3 IMFAR Abstracts: Prosody, Language, and Autism in China

The 6th Institutional Meeting for Autism Research, IMFAR, will be held in Seattle from May 3 – 5. Michelle Dawson at Autism Crisis has posted the abstracts for two of the three studies she is involved with, How many hours is forty hours? Range of Treatment Intensity in Lovaas (1987) (M. Dawson, L. Mottron) and Intelligence in Autism: What are the good predictors? (L. Mottron, I. Soulières, M. Dawson, M. Gernsbacher). A number of abstracts on topics ranging from maternal plasma antibodies, epilepsy, GI symptoms, mercury prenatal stress and maternal serotonin levels, the incidence of ASD in the prison population—are highlighted by Autism Diva.

Below are the abstracts for three papers (there are a lot of papers, not to mention the poster presentations) that are of particular interest to me.

• Emotional Prosody in Children and Adolescents with Autism

  L. R. Edelson, R. Grossman, H. Tager-Flusberg (Boston University)

• Introduction: Individuals with autism are often described anecdotally as having an odd quality to their vocal prosody. This study investigates how emotional speech of individuals with autism differs prosodically from that of typically developing peers, using quantifiable acoustic analyses.

  Methods: Participants included 33 males (mean age: 14;2; range: 8-19 years); 20 with a diagnosis of autism (ASD) and 13 age- and IQ-matched typically-developing (TD) controls. Participants watched a video of a young man telling four short stories, each containing five distinct emotions: neutral, happiness, fear, anger, and surprise. We digitally recorded the retelling of these stories. Acoustic measurements included pitch (F0), intensity, and rate of speech. Pitch- and intensity range were also calculated. We made qualitative judgments regarding pitch slopes.

  Results: The ASD group produced significantly higher pitches and lower intensities with wide ranges of each. The trend for rate of speech neared significance with the ASD group producing fewer syllables per second.
  Chi-squared analyses showed significant group differences for pitch slope, with the ASD group favoring a downward slope, and the TD group favoring a rising-falling slope. The TD group also used significantly more complex slopes involving both rises and falls than did the ASD group; the ASD group produced more flat utterances. The greatest group differences for pitch slope and slope complexity were found in the fear and anger sentences.

  Conclusions: The ASD group shows a quantifiably distinct profile for emotional prosody, particularly when emulating fear and anger. This group tends to speak more slowly and in higher, quieter voices, using more canonical (i.e., falling for a statement) pitch slopes and producing more flat utterances. Those who did vary their intonation did so with significantly larger pitch- and intensity ranges.

  Sponsor: NAAR, NIH Grant U19 DC 03610

This study is of interest to me because I have long noticed that Charlie, who is minimally verbal, is especially attentive to how a person speaks—to the tone and pitch and rhythm of the human voice; to what I have called the music of speech. Also, I recently have been attempting to teach Charlie some Mandarin: In Chinese, the tone (level, rising, dipping, falling, neutral) of one’s voice is as important as the vowel and consonant sounds of a syllable or a word to distinguis meaning. Charlie and I often have “conversations” of sounds and tones without actual words. (We did more of this today than usual as he is recovering from his cold and has been coughing.) And my thinking about my conversing with Charlie drew my attention to the next abstract:

• Properties of Discouse and the Language of Children with Autism

  L. D. Swensen, L. Naigles, D. Fein (University of Connecticut)

• Background: Little research has investigated how the discourse between mothers and their autistic children might relate to the childs language development. ASD children have difficulties with pragmatics, including conversational competence (Dunn & Rapin, 1997). However, mothers of ASD children who engage in more joint attention have children who progress in syntax more quickly (Rosenthal Rollins & Snow, 1998).

  Objectives: We investigated whether specifics of the interchanges between mothers and their children with autism predict future language progress in those children, potentially shedding light on why some children make great progress with language while others do not.

  Methods: Participants are 10 boys with Autism Spectrum Disorder (ASD) participating in a longitudinal study. At Visits 1-4 (33-45 months old) the mother-child dyads participated in 15-minute free play sessions, which were transcribed and coded for discourse type (Ninio & Snow, 1987). Our first analysis compared the interchanges of the two children whose outcomes at visit 4 were the most linguistically divergent (A=better outcome, B=poorer outcome).

  Results: The most common type of interchange dealt with negotiating activities (e.g. MOT: Do you want to play with the puzzle?) At visit 2, when child A was 41 months, he engaged in more negotiating interchanges than child B (45 months). Moreover, As exchanges included more turns than Bs; A also engaged in pretend play negotiations, while B did not. While As standardized scores were already somewhat ahead of Bs at visit 2, they diverged more strongly at visits 3 and 4.

  Discussion: These analyses will be extended to the rest of the ASD sample, as well as our typical controls. This pattern of findings suggests that both more and longer negotiating exchanges facilitate ASD childrens language development. Discourse analyses with this population suggest both linguistic and clinical implications.

  Sponsors: NAAR, NIH-DCD

This abstract made me pause and review how often I use a phrase like “do you want to do X?” when initiating speech with Charlie. Lately I have been working hard to use other words besides “want” (while Charlie himself has been saying “I want” somewhat more).

This third abstract reinforced in me how cultural differences can influence the understanding of autism:

• Autism in China: Lessons Learned from a Population-Based Study

  L. Lee, H. Wang, Y. Guo, R. A. Harrington, R. Landa, N. J. Craig (Johns Hopkins Bloomberg school of Public Health)

• Background: ASD prevalence estimates using population-based approaches in developing countries are greatly needed.

  Objectives: To report on challenges and lessons learned from a population-based epidemiologic pilot study in China and to describe ASD screening in a Chinese population.

  Methods: The Social Communication Questionnaire (SCQ) and the ADI-R were translated into Chinese and culturally modified according to the region from which the study population was drawn. The translation effort was conducted by an expert panel from China and the US. Children aged 3-5 years who resided in Wei-Chang, Shandong Province were eligible for SCQ screening. Parents of children with SCQ>=15 were invited for an ADI-R.

  Results: Some items from the SCQ and ADI-R were difficult to translate into Chinese or make culturally appropriate. For example, there is no difference between “he” and “she” in Chinese and some gestures (e.g. pointing) are considered culturally inappropriate and are suppressed. A lack of gestures, “being quiet and alone”, and preoccupation are considered socially desirable behaviors for young children. The One-Child policy also makes it more challenging for parents to compare behaviors of their child with same age typically developing children. A total of 1716 children were screened and 27 completed the ADI-R. The mean SCQ score was 8.35 with 5.7% (n=98) >=15; only 1 out of 27 (3.7%) was an ADI-R determined autism case. In a subgroup analysis we found that higher SCQ scores were mainly due to higher positives in restricted and repetitive behavior items.

  Conclusion: Although most parents in this study are primary care providers, they do not have the best knowledge about their child because, before age 3, the majority of children were raised by grandparents. Future autism studies intending to adopt Western-developed tools in China need to culturally modify the tools a great deal and modify them according to geographic region.
  Supported by NIH FIC.

Ta is Mandarin for both “he” and “she,” while keuih is the Cantonese; gender difference is visible in the written, but not in the spoken, word. I am third-generation Chinese American (my grandparents on both sides emigrated from southern China to northern California) but my parents and relatives did not emphasize making eye contact (and all the more so because I was extremely shy). “……[P]ersonal experience of any illness or disability is deeply affected by the culture in which one lives,” writes psychiatrist Lorna Wing in review of Roy Richard Grinker’s Unstrange Minds: Remapping the World of Autism in the March 8th Nature, volume 446. As a baby, Charlie indeed preferred to be “quiet and alone,” and some of my relatives did not see this as a sign of anything wrong; further, my family (like many families, of course) puts a huge store in education and the thought that Charlie was going to be in “special education” took some adjusting to (and, as readers of Autismland, the daily online journal I used to write about Charlie may recall, my parents are Charlie’s favorites). As Wing also notes, there is an “intimate connection between cultural attitudes to autism and the quality of life for those affected and their families”—-and perhaps the connection is so intimate that we do not even notice or acknowledge it.

Too, culture can certainly influence both the sound of speech and how one uses speech to interact: Charlie’s first speech therapist, whom we met while we were living in Minnesota, was from Las Vegas originally (indeed, the first time I talked to her on the phone, she said to me “You have a West Coast accent!”). She has worked at an autism school in Ireland and more than a few times noted that she must be teaching a number of Irish children to talk West-Coast-American style; one of Charlie’s therapists (a New Jersey native) noted that he still has a few words with a Midwestern accent, as many of his first therapists were from Minnesota and Wisconsin. Finally, I will also note that most of the members of my Chinese American family are not big talkers; I only truly learned how to converse, debate, negotiate, and otherwise spar verbally when I came back East (to New Jersey) to attend college.

I do occasionally wonder what it would have been like if Charlie’s first language had been Chinese.