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.