Collaborative competence in dialogue: Pragmatic language impairment as a window onto the psychopathology of autism

Background Pragmatic language, including conversational ability, can be difficult for people with autism. Difficulties with dialogue may reflect impairment in interpersonal engagement more than general language ability. Method We investigated conversational abilities among children and adolescents with and without autism (n = 18 per group) matched for language proficiency and productivity. Videotaped conversations from the Autism Diagnostic Observational Schedule (ADOS, Lord, Rutter, DiLavore, & Risi, 2001) were rated according to the Collaborative Competence in Dialogue (CCD) scale featuring six verbal and non-verbal ‘cues’ that conversational partners use to sustain dialogue. Results Participants with autism produced significantly fewer ‘typical’ communicative cues and more cues rated as intermittent or rote/stereotyped, even when non-verbal items (gaze) were removed from consideration. Within the autism group, competence in dialogue was not correlated with ‘general’ language ability, but was correlated with a measure of pragmatic ability. Conclusions Difficulties with collaboration in dialogue may mirror the intermittent or incomplete interpersonal engagement of children with autism. Implications Assessment of language ability in autism should include observation in unstructured social settings.