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An Exploration of Intersubjectivity in Clinical Interactions Involving Children with and Without Autism Spectrum Disorder (ASD)

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An Exploration of Intersubjectivity in Clinical Interactions Involving Children with and Without Autism Spectrum Disorder (ASD) An exploration of intersubjectivity in clinical interactions involving children with and without autism spectrum disorder (ASD) Kerrie Megan Delves ORCID identifier: 0000-0002-8966-1352 Doctor of Philosophy September, 2017 The School of Languages and Linguistics, The University of Melbourne. The thesis is being submitted in total fulfilment of the degree. Abstract This thesis explores interactional behaviours related to achieving intersubjectivity in clinical interactions involving children with and without autism spectrum disorder (ASD). Intersubjectivity is shared understanding between participants and this study views communication as the site for the establishment, maintenance and restoration of intersubjectivity. The study of intersubjectivity in children with and without ASD is potentially revealing as impairments in social communication are a core component of ASD (American Psychiatric Association, 2013) and difficulties understanding others’ perspectives are well-documented in ASD research (Leslie, 1991). This study uses a corpus of approximately 60 hours of dyadic interactions involving 40 children participating in standardised cognitive tests administered by a researcher in a laboratory setting. Half the children are typically developing (TD) and half have ASD. Interactions were transcribed and analysed using Conversation Analysis (CA) methodology. The data is established as institutional due to the goal-oriented focus of the interaction and the participants’ prescribed roles as test- administrator and test-taker. The study presents an overview of interactional behaviours demonstrating problems with intersubjectivity, including repair sequences. Repair sequences containing open class repair initiation (OCRI) (Drew, 1997) are examined in detail. OCRI consists of repair initiated by the other, in the next turn, using a token such as ‘sorry?’, ‘huh?’ or ‘what?’. I identified 27 instances of the adult producing an OCRI; 16 with TD children and 11 with children with ASD. In support of Drew (1997), I found that OCRI often occurs following a sequentially inapposite turn, or a turn where the sequential or ‘activity’ connectedness to the prior talk is problematic. When responding to OCRI both groups of children overwhelmingly produced a repair attempt, usually a re-saying. While subtle differences between the groups are discussed, analysis demonstrates the sophisticated ways both groups of children are able to orient to and respond to OCRI devices. While OCRI sequences showed similarity between the two groups, analysis of an ambiguous marker of problems with intersubjectivity highlights their differences. This study identified a new phenomenon, prosodically marked ‘yeah’ (PMY), which can signal problems with intersubjectivity but does not always do so. In these sequences, the adult responds to a potentially problematic turn with the response token ‘yeah’, produced with high pitch onset, high rising terminal pitch and interspersed with laughter tokens. I identified 28 excerpts where the adult produced a PMY; 16 with TD children and 12 with children with ASD. I found that TD children usually oriented to PMY as if it i was related to maintaining intersubjectivity, by orienting to it as a repair initiator or a request for confirmation. Conversely, children with ASD rarely oriented to PMY as if it was concerned with intersubjectivity, by orienting to it as a continuer or as not requiring response. This thesis furthers research on interaction and ASD by demonstrating complex ways that children with ASD can navigate the social requirements of their interactions. However, findings also suggest there are subtle differences in the ways children with ASD interpret specific actions in interaction, when compared to TD children; such differences have been difficult to capture with traditional quantitative research designs typically used in ASD research. ii Declaration I declare that: (i) the thesis comprises only original work towards the Doctor of Philosophy; (ii) due acknowledgement has been made in the text to all other material used; and (iii) the thesis is fewer than the maximum word limit in length, exclusive of tables, references and appendices. ……………………………………………………………….. Kerrie Delves 6 September 2017 iii iv In Memory of Roger Julyan Wales (1938 – 2011); without whose support I would never have taken the first step on this journey. v vi Acknowledgements A huge thank you goes firstly to my supervisor, and friend, Lesley Stirling. This thesis is the product of a long endeavour and I thank her for her unwavering support, encouraging feedback and genuine excitement in my progress. I wish to also thank the additional members of my PhD advisory panel, Gillian Wigglesworth and Barbara Kelly, and the support I received from the School of Languages and Linguistics at the University of Melbourne. Thank you also to Cheryl Dissanayake, who generously offered her research data for interaction analysis and has helped develop my understanding of autism spectrum disorder. I wish to also thank Susan Douglas, my academic mentor, whose knowledge of ASD and language development is as comprehensive as her knowledge of techniques to improve productivity. I thank her for our writing meetings and the opportunities she gave me to discuss my many half-baked ideas. I wish to thank all the members of the Melbourne CA Group (CAG) for their feedback on my data and the fruitful discussions which ensued. There is no question that the quality of the analysis in this research was profoundly improved by our monthly data sessions. Special thanks to CAG member Sascha Rixon who read various parts of this thesis and offered helpful feedback. Thanks also to the numerous audience members who gave critical feedback at various presentations on this research over the years and to two examiners whose suggestions contributed to making this a better document. All errors which remain in this work are my own. Thank you to my family and friends for their support over the years. Especially to my parents, Cathy and Harley, and to Nick for his support and the illustrations in chapter 4. vii viii Table of contents List of tables .................................................................................................................................................. xv List of figures ................................................................................................................................................. xv 1 Introduction ............................................................................................................................................ 1 1.1 Conversation Analysis ........................................................................................................................... 2 1.1.1 An emic perspective ......................................................................................................................... 3 1.1.2 Intersubjectivity ................................................................................................................................ 3 1.2 The structure of this thesis .................................................................................................................... 4 2 Literature review ..................................................................................................................................... 7 2.1 Introduction ........................................................................................................................................... 7 2.2 Autism spectrum disorder ..................................................................................................................... 8 2.2.1 History ............................................................................................................................................... 8 2.2.2 Diagnosis ......................................................................................................................................... 10 2.2.2.1 DSM-IV and ICD-10 ................................................................................................................. 10 2.2.2.2 DSM-5 .................................................................................................................................... 11 2.2.2.3 Diagnostic tools ...................................................................................................................... 13 2.2.3 Epidemiology .................................................................................................................................. 13 2.2.4 Aetiology ......................................................................................................................................... 14 2.2.5 Autism spectrum disorder and language ........................................................................................ 16 2.2.5.1 Prelinguistic communication .................................................................................................. 17 2.2.5.2 Echolalia ................................................................................................................................. 18 2.2.5.3 Syntax and morphology ......................................................................................................... 19 2.2.5.4 Phonetics and phonology ....................................................................................................... 20 2.2.5.5 Semantics ..............................................................................................................................
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