Deficits in Understanding Perspective-Dependent Spatial Language By Older Children with ASD

Background:

The earliest reports on autism spectrum disorder (ASD) describe pronoun reversal errors, where individuals confuse you with I¹. Subsequent research has suggested that such errors result from underlying deficits in perspective-taking in ASD^2–4: specifically, that individuals do not understand others’ perspectives and therefore cannot understand that the person referred to by you or I depends on who is speaking. If so, the same perspective-shifting deficit should then apply to spatial terms, like prepositions, since they can also be perspective dependent. For example, when two people are facing one another, the position “to the left” of one person is the opposite of “to the left” of the other.

Despite these parallels, there is limited research on spatial-language use in ASD⁵, and, as far as we are aware, there is no research on their interpretation of such terms. If there is an underlying deficit in perspective-taking in ASD, it should affect both expressive and receptive spatial language.

Objectives:

We aim to determine whether children with ASD show relative weaknesses understanding perspective-dependent spatial language.

Methods:

Sixteen (16) older children and adolescents with ASD participated, along with 18 neurotypical (NT) peers. Groups were not significantly different in age (M ASD=13;5, M NT=13;7 p=0.86), sex (4 F ASD, 5 F NT, p=1), IQ (K-BIT 2⁶, M ASD = 111, M NT = 111, p=0.95), and language (CELF-4⁷ Core Language, M ASD = 106, M NT = 109, p = 0.68).

We presented 128 spatial arrays on a computer screen. In each, a doll is pictured in the middle of the screen, with four black shapes surrounding her (Figure 1). From trial to trial, the doll’s position changes, so that she is facing different directions, but the shapes’ positions are fixed.

At the beginning of each trial, participants hear a command in the “doll’s voice”, e.g. “Click on the shape above me”. For half of the trials, the position of the object is described from the doll’s perspective (e.g., “…on my left”), and for the other half, the shape’s position is described from the participant’s perspective (e.g., “…on your left”).

Participants use a mouse to highlight and select the shape described.

Results:

We used a 2x2 repeated-measures ANOVA to measure the effect of Group (ASD vs. NT) and Perspective (Doll vs. Child) on shape-selection accuracy.

There was a significant interaction between Group and Perspective (F_(1,32)= 4.53, p=0.04), where children with ASD were less accurate at selecting a shape when the shape’s position was described from the doll’s perspective.

Conclusions:

Results show that older children and adolescents with ASD – even those with normal language scores – struggle to accurately interpret prepositions when they reflect another’s perspective. Because prepositions are some of the most frequently used words in English, this presents a persistent problem during reciprocal conversation. Thus, we believe that language deficits in perspective-taking should be intervention targets for children with ASD, even for those who score within normal ranges on standardized language tests.