Pragmatics in children with autism spectrum disorder

Pragmatics examines how context influences language meaning, with a focus on implied meanings and social factors that impact communication. Children with autism spectrum disorder (ASD) face significant challenges in pragmatic skills, attributed to factors such as structural language deficits, theory of mind, executive function, comorbidities of ASD and parental pragmatic skills, which impact their social interactions and conflict resolution. They may exhibit behavioural responses similar to typically developing (TD) children while performing a pragmatic task. Still, their neural mechanism differs, particularly in the medial prefrontal cortex, temporal regions, temporal lobe, central parietal regions, limbic networks, and Default Mode Network (DMN). These deficits are often assessed using tools like the Children’s Communication Checklist-2, Test of Pragmatic Language and neuroimaging, particularly Magnetic Resonance Imaging (MRI). It is of paramount importance to understand pragmatic impairment in children with ASD to provide appropriate interventions. This review aims to give an overview of the pragmatics in children with ASD, which can provide a foundation to comprehend their pragmatic challenges better and guide the development of targeted interventions to improve their social interactions and language skills.