2026, Vol. 6, Issue 10, Part A

Keywords: Pragmatics, Autism, Minimally speaking, AAC

Introduction

Pragmatics is defined as the linguistic domain that guides the appropriate use of language across a variety of social contexts. This refers to social, emotional and communicative aspects of social interaction. Importantly, pragmatics assists the listener to accurately interpret intentions and references of the speaker (Dey, 2023; Eragamreddy, 2024) ^{[1, 2]}. There are several speech acts that are considered to be part of pragmatic skills. These include directives (requests and orders), commissives (promises, offers), assertives (statements, claims) and verdicts (judgements, assessments) (Altikriti, 2011; Searle, 1969) ^{[3, 4]}. The development of pragmatics begins quite early in typically developing (TD) children. These acts become increasingly fine‑grained and socially sensitive throughout preschool and school years as children develop greater mastery of lexicocommunicative and pragmatic skills. During these years they go on to achieve sophistication in the use of previously acquired intents such as justification, promises, prohibitions, challenges, apologies, explanations, refusals, and disagreements (Papafragou, 2018) ^[5]

Differences in social communication are identified as one of the core features in Autism Spectrum Disorder (ASD) (American Psychiatric Association, 2013) ^[6]. Autistic children present with a wide range of spoken language skills from minimally speaking to speaking. At least a third of autistic children are thought to remain minimally speaking throughout their lifetime (Rose et al., 2016) ^[7]. Kasari et al. (2013) ^[8] provided an operational definition for ‘minimally verbal’ as ‘fewer than 20 functional words’ for research purposes. This study adopts the above definition to describe minimally speaking autistic children. Although many autistic children who are minimally speaking develop spoken language when provided with evidence based early intervention, approximately 25-30% remain minimally speaking beyond the age of five years (Guerrara, 2025) ^[9].

Differences in pragmatic language have been reported in the absence of syntactic, semantic and phonologic difficulties (Young et al., 2005) ^[10] and are seen even in speaking children with highly sophisticated semantics and syntax (Volden et al., 2009) ^[11]. Autistic children, also show restricted use of gestures and preverbal productions and do not show the same pattern of transitioning from non-spoken communication to spoken communication when compared with their TD peers. Ramos-Cabo et al., (2019) ^[12] noted qualitative and quantitative differences in the gesture-language trajectory between autistic children and their TD peers. Research has attempted to look at the communicative intentions expressed by autistic children using their early words. Some of these studies have noted that communicative intentions like requesting and protesting were the same in autistic as well as TD children (Maljaars et al., 2011) ^[13]. However, autistic children showed a lack of declarative function which was referred to as a difference in referential skills. LaVelle et al., (2021) ^[14] explored the use of gestures in minimally speaking autistic children and adults. They observed that autistic children used gestures predominantly for imperative functions while there is an expansion of communicative functions in adolescents which was accomplished using gesture-speech combinations.

Previous research has employed standardized measurements and assessment tools to quantify pragmatic abilities in autistic children and adolescents (Lam et al., 2012) ^[15]. However, standardized evaluations may not adequately document the varied skills demonstrated by autistic children who are minimally speaking. Kasari et al., (2013) ^[8] documented floor effects in standardized assessments by children who are minimally speaking. These children were observed to be demonstrating such skills in other situations and contexts. Few studies have also used semi-structured and naturalistic contexts. These studies employed a natural language sampling methodology or recordings of spontaneous expressive language (Sheba et al., 2025) ^[16]. Language sampling can give a more comprehensive view of an individual child’s pragmatic abilities and is more relevant when the heterogeneity of autistic children is considered. The current study makes an attempt to use a combination of structured observations, semi-structured play-based interactions and semi-structured interviews to profile pragmatic skills in autistic children. While several studies have focused on pragmatic language in verbally fluent speakers (Cardillo et al., 2020; Puricelli et al., 2024) ^{[17, 18]} or minimally speaking children in isolation (LaVelle at al., 2021) ^[14], few have compared these profiles across expressive levels within the same preschool-age group (Kasari et al., 2013) ^[8]. Moreover, minimally speaking autistic children are often underrepresented in research despite increasing clinical recognition of their communicative intent.

Expressive-language level alone may not reflect a child’s pragmatic abilities, as speaking children may struggle with reciprocal communication while minimally speaking children may communicate effectively through gestures, vocalizations, facial expressions, or AAC. Assessing pragmatic skills across expressive levels can therefore identify individual communication strengths and needs without equating limited speech with an absence of communicative intent (Volden et al., 2009) ^[11].

The aim of the current study was to profile and compare the pragmatic language abilities of minimally speaking and speaking autistic children in the preschool age group. The objectives were the following:

• To document the pragmatic functions used by children across expressive groups.
• To identify strengths and limitations with respect to pragmatic skills in each group.
• To assess initiation, maintenance, and contextual adaptability.

2. Materials and methods

Twenty-four children within the age range 2–4 years with a clinical diagnosis of ASD were included in the study. The participants were part of a larger study that analyzed the development of communicative behaviors in autistic children. Data was collected from autistic children who were under regular follow up between June 2024 and June 2025 in a tertiary care center for children and adolescents with neurodevelopmental conditions. The data collection procedures were reviewed by the institutional ethics committee and was given ethical clearance (reference number 04/CDC/2024). The purpose of the study and data collection procedures were provided to the parents/care givers and voluntary consent was obtained from them. All the children had a Childhood Autism Rating Scale (CARS, Schopler et al., 2010) ^[19] score of 30 or above. Participants included 5 females and 19 males. They were divided into two groups namely minimally speaking (n = 15) or speaking (n = 9). Pragmatic skills were assessed using the Pragmatics Profile of Everyday Communication Skills in Children (Dewart et al., 1995) ^[20], through a combination of structured observations, semi-structured play-based interactions, and semi-structured caregiver interviews. The pragmatics profile was originally developed by Dewart and Summers in 1988 and revised in 1995. It was developed to provide practitioners a tool for collecting information about the child’s communication outside the clinical settings, particularly in everyday life settings.

Data were collected by a Developmental Therapy trainee, who was undergoing her final year postgraduate training in early intervention for neurodevelopmental conditions. The trainee had completed supervised clinical placements in early childhood intervention services specifically for autistic children and received additional study-specific training in the observation protocol and caregiver interview procedures prior to commencing data collection. Each data collection session lasted less than 40 minutes and was conducted in a quiet, child‑friendly room at the clinic. The trainee met with the child and their primary caregivers for a semi‑structured play‑based interaction. A standard set of developmentally appropriate toys was available to facilitate naturalistic communicative exchanges. The trainee used strategic prompts (e.g., time delays, expectant looks, open questions, and communication temptations) to elicit a range of pragmatic behaviours without directing the interaction in a highly structured manner. In addition to direct observation, supplementary information was obtained through a structured observations of caregiver-child interaction as well as semi‑structured caregiver interview. Caregivers were asked to provide concrete examples of specific pragmatic behaviours their child demonstrated in everyday contexts as prescribed in the test manual. The following pragmatic domains were targeted for observation and coding: attention directing, requesting, rejecting, greeting, self‑expression and self‑assertion, naming, commenting, giving information, initiating an interaction, maintaining an interaction as well as contextual variation for persons and situations. For each domain, a behavior was coded as “present” if the child consistently demonstrated observable instances of that behavior during the session or if the caregiver reported such instances; it was coded as “absent” if no instance was observed or reported.

Coding was completed immediately after each session, using a checklist provided in the test manual. The checklist operationalised each behaviour with brief, observable criteria (e.g., “requesting: child uses gesture, vocalisation, or word to obtain an object, action, or attention”). To enhance reliability, a subset of participants was independently re-evaluated by the first author, a qualified speech-language pathologist. Any discrepancies were resolved through discussion and clarification.

Data were entered into a spreadsheet. Descriptive statistics were computed separately for each group using Microsoft Excel. For each pragmatic skill, the number and percentage of children in whom the skill was marked “present” were calculated. These percentages were then compared across groups to describe patterns of skill emergence. Results are presented as frequencies and percentages.

3. Results and discussions

The present study aimed to profile and compare the pragmatic language abilities of minimally speaking and speaking autistic children in the preschool age group. Consistent with this aim, the findings reveal both shared pragmatic strengths and marked group differences in the breadth and variety of pragmatic acts. Figure 1 shows the percentage of minimally speaking and speaking autistic children demonstrating the various pragmatic skills selected for the study. Descriptive analysis indicated that requesting and rejecting were pragmatic strengths shared by all children in the sample. Every child in both the speaking and minimally speaking groups demonstrated these skills, consistent with requesting and rejecting being the most established pragmatic functions in both groups. This pattern aligns with prior evidence that early communicative acts in autism are often dominated by instrumental functions such as making requests and expressing refusal. Stone et al. (1997) ^[21] reported that autistic children requested more often and commented less often compared to age-matched controls. Şimşek et al. (2024) ^[22] also noted a predominance of refusal and requesting among pragmatic functions in autistic children, with refusal being more common than requesting.

Speaking children demonstrated a broader pragmatic repertoire than minimally speaking children with more than 50% of the speaking children demonstrating at least 9 out of the 12 pragmatic skills included in the study. Most speaking children used self-expression/assertion, naming, and commenting—functions that support social sharing and joint attention—whereas minimally speaking children showed a more restricted profile, with only one child demonstrating self-expression/assertion and none using naming or commenting. Greeting was more frequently observed among speaking children. All speaking children demonstrated greeting, compared with 9 of 15 minimally speaking children, suggesting that speech level may facilitate engagement in conventional social routines. This mirrors findings by LaVelle et al. (2020) ^[23], who reported that minimally speaking autistic individuals relied heavily on agreeing/acknowledging, responding, and requesting, while speaking individuals used commenting more frequently. Maljaars et al. (2011) ^[13] similarly observed that speaking autistic children demonstrated a proportion of communicative functions that more closely resembled typically developing peers than minimally speaking autistic children.

Initiation of interaction was relatively preserved in both groups: all speaking children and 11 of 15 minimally speaking children, initiated interactions. This indicates that the drive to communicate is not solely dependent on spoken output levels. Maintaining interaction was limited across the sample. Only one speaking child demonstrated skills for maintaining interactions, and no minimally speaking child did so underscoring a core area of pragmatic vulnerability in early autism. This is consistent with previous literature exploring initiation and maintenance of interaction in autistic children. LaVelle et al., (2020) ^[23] noted that minimally speaking autistic children and adolescents used speech to initiate communication but faced challenges in reciprocal interactions and sustaining conversational exchanges. Plate et al. (2024) ^[24] further reported that autistic infants often initiated interactions with caregivers, experienced breakdowns, and made repairs, but their repertoires of repair strategies were smaller than those of non-autistic infants.

No minimally speaking child demonstrated pragmatic skills that varied according to communication partner or situation. Among speaking children, 3 of 9 demonstrated contextual variation for both persons and situations. This indicates that, contextual flexibility which is the ability to vary communication according to partner or situation, was absent in minimally speaking children and present in only a subset of speaking children (3 of 9). This finding highlight that even among pre-schoolers with emerging speech, context-sensitive pragmatic adaptation remains an area of significant challenge. Volden et al. (2009) ^[11] noted that autistic children who develop age-appropriate structural language still show difficulties in pragmatic skills. Furthermore, Aldred et al. (2004) ^[25] reported that pragmatic difficulties persist and further difficulties evolve even in autistic children who develop spoken language, including fewer and less skilled attempts to initiate communication, a narrower range of pragmatic skills, and difficulties producing novel language. Together, these results suggest that while minimally speaking and speaking autistic pre-schoolers share foundational communicative strengths, speaking children exhibit more diverse and socially nuanced pragmatic abilities, pointing to distinct targets for early intervention.

The findings of this study support designing early intervention practices that cater to the strengths of each individual autistic child rather than using a universal approach to pragmatic intervention. For minimally speaking children intervention should build on existing strengths in requesting and rejecting while explicitly expanding pragmatic repertoire towards social functions. Meanwhile for speaking children early intervention should target higher order pragmatic skills that supports maintaining interactions as well as contextual adaptations early in language intervention. Incorporating Augmentative and Alternative Communications (AAC) early in the intervention process will support both groups but is extremely meaningful for minimally speaking children. Systematic instruction using speech-output technologies and aided AAC modelling has been shown to increase socio-communicative behaviours in minimally speaking pre-schoolers, particularly when peers are also taught to use the same AAC system. High-tech AAC aids appear especially effective for increasing social communication, interaction, and speech production compared with low-tech options. A systematic review by Sennott et al., (2016) ^[26] recommended that aided AAC modelling interventions, where communication partners model AAC use during natural interactions produced consistent positive effects on all components of language including pragmatics in beginning communicators. Similarly, Pope et al., (2024) ^[27] suggested that combining AAC with naturalistic developmental behavioural interventions (NDBIs) yielded larger language effect sizes than NDBIs alone for minimally speaking autistic children.

4. Conclusion

The present study was an attempt to highlight differences in pragmatic skills among speaking and minimally speaking autistic children. The finding highlighted that speaking and minimally speaking autistic children possessed distinct pragmatic profiles. Speaking children were observed to have a wider profile. However, it was also observed that minimally speaking children did possess some pragmatic skills albeit limited but comparable to their language abilities. One indication of this study is that having viable communication modalities may support autistic children to acquire wider pragmatic skills. In addition to working on language skills, it is advisable to provide alternate communication modalities as part of routine language intervention to support and model increased social participation among autistic children. This will ensure that pragmatic skills will show a steady development as the child passes through intervention.

Limitations of the study: The sample size was small and comprised a convenience sample of speaking and minimally speaking children, which limits statistical power and generalizability to broader populations of children with diverse communication profiles. Additionally, the cross-sectional design precludes inferences about developmental trajectories or causal relationships between speech status and pragmatic skill profiles. The analytic approach was descriptive, with no formal statistical testing or adjustment for multiple comparisons. While appropriate for preliminary profiling, this limits confidence in the robustness and replicability of observed group differences. Future studies with larger, well-characterized cohorts, longitudinal designs, multimodal assessment, and neurodiversity-affirming, strength-based frameworks are needed to extend these findings.

Declaration of interests

No conflicts

References

1. 1.Dey M. FOUR MAIN CHARACTERISTICS OF ENGLISH PRAGMATICS. LLT Journal: A Journal on Language and Language Teaching. 2023;26(2).
2. 2.Eragamreddy N. Exploring Pragmatics: Uncovering the Layers of Language and Meaning. International Journal of Current Science Research and Review. 2024;7(3).
3. 3.Altikriti SF. Speech act analysis to short stories. Journal of language teaching and research. 2011;2(6):1374.
4. 4.Searle JR. Speech Acts: An Essay in the Philosophy of Language. Cambridge: Cambridge University Press; 1969.
5. 5.Papafragou A. Pragmatic Development. Language Learning and Development. 2018;14:167-169.
6. 6.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). 2013.
7. 7.Rose V, Trembath D, Keen D, Paynter J. The proportion of minimally verbal children with autism spectrum disorder in a community-based early intervention programme. Journal of intellectual disability research: JIDR. 2016;60(5):464–477.
8. 8.Kasari C, Brady N, Lord C, Tager‐Flusberg H. Assessing the minimally verbal school‐aged child with autism spectrum disorder. Autism Research. 2013;6(6):479-493.
9. 9.Guerrera S, Fucà E, Petrolo E, De Stefano A, Casula L, Logrieco MG et al. Exploring the clinical features of minimally verbal autistic children. Frontiers in Psychiatry. 2025;16.
10. 10.Young E, Diehl J, Morris D, Hyman S, Bennetto L. The use of two language tests to identify pragmatic language problems in children with autism spectrum disorders. Language, speech, and hearing services in schools. 2005;36(1):62-72.
11. 11.Volden J, Coolican J, Garon N, White J, Bryson S. Brief report: pragmatic language in autism spectrum disorder: relationships to measures of ability and disability. Journal of autism and developmental disorders. 2009;39(2):388–393.
12. 12.Ramos‐Cabo S, Vulchanov V, Vulchanova M. Gesture and Language Trajectories in Early Development: An Overview From the Autism Spectrum Disorder Perspective. Frontiers in Psychology. 2019;10.
13. 13.Maljaars J, Noens I, Jansen R, Scholte E, Van Berckelaer-Onnes I. Intentional communication in nonverbal and verbal low-functioning children with autism. Journal of communication disorders. 2011;44(6):601-14.
14. 14.La Valle C, Chenausky K, Tager-Flusberg H. How do minimally verbal children and adolescents with autism spectrum disorder use communicative gestures to complement their spoken language abilities? Autism & Developmental Language Impairments. 2021;6.
15. 15.Lam Y, 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. 2012;6:792-797.
16. 16.Sheba SH, Reliyanti E, Ekasari T. Understanding speech acts in adolescents with asd: a pathway to enhance interaction. The Journal of English Language Teaching, Literature, and Applied Linguistics. 2025;7(2):106–114.
17. 17.Cardillo R, Mammarella I, Demurie E, Giofrè D, Roeyers H. Pragmatic Language in Children and Adolescents With Autism Spectrum Disorder: Do Theory of Mind and Executive Functions Have a Mediating Role? Autism Research. 2020;14(5):932-945.
18. 18.Puricelli L, Marenda C, Filippo A. The development of social-conversational skills in children with autism spectrum disorder: similarities and differences with typically developing children and late talkers. Pilot study. Journal of Advanced Health Care. 2024;6(1).
19. 19.Schopler E, Reichler RJ, Renner BR. The childhood autism rating scale (CARS). Los Angeles, CA: Western Psychological Services; 2010.
20. 20.Dewart H, Summers S. The pragmatics profile for everyday communication skills in children. NFER-Nelson. 1995.
21. 21.Stone W, Ousley O, Yoder P, Hogan KL, Hepburn S. Nonverbal Communication in Two- and Three-Year-Old Children with Autism. Journal of Autism and Developmental Disorders. 1997;27:677-696.
22. 22.Şimşek K, Şenol NEG, Birol N, Gündüz EY. Investigation of communicative behaviors and communication functions of Turkish individuals with autism spectrum disorder through Communication Matrix. International Journal of Developmental Disabilities. 2024;72:187-202.
23. 23.La Valle C, Plesa-Skwerer D, Tager-Flusberg H. Comparing the Pragmatic Speech Profiles of Minimally Verbal and Verbally Fluent Individuals with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. 2020;50(10):3699-3713.
24. 24.Plate SN, Iverson JM. Breakdowns and repairs: Communication initiation and effectiveness in infants with and without an older sibling with autism. Infant behavior & development. 2024;74.
25. 25.Aldred C, Green J, Adams C. A new social communication intervention for children with autism: pilot randomised controlled treatment study suggesting effectiveness. Journal of child psychology and psychiatry, and allied disciplines. 2004;45(8):1420-30.
26. 26.Sennott SC, Light JC, Mcnaughton D. AAC Modeling Intervention Research Review. Research and Practice for Persons with Severe Disabilities. 2016;41:101-115.
27. 27.Pope L, Light JC, Laubscher E. The Effect of Naturalistic Developmental Behavioral Interventions and Aided AAC on the Language Development of Children on the Autism Spectrum with Minimal Speech: A Systematic Review and Meta-analysis. Journal of Autism and Developmental Disorders. 2024;55:3078-3099.
28. 28.Ervin-Tripp S, Guo J, Lampert J. Politeness and persuasion in children’s control acts. Journal of Pragmatics. 1990;14:307–31.
29. 29.Kim SH, Junker D, Lord C. Observation of Spontaneous Expressive Language (OSEL): A New Measure for Spontaneous and Expressive Language of Children with Autism Spectrum Disorders and Other Communication Disorders. Journal of Autism and Developmental Disorders. 2014;44:3230–3244.
30. 30.Luyster R, Qiu S, Lopez K, Lord C. Predicting outcomes of children referred for autism using the MacArthur-Bates Communicative Development Inventory. Journal of speech, language, and hearing research: JSLHR. 2007;50(3):667-81.