Signaling of noncomprehension in communication breakdowns in fragile X syndrome, Down syndrome, and autism spectrum disorder

Abstract

The ability to indicate a failure to understand a message is a critical pragmatic (social) language skill for managing communication breakdowns and supporting successful communicative exchanges. The current study examined the ability to signal noncomprehension across different types of confusing message conditions in children and adolescents with fragile X syndrome (FXS), Down syndrome (DS), autism spectrum disorder (ASD), and typical development (TD). Controlling for nonverbal mental age and receptive vocabulary skills, youth with comorbid FXS and ASD and those with DS were less likely than TD controls to signal noncomprehension of confusing messages. Youth with FXS without ASD and those with idiopathic ASD did not differ from controls. No sex differences were detected in any group. Findings contribute to current knowledge of pragmatic profiles in different forms of genetically-based neurodevelopmental disorders associated with intellectual disability, and the role of sex in the expression of such profiles. Learning Outcomes Upon completion of this article, readers will have learned about: (1) the social-communicative profiles of youth with FXS, DS, and ASD, (2) the importance of signaling noncomprehension in response to a confusing message, and (3) the similarities and differences in noncomprehension signaling in youth with FXS (with and without ASD), DS, idiopathic ASD, and TD.

A Duck Wearing Boots?! Pragmatic Language Strategies for Repairing Communication Breakdowns Across Genetically Based Neurodevelopmental Disabilities

“…Differences in symptom expression have also been observed between FXS and nonsyndromic ASD, making it particularly important to define carefully those areas of overlap and divergence, in order to understand how FMR1 may contribute to ASD-relevant symptomatology. In this vein, and in line with prior work (see Abbeduto, McDuffie, & Thurman, 2014;Martin et al, 2017), this study employed a component-feature approach to further clarify specific pragmatic skills (i.e., communication repair) that may be differentially impacted in FXS and ASD, as well as DS. The limited studies on communication breakdown in FXS and DS have focused primarily on the ability to signal noncomprehension (confusion) when presented with unclear messages.…”

“…The limited studies on communication breakdown in FXS and DS have focused primarily on the ability to signal noncomprehension (confusion) when presented with unclear messages. For example, studies found that individuals with DS (Abbeduto et al, 2008;Martin et al, 2017) and FXS (Abbeduto et al, 2008;Thurman, Kover, Brown, Harvey, & Abbeduto, 2017) were less likely than TD controls to signal noncomprehension of a confusing message, with additional evidence that comorbid ASD negatively impacts this skill in FXS (Martin et al, 2017). No studies other than the study by Levy et al (2003), which included one male with FXS, have examined the ability of individuals with FXS to repair their own statements, and only one case study of four children has investigated repair skills in DS, with findings showing appropriate responses to requests for clarification (Coggins & Stoel-Gammon, 1982).…”

“…In FXS, females are typically less affected phenotypically with lower rates of ASD (owing to the presence of an unaffected copy of FMR1 on females' second X chromosome; e.g., Clifford et al, 2007;Hagerman et al, 1992;Hall, Lightbody, Hirt, Rezvani, & Reiss, 2010;Klusek et al, 2014b;Lee et al, 2016). Therefore, it may be likely that females with FXS show a distinct pattern of pragmatic strengths and weaknesses from males, although evidence on the impact of sex on noncomprehension signaling (another pragmatic skill related to communication breakdowns, described above) is mixed (Abbeduto et al, 2008;Martin et al, 2017;Thurman et al, 2017). In DS, one study found that a small sample of parents reported higher rates of pragmatic impairment in males (Berglund, Eriksson, & Johansson, 2001), whereas a more recent study with an older age group found no differences in parent report of pragmatic skills (Lee et al, 2017).…”

Specificity: A Phenotypic Comparison of Communication-Relevant Domains Between Youth With Down Syndrome and Fragile X Syndrome

“…The existing literature has been mixed with regard to these latter domains. Although several studies have pointed to sex-differences in pragmatics, behavior, and communication skills (Lund, 1988 ; Berglund et al, 2001 ; Määttä et al, 2006 ; Van Gameren-Oosterom et al, 2011 ; de Sola et al, 2015 ; Lee et al, 2017 ), studies focused on the adolescent period specifically have generally shown no sex differences with regard to pragmatics (Martin et al, 2017 ) or behavior (Jacola et al, 2014 ). Taken together, these results suggest that sex differences in DS may vary as a function of chronological age and developmental level and, perhaps, the context of assessment.…”

Adaptive behavior in infants and toddlers with Down syndrome and fragile X syndrome

“…Future research may also consider alternative methods, such as lab‐based measures to confirm or further delineate patterns of phenotypic specificity between DS and FXS across certain areas. For example, within the Communication domain, children with DS may demonstrate greater needs in expressive skills whereas children with FXS may have greater needs in the area of pragmatic language abilities (Abbeduto, Warren, & Conners, ; Martin et al, ). Another limitation is the lack of assessment of ASD features in the DS group.…”