The Double Interview Task: Assessing the Social Communication of Children with Asperger Syndrome

Assessment of Social Cognition

The core deficits associated with Asperger Syndrome are in the social or pragmatic use of language. Therefore, it falls under a speech-language pathologist's scope of practice to assess and provide services or support to individuals with Asperger Syndrome experiencing these difficulties. The challenge then becomes how to best assess social cognition.

Standardized tests. Some standardized tests available in the field of speech-language-pathology that assess students' pragmatic skills include the Test of Pragmatic Language (TOPL) (Terasaki & Gunn, 1992) and the Social Pragmatic Subtest of the Comprehensive Assessment of Spoken Language (CASL) (Carrow-Woolfolk, 1999). In the TOPL (Terasaki & Gunn, 1992), students are presented with social scenarios and they are required to respond with an example of how they would handle the situation. The CASL (Carrow-Woolfolk, 1999) includes a range of subtests that are designed to explore receptive, expressive and receptive language. A subtest of pragmatic judgment can be used with children of all ages.

Standardized tests are limited in their practical application and may not paint an accurate picture of a student's true social pragmatic difficulties in ongoing communicative interactions (Winner, 2002). Individuals with Asperger Syndrome have a disability that is highlighted in conversation. Conversations occur with no advanced notice, yet they require sophisticated planning, timing, and self-regulation in their execution and therefore reveal impairments that are not evident on standardized tests (Turkstra, Ciccia, & Seaton, 2003).

Factors that promote theory of mind task performance may also promote good performance on other standardized tests such as the CASL (Carrow-Woolfolk, 1999) and the TOPL (Terasaki & Gunn, 1992). A number of studies have shown that theory of mind task performance is correlated with level of verbal skills (Bowler, 1992; Eisenmajer & Prior, 1991; Fombonne, Siddons, Achard & Frith, 1994; Happe, 1995; Yirmiya and Shulman, 1996). Students with high functioning autism and Asperger syndrome have been shown to pass relatively high- level theory of mind tasks without demonstrating appropriate levels of social adaptation in natural settings (Klin, 2000; Silliman et. al, 2003). Children with Asperger Syndrome typically have good verbal skills, which could contribute to a better performance on formalized tests than in daily communicative situations.

Individuals with Asperger Syndrome have difficulty generalizing, particularly in novel social situations, which makes up most spontaneous social situations in real life. Central Coherence Theory (Frith, 1989) accounts for this deficit in the ability to understand the larger picture. Typically in formalized tests, the problem to be solved is clearly defined by the question posed, or tests items are presented in isolation, thus not identifying a difficulty with generalization. Social situations rarely appear this clear cut in real life. Most responses on theory of mind tasks are classified as either a theory of mind response or a non-theory of mind response. The dichotomous nature of theory of mind tasks doesn't appear adequate for describing the "flexible and abstract aspects of social-cognition," (Winner, 2000, p. 6). These children have a range of difficulties with social communication, which is most evident in every day interactions. A continuum of social dysfunction in individuals with autism spectrum disorders is often observed in naturalistic settings (Wing, 2000).

Overall, performance on formalized tests appears to be influenced by language abilities and these tests fail to capture the complex difficulties of children with Asperger Syndrome. Children with social cognitive learning difficulties, such as those with Asperger Syndrome may score within normal limits on a formal speech and language assessment, but be unable to socially interact with their peers. Often times the assumption is made that if a student has skills to understand and formulate language, the pragmatic aspect of language is in place. Children with social-cognitive deficits can demonstrate an excellent command of language and more rote or rule based learning, but at the same time have significant problems functioning in the world around them (Winner, 2000).