Voice abnormality in boys with high-functioning autism spectrum disorders: Diagnostic and psychosocial implications
Smerbeck, Audrey Marie
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Social-communicative deficits are part of the definition of high-functioning autism spectrum disorders (HFASDs). Voice abnormalities in HFASDs have been reported repeatedly in the research and clinical case literature, with occasional mention of nasality. Hypernasality has been linked to a wide variety of negative listener judgments and could potentially play a role in the poor interpersonal functioning which characterizes the HFASDs. This study compared standardized speech samples of 29 boys aged 6 – 13 with HFASDs to those of 29 typically developing (TD) boys matched on age and ethnicity to assess nasality differences between the two groups. Ten university students who were blind to the hypotheses being tested rated speech samples on nasality. Raters also reported their perceptions of socially relevant, internal state, and gender-stereotype relevant adjectives as well as their estimate of the speaker's age and disability status. Also examined were parent ratings of autism spectrum disorder symptoms as well as parent ratings of negative affect and social skills. Results indicated significantly greater nasality in the HFASD group than the TD group. Listeners rated the HFASD group significantly higher than the TD group on negative socially relevant adjectives, a finding which was mediated by nasality. Compared to TD speakers, speakers with HFASDs were rated lower on dominance and perceived age, as well as higher on weakness and perceived disability; these findings were also mediated by nasality. Nasality did not consistently predict parent ratings with the exception of increased nasality associated with decreased parent-reported negative affect in the HFASD group, an unexpected finding. Diagnostic and psychosocial implications as well as directions for future studies are discussed.