EC Paediatrics

Research Article Volume 12 Issue 9 - 2023

The Effectiveness of Imitative and Cognitive Methods on Pragmatic Skills in Autistic Children

Masoud Moghaddamnia1 and Maryam Khalilkhaneh2*

1Psychiatrist, Assistant Professor, Medical Science, Shahed University, Tehran, Iran
2Linguistics, Ferdowsi University of Mashhad, Mashhad, Iran

*Corresponding Author: Maryam Khalilkhaneh, Linguistics, Ferdowsi University of Mashhad, Mashhad, Iran.
Received: July 10, 2023; Published: August 16, 2023



Introduction: Human growth is dependent on social interactions. As a significant part of the human entity, language plays a crucial role in this regard. Humans communicate through verbal and nonverbal languages. Conversational skills are the most important pragmatics skills, and children with autism spectrum disorder suffer from significant deficits in pragmatics, and because of this they face successive communication failures due to impaired pragmatic and conversational skills. Thus, developing treatment methods that focus on improving the conversational skills of these children is especially important. The present study aims at evaluating the function of pragmatic skills and the severity of this disorder in 60 Persian speaking children with autism aged 4 - 10. The participants were randomly divided into two groups. The first group consisted of 30 autistic children who received the interventional method of reciprocal imitation and the second group encompassed 30 autistic children undergoing the effectiveness of the cognitive model- a cybernetic-based approach-on enhancing the speech of children with autism.

Awareness of how this approach works and its effectiveness on improving language and social skills can be a guide for therapeutic protocols to improve the development of theory of mind in children with a variety of language disorders.

Methods: This is a descriptive-analytical study. The instrument used in this study was the Children's Communication Checklist, 2nd edition to measure the pragmatic skills and the Childhood Autism Rating Scale-Second Edition (CARS-2). All of these children were also evaluated by a child psychiatrist and a child neurologist and investigation was based on autism criteria and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V). Eventually, the data were analyzed by independent t-test in R environment.

Results: A significant difference was observed between autistic subjects and standard scores, i.e. there was a significant difference (p < 0.001) between the scores of autistic subjects receiving reciprocal imitation training and those undergoing cognitive intervention.

Conclusion: By and large, it can be concluded that undergoing cognitive treatment method, can be effective in treating language disorder in children with autism.

Keywords: Reciprocal Imitation Training; Cognitive Treatment Method; Pragmatics; Autism

  1. Kumaria A and Sitarman M. “Can vagus nerve stimulation improve social cognition in autism?” Journal of Cortex 115 (2019): 350-351.
  2. Rajendran G and Mitchel P. “Cognitive theories of autism”. Journal of Developmental Review 27 (2007): 224-260.
  3. Anderson MP., et al. “Bridging from Cells to Cognition in Autism Pathophysiology: Biological Pathways to Defective Brain Function and Plasticity”. American Journal of Biochemistry and Biotechnology2 (2008): 167-176.
  4. Hus V and Lord C. “The autism diagnostic observation schedule, module 4: revised algorithm and standardized severity scores”. Journal of Autism Developmental Disorders8 (2014): 1-17.
  5. Melogno S., et al. “Profile of the linguistic and metalinguistic abilities of a gifted child with autism spectrum disorder: A case study”. Child Language Teaching and Therapy1 (2015): 113-126.
  6. Sigan L., et al. “The Oral and Written Language Scales: Is it useful for older children with autism spectrum disorder?” Research in Autism Spectrum Disorders 2 (2008): 137-146.
  7. Levy Y and Yuda CH. “Language performance in silbing of noneverbal children with autism”. Journal of Autism 101 (2001): 344-354.
  8. Bates E and Dick F. “Language, Gesture, and the Developing Brain”. Developmental Psychobiology 40 (2002): 293-310.
  9. Ozonoff S. “Editorial perspective: autism spectrum disorders in DSM-5-an historical perspective and the need for change”. Journal of Child Psychology and Psychiatry10 (2012): 1092-1094.
  10. Lauritsen M and Ewald H. “The genetics of autism”. Journal of Psychiatry9 (2001): 411-427.
  11. Lefebvre A., et al. “Neuroanatomical Diversity of Corpus Callosum and Brain Volume in Autism: Meta-analysis, Analysis of the Autism Brain Imaging Data Exchange 12. Project, and Simulation”. Biological Psychiatry 78 (2015): 126-134.
  12. Smidt J., et al. “Formal genetic findings in attention-deficit/hyperactivity disorder”. Journal of Psychiatry 41 (2003): 1026-1036.
  13. Manor-Binyamini I and Schreiber-Divon M. “Repetitive behaviors: Listening to the voice of people with highfunctioning autism spectrum disorder”. Journal of Research in Autism Spectrum Disorders 64 (2019): 23-30.
  14. Grafman J and Litvan I. “Importance of deficits in executive functions”. Journal of Lancet Neurology11 (2007): 994-1003.
  15. Mackinlay R and Charman T. “High functioning children with autism spectrum disorder: A novel test of multitasking”. Brain and Cognition1 (2005): 14-24.
  16. loveland KA., et al. “Fronto-limbic Functioning in Children and Adolescents with and without Autism”. Neuropsychologia1 (2008): 49-62.
  17. Damasio AR and Maurer MG. “A neurological model for childhood autism”. Archives of Neurology12 (1978): 777-786.
  18. Manolitsi M and Botting N. “Language abilities in children with autism and language impairment: using narrative as a additional source of clinical information”. Child Language Teaching and Therapy1 (2011): 39-55.
  19. Ozonoff S., et al. “Autism spectrum disorder”. Newyork: American Psychiatric publishing (2007).
  20. Guedes Neta MDL and Varanda C. “The role of mirror neurons in autism Impairment, 24th European Congress of Psychiatry”. European Psychiatry 33 (2016): 5374-5375.
  21. C Hamilton AFDe. “Reflecting on the mirror neuron system in autism: A systematic review of current theories”. Developmental Cognitive Neuroscience 3 (2013): 91-105.
  22. Raymaekers R., et al. “EEG study of the mirror neuron system in children with high functioning autism”. Brain Research 1304 (2019): 113-121.
  23. Xu N., et al. “Inflammatory cytokines: potential biomarkers of immunologic dysfunction in autism spectrum disorders”. Mediators Inflammation (2015): 10.
  24. Theoharides T., et al. “Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders”. Translational Psychiatry6 (2016): e844.
  25. Smalley S., et al. “Genetic linkage of attention-deficit/hyperactivity disorder on chromosome 16p13, in a region implicated in autism”. Journal of Genetic 71 (2002): 959-963.
  26. Patriquin MA., et al. “Neuroanatomical and neurofunctional markers of social cognition in autism spectrum disorder”. Human Brain Mapping11 (2016): 3957-3978.
  27. Baron-Cohen S., et al. “The amygdala theory of autism”. Neuroscience and Biobehavioral Reviews3 (2000): 355-364.
  28. Abrahams BS and Geschwind DH. “Connecting genes to brain in the autism spectrum disorders”. Archives of Neurology4 (2010): 395-399.
  29. Blackmon K. “Structural MRI biomarkers of shared pathogenesis in autism spectrum disorder and epilepsy”. Epilepsy and Behavior 47 (2015): 172-182.
  30. Bo J., et al. “Do children with autism spectrum disorders have motor learning difficulties?” Research in Autism Spectrum Disorders 23 (2016): 50-62.
  31. Lee K., et al. “The use of movement-based interventions with children diagnosed with autism for psychosocial outcomes-A scoping review”. Research in Autism Spectrum Disorders 24 (2016): 52-67.
  32. Pintomartin J and Levy SE. “Early diagnosis of Autism spectrum disorders”. Journal of Neurobiology 101 (2004): 344-354.
  33. Lefebvre A., et al. “Neuroanatomical Diversity of Corpus Callosum and Brain Volume in Autism: Meta-analysis, Analysis of the Autism Brain Imaging Data Exchange Project, and Simulation”. Biological Psychiatry 78 (2015): 126-134.
  34. Eigsti IM., et al. “Language comprehension and brain function in individuals with an optimal outcome from autism”. NeuroImage: Clinical 10 (2016): 182-191.
  35. Zhang F and Roeyers H. “Exploring brain functions in autism spectrum disorder: A systematic review on functional near-infrared spectroscopy (fNIRS) studies”. International Journal of Psychophysiology 137 (2019): 41-53.
  36. M Wadsworth H., et al. “Action simulation and mirroring in children with autism spectrum disorders”. Behavioural Brain Research 341 (2018): 1-8.
  37. Rizzolatti G., et al. “The Mirror Neuron Mechanism”. Reference Module in Neuroscience and Biobehavioral Psychology (2019): 1-12.
  38. Frye R and Beachamp M. “Receptive language organization in high-functioning autism”. Journal of Neurology5 (2009): 231-236.
  39. Loukusa S., et al. “Use of context in pragmatic language comprehension by children with Asperger syndrom and high-functioning Autism”. Journal of Autism 37 (2007): 1049-1059.
  40. Levy Y and Yuda Ch. “Language performance in silbing of noneverbal children with autism”. Journal of Autism 101 (2001): 344-354.
  41. Santangelo S and Tsatsanis K. “What is known about autism: genes, brain and bahaviour”. Journal of Pharmacogenomics 5 (2005): 71-92.
  42. Oberman L., et al. “EEG evidence for mirror neuron dysfunction in autism spectrum disorders”. Cognitive Brain Research4 (2005): 190-198.
  43. Gentilucci M and C Corballis M. “From manual gesture to speech: A gradual transition”. Neuroscience and Biobehavioural Reviews 30 (2006): 949-960.
  44. C Corballis M. “Language as gesture”. Human Movement Science 28 (2009): 556-565.
  45. L Rowe., et al. “Early gesture selectively predicts later language learning”. Developmental Science1 (2009): 182-187.
  46. Helland WA and Helland T. “Emotional and behavioural needs in children with specific language impairment and in children with autism spectrum disorder: The importance of pragmatic language impairment”. Research in Developmental Disabilities 70 (2017): 33-39.
  47. Grace Lam Y and Yeung S. “Towards a convergent account of pragmatic language deficits in children with high-functioning autism: Depicting the phenotype using the Pragmatic Rating Scale”. Research in Autism Spectrum Disorders 6 (2012): 792-797.
  48. Sharifian F. “Cultural Linguistics and linguistic relativity”. Language Science (2016): 1-10.
  49. American Psychiatric Association. “Diagnostic and statistical manual of mental disorders”. 5th Edition. Washington, DC (2013).
  50. CARS-2: Childhood Autism Rating Scale™ -Second Edition (CARS-2), Schopler, Van Bourgondien, Wellman, and Love, Texas educational Agency (2015).
  51. Kazemi Y., et al. “Adaptation of the children's communication checklist-(CCC-2) to Persian and determining its psychometric values”. Joseph Riley Recruitment Services JRRS2 (2014): 281- 291.
  52. Kazemi Y., et al. “Children's Communication Checklist: the Study of Persian Children”. International Journal of Rehabilitation Research Science3 (2007): 1-5.
  53. Bishop DV. “Childrens Communication Cheklist”. 2nd edition, USA; Pearson (2006).
  54. Bishop DV. “Genes, Cognition, and Communication: insights from neurodevelopmental disorder”. Journal of Science1 (2009): 1-18.
  55. Ingersoll B. “Teaching children with autism to imitate using a Naturalistic Treatment Aproach: Effect on imitation, language, play, and social behaviors”. (Unpublished Doctoral Dissertation, University of California, San Diego) (2003).
  56. Want SC and Harris PL. “How do children ape? Applying concepts from the study of non-human primates to the developmental study of ‘‘imitation” in children”. Developmental Science 5 (2003): 1-4.
  57. Ingersoll B., et al. “The effect of sensory feedback on immediate object imitation in children with autism”. Journal of Autism and Developmental Disorders 33 (2003): 673-683.
  58. Save-Pédebos J., et al. “The development of pragmatic skills in children after hemispherotomy: Contribution from left and right hemispheres”. Epilepsy and Behavior 55 (2016): 139-145.
  59. Larkin F., et al. “Collaborative competence in dialogue: Pragmatic language impairment as a window onto the psychopathology of autism”. Research in Autism Spectrum Disorders 43-44 (2017): 27-39.
  60. A Knaus., et al. “Handedness in Children with Autism Spectrum Disorder”. Perceptual and Motor Skills2 (2016): 542-559.
  61. De Giacomo A., et al. “Aggressive Behaviors and Verbal Communication Skills in Autism Spectrum Disorders”. Global Pediatric Health 3 (2016): 1-5.
  62. Camodeca A., et al. “Intact Verbal Fluency Abilities in the Broad Autism Phenotype, Psychiatry Research”. Psychiatry Research (2018).
  63. Chinello A., et al. “Persistent primary reflexes affect motor acts: Potential implications for autism spectrum disorder”. Research in Developmental Disabilities 83 (2018): 287-295.
  64. S Nomi J., et al. “Insular function in autism: Update and future directions in neuroimaging and interventions”. Progress in Neuro-Psychopharmacology and Biological Psychiatry 89 (2019): 412-426.
  65. Loveland K., et al. “Speech Acts and the Pragmatic Deficits of Autism”. Journal of Speech and Hearing Research4 (1989): 593-604.
  66. Kissine M., et al. “Children with Autism Understand Indirect Speech Acts: Evidence from a Semi-Structured Act-Out Task”. PLoS One11 (2015): e0142191.

Masoud Moghaddamnia and Maryam Khalilkhaneh. The Effectiveness of Imitative and Cognitive Methods on Pragmatic Skills in Autistic Children. EC Paediatrics 12.9 (2023): 01-13.