Is there really nothing inherently atypical about language development in autism? Part II

 Cross-posted at FacilitatedCommunication.org.

Following up on my previous post on the FC-friendly claim in Gernsbacher, Morson & Grace that there is nothing inherently atypical about language development in autism I now turn to Gernsbacher, Morson & Grace’s 2016 paper.

This paper looks at three linguistic factors that have been claimed to be characteristic of autistic speech: pronoun reversals, echolalia, and a smaller-than-to-be-expected lag between comprehension and production. Gernsbacher et al. argue that none of these is unique to autism, and therefore that “none can or should serve as diagnostic of autism.” They furthermore suggest that, while they also occur in typical development, these factors are only seen as pathological in autism because of the pathological way in which we view autistic people.  

As an example of this, Gernsbacher et al. opens with a behavior that is often linked to autism: “using another person’s hand to indicate wants and needs”. Indeed, it has often been observed that individuals with autism sometimes use other people’s hands as tools, or lead people across the room to something they want. Gernsbacher et al. argue that this sort of behavior, when carried out by non-autistic people “is considered a highly adaptive form of communication that is as sophisticated as (if not more sophisticated than) pointing, looking, and other mechanisms for requesting joint attention.” But what they overlook is the different ways in which “using another person’s hand” can occur. Is the child looking up at the adult while leading him or her to an object of interest or desire, or is the child simply dragging the adult, or the adult’s hand, to the desired object? While it may be hard to tell the degree to which a child is communicating with the adult as an intentional agent, or merely treating the adult as a tool, these are, nonetheless, two distinct behaviors, and the latter is more worrying (and more suggestive of autism) than the former.

Turning, now, to the three linguistic phenomena under consideration, Gernsbacher et al. first address pronoun reversal. They begin, quite reasonably, by dismissing the psychoanalytic account of why autistic children reverse “you” and “I” (the notion that autistic children lack awareness of their own identity). But they do not consider the alternative account: namely, that pronoun reversal suggests a difficulty with perspective taking: the same sort of difficulty that arises with the false-belief tests.

Instead, Gernsbacher et al. cite a variety of papers that show that pronoun reversal is not unique to autism and occurs in a variety of non-autistic populations, including precocious neurotypicals and in children with various other disabilities: Evans & Demuth (2012), Schiff-Myers (1983), Clark (1978), Petito (1987), Perez Pereira (1999), and Yoder et al. (1998). These findings are non-controversial.

What some researchers have cited as specific to autism, however, is a relatively high frequency of pronoun reversals—something that Gernsbacher et al. do not directly address. Here, the studies are inconsistent. Naigles et al. (2016) comparing 18 TD (typically developing) toddlers and 15 children with ASD at similar language levels, found low rates of pronoun reversals in each group, but slightly higher rates in the ASD group. Furthermore, they found that “In the ASD group, early language and joint attention scores contributed significantly and independently to the incidence of reversal”—which suggests that pronoun reversals in autism are explained, in part, by autism-specific phenomena (i.e., Joint Attention deficits). Barokova & Tager-Flusberg (2020), on the other hand, looked at language samples from autistic children at 2, 3, 4, years, a developmental period during which they used more and more first and second person pronouns, and, yet “very rarely” reversed their pronouns. Barokova & Tager-Flusberg’s conclusion: “This lack of pronoun errors suggests that pronoun difficulty in autism might not occur for long periods of time throughout development and might not be as prevalent in autism as previously thought.”

The only mention Gernsbacher et al. make of frequency of pronoun errors appears to be in reference to pronoun errors in general, not pronoun reversals in particular. First, they state that “when autistic children are carefully matched with non-autistic children in their language production skills, autistic children do not produce more pronoun errors than non-autistic children.” Their reference for this is Norbury & Bishop (2003). But the pronoun errors surveyed by Norbury & Bishop do not include pronoun reversal errors, and, as for the types of pronoun errors they do discuss, they in fact do find autism-specific difficulties:

In  only  one  area  did  the  clinical groups appear to differ and that was with respect to referencing, in particular in  producing  ambiguous  nouns  and  pronouns.  These  types  of  errors  were more common in children with a diagnosis of autism.

Second, Gernsbacher et al. state that “when autistic children are carefully matched with non-autistic children in their language comprehension skills, autistic children do not comprehend pronouns more poorly than non-autistic children”.  (Here their reference is a conference paper,  Edelson et al. 2011). But it is hardly surprising that pronoun comprehension is tied to language comprehension. Furthermore, as we saw, comprehension has consistently turned up as an autism-related language weakness.

Similar issues come up in Gernsbacher et al.’s discussion of echolalia. They emphasize that it isn’t unique to autism, but again, this is noncontroversial. They mention that echolalia can be communicatively functional and that it fades away as language skills improve, but these, too, are noncontroversial. The interesting question, rather, is whether echolalia is more frequent in autism. Citing van Santen et al. (2013), Gernsbacher et al. claim that it is not.

What’s complicated about Gernsbacher et al.’s claim is that it includes as instances of echolalia what they call “self-echoing.” However, since most people consider this particular phenomenon merely repetition (or self-repetition) rather than echolalia, it is not generally included in claims about echolalia in autism. As far as the common understanding of echolalia goes, Gernsbacher et al. claim, citing van Santen et al., that “autistic children are no more likely than non-autistic children with language delay to echo another person.” But van Santen et al., while they find that self-repetition is not more frequent in autism, state that their results “confirm previous findings that children with ASD repeat the language of others more than other populations of children.”

In particular, van Santen et al., find that rates of echolalia not only reliably distinguish autistic children from TD (typically developing) children, but also reliably distinguish the subset of autistic children without language delays from TD children. Indeed, their two autistic subgroups, those with and without language delays, “had nearly identical rates of echolalia despite significant differences in overall language ability”—suggesting that echolia, in autism, is independent of language delay. (They also note, interestingly, that echolalia appears to be independent of number/severity of autistic traits—e.g., ADOS scores). While van Santen et al. do find that the participants with Specific Language Impairment (SLI) had similar levels of echolia to the ASD groups, they “cautiously conclude that it [the SLI group] was in-between the ASD groups and the TD group.”

Finally, Gernbacher et al. turn to the issue of whether there is a smaller-than-expected lag between comprehension and production in language in autism. Here they cite Kwok et al., a meta-analysis that fails to find such a lag in comprehension of vocabulary and syntax. However, as Kwok et al. themselves note, these findings do not rule out an expressive-over-receptive advantage at higher levels of language. Higher levels include not just complex sentences, but also the level of discourse: dialogs, paragraphs, narratives. Indeed, indicators of comprehension difficulties in autism, as we discussed earlier, appear in a number of the papers Gernsbacher et al. cite.

And this, for all the arguments that Gernsbacher et al. attempt to make against autism-specific language difficulties, takes us back to what is perhaps the most significant area of difficulty—beyond vocabulary, beyond basic syntax, beyond idioms and metaphors—namely, overall comprehension.

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References

Barokova, M., & Tager-Flusberg, H. (2020). Person-reference in autism spectrum disorder: Developmental trends and the role of linguistic input. Autism research : official journal of the International Society for Autism Research, 13(6), 959–969. https://doi.org/10.1002/aur.2243

Clark E. V. (1978). From gesture to word: on the natural acquisition. In Human Growth and Development: Wolfson College Lectures, ed. J. S. Bruner, A. Garton, pp. 85–120. Oxford, UK: Oxford Univ. Press

Edelson L.R., Meyer A.T., Tager-Flusberg H. (2011). Cues to pronominal reference resolution in children with and without autism spectrum disorders. Presented at Int. Meet. Autism Res., San Diego.

Evans, K.E., & Demuth K. (2012). Individual differences in pronoun reversal: evidence from two longitudinal case studies. Journal of Child Language, 39, 162–91

Gernsbacher, M. A., Morson, E. M., & Grace, E. J. (2016). Language and Speech in Autism. Annual review of linguistics, 2, 413–425. https://doi.org/10.1146/annurev-linguist-030514-124824

Henderson, L. M., Clarke, P. J., & Snowling, M. J. (2011). Accessing and selecting word meaning in autism spectrum disorder. Journal of Child Psychology and Psychiatry, 52, 964-973.

Naigles, L. R., Cheng, M., Rattansone, N. X., Tek, S., Khetrapal, N., Fein, D., & Demuth, K. (2016). "You're telling me!" The Prevalence and Predictors of Pronoun Reversals in Children with Autism Spectrum Disorders and Typical Development. Research in autism spectrum disorders, 27, 11–20.

Norbury, C. F., & Bishop, D. V. M. (2002). Inferential processing and story recall in children with communication problems: A comparison of specific language impairment, pragmatic language impairment and high-functioning autism. International Journal of Language Communication Disorders, 37, 227–251.

Perez Pereira M. (1999). Deixis, personal reference, and the use of pronouns by blind children. ´ Journal of Child Language, 26, 655–80.

Petito L. A. (1987). On the autonomy of language and gesture: evidence from the acquisition of personal pronouns in American Sign Language. Cognition 27, 1–52.

Schiff-Myers N. B. (1983). From pronoun reversals to correct pronoun usage: a case study of a normally developing child. Journal of Speech and Hearing Disorders, 48, 394–402

van Santen, J. P., Sproat, R. W., & Hill, A. P. (2013). Quantifying repetitive speech in autism spectrum disorders and language impairment. Autism research : official journal of the International Society for Autism Research, 6(5), 372–383. https://doi.org/10.1002/aur.1301

Yoder, P. J. , Warren, S. F., McCathren,  R. B. (1998). Determining spoken language prognosis in children with developmental disabilities. American Journal of Speech Language Pathology, 7, 77–87.

Common Core-inspired grammar fallacies, and why we need paper graders

I was just talking with an AI professor at a Halloween party, and he told me that he now requires his students to run all their papers through Grammarly before turning them in.

That reminded me of this old post; it also made me wonder to what extent we can all learn from the feedback--imperfect though it is--provided by automated editors like Grammarly.

Common Core-inspired grammar fallacies, and why we need paper graders

An article in a February issue of Edweek, Will the Common Core Step Up Schools' Focus on Grammar?, repeats the false choice I blogged about earlier between isolated grammar lessons and unstructured reading and writing assignments:

Determining the best approach for teaching grammar and semantics is now once again a critical conversation topic. Should teachers dedicate time to stand-alone grammar lessons and tasks---diagramming sentences, for instance, or memorizing the differences between adjectives and adverbs? Or can students learn the language system through broad writing and reading?

Later on in the piece, however, author Liana Heitin acknowledges that the Common Core, at least accordingly to some interpretations, has taken a middle ground, appearing to embrace what I’ve called “applied syntax”:

The standards do, however, focus more on grammar application than most previous state standards, some say—which could encourage more authentic grammar work.

On the other hand, the standards (and their professional interpreters) still fall for Fallacy II: failing to factor out those aspects of grammar that native English speakers already know:

the grammar skills in the content standards don’t differ too much from most previous state standards… For instance, they ask students to ‘use an apostrophe to form contractions’ and ‘form and use regular and irregular verbs’—benchmarks that shouldn’t much surprise teachers. 

“Whereas before it was OK for a kid to identify nouns, now, it’s that they actually have to be able to use them and use them correctly,” said [one teacher].

Native English speakers do need to learn written conventions like when to use an apostrophe; they don’t need to learn how to conjugate English verbs and how to use English nouns. The latter skills belong in Common Core Standards for ESL, not Common Core Standards for ELA.

However willing teachers are to teach native speakers how to conjugate verbs and use nouns, Liana Heitin and the teacher she quotes have reservations about embedding grammar instruction in the feedback-on-multiple-writing-drafts approach I suggested earlier:

The realities of classroom management can make teaching grammar through writing tough as well. “Ideally, you wouldn’t have to teach [basic grammar skills] in isolation—you’d be having students writing a paper and then correcting it,” said Meghan Everette, a 3rd grade teacher…. “But it doesn’t really work out that way.”  

“Young students need a lot of direction in learning new skills, she said. And managing that kind of individualized task with 20 or 30 students is just too time consuming.”

Yes, as I noted earlier, marking up a stack of student papers is one of the most tedious teaching tasks out there. And yet, teachers used to do that regularly. If that’s too much to ask of today’s teachers, then let’s try something similar to the classroom teacher vs. classroom management labor-division I suggested in my last post. In addition to classroom teachers, let’s hire paper graders—akin to those we find in large college classes. Again, we can safely offset the cost of the added personnel by increasing average class size.

Not all of the student self-correction process needs to be labor-intensive for teachers. Many errors needn’t be explicitly pointed out in order for students to fix them. Sometimes it’s just a matter of requiring students to actually re-read, and proofread, their papers—something that fewer and fewer seem to be in the habit of doing.

Teachers can also motivate careful revisions with minimal time expenditure by harnessing the tremendous editorial power of the Word Limit. As anyone who has faced one of these can tell you, cutting out words without sacrificing content generally involves drastically improving your prose. So why not ask students to reduce their word count, say, by 50%, without eliminating any content, from penultimate to final draft?

Social emotional learning and academic slippage in the post-Pandemic era

In the years since I wrote this post, the emphasis on social-emotional learning is greater than ever. Somehow the pandemic has become an excuse for shifting the balance away from straight-up academics towards even more social emotional learning, even as declines in academic skills are at least as worrying as declines in socio-emotional maturity.

Social emotional learning for everyone, or special interventions for disruptors?

Grit, growth mindsets, social emotional learning (SEL): these latest edu-fads are flourishing as never before--the more so as No Child Left Behind is succeed by the more optimistic Every Student Succeeds Act. In assessing our school children, states must now include at least one “non-academic” measure. The claim, of course, is that non-academic factors ultimately influence academic performance. And who would argue with the idea that how much you persevere and how engaged you are affect how much you learn?

But when schools divert students away from learning activities in order to engage in “social emotional learning,” (SEL), it’s reasonable to be skeptical--even when we encounter “research” that “shows” that some of these SEL programs are increasing academic test scores.

In particular, we must rule out:

1. The Hawthorne Effect

2. The possibility that the extra staffing and investment involved may, independently of any SEL-specific activities, have positive ripple effects on classroom academics

3. The possibility that SELs programs improve academic achievement only inasmuch as they improve classroom behavior.

This last factor strikes me as the most likely reason for the efficacy of those SELs programs that are in fact effective. Disruptive, distracting behavior imposes a tremendous drain on teaching/learning—for perpetrators and victims alike.

But then the question becomes: is having the entire school population participate in weekly/daily SEL programs really the most efficient way to improve the behavior of the specific students who disrupt learning? How about instead doing the following:

1. Split the classroom teaching/classroom management positions into two separate jobs.
2. Put highly qualified teachers up front and highly qualified classroom managers in back.
3. Give the latter the authority to remove disruptive students (temporarily or for the long term).
4. Offset the expense of extra adults in classrooms with substantially larger class sizes.
5. Spend the money that would have been spent on SEL instruction for the entire student body on special psychiatric and academic services for disruptive students.

Autism in America: gratuitous barriers to productive employment, Part II

Addendum: in the end, the way around the English requirement was a waiving of the school's rules against undergraduates taking online classes. The online version of the English classes bypassed some of the problems with group work. 

Indeed, it turns out that online classes in general eliminate many autism-specific, classroom-based barriers.

Without a well-timed global pandemic, graduation may have remained elusive.

Autism in America: gratuitous barriers to productive employment, Part II

I ended my previous post with the following cliffhanger: current trends in American education, extending now all the way into college, are making the required courses less and less hospitable to autistic kids—even at schools that have a relatively small number of distribution requirements and profess to be autism friendly.

Let’s now descend that cliff down to the English requirements for a computer science major at one such school. To a prospective student and his parent, checking out his program of study ahead of time to make sure it’s feasible, these requirements don’t look too bad. Three courses in Composition and Rhetoric: how bad can this be? While you can’t forget how poorly your child did on the Critical Reading section of the SATs, you remember how his Writing score was much closer to average. So Composition and Rhetoric will be challenging, but surely not prohibitive. Surely the courses will focus on writing rather than reading, and what reading there is will come from books on composition and rhetoric rather than the literary fiction that your child (along with many of his autistic peers) can’t make head or tail of. Right?

Wrong.

But you and your child don’t find this out until the courses get under way. First semester is, in fact, OK. As you’d hoped, the main reading assignments come from a composition book, and the only autism-unfriendly challenges are that students submit journals and conduct in-person interviews. Sure, it would be nice if your child’s mechanical writing skills actually showed improvement as a result of this class, but, what did you expect, really? What’s important is that your child passed the class with a not-too-terrible grade, and now he has one down, only two more to go.

With additional accommodations in place that you wished you’d known about earlier but hope now will make things easier (specifically a written transcript of all your child’s classes), you fully expect that the second round of Writing and Rhetoric will go at least as well as the first. But then it becomes clear that this particular class features social challenges that your child last had to deal with in middle school. Just as in certain middle school English classes, a big part of the grade, it turns out, is going to be based on “peer review”—reviewing his classmates’ work—and working in a group on a group project—both inside and outside of class. Indeed, the transcripts of the class turn out to be quite short because most of the class time involves students working in groups. And it quickly becomes clear that your child’s group mates are leaving him out because they’d rather not deal with him, and that his instructor is penalizing him for not succeeding in working with them. This class, in other words, is turning out not only to be autism-unfriendly, but diagnostic for autism: where moderately autistic means a non-passing grade. You encourage him to drop the class and seek out alternatives.

Specifically, you encourage him to email all the professors who are teaching the final round of Composition and Rhetoric to find out which ones are autism friendly. And what you find out is that all the final-round courses involve literature, whether short stories (e.g., Barn Burning and A Perfect Day for Banana Fish); poetry (e.g., Wordsworth); or plays. Included among the plays are Shakespeare’s Tempest, the relationship-intensive How I Learned to Drive, and Who’s Afraid of Virginia Wolf, the film version of which has figured in a famous autism study underscoring how autistic viewers focus on all the wrong details. There’s no way in hell your child is going to pass Composition and Rhetoric III—even if he has a more sympathetic professor, even if he avoids those sections that require peer-review, group work, and multi-media adaptations of literature, and even if every relevant and available accommodation is enacted in a timely fashion and without any glitches.

Then you check out the entire English department listings, hoping to find something your son can request as a substitute course—expository writing? technical writing?—and discover nothing else but literature courses. However tight the job market continues to be for English PhDs, and however poor the expository writing skills or more and more college freshmen are proving to be, apparently no one is asking anyone to offer courses in the mechanics of expository writing.

Meanwhile, you face the very real possibility that your high functioning son may end up dropping out of a college that was initially quite enthusiastic about admitting him.

And you wonder to what extent the poor lifetime prognosis of kids like him is a function of autism itself vs. a byproduct of America’s special variety of neurotypical rigidity.

Autism in America: gratuitous barriers to productive employment

 I wrote this post some time ago, but the concerns I express here endure. However, I'd like to add two additional points:

1. The job prospects of many higher-functioning autistic individuals have been even further compromised by the ongoing expansion of "autism" to include two groups: 

• people formerly diagnosed with Asperger's
• people who advanced through school without any special supports and who were diagnosed only after reaching adulthood (despite the fact that the symptoms of autism, as per the diagnostic criteria, must be present in childhood). 

This means that companies who've made it their mission to allot a certain percentage of their job openings to "autistic individuals" are often filling their quotas with hirees who barely meet the criteria for autism.

2. There are, on the other hand, some superb and dedicated job coaches at some of the more truly autism-friendly colleges and universities who have made it their priority to work with *all* their autistic graduates, including those with more significant autism symptomology, to help them find gainful employment.

Autism in America: gratuitous barriers to productive employment

America prides itself on being way ahead of the rest of the world in its treatment of people with special needs. And sure, the U.S. probably has more accessible buildings, studded curb cuts, and special ed support services per capita than any other place on earth. More therapists, therapy rooms, weighted vests, preferential seating, FM-systems, enlarged screens, sign language interpreters, text-to-speech, speech-to-text, assistive communication, IEP meetings, extra time on tests, offices of disability services, etc., etc.. The U.S. can probably also boast pre-eminence in pro-special needs lip-service--all that public advocacy, all that sensitivity training, all those feel-good articles, and all those Disability Studies programs.

But when it comes to people with High Functioning Autism and Asperger’s Syndrome, we fall far short in a number of key ways. In particular, we’ve erected a number of uniquely American barriers to productive employment.

First, there’s the uniquely American “college for all” movement, which, combined with our growing obsession with credentialing, means that more jobs and vocational training programs than ever require college degrees—or at least strongly prefer applicants who have such degrees—including jobs and training programs that in other countries require only a high school diploma, if that.

Then there’s college itself. In most other countries, even if you do go to college, you don’t have to take courses outside your area of specialization. As a result, if you’re a biophysics major who can’t write a decent literature or history paper, you can still be confident you’ll get your degree.

But here in the US, getting a decent job means succeeding in a variety of different courses in college, including college English and various other humanities classes. And, for those on the autistic spectrum, such courses are frequently areas of disproportionate weakness.

College-level distribution requirements, in theory, need not be fatal to a bright, moderately autistic student. At Canadian colleges, I’ve been told, there are English courses specifically designed for computer science majors: courses that differ from those for literature majors. And even though American colleges do not tailor their English classes in this way, an American autistic student could, theoretically, satisfy an English requirement with a course in expository essay writing as opposed to one in the 19th century novel.

But current trends in American education, extending now all the way into college, are making the required courses less and less hospitable to autistic kids—even at schools that have a relatively small number of distribution requirements and profess to be autism friendly.

Is there really nothing inherently atypical about language development in autism?

 (Cross-posted at FacilitatedCommunication.org.)

In 2015 and 2016, Gernsbacher, Morson and Grace published a pair of articles on language development in autism. In these papers, the authors try to make a case that there’s nothing inherently atypical about language development in autism as compared to (1) typical language development and/or (2) development in non-autistic children with general language delays. The notion that there is no autism-specific language deficit, if true, would lend support to the notion that there’s nothing suspect about the linguistic skills outputted by individuals being subjected to FC/RPM/S2C.

Today I continue my critique of Gernsbacher’s FC-friendly papers with the 2015 paper, Language Development in Autism.

Weaponizing "Open-minded"

I realize I'm participating in an occasionally problematic trend when I say that something has been weaponized. These days, more and more things are said to have been weaponized:

But one term that I really do think has been weaponized as never before is the term "open-minded." For proponents of pseudoscientific practices (like, say, Facilitated Communication, Rapid Prompting Method, and Spelling to Communicate), open-minded seems to mean, specifically, open to pseudoscience.

That is, if you insist on scientific evidence and rigorous, controlled testing, you have failed to be open-minded.