Journal of Communication Disorders 54 (2015) 2–14

Contents lists available at ScienceDirect

Journal of Communication Disorders

Trajectories of pragmatic and nonliteral language

development in children with autism spectrum disorders
Elisabeth M. Whyte *, Keith E. Nelson
The Pennsylvania State University, United States

A R T I C L E I N F O A B S T R A C T

Article history: Children with autism spectrum disorder (ASD) often have difficulties with understanding
Received 9 January 2014 pragmatic language and also nonliteral language. However, little is understood about the
Received in revised form 30 October 2014 development of these two language domains. The current study examines pragmatic and
Accepted 7 January 2015 nonliteral language development in 69 typically developing (TD) children and 27 children
Available online 17 January 2015 with ASD, ages 5–12 years. For both groups, performance on pragmatic language and
nonliteral language scores on the Comprehensive Assessment of Spoken Language
Keywords: increased significantly with chronological age, vocabulary, syntax, and theory of mind
Language development
abilities both for children with ASD and TD children. Based on a cross-sectional trajectory
Autism spectrum disorder
analysis, the children with ASD showed slower rates of development with chronological
Pragmatic language
Theory of mind
age relative to TD children for both the pragmatic language and nonliteral language
subtests. However, the groups did not show significant differences in the rate of
development for either pragmatic language or nonliteral language abilities with regard to
their vocabulary abilities or TOM abilities. It appears that children with ASD may reach
levels of pragmatic language that are in line with their current levels of basic language
abilities. Both basic language abilities and theory of mind abilities may aid in the
development of pragmatic language and nonliteral language abilities.
Learning outcomes: After reading this article, the reader will understand: (1) the
relation between basic language abilities (vocabulary and syntax) and advanced language
abilities (pragmatic and nonliteral language), (2) how the cross-sectional trajectory
analysis differs from traditional group matching studies, and (3) how pragmatic and
nonliteral language development for children with autism shows both similarities and
differences compared to typically developing children.
ß 2015 Elsevier Inc. All rights reserved.

1. Introduction

Individuals with autism spectrum disorders (ASDs) have difficulties with the development of social and communicative
abilities. However, for domains of language development, some theories (such as the relevance theory; e.g., Happé, 1993)
suggest that some areas of language (especially the domains of pragmatic language or nonliteral language) may be
disproportionately impacted for those individuals with autism who do show considerable development in their vocabulary
and/or syntax abilities. For typically developing (TD) children, skills in both nonliteral language and pragmatic language

* Corresponding author at: Department of Psychology, 141 Moore Building, The Pennsylvania State University, University Park, PA 16802, United States.
Tel.: +1 814 863 5626.
E-mail address: emv131@psu.edu (E.M. Whyte).

http://dx.doi.org/10.1016/j.jcomdis.2015.01.001
0021-9924/ß 2015 Elsevier Inc. All rights reserved.
 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14 3

continue to improve throughout childhood (Rundblad & Annaz, 2010a; Ryder & Leinonen, 2003). Some research suggests
that as a group, children with autism spectrum disorder (ASD) often have a difficult time understanding both pragmatic
language (Lam & Yeung, 2012; Tager-Flusberg & Anderson, 1991) and nonliteral language (Rundblad & Annaz, 2010b).
However, individuals with ASD show great variability in the rate of language acquisition across development (Tek, Mesite,
Fein, & Naigles, 2014). Understanding the predictors of progress in pragmatic language and nonliteral language development
for individuals with autism may be crucial for creating appropriate individualized targets for intervention (Klin et al., 2007).
Comprehension of pragmatic language and nonliteral language share a common feature in that they require children to
not only understand the individual meaning of words embedded in a sentence structure, but also to understand and respond
appropriately to the communicative intent of language embedded in social and linguistic contexts (McTear & Conti-
Ramsden, 1992). The specific definition of pragmatic language versus nonliteral language (as well as the boundary between
these domains) varies between research studies, as well as the tasks used to assess abilities in these domains. The current
study examines predictors of the development of pragmatic language and nonliteral language abilities using two subscales
from the Comprehensive Assessment of Spoken Language (CASL; Carrow-Woolfolk, 1999). Pragmatic language in this case
refers to the understanding and use of the literal aspects of context during communication (e.g., understanding the socially
appropriate use of language for relevant contexts, such as: greetings, expressions of gratitude, making direct requests and
answering questions). Nonliteral language refers to use of language where there is a specific mismatch between the literal
meaning of the individual words of the phrase and the expected interpretation (e.g., ‘‘he was such a turtle’’ means that ‘‘he
was slow’’ and not ‘‘he was a reptile with a shell’’). Types of nonliteral language include figurative language (e.g., metaphors,
such as ‘‘the girl was a butterfly’’), sarcasm (e.g., saying ‘‘good job’’ when someone does poorly), and indirect requests (e.g., ‘‘I
want all eyes on the board’’). Importantly, various aspects of nonliteral language may vary in how close the intended
meaning of the phrase is to the individual words.
The majority of research on both pragmatic language and nonliteral language abilities in children with ASD has used
group-matching designs (often averaging across large age ranges). However, the overall heterogeneity in language abilities
in children with ASD can be problematic for group matching designs (Tager-Flusberg, 2004). In particular, little is known
about the development with age of these abilities in children with ASD. In addition, little is known about how vocabulary
and/or syntax development relates to either pragmatic language or nonliteral language development for children with ASD,
and whether or not these developmental relations differ between children with ASD and TD. Research has recently begun to
use more developmentally sensitive approaches to examining language abilities for children with autism (e.g., Rundblad &
Annaz, 2010b), but there are still remaining questions about the relative progress in development of pragmatic language and
figurative language. The current study uses a cross-sectional developmental trajectory analysis (Thomas et al., 2009) to
examine how pragmatic language and nonliteral language abilities develop in children with ASD and TD with regard to their
age, syntax, and vocabulary abilities.

1.1. Typical and atypical development

Pragmatic language abilities develop across childhood and into adolescence for TD children (Nippold, 2000; Ryder &
Leionen, 2014). For example, Ryder and Leinonen (2003) suggest that 5-year-old children are able to understand and answer
more complex questions than 3- or 4-year-old children based on their increasingly more complex ability to use contextual
information. Lokusa, Leinonen, & Ryder (2007) examined pragmatic language abilities in children, ages 3–9, and found that
while three-year-old children were able to use some context for resolving potential ambiguity when answering questions,
the use of context increased substantially among the older children. Research suggests that children with ASD have
difficulties in their pragmatic language development, including difficulties with the use language in the context of social
conversations (Loukusa & Moilanen, 2009; Reichow, Salamack, Paul, Volkmar, & Klin, 2008; Volden, Coolican, Garon, White,
& Bryson, 2009; Young, Diehl, Morris, Hyman, & Bennetto, 2005). Lam and Yeung (2012) found that children and adolescents
with ASD, ages 8–15 years, performed worse than individuals with TD when using an observational scale to measure the
pragmatic language abilities, such as having more instances of ‘‘out-of-synchrony communicative behavior’’ (Lam & Yeung,
2012). Children with ASD do show some developmental progress in pragmatic abilities. Specifically, Loukusa, Leinonen,
Kuusikko, et al. (2007) found that children with ASD who were 10–12 years old performed better at pragmatic language
measures than children with ASD who were younger (7–9 years), suggesting that pragmatic language abilities and the use of
context increases with age and experience for individuals with ASD.
Nonliteral language comprehension also shows a protracted developmental period across childhood in typical
development. Some TD children, ages 4–6 years, are able to demonstrate an emerging knowledge of metaphors, with older
children and adolescents showing greater levels of metaphor comprehension (Le Sourn-Bissaoui, Caillies, Bernard, Deleau, &
Brule, 2012; Rundblad & Annaz, 2010a; Vosinadou & Ortony, 1983; Winner, Rosenstiel, & Gardner, 1976). Additionally,
comprehension of indirect requests (Bernicot, Laval, & Chaminaud, 2007; Ledbetter & Dent, 1988) and sarcasm (Glenwright
& Pexman, 2010) also increase with age for TD children. Children with ASD may also have difficulties with understanding
various aspects of nonliteral language compared to their same-age typically developing peers (Dennis, Lazenby, & Lockyer,
2001; MacKay & Shaw, 2004; Martin & McDonald, 2004; Rundblad & Annaz, 2010b). Research has found that children with
ASD (diagnosed with Asgerger’s syndrome or high functioning autism) perform worse than TD children on measures of
metaphor comprehension (Dennis et al., 2001; Nikolaenko, 2004). In addition, MacKay and Shaw (2004) found that children
with Asgerger’s syndrome showed difficulties on a variety of nonliteral language measures (including irony, metonymy, and
4 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14

indirect requests) compared to TD children. While many studies find differences, at the group-level, in pragmatic and
nonliteral language abilities between TD children and children with ASD, important questions still remain about the
development of these language abilities both in individuals with TD and ASD.

1.2. Factors supporting development

Factors supporting understanding of pragmatic language and nonliteral language for children have been examined in the
literature, including the potential contributions of basic language abilities and theory of mind (TOM) for both language
domains, though these relationships have been more commonly studied with regard to nonliteral language. For TD children,
there is some evidence that language abilities develop together in parallel, with basic language abilities (such as vocabulary)
correlating strongly with nonliteral language abilities (Johnson, 1991; Rundblad & Annaz, 2010a). Research suggests that
understanding of nonliteral language is supported by the ability to use the linguistic and social context to abstract meaning,
and that vocabulary and syntax abilities are likely to support this process (Gernsbacher & Pripas-Kapit, 2012; Rundblad &
Annaz, 2010a; Vosniadou, 1987). With regard to pragmatic language, Volden et al. (2009) found that a composite of
expressive and receptive basic language abilities predicted a large portion of the variance in pragmatic language ability for
children with ASD. Eisenmajer and Prior (1991) found that pragmatic language abilities correlated with several basic
language measures, supporting the relationship between basic language abilities and pragmatic language. There is, however,
some controversy in the literature as to whether or not nonliteral language abilities are disproportionately impacted for
children with ASD, beyond their potential differences in basic language abilities. For example, Rundblad and Annaz (2010b)
found that receptive vocabulary abilities only predicted performance on metonyms, but not metaphors, in their sample of 10
children with ASD.
The relevance theory has driven research focused on the potential role of theory of mind for contributing to pragmatic
language (Le Sourn-Bissaoui, Caillies, Gierski, & Motte, 2011; Loukusa & Moilanen, 2009) difficulties for children with ASD.
Loukusa and Moilanen (2009) suggest that receptive vocabulary skills alone may be insufficient for understanding various
aspects of pragmatic language for individuals with ASD, due to their likely difficulties with regard to the use of the social and
linguistic context for understanding the meaning of these utterances. This line of research largely suggests that individuals
with ASD struggle with these more advanced language abilities, even when they have good basic language abilities
(e.g., receptive vocabulary), potentially due to weaknesses in utilizing the social and linguistic context for understanding the
meaning of these utterances (Loukusa & Moilanen, 2009; Noens & van Berckelaer-Onnes, 2005).
Thus, limitations with theory of mind abilities have been implicated in difficulties with understanding nonliteral
language, especially with regard to understanding metaphors (Happé, 1993). While primarily examined with regard to
performance on first- or second-order false belief measures (e.g., Happé, 1993), there have overall been mixed results with
using false belief measures with older children, with some studies failing to find a unique contribution of false belief
performance on nonliteral language abilities (e.g., Norbury, 2005; Rundblad & Annaz, 2010b). Other advanced measures of
theory of mind, that are more developmentally sensitive across childhood, may instead better elucidate these relations. For
example, performance on the children’s ‘‘reading the mind in the eyes’’ task (RMTE; Baron-Cohen, Wheelwright, Spong,
Scahill, & Lawson, 2001) is correlated with idiom comprehension abilities (e.g., understanding phrases such as ‘‘raining cats
and dogs’’) in children with autism (Whyte, Nelson, & Scherf, 2014), but it is unknown how this measure relates to measures
of pragmatic language or nonliteral language abilities.
Other research suggests that receptive vocabulary may be an area of relative strength for individuals with ASD when
compared to their syntax abilities (Eigsti, Bennetto, & Dadlani, 2007). It is possible that syntax abilities, specifically, are
predictive of their relative pragmatic (Volden et al., 2009) and nonliteral language abilities (Gernsbacher & Pripas-Kapit,
2012; Norbury, 2004, 2005; Whyte, Nelson, & Khan, 2013) for individuals with ASD, rather than a diagnosis of ASD in
particular. For nonliteral language, Norbury (2005) found that syntax comprehension is a better predictor of metaphor
comprehension than receptive vocabulary in particular, for children with language impairments, regardless of whether or
not they exhibited social impairments associated with ASD. Additionally, children with ASD (especially those with good
syntax abilities) were able to benefit from the use of context in understanding unfamiliar idiomatic phrases (Norbury, 2004).
This line of research overall suggests that some children with ASD may not show impairments in pragmatic language or
nonliteral language if they show significant progress in the development of their basic language abilities (Gernsbacher &
Pripas-Kapit, 2012; Norbury, 2004, 2005; Whyte et al., 2014). Thus, understanding the role of expressive vocabulary and
syntax abilities in supporting the development of pragmatic language and nonliteral language may be important for
choosing appropriate matching variables to prevent biased conclusions about the nature of language abilities for individuals
with ASD. Further, any theoretical account of language development in children with TD as well as those with ASD needs to
take into account how the varied language domains may develop together across childhood, and how this also may interact
with other domains, such as theory of mind.

1.3. Developmental trajectories

One approach to examining potential relations between language domains across development, arising from the
neuroconstructivist theory, is the cross-sectional developmental trajectory analysis (Thomas et al., 2009). The
developmental trajectory analysis described by Thomas et al. (2009) allows for examining differences in the rate of
 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14 5

growth of language abilities across development, even for cross-sectional samples, using ANCOVA models to directly
compare the potential differences in the intercepts and slopes of the trajectories. It is possible to look at age-related
trajectories for a group of children with ASD compared to TD children to see if the children with ASD have a different rate of
development with regard to chronological age. It is also possible to examine the rate of development in a behavior as a
function of various possible predictors, such as vocabulary or syntax (Annaz, Karmiloff-Smith, & Thomas, 2008; Thomas
et al., 2009). This analysis approach can detect group differences in the intercept of the trajectory (defined as differences at
the youngest point of overlap in scores on the predictor variable between the groups), slowed rate of development (defined
as differences in the slopes of the trend lines between groups), or both (Annaz et al., 2008; Thomas et al., 2009) for each
potential predictor variable. This stands in contrast to traditional group matching approaches that are only sensitive to
overall group differences.
For group matching approaches, the choice of matching variables needs to be theory-driven, as improperly matched
groups runs a risk of leading to biased conclusions about the nature of symptoms in autism (Gernsbacher & Pripas-Kapit,
2012; Jarrold & Brock, 2004; Thomas et al., 2009). However, the trajectory approach does not require this same a priori group
matching. Instead of controlling for differences in vocabulary and other potential matching variables between groups, this
approach can tell us important information about how these variables may actually provide important contributions to the
rate of development of pragmatic and nonliteral language abilities. While this approach does not reduce the need for
longitudinal research, it is more developmentally sensitive than group matching designs, and can potentially inform future
longitudinal research (Annaz et al., 2008; Thomas et al., 2009).
This cross-sectional developmental trajectory approach has been previously used in several studies to examine the
development of vocabulary, nonliteral language, and face processing abilities of children with ASD (Annaz, Karmiloff-Smith,
Johnson, & Thomas, 2009; Kover, McDuffie, Hagerman, & Abbeduto, 2013; Rundblad & Annaz, 2010b). For example,
Rundblad and Annaz (2010b) used a developmental trajectory analysis to examine two different aspects of nonliteral
language (metaphors and metonyms) in 11 children with ASD, ages 5–11 years. For the children with ASD, receptive
vocabulary predicted performance on metonyms, but not metaphors (Rundblad & Annaz, 2010b). However, additional
measures of language abilities (including syntax abilities and expressive vocabulary abilities) and larger sample sizes are
needed to further investigate development of nonliteral language for children with ASD.

1.4. Current study

The current study uses the trajectory analysis methods of Thomas et al. (2009) to examine how age, vocabulary, syntax,
and theory of mind predict performance on the pragmatic language and nonliteral language subtests of the Comprehensive
Assessment of Spoken Language (CASL; Carrow-Woolfolk, 1999) for children with ASD and TD. The two subtests from the CASL
(pragmatic language and nonliteral language) were chosen due to their potential use in measuring nonliteral and pragmatic
language in clinical settings (e.g., Reichow et al., 2008). Additionally, these outcome measures are sensitive across a wide age
range of development and are unlikely to show ceiling or floor effects for either individuals with TD or ASD.
For the current study, the age range of 5–12 years was chosen such that it would be likely that TD children aged 5–6 may
perform poorly on these measures, with increasing mastery of pragmatic and nonliteral language with increasing age for the
TD children. Thus, it is hypothesized that there may not be a difference in the youngest age of overlap between groups for the
current sample (representing the intercepts of the trajectories). The primary outcome of interest, instead, is the comparison
of the rate of development between groups for each trajectory. The current study hypothesizes that children with ASD will
have slower rates of development of nonliteral and pragmatic language trajectories from the TD group when examining
chronological age, but the two groups will not have significantly different nonliteral or pragmatic language trajectories when
examining relations with syntax age-equivalence scores, vocabulary age-equivalence scores, or TOM scores. Additionally, it
is predicted that TOM abilities will significantly relate to individual differences in pragmatic and nonliteral language
abilities, above and beyond the contributions of basic language abilities.

2. Method

2.1. Participants

2.1.1. Children with ASD

A total of 26 children (21 m, 5 f), ages 5–12 (M = 9.07, SD = 1.87) years, who were previously diagnosed with an autism
spectrum disorder (ASD), participated in the study (see Table 1). Highly verbal children were included if they had a previous
diagnosis by a clinician under the DSM-IV criteria (American Psychiatric Association, 1994) of autism or high-functioning
autism (n = 8), Asperger’s syndrome (n = 13), or pervasive developmental disorder (PDD-NOS; n = 5), based on parent report.
The current study collapses across these diagnostic labels, as suggested by the newest DSM-5 criteria (e.g., Mahjouri & Lord,
2012); especially given the recent concerns of potential variability in how these diagnostic labels were applied by clinicians
and researchers (e.g., Lord et al., 2012). Participants were included if they were able to speak in sentences, were receiving
treatment services or educational supports related to ASD, and had a raw score above 60 on the parent report Social
Responsiveness Scale (SRS) that indicated the presence of high current levels of autistic social impairments (Constantino,
2002). Scores on the SRS measure of autism symptom severity ranged from 60 to 155 (M = 108.61) for the children with
6 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14

Table 1
Mean (SD) and range for age, basic language abilities, and background measures for individuals with ASD
and TD.

ASD TD

# of participants 26 69
Age (in months) 115.5 (22.7) 105.97 (24.14)
69–153 63–147
Syntax age-equiv. 93.0 (27.8) 108.62 (33.0)*
48–150 54–186
Vocabulary age-equiv. 111.1 (29.3) 127.13 (37.7)
58–180 70–222
Nonverbal IQ age-equiv. 120.0 (52.1) 127.13 (37.6)
62–222 56–222
SRS total raw 107.1 (24.5) 21.43 (11.7)*
60–155 2–50

Note: ASD, autism spectrum disorder; TD, typical development; syntax, syntax construction subtest of the
Comprehensive Assessment of Spoken Language; vocabulary, verbal IQ subtest of the KBIT-2; nonverbal IQ,
nonverbal IQ subtest from the KBIT-2; SRS, Social Responsiveness Scale.
* p < .05.

ASD. One additional child with ASD (not included in the above totals) was excluded due to having a score below 60 on
the SRS.
A total of 21 of the 26 children with ASD were either currently or previously enrolled in speech therapy services.
Participants were native English speakers from middle-class neighborhoods in the United States, and had normal or
corrected-to-normal hearing and vision. Parent report indicated that 22 children were non-Hispanic and Caucasian, 2
children were Hispanic and Caucasian, 1 child was American Indian, and 1 child was biracial. Participants were recruited
through fliers distributed through an autism participant recruitment database, special education classrooms at schools, and
autism social skills intervention programs.

2.1.2. TD children
A total of 69 typically developing children (39 m, 30 f), ages 5–12 years (M = 8.4 years, SD = 24.14), participated in the
study (see Table 1). Children were excluded from the TD group if they had a diagnosis of a language impairments, a diagnosis
of any other developmental disorder (such as ADHD or autism), were currently receiving speech therapy services, or had a
score on the SRS above 50 (allowing for a 10 point gap in the SRS scores between groups). Participants were native English
speakers from middle-class neighborhoods, with normal or corrected-to-normal hearing and vision. Parent report indicated
that 57 children were non-Hispanic and Caucasian, 5 children were Hispanic and Caucasian, 1 child was American Indian, 5
children were biracial, and 1 child was African-American. Participants were recruited using fliers and phone calls to families
from a participant recruitment database containing information from birth records in a geographic area within
approximately an hour drive of the university.
The TD children were recruited to span from the youngest mental age (represented by age-equivalence scores on
vocabulary and syntax) to the oldest chronological age of the children with ASD (see Table 1). When using a trajectory
analysis, restricting the normal variability of the TD children by removal of any individuals with high performance on any
predictor variable may bias the results of the trajectories (Thomas et al., 2009), and it is recommended that specific group
matching on the predictor variables not be done for this analysis. Thus, while the children with ASD had significantly lower
syntax scores than TD children, t(93) = 2.29, p < .05, this mean difference for syntax is unlikely to impact any of the current
study results. The children with ASD also had higher SRS scores than the TD children, t(93) = 23.02, p < .05. For the TD
children, chronological age was predictive of 74.5% of the variance in vocabulary age-equivalence scores, from the verbal IQ
subtest of the Kaufman Brief Intelligence Test, 2nd edition (KBIT2; Kaufman & Kaufman, 2004), and 66.2% of the variance in
syntax age-equivalence scores from the CASL syntax construction subtest. In addition, standardized nonverbal IQ scores
(from the KBIT-2 nonverbal IQ subtest) for the TD children were in the average range (M = 107.68; SD = 15.71).

2.2. Measures

2.2.1. Pragmatic language

The Pragmatic Judgment subtest of the CASL was completed (Carrow-Woolfolk, 1999). Items on this measure involved
judging the appropriate use of language in a social context (e.g., explaining that it is n’t appropriate to talk about dissecting
worms when eating lunch at school, or to talk loudly in a movie theater), and verbally producing language appropriate for
the context (e.g., ordering food in a restaurant, making requests, saying please or thank you, asking for directions, and
greeting people appropriately). An example item includes: ‘‘Suppose the telephone rings. You pick it up. What do you say?’’
(Carrow-Woolfolk, 1999). Responses did not need to be grammatically correct as long as they were pragmatically
appropriate for the situation. Raw scores could range from 1 to 63.
 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14 7

2.2.2. Nonliteral language

The Nonliteral Language subtest of the CASL was completed (Carrow-Woolfolk, 1999). This subtest contains various types
of nonliteral language expressions, where the intent of the spoken phrases differs from a literal interpretation, categorized as
figurative, indirect requests, and sarcasm (Carrow-Woolfolk, 1999). Each non-literal phrase is presented in the context of a
short sentence supporting the figurative meaning. For example, items could include metaphors, such as: ‘‘Janet was waiting
for Sara to finish changing into her swimsuit. Janet said, ‘You are such a turtle.’ What did Janet mean?’’ An example of indirect
requests included: ‘‘The teacher told the class that he wanted all eyes on the board. What did he mean?’’ The two children
scoring zero points on this measure (one with ASD and one with TD) are excluded from the analysis due to recommendations
of the test protocols (Carrow-Woolfolk, 1999). Total nonliteral raw scores could range from 1 to 50.

2.2.3. Syntax
The Syntax Construction subtest of the CASL was completed (Carrow-Woolfolk, 1999). The experimenter presented
pictures and asked the child to verbally complete sentences. The targeted syntactic structures (e.g., verb tense, plurals, and
prepositional phrases) in the sentences grew increasingly complex throughout the test. Syntax raw scores (out of a possible
60 points) were converted into age-equivalence scores (in months).

2.2.4. Vocabulary
Receptive and expressive vocabulary abilities were assessed using the Verbal IQ subtests from the Kaufman Brief
Intelligence Test, 2nd edition (KBIT2; Kaufman & Kaufman, 2004). This vocabulary measure was a composite of two sub-tests,
verbal knowledge (measuring receptive vocabulary) and riddles (measuring verbal comprehension and expressive
vocabulary). The riddles subtest asked children to provide one word answers to questions such as: ‘‘what hops, eats carrots,
and has long ears?’’ (e.g., rabbit or bunny). Total raw vocabulary scores (out of 108 points) were converted into age-
equivalence scores (in months).

2.2.5. Theory of mind

The children’s version of the ‘‘Reading the Mind in the Eyes’’ (RMTE) task was used to measure theory of mind abilities
(Baron-Cohen et al., 2001). During this task, children viewed pictures of the eye regions of faces. The children were asked to
choose one of four labels which best matched the expression or mental state of the person in the pictures (i.e., shy, worried,
thinking about something, not believing). The labels were read out loud to the children. Scores could range from 0 to 28.

2.2.6. Additional background measures

The matrices subtest of the KBIT-2 was used to measure nonverbal IQ (Kaufman & Kaufman, 2004). One parent for each
child completed the Social Responsiveness Scale (SRS), which is a questionnaire used to assess current social skills and
repetitive behaviors, with higher scores indicating more severe social impairments associated with ASD symptomology
(Constantino, 2002). Nonverbal IQ and SRS scores were not significantly correlated with either pragmatic language or
nonliteral language scores (all p > .05).

2.3. Procedure

Prior to their child’s participation in the study, a parent or legal guardian provided informed consent and then completed
a brief demographic questionnaire and the SRS for their child. In addition, all children provided verbal assent prior to
participating. The experimental procedures complied with the standards of the university’s review board. Participant
families were compensated for their time. The study was completed over two hours (completed over 1 or 2 sessions). Testing
took place either in offices in the research lab, or in a quiet room in the child’s home (for families who were unable to travel to
the lab). Testing procedures were kept as similar as possible across testing locations, and children completed the tasks in the
same order. For all tasks in the current study, the test items were read aloud to the children, and children were asked to
respond verbally (or by pointing when appropriate). Breaks were provided between tasks as necessary to ensure attention.

2.4. Developmental trajectory analysis

The cross-sectional developmental trajectory analysis approach followed the methods of Thomas et al. (2009). Separate
regressions were conducted for each group (ASD and TD) to see if each of the outcome variables (pragmatic language and
nonliteral language) increases with each of the predictor variables (chronological age, syntax age-equivalence scores,
vocabulary age-equivalence scores, or TOM scores). These regressions allow for establishing whether or not the outcome
measures show a significant relation with the predictors for each of the two groups (e.g., if pragmatic language increases
with age). In addition, Cook’s Distance values were calculated for each regression, with all values less than the recommended
cut-off of one, suggesting that there were no significant outliers in the current dataset for either the ASD or TD groups.
Once establishing that there are reliable linear trajectories for each group, the trajectories of the two groups are compared
using ANCOVA models, with pragmatic CASL scores and nonliteral CASL scores as separate outcome variables. Thomas et al.
(2009) suggests that each predictor variable needs to be re-scaled to compare the groups starting from the youngest age at
which the two groups overlap to be able to interpret differences between groups at the intercept. To prevent extrapolating
8 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14

outside the age/score ranges measured, the predictor variables were scaled by subtracting each individual’s score (from both
groups) from the youngest age at which the two groups overlapped, so that zero represented the first point of overlap
between the two trajectories (Thomas et al., 2009). This scaling is done so that the value of zero for the intercept represents
the start of the age range that has been measured, and thus potential differences measured in the intercept of the trajectory
(e.g., the ‘‘youngest age of overlap’’ or ‘‘earliest point of overlap’’) refer to measurements at this zero point for each predictor
variable. For chronological age and RMTE scores, this was scaled as months from the youngest age of the ASD group. For the
vocabulary and syntax predictor variables, where the TD group performed slightly higher than the ASD group, this was
instead scaled to months from youngest TD age-equivalence score.
To compare cross-sectional developmental trajectories for chronological age, an ANCOVA is conducted with the predictor
variables of: diagnosis as a fixed factor (representing potential differences in the intercept – at the youngest age of overlap
between groups), as well as age (months from the youngest age of overlap) as a covariate. This model also includes the
analysis of the interaction between scaled age scores and diagnosis (representing the slope of the trajectory, and specifically
measuring potential differences in the rate of development with age; Thomas et al., 2009). Thus, unlike group matching
studies (comparing one mean value averaging across age), the results from this trajectory analysis provide two pieces of
information about potential differences between the trajectories for individuals with ASD and TD with regard to age. First, is
there a significant difference in the youngest age of overlap between the groups (representing the intercept of this
trajectory)? Second, is there a difference in the rate of development between the groups (indicated by a significant
interaction between diagnosis and the scaled age variable)? The results from both of these potential differences are included
in the below results, though this second result (the rate of development) is of primary interest in the current study. The same
models are then repeated separately for the vocabulary, syntax, and RMTE predictors, in place of age in the models.

3. Results

3.1. Pragmatic language trajectories

Pragmatic language scores from the CASL increased with chronological age, both for TD children, R2 = .66, F(1,66) = 126.20,
p < .001, and children with ASD, R2 = .32, F(1,23) = 10.72, p < .01. Comparing the groups, the TD children and children with
ASD did not significantly differ at the youngest age of overlap between groups (representing no differences in the intercept of
the trajectories), p > .05. Children with ASD exhibited a slower rate of development for pragmatic language with
chronological age compared to the TD children; interaction of age x group (representing differences in the slope of the
trajectories), F(1,89) = 3.90, p < .05, h2p ¼ :04. See Fig. 1.

(A) (B)

(C) (D)
Fig. 1. Developmental trajectories of pragmatic language (raw scores) in children with ASD and TD, with regard to (A) chronological age (in months), (B)
syntax age-equivalence scores and (C) vocabulary age-equivalence scores, and (D) theory of mind (TOM) raw scores. The R2 values indicate proportion of
variance accounted for by the predictor for each group (TD and ASD).
 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14 9

Pragmatic language increased with syntax age-equivalence scores, both for TD children, R2 = .68, F(1,66) = 139.57,
p < .001, and children with ASD, R2 = .70, F(1,23) = 53.21, p < .001. Comparing the groups, the TD children and children with
ASD did not significantly differ at the earliest point of overlap in syntax scores between groups, p > .05, and further there was
not a significant interaction between syntax abilities and diagnosis, p > .05, suggesting that the groups did not differ in their
pragmatic trajectories with regard to syntax. See Fig. 1.
Pragmatic language raw scores increased with vocabulary age-equivalence scores, both for TD children, R2 = .72,
F(1,64) = 163.32, p < .001, and children with ASD R2 = .61, F(1,23) = 36.41, p < .001. Comparing the groups, the TD children
and children with ASD did not significantly differ at the lowest point of overlap in vocabulary scores between groups, p > .05,
and there was not a significant interaction between vocabulary and diagnosis, p > .05, suggesting that the groups did not
differ in their pragmatic trajectories with regard to vocabulary abilities. See Fig. 1.
Pragmatic language raw scores increased with TOM scores, both for TD children, R2 = .32, F(1,66) = 31.43, p < .001, and
children with ASD R2 = .37, F(1,23) = 13.52, p < .001. Comparing the groups, the TD children and children with ASD did not
significantly differ at the lowest point of overlap in TOM scores between groups, p > .05, and there was not a significant
interaction between TOM and diagnosis, p > .05, suggesting that the groups did not differ in their pragmatic trajectories with
regard to TOM abilities. See Fig. 1.

3.2. Nonliteral language trajectories

Nonliteral language raw scores from the CASL increased with chronological age, both for TD children, R2 = .70,
F(1,66) = 151.46, p < .001, and children with ASD, R2 = .21, F(1,23) = 6.17, p < .05. Comparing the groups, the TD children and
children with ASD did not significantly differ at the youngest age of overlap between groups, p > .05. Children with ASD
exhibited a slower rate of development for nonliteral language with chronological age compared to the TD children;
interaction of age x group, F(1,89) = 14.06, p < .001, h2p ¼ :14. See Fig. 2.
Nonliteral language raw scores increased with syntax age-equivalence scores for TD children, R2 = .69, F(1,66) = 146.41,
p < .001, and children with ASD, R2 = .57, F(1,23) = 29.82, p < .001. Comparing the groups, the TD children and children with
ASD did not significantly differ at the lowest point of overlap in syntax scores between groups, p > .05. Children with ASD
exhibited a slower rate of development than TD children for nonliteral language with regard to syntax age-equivalence
scores, F(1,89) = 3.94, p < .05, h2p ¼ :04. See Fig. 2.
Nonliteral language raw scores increased with vocabulary age equivalence scores, both for TD children, R2 = .68,
F(1,64) = 133.43, p < .001, and children with ASD, R2 = .66, F(1,23) = 44.18, p < .001. Comparing the groups, the TD children
and children with ASD did not significantly differ at the lowest point of overlap in vocabulary scores between groups, p > .05,
and there was not a significant interaction between vocabulary abilities and diagnosis, p > .05, suggesting that the groups did
not differ in their nonliteral language trajectories with regard to vocabulary abilities. See Fig. 2.

(A) (B)

(C) (D)
Fig. 2. Developmental trajectories of nonliteral language (raw scores) in children with ASD and TD with regard to with regard to (A) chronological age (in
months), (B) syntax age-equivalence scores and (C) vocabulary age-equivalence scores, and (D) theory of mind (TOM) raw scores. The R2 values indicate
proportion of variance accounted for by the predictor for each group (TD and ASD).
10 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14

Nonliteral language raw scores increased with TOM scores, both for TD children, R2 = .44, F(1,66) = 51.70, p < .001, and
children with ASD, R2 = .31, F(1,23) = 10.33, p < .01. Comparing the groups, the TD children and children with ASD did not
significantly differ at the lowest point of overlap in TOM scores between groups, p > .05, and there was not a significant
interaction between TOM abilities and diagnosis, p > .05, suggesting that the groups did not differ in their nonliteral
language trajectories with regard to TOM abilities. See Fig. 2.

3.3. Partial correlations

To further examine the relationship between TOM abilities and each of the two outcome variables, partial correlations
(controlling for both vocabulary and syntax age-equivalence scores) were conducted. When controlling for basic language
abilities, TOM abilities significantly correlate with pragmatic language scores for TD children, r(61) = .25, p < .05, but not for
children with ASD, p > .05. TOM abilities significantly correlate with nonliteral language abilities for TD children, r(61) = .42,
p < .01, and for children with ASD, r(20) = .37, p < .05.

4. Discussion

The current study used a cross-sectional trajectory approach, following the methods of Thomas et al. (2009), to examine
the development of pragmatic language and nonliteral language (metaphor, sarcasm, indirect requests) for children with
ASD and TD children. For both TD children and children with ASD, ages 5–12 years, chronological age, basic language abilities
(syntax and vocabulary), and TOM abilities, were significantly predictive of raw scores on both the pragmatic language and
nonliteral language subtests of the CASL. Older children with ASD had higher numbers of correct responses on the pragmatic
language and nonliteral language subtests of the CASL than younger children with ASD. In addition, children with ASD who
had higher vocabulary or syntax age-equivalence scores performed better on nonliteral language and pragmatic language
measures than children with ASD who had lower vocabulary or syntax scores.
For the trajectory analysis, as predicted, no analysis showed significant differences for the youngest age of overlap
between groups (representing the intercept of the trajectory), or for the lowest overlap in either vocabulary or syntax scores.
This was largely due to the low scores of the TD group at the youngest ages (e.g., 5 years) on the particular measures used in
this study, and this age range (5–12 years) was chosen to be able to specifically focus on the rate of development for these
outcome variables. The current results suggest that while the children with ASD showed a slower rate of development of
both pragmatic language and nonliteral language compared to TD children with regard to age, the rate of development for
the groups did not significantly differ when accounting for vocabulary abilities or TOM abilities. Similarly, the rate of
development did not significantly differ for pragmatic language abilities when accounting for syntax abilities. However, for
the nonliteral language measure, when accounting for syntax abilities, children with ASD did show a significantly slower rate
of development than TD children.

4.1. Pragmatic language development

The current study found that syntax abilities (as measured by the syntax construction subtest of the CASL) and vocabulary
abilities (receptive vocabulary and riddles subtest of the KBIT-2) were both strong predictors of pragmatic language
(as measured by the pragmatic language subtest of the CASL) in children with ASD and TD children. The results of the current
study are consistent with prior research studies suggesting that basic language abilities can predict current performance on
pragmatic language abilities in children with ASD (Volden et al., 2009). For example, Volden et al. (2009) found that a
combination of expressive and receptive basic language abilities significantly predicted pragmatic language abilities in
children, ages 6–13 years, with ASD. The results for age suggested that there was not a significant difference at the youngest
age of overlap between the two groups, but that the slopes of the trajectories (measuring rate of development with age) were
significantly different. The current study adds to the literature with the finding that pragmatic language abilities show a
slower rate of development with age for children with ASD, compared to TD children, but the rate of development did not
differ between groups with regard to either vocabulary or syntax abilities. This suggests that individuals with ASD show
similar trajectories for pragmatic abilities when accounting for their basic language abilities, supporting theories of
pragmatic language development that emphasize the important foundation of basic language abilities for individuals with
ASD. Additionally, pragmatic language abilities were higher for both children with ASD and TD when they had higher TOM
abilities (with no significant difference between groups in the intercept and slope of the trajectories). However, when
controlling for basic language abilities, TOM was only related to pragmatic language for the TD group and not the children
with ASD. This TOM task measures the understanding of complex mental states (based on labeling the expressions of the eye
regions of faces). The results provide some positive evidence for the conclusion that theory of mind abilities potentially
contribute to the development of pragmatic language abilities, particularly for TD children.

4.2. Nonliteral language development

Nonliteral language abilities showed significant increases with age and both measures of basic language abilities for
children with ASD and TD children. When examining the trajectory for chronological age, there was no difference between
 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14 11

the groups at the youngest age of overlap, but children with ASD showed a slower rate of development with increasing age. A
benefit of the trajectory analysis in the current study was that separately including vocabulary or syntax as predictors
allowed for revealing how these two aspects of basic language show mostly similar, but also certain different relations, with
aspects of nonliteral language development. For the syntax predictor, children with ASD showed a slightly but significantly
slower rate of development compared to the TD group for nonliteral language. In contrast, the rate of development for
nonliteral language abilities was not significantly different between children with ASD and TD in relation to their vocabulary
abilities.
The results of the current study are not consistent, however, with one previous study of nonliteral language using a
similar cross-sectional developmental trajectory analysis. Rundblad and Annaz (2010b) found that the children with ASD did
not show a significant relation between either predictor variable (age or receptive vocabulary) and metaphor performance,
with many of the children with ASD scoring zero out of 10 possible points on metaphor comprehension. Additionally, the
children with ASD did not show increases in metonym comprehension with chronological age, though metonym scores did
increase with vocabulary. Especially given that Rundblad and Annaz (2010b) found different patterns in their trajectory
analysis between their two measures of nonliteral language, it is likely that different measures of nonliteral language may
show different trajectory results. For the current study, the use of developmentally sensitive measures (e.g., inclusion of a
mix of easy and hard items in the CASL measure) and a larger sample of individuals with ASD provided evidence that children
with ASD are able to learn nonliteral language, that knowledge of nonliteral language increases with age, and that their
nonliteral language development is largely in line with their combined receptive and expressive vocabulary developmental
levels. The vocabulary measure used in the current study included verbal comprehension abilities (e.g., answering questions,
such as ‘‘what hops, eats carrots, and has long ears?’’) in addition to receptive vocabulary abilities, which differs from the
more traditional receptive vocabulary measure used in previous studies (e.g., Rundblad & Annaz, 2010b). Thus, the choice of
language variables is likely to impact the results.
The present results suggest that when particular children with ASD have managed to achieve significant receptive and
expressive vocabulary skills, these skills will dynamically play into greater successes in acquiring new levels of nonliteral
language, in a fashion similar to the dynamic supports in TD provided by advancing vocabulary abilities. However, children
with ASD did show slower rates of development in their nonliteral language abilities when considering scores on syntax
(although syntax was still a significant predictor of nonliteral language scores), which does not directly support the
hypothesis of Gernsbacher and Pripas-Kapit (2012). Instead, a combination of basic language skills and TOM abilities may
play a role in the development of nonliteral language comprehension. Scores on the RMTE task also showed significant
relations to nonliteral language in both the trajectory analysis and the partial correlation analysis. TOM abilities predicted
nonliteral language performance for both TD children and children with ASD (with no group difference in the intercept or
slopes of the trajectory analysis). The correlation between TOM abilities and nonliteral language remained significant even
after controlling for basic language abilities. The current study supports the hypothesis that nonliteral language skills are
related to both basic language and TOM abilities.

4.3. Limitations and future directions

The sample in the current study was comprised of high functioning and verbal individuals with ASD (diagnosed with
autism, Asgerger’s syndrome, or PDD-NOS). Therefore, it is possible that the results may not generalize to lower functioning
individuals with ASD. Additionally, current scores on diagnostic observational measures, such as the Autism Diagnostic
Observation Scale (ADOS; Lord, Rutter, DiLavore, & Risi, 1999) were not available for the participants with ASD in the current
study. Future research should include, when feasible, ADOS testing scores for participants. It is important to note that
nonliteral language skills have been shown to not correlate strongly with measures of autistic social symptoms (Norbury,
2004, 2005; Rundblad & Annaz, 2010a, 2010b), and both children with a diagnosis of autism or a diagnosis of Asperger’s
syndrome showed difficulties with metaphor comprehension in previous research. Thus, differences in diagnostic inclusion
criteria would be unlikely to impact the results of the present research.
It may, however, be possible to see different results when measuring receptive skills through procedures that do not
require complex language production. Future research should use additional measures of syntax, nonliteral, and
pragmatic aspects of language to see if the present results replicate across different measures of language development.
Group matching designs, in particular, should be sensitive to how variability in the choices of matching variables may
lead to different conclusions about the nature of language abilities for children with ASD (e.g., Norbury, 2005; Whyte
et al., 2014).
Future research should include longitudinal designs to examine how various aspects of nonliteral and pragmatic
language develop over time within individual children. While the cross-sectional trajectories are a helpful tool for examining
trends across groups of people, it is likely that sub-groups of individuals with ASD will show different patterns of language
development over time. The cross-sectional trajectories, however, can help with informing longitudinal study designs by
suggesting measures that are likely to show development across target age ranges. The current study suggests that the CASL
may be developmentally sensitive measures for examining pragmatic and nonliteral language abilities for children with ASD,
and that the KBIT-2 composite of expressive and receptive vocabulary abilities may be an important predictor of success on
figurative and pragmatic language abilities.
12 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14

4.4. Conclusions

The current study examined cross-sectional developmental trajectories for both pragmatic language (understanding
contextually appropriate language) and nonliteral language subtests of the CASL (comprised of figurative language,
sarcasm, and indirect requests). The children with ASD (ages 5–12 years) showed a slower rate of development for both
pragmatic language and nonliteral language with chronological age. However, both chronological age and basic language
age-equivalence scores significantly predicted performance on nonliteral and pragmatic language for the children with
ASD, as well as for children with TD. The present results provide a strong challenge to prior suggestions (e.g., Loukusa &
Moilanen, 2009) that pragmatic and/or nonliteral language skills represent particularly difficult domains for children with
ASD, above and beyond basic language difficulties. Instead, the pragmatic trajectories for children with ASD and TD
children did not significantly differ when accounting for either vocabulary or syntax abilities. In like fashion, for nonliteral
language abilities, developmental trajectories for the TD and ASD did not significantly differ when accounting for
vocabulary abilities, though the children with ASD did show slower rates of development for nonliteral language when
accounting for syntax abilities.
Although the children with ASD may reach vocabulary and syntax benchmarks more slowly than the typically
developing children, for any given level of vocabulary or syntax the children with ASD appear to have dynamically applied
their basic language skills with similar effectiveness as TD children to the mastery of new levels of pragmatic language and
to nonliteral language. These results give new emphasis to the previously tentative conclusion that when children with
ASD are able to improve their basic language skills then it is highly likely that the children will also make improvements in
pragmatic language and in use of other nonliteral language expressions. Additionally, a combination of basic language
abilities, as well as advanced TOM abilities, may aid in the understanding of both pragmatic language and nonliteral
language. Thus, when a child is in the progress of newly sorting out multiple relations between a pragmatic linguistic
expression and different contexts (or between literal versus nonliteral meanings), these new mappings will be more richly
supported as both the basic language abilities and TOM abilities of the child improve. Understanding predictors of
individual differences both in the present study and in future longitudinal research can aid the selection of individualized
intervention targets in multiple domains of language, including pragmatic language and nonliteral language abilities
(Nelson, 2001; Nelson, Welsh, Camarata, Heimann, & Tjus, 2001; Whyte, Nelson, & Khan, 2013). Further, the results of the
current study should provide encouragement to future innovations in language therapies and interventions that would
aim to jointly facilitate complex syntax growth for individuals with ASD and growth in aspects of pragmatic or nonliteral
language.

Funding

A liberal arts dissertation improvement award from Penn State provided funding for this research.

Conflict of interest

None declared.

Appendix A. Continuing education questions

1. According to past research, typically developing children as young as _____ are able to demonstrate some basic
knowledge of nonliteral language.
a. 2 to 3 years
b. 4 to 6 years
c. 7 to 8 years
d. 9 to 11 years
2. Differences between group matching designs and the cross-sectional developmental trajectory analysis include:
a. Longitudinal data
b. The need for a priori group matching
c. Cross-sectional data
d. Information about group differences in the rate of development
e. Both B and D
3. The results for the pragmatic language outcome measure suggests that compared to typically developing children,
children with autism spectrum disorders (ASD) show:
a. Delays in the onset of pragmatic language with regards to chronological age
b. Delays in the rate of pragmatic language with regards to chronological age
c. Delays in the rate of pragmatic language with regards to syntax abilities
d. Delays in the rate of pragmatic language with regards to vocabulary abilities
4. True or false: The current study found that children with ASD who had higher vocabulary abilities performed better on
nonliteral language than children with ASD who had lower vocabulary abilities.
 E.M. Whyte, K.E. Nelson / Journal of Communication Disorders 54 (2015) 2–14 13

5. For typically developing children, figurative and pragmatic language abilities are significantly predicted by:
a. Age
b. Vocabulary abilities
c. Syntax abilities
d. Theory of mind
e. All of the above

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