Pragmatic impairments in adults with childhood diagnoses of autism or developmental receptive language disorder

Audiotaped conversational samples from adults diagnosed as having autistic disorders (n=15) or developmental receptive language disorders (n=17) in childhood were transcribed and analyzed using methods based on those of Bishop and Adams (1989). Subjects with autism showed substantially greater pragmatic impairment not explicable by generalized impairment of verbal skills. This was mainly due to autistic subjects' greater difficulty in forming context-relevant communicative intentions; in contrast, pragmatic impairments arising from failures in translating intentions into spoken utterances (i.e., impairments at the level of execution) did not distinguish between the groups. In both diagnostic groups, impairment in forming appropriate communicative intentions was closely related to more generalized impairment of reciprocal social behavior.The author was supported by the Bethlem Royal and Maudsley Hospital Research Fund. Lynn Mawhood very kindly provided all of the primary data and extracted the conversational samples from her recorded interviews. I also thank Dorothy Bishop, Mary Crowson, Helen Eales, and Professor Sir Michael Rutter for advice and help in various aspects of the study.