Syndrome
Neuro-typical
Normal non-verbal ability but shows language
delay/disorder pre-school
Individuals may have no speech or functional
communication and severe learning difficulties.
Normal non-verbal ability and no clinically
significant language delay preschool.
Wider phenotype overlapping with neurotypical.
Normal range of social skills
4
Background Prosody ASD

• Disordered expressive prosody
• frequently described in autism
• captured in standardised assessments e.g. ADOS.
• perceived by listeners as poor inflection and
  excessive or misassigned stress
• an added barrier to social acceptance.
• Receptive prosody
• May underpin disordered expressive prosody
• Hardly researched at all

5
Prosody in Autism Spectrum Disorders.

• Disordered Expressive Prosody
• Exaggerated
• a diesel express
• fish fingers and bread
• Monotonous
• rescuing the cat.
• chocolate ice-cream and cake
• Sing-song
• I had it at Easter
• cheese sandwiches cake
• Adopted Accent

6
Method Participants

• 31 children aged 6 to 13 with autism as defined
  by ICD-10 and non-verbal ability within the
  normal range
• 36 children aged 5 to 13 with Aspergers Syndrome
  as defined by ICD-10
• 100 Typically developing children matched for
  verbal mental age, sex and socioeconomic status.

7
Method

• All of the children completed the PEPS-C test
  (Profiling Elements of Prosodic Systems in
  Children, Peppé and McCann, 2003) and the British
  Picture Vocabulary Scales-II (BPVS Dunn et al.
  1997).
• The children with HFA and AS completed a further
  battery
• Test for Reception of Grammar (TROG)
• Clinical Evaluation of Language Fundamentals-3UK
  expressive subtests (CELF)
• Ravens Matrices (RM)

8
PEPS-C Profiling Elements of Prosodic Systems in
Children
Turn-End Affect Chunking Focus Auditory
Discrimination Imitation
9
Results Language measures

• The children with AS achieved higher standard
  scores than the HFA groups in all measures
• BPVS plt0.0005
• TROG plt0.0005
• CELF plt0.0005
• RM p0.008

10
HFA and AS Language Results
AS
HFA
11
Results Prosody

• MANCOVA with BPVS age equivalent as covariate
• The HFA group score significantly lower than the
  AS group in
• Prosody Total (plt0.0005).
• Affect Input (plt0.0005),
• Affect Output (plt0.0005),
• Intonation Input (p0.001),
• Focus Output (plt0.0005),
• Prosody Input (plt0.0005),
• Prosody Output (plt0.0005)

12
Prosody Results
13
Prosody Results
14
Discussion Points

• Why do children with HFA differ from children
  with AS on prosody?
• Are they in fact different disorders?
• HFA group has a significant language impairment
  and prosody correlated highly with language.
  Disordered prosody may be an aspect of language
  impairment rather than ASD per se.
• Is the PEPS-C not sensitive enough for the
  children with AS?
• Ceiling scores were evident in the AS group

15
Summary

• Children with AS have better language skills than
  children with HFA. However, there is a great
  deal of overlap.
• Children with HFA have a prosodic impairment
  whereas children with AS perform in line with
  typical children
• In both groups prosodic ability correlates highly
  with language ability
• Pilot studies suggest that prosodic therapy,
  focusing on receptive skills, may appropriate for
  children with autism

16
Acknowledgements

• Grateful thanks to
• all the children who participated
• their families
• their teachers and schools
• their Speech and Language Therapists
• the Scottish Health Executives Chief Scientist
  Office and the Economic and Social Research
  Council for funding.