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BACKGROUND: Employment rates among individuals on the autism spectrum or with intellectual disabilities (ID) remain extremely low. Although job coaching services have contributed to successful employment for these individuals, few studies have examined the importance of such support, and even fewer have explored which services are valued most by stakeholders. OBJECTIVE: We examined the importance of employment support services through employee, employer, and job coach perspectives, and employee and employer satisfaction of job coach support. METHODS: A multiple-case study was designed with a community organization providing employment support to individuals on the autism spectrum or with ID, and their employers. Nine employee-employer-job coach triads evaluated the importance of specific services and rated their satisfaction with the job coach support. RESULTS: Services were rated as important, however, some discrepancies were observed between the groups in their ratings of services (e.g., soliciting regular feedback about the employee’s performance). Satisfaction was high for employees and employers; both groups indicated that they would recommend these services. CONCLUSIONS: Job coach support was highly valued by all groups, underscoring the need for these services to be widely available, and suggesting that this support may serve as a critical factor in improving employment outcomes among this population.

BACKGROUND: The effectiveness of music-based interventions (MI) in autism has been attested for decades. Yet, there has been little empirical investigation of the active ingredients, or processes involved in music-based interventions that differentiate them from other approaches. OBJECTIVES: Here, we examined whether two processes, joint engagement and movement, which have previously been studied in isolation, contribute as important active ingredients for the efficacy of music-based interventions. METHODS: In two separate analyses, we investigated whether (1) joint engagement with the therapist, measured using a coding scheme verified for reliability, and (2) movement elicited by music-making, measured using a computer-vision technique for quantifying motion, may drive the benefits previously observed in response to MI (but not a controlled non-MI) in children with autism. RESULTS: Compared to a non-music control intervention, children and the therapist in MI spent more time in triadic engagement (between child, therapist, and activity) and produced greater movement, with amplitude of motion closely linked to the type of musical instrument. CONCLUSIONS: Taken together, these findings provide initial evidence of the active ingredients of music-based interventions in autism.

Background Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by socio-communicative difficulties and restricted patterns of behavior. Despite these challenges, some individuals with ASD have preserved or even enhanced sensory skills, for example in the case of music. As such, music provides a key way to study sensory processing and individual differences in ASD. However, current studies of music perception in ASD have mixed results. Methods This study sought to examine music perception in terms of melodic pitch, rhythm, and memory in school-age children with ASD compared to typically-developing (TD) children. Music perception was investigated as a function of verbal and non-verbal IQ, age, and ASD social symptom severity. Results Children with ASD performed similar to TD children on melodic pitch perception, rhythm perception and melodic memory. Melodic pitch perception in particular was strongly associated with non-verbal cognitive abilities in the ASD group. Similar effects of age on performance were observed in ASD and TD; in particular, rhythm discrimination increased with age in both groups. Music perception in ASD was not associated with ASD social symptom severity. Discussion These findings provide further evidence for intact melodic and rhythmic perception in children with ASD. In addition, music perception abilities were related to non-verbal cognitive ability and age in ASD, and not with ASD social symptom severity. This research provides a better understanding of individual differences in auditory processing, helps to better define phenotypes in ASD, and can guide future studies on the effects of music therapy in ASD.

This study adds to a small literature on social skills measures and interventions for adults with autism spectrum disorder (ASD) or related social communication difficulties (SCD) without intellectual disability (ID). In study 1, a new multimodal assessment tool, the role-play assessment of social skills (R-PASS), was used to measure real-time application of social skills. The scores of adults with ASD/SCD were marginally lower than those of neurotypical adults, with a large effect size, suggesting that the measure can identify differences between the two groups. Therefore, the R-PASS shows potential as an objective tool to assess dynamic and naturalistic social skills. In Study 2, a pre–post single-group design study, we measured the effectiveness of a drama-based social skills intervention for seven participants who self-identified as having ASD/SCD. The R-PASS was used by external raters blind to diagnosis and intervention status to compare the performance of intervention participants to that of neurotypical adults. R-PASS scores suggested substantial improvement of social skills in the majority of participants post-intervention. Furthermore, relatives’ and participants’ perception of their social communication and self-regulation skills improved from pre- to post-intervention. These results suggest that the intervention may have helped the participants improve their social skills.

Few evidence-based services exist for people with Autism Spectrum Disorder (ASD) as they transition into adulthood, particularly those that foster appreciation of one's own goals and strengths. We developed a transition service for adults with ASD (without Intellectual Disability), and conducted a randomized controlled trial (RCT) focusing on self-report of Quality of Life and Self-Determination outcomes. Thirty participants aged 18-29 were randomized to immediate or delayed intervention, with 26 participants analyzed after 4 were lost to follow-up. Curriculum was tailored to participants' self-expressed needs in three areas: social communication, self-determination, and working with others. Groups of four-to-six participants with ASD and two facilitators met weekly for 10 weeks. Positive intervention effects were observed on self-report of Quality of Life; the intervention group scored on average 2 points higher than the control group, 95% CI [-0.2, 3.9]. Positive effects were also observed on the Self Determination Scale (Interpersonal Cognitive Problem-Solving subdomain), where the intervention group scored 2 points higher than control group 95% CI [0.082, 3.4]. In addition, participants rated skills targeted by the curriculum 6 points higher after versus before intervention, 95% CI [3.7, 8.6]. This was echoed by a subset of parents rating their child's skills as seven points higher after versus before intervention, 95% CI [1, 14]. Autism Research 2018, 11: 1712-1728. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: These findings indicate that it is possible to increase Self-Determination and subjective Quality of Life in adults with ASD through a brief group-format service, and provide a model for doing so. Self-Determination abilities are linked to improved adult outcomes in individuals with other disabilities. These often overlooked factors should be incorporated in programming for adults with ASD as they transition to adulthood.

Studies of bilingual children with Autism Spectrum Disorders (ASD) have focused on early language development using parent report measures. However, the effect of bilingual exposure on more complex linguistic abilities is unknown. In the current study, we examined the impact of amount of language exposure on vocabulary and morphological skills in school-aged children with ASD who did not have intellectual disability. Forty-seven typically developing children and 30 children with ASD with varying exposure to French participated in the study. We investigated the impact of amount of language exposure, nonverbal IQ, age, and working memory on language abilities via regression analyses. Current amount of language exposure was the strongest predictor of both vocabulary skills (accounting for 62% of the variance) and morphological skills (accounting for 49% of the variance), for both typically-developing children and children with ASD. These findings highlight the central role amount of language exposure plays in vocabulary and morphological development for children with ASD, as it does for typically-developing children. In addition, they provide further evidence that, when provided with adequate language exposure, many children with ASD are capable of acquiring two languages. Autism Research 2018, 11: 1667-1678. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We studied typically developing children and children with ASD living in a bilingual society who had varying exposure to French (ranging from bilinguals to monolinguals). We investigated the impact of amount of language exposure, nonverbal IQ, age, and working memory on their vocabulary and morphological skills. Current amount of language exposure was the strongest predictor of language skills in both groups of children. Findings indicate that when provided with adequate language exposure, many children with ASD are capable of acquiring two languages.

Music has been identified as a strength in people with Autism Spectrum Disorder; however, there is currently no neuroscientific evidence supporting its benefits. Given its universal appeal, intrinsic reward value and ability to modify brain and behaviour, music may be a potential therapeutic aid in autism. Here we evaluated the neurobehavioural outcomes of a music intervention, compared to a non-music control intervention, on social communication and brain connectivity in school-age children (ISRCTN26821793). Fifty-one children aged 6–12 years with autism were randomized to receive 8–12 weeks of music (n = 26) or non-music intervention (n = 25). The music intervention involved use of improvisational approaches through song and rhythm to target social communication. The non-music control was a structurally matched behavioural intervention implemented in a non-musical context. Groups were assessed before and after intervention on social communication and resting-state functional connectivity of fronto-temporal brain networks. Communication scores were higher in the music group post-intervention (difference score = 4.84, P = .01). Associated post-intervention resting-state brain functional connectivity was greater in music vs. non-music groups between auditory and subcortical regions (z = 3.94, P z = 3.16, P z = 4.01, P z = 3.57, P

Promoting self-determination (SD) in youth with disabilities is positively related to better post-secondary outcomes, such as employment and independence. Despite extensive research into SD and quality of life (QoL) for people with intellectual and developmental disabilities, the relation between the two has not been examined for young adults with autism spectrum disorder (ASD) without intellectual disability (ID). The aim of this pilot study was to examine the relationship between two complementary measures of SD, namely the Arc’s Self-Determination Scale (Wehmeyer and Kelchner 1995) and the AIR Self-Determination Scale (Wolman et al. 1994), and QoL for young adults with ASD without ID. Thirty young adults with ASD without ID living in Canada completed self-report questionnaires of SD and QoL. Correlational analyses indicated that two measures of SD were significantly associated with QoL. Regression analyses revealed that individuals with higher SD scores reported higher perceptions of life satisfaction. Thus, SD, assessed by two complementary measures, was found to be positively associated with QoL. Subsequent research should further elucidate the association between SD and QoL and examine how best to promote SD as a means of enhancing the QoL of young adults with ASD as they transition into adulthood.

We present two experiments examining the universality and uniqueness of reduced context sensitivity in language processing in Autism Spectrum Disorders (ASD), as proposed by the Weak Central Coherence account (Happe & Frith, 2006, Journal of Autism and Developmental Disorders, 36(1), 25). That is, do all children with ASD exhibit decreased context sensitivity, and is this characteristic specific to ASD versus other neurodevelopmental conditions? Experiment 1, conducted in English, was a comparison of children with ASD with normal language and their typically-developing peers on a picture selection task where interpretation of sentential context was required to identify homonyms. Contrary to the predictions of Weak Central Coherence, the ASD-normal language group exhibited no difficulty on this task. Experiment 2, conducted in German, compared children with ASD with variable language abilities, typically-developing children, and a second control group of children with Language Impairment (LI) on a sentence completion task where a context sentence had to be considered to produce the continuation of an ambiguous sentence fragment. Both ASD-variable language and LI groups exhibited reduced context sensitivity and did not differ from each other. Finally, to directly test which factors contribute to reduced context sensitivity, we conducted a regression analysis for each experiment, entering nonverbal IQ, structural language ability, and autism diagnosis as predictors. For both experiments structural language ability emerged as the only significant predictor. These convergent findings demonstrate that reduced sensitivity to context in language processing is linked to low structural language rather than ASD diagnosis.

The engagement of two groups of parents and preschoolers while sharing a wordless picture book and an interactive e-book are described, specifically comparing children with typically developing language (TD) versus children with language impairments (LI). Parent–child dyads were video recorded in a laboratory (TD group, n = 10 ) or at a clinical site (LI group, n = 10 ) while sharing a wordless picture book (WL condition) and an e-book (EB condition). Our assessment focused on the areas of (1) child persistence and (2) child verbal engagement (length of turns, verbal responses to parental prompts, gestural responses). The LI group spent more time with the WL book than the TD group, which was unexpected due to prior reports of poor engagement with print books by LI children; therefore we speculate that children with LI engage with books to the extent that the language demands of the book and the interaction are adapted to the child’s linguistic capabilities. The LI and TD groups showed similar levels of nonverbal engagement with the EB. Parents in the EB condition behaved differently: parents of TD children coordinated their talk with their child’s actions and perceptions; parents of LI children increased the number of questions and demands for responses markedly, whereas their children reduced the proportion of verbal responses significantly in comparison with the WL condition. Further research is required to develop guidelines for effective sharing of e-books with children with LI.

Purpose We investigated whether enhanced auditory short-term memory may contribute to the learning of novel word forms in children with Autism Spectrum Disorder. We also evaluated whether delayed but qualitatively normal, versus atypical, cognitive processes underlie non-word repetition in this population via a detailed error analysis. Method English-speaking children with Autism Spectrum Disorder (who had significant language delay) and typically-developing children matched pairwise on language ability were compared on the Syllable Repetition Task (Shriberg et al., 2009). Results All children exhibited better performance on stimuli of shorter vs. longer syllable length. In addition there was a significant interaction whereby children with Autism Spectrum Disorder performed better than typically-developing children at the longest syllable length. Repetition accuracy was significantly correlated with language level in both groups. In contrast, the relationship between Repetition accuracy and age was only marginally significant in the Autism Spectrum Disorder group and did not reach significance in the typically-developing group. This underscores the importance of language level to non-word repetition performance, and supports the practice of matching on language rather than age alone. An error analysis (Shriberg et al., 2012) showed many similarities between groups in terms of number of consonants deleted, encoding accuracy, and transcoding accuracy components of the task. However the Autism Spectrum Disorder group tended to display better auditory short-term memory with a medium effect size, though this did not reach significance given the small sample size. Conclusion These findings extend evidence of delayed but qualitatively normal non-word repetition previously described in preadolescents with Autism Spectrum Disorder (Williams et al., 2013) to younger kindergarten-age children with Autism Spectrum Disorder and language delay, indicating that non-word repetition is not an area of specific difficulty for this population. With respect to enhanced auditory short-term memory, we found preliminary evidence of better memory for longer nonwords in children with Autism Spectrum Disorder compared to younger typically developing children who were matched on language.

The study investigated how narratives are influenced by both autism spectrum disorder (ASD) and bilingualism. We analyzed the short narratives of school-age Quebec French-speaking children: bilinguals with and without ASD, and monolinguals with and without ASD. Children were given sets of three picture cards depicting a scenario, and were asked to sequence the cards and tell a story. We measured: (1) language production (number of utterances, total number of words), (2) macrostructure (appropriate sequencing of events, number of events mentioned, coherence), (3) microstructure (character introductions, maintenance of referential terms, use of grammatical gender, use of connectives), and (4) evaluative devices (both linguistic and non-linguistic), and mental state terms. With respect to language production, bilinguals produced more utterances than monolinguals, despite having marginally lower receptive vocabulary scores in French. With respect to macrostructure, typically-developing children provided more coherent narratives. No significant differences were found on microstructure or evaluative devices, but evaluative devices were infrequent for all groups. There were no decrements in the narratives of bilingual children relative to monolingual children, both with and without ASD; in fact we found an increased number of utterances in the narratives of bilinguals. The current findings suggest that bilingualism does not negatively affect narrative skills in children with ASD.

We examined the lexical and grammatical skills of monolingual and bilingual school-age children with autism spectrum disorders (ASD). Thirteen monolingual and thirteen bilingual children with ASD without intellectual disability, were compared on standardized measures of vocabulary and morphology. Findings revealed that bilingual children performed in the average monolingual range on a standardized receptive vocabulary test and slightly below the average range on a standardized morphological task in their dominant language. Prior work indicates that bilingual exposure is not detrimental for early language development in children with autism. The current findings suggest that at school age, bilinguals with ASD show similar language development patterns as those described in the literature on typically-developing bilinguals.

We examine the impact of bilingualism on verbal fluency in four groups of school-age (5 to 10 years-old) children: 13 Typically-developing (TYP) monolingual children, 13 TYP bilingual children, 13 monolingual children with Autism Spectrum Disorders (ASD) and 13 bilingual children with ASD. Participants were matched on chronological age and nonverbal IQ. Verbal fluency was examined via the word association subtest of the Clinical Evaluation of Language Fundamentals (CELF-4; Semel et al., 2003). The bilingual ASD group performed unexpectedly well on the verbal fluency task, not differing from the typically-developing groups, but outperforming the monolingual ASD group with respect to number of correct words produced. These findings are in line with previous research on bilingual children with ASD (e.g., Hambly & Fombonne, 2012) and taken together suggest that bilingualism does not have a negative impact on the lexical-semantic skills of children with ASD.

Little is understood about how children attend to and learn from gaze when learning new words, and whether gaze confers any benefits beyond word mapping. We examine whether 6- to 11-year-old typically-developing children (n = 43) and children with Autism Spectrum Disorder (n = 25) attend to and learn with gaze differently from another directional cue, an arrow cue. An eye-tracker recorded children’s attention to videos while they were taught novel words with a gaze cue or an arrow cue. Videos included objects when they were static or when they were manipulated to demonstrate the object’s function. Word learning was measured immediately after videos and one week later. In contrast to an arrow cue, children in both groups looked longer at a gaze cue and had more contingent looks from the gaze cue to the referent. Exploratory analyses demonstrated that across both groups, children with higher versus lower social competence skills recalled more semantic features about the referent in the gaze condition. We discuss how these findings add to our theoretical understanding of how gaze supports word learning.

It is well established that children with typical development (TYP) exposed to more maternal linguistic input develop larger vocabularies. We know relatively little about the linguistic environment available to children with autism spectrum disorders (ASD), and whether input contributes to their later vocabulary. Children with ASD or TYP and their mothers from English and French-speaking families engaged in a 10 min free-play interaction. To compare input, children were matched on language ability, sex, and maternal education (ASD n = 20, TYP n = 20). Input was transcribed, and the number of word tokens and types, lexical diversity (D), mean length of utterances (MLU), and number of utterances were calculated. We then examined the relationship between input and children's spoken vocabulary 6 months later in a larger sample (ASD: n = 19, 50–85 months; TYP: n = 44, 25–58 months). No significant group differences were found on the five input features. A hierarchical multiple regression model demonstrated input MLU significantly and positively contributed to spoken vocabulary 6 months later in both groups, over and above initial language levels. No significant difference was found between groups in the slope between input MLU and later vocabulary. Our findings reveal children with ASD and TYP of similar language levels are exposed to similar maternal linguistic environments regarding number of word tokens and types, D, MLU, and number of utterances. Importantly, linguistic input accounted for later vocabulary growth in children with ASD. Autism Res 2015, 8: 214–223. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

This study investigated the effects of bilingualism on set-shifting and working memory in children with autism spectrum disorders (ASD). Bilinguals with ASD were predicted to display a specific bilingual advantage in set-shifting, but not working memory, relative to monolinguals with ASD. Forty 6- to 9-year-old children participated (20 ASD, 20 typically-developing). Set-shifting was measured using a computerized dimensional change card sort (DCCS) task, and by parent report of executive functioning in daily life. Results showed an advantage for bilingual relative to monolingual children with ASD on the DCCS task, but not for set-shifting in daily life. Working memory was similar for bilinguals and monolinguals with ASD. These findings suggest that bilingualism may mitigate some set-shifting difficulties in children with ASD.

The acoustic correlates of discourse prominence have garnered much interest in recent adult psycholinguistics work, and the relative contributions of amplitude, duration and pitch to prominence have also been explored in research with young children. In this study, we bridge these two age groups by examining whether specific acoustic features are related to the discourse function of marking contrastive stress by preadolescent speakers, via speech obtained in a referential communication task that presented situations of explicit referential contrast. In addition, we broach the question of listener-oriented versus speaker-internal factors in the production of contrastive stress by examining both speakers who are developing typically and those with high-functioning autism (HFA). Diverging from conventional expectations and early reports, we found that speakers with HFA, like their typically developing peers (TYP), appropriately marked prominence in the expected location, on the pre-nominal adjective, in inst...

Mental state terms and personal narratives are conversational devices used to communicate subjective experience in conversation. Pre-adolescents with high-functioning autism (HFA, n = 20) were compared with language-matched typically-developing peers (TYP, n = 17) on production of mental state terms (i.e., perception, physiology, desire, emotion, cognition) and personal narratives (sequenced retelling of life events) during short conversations. HFA and TYP participants did not differ in global use of mental state terms, nor did they exhibit reduced production of cognitive terms in particular. Participants with HFA produced significantly fewer personal narratives. They also produced a smaller proportion of their mental state terms during personal narratives. These findings underscore the importance of assessing and developing qualitative aspects of conversation in highly verbal individuals with autism.

Typically developing children understand and predict others’ behavior by extracting and processing relevant information such as the logic of their actions within the situational constraints and the intentions conveyed by their gaze direction and emotional expressions. Children with autism have difficulties understanding and predicting others’ actions. With the use of eye tracking and behavioral measures, we investigated action understanding mechanisms used by 18 children with autism and a well-matched group of 18 typically developing children. Results showed that children with autism (a) consider situational constraints in order to understand the logic of an agent’s action and (b) show typical usage of the agent’s emotional expressions to infer his or her intentions. We found (c) subtle atypicalities in the way children with autism respond to an agent’s direct gaze and (d) marked impairments in their ability to attend to and interpret referential cues such as a head turn for understanding an agent’s intentions.

Conversation is a primary area of difficultly for individuals with high-functioning autism (HFA) although they have unimpaired formal language abilities. This likely stems from the unstructured nature of face-to-face conversation as well as the need to coordinate other modes of communication (e.g. eye gaze) with speech. We conducted a quantitative analysis of both verbal exchange and gaze data obtained from conversations between children with HFA and an adult, compared with those of typically-developing children matched on language level. We examined a new question: How does speaking about a topic of interest affect reciprocity of verbal exchange and eye gaze? Conversations on generic topics were compared with those on individuals’ circumscribed interests, particularly intense interests characteristic of HFA. Two opposing hypotheses were evaluated. Speaking about a topic of interest may improve reciprocity in conversation by increasing participants’ motivation and engagement. Alternatively, it could engender more one-sided interaction, given the engrossing nature of circumscribed interests. In their verbal exchanges HFA participants demonstrated decreased reciprocity during the interest topic, evidenced by fewer contingent utterances and more monologue-style speech. Moreover, a measure of stereotyped behaviour and restricted interest symptoms was inversely related to reciprocal verbal exchange. However, both the HFA and comparison groups looked significantly more to their partner’s face during the interest than generic topic. Our interpretation of results across modalities is that circumscribed interests led HFA participants to be less adaptive to their partner verbally, but speaking about a highly practiced topic allowed for increased gaze to the partner. The function of this increased gaze to partner may differ for the HFA and comparison groups.

Individuals with autism show a complex profile of differences in imitative ability, including a general deficit in precision of imitating another's actions and special difficulty in imitating nonmeaningful gestures relative to meaningful actions on objects. Given that they also show atypical patterns of visual attention when observing social stimuli, we investigated whether possible differences in visual attention when observing an action to be imitated may contribute to imitative difficulties in autism in both nonmeaningful gestures and meaningful actions on objects. Results indicated that (a) a group of 18 high-functioning 8- to 15-year-olds with autistic disorder, in comparison with a matched group of 13 typically developing children, showed similar patterns of visual attention to the demonstrator's action but decreased attention to his face when observing a model to be imitated; (b) nonmeaningful gestures and meaningful actions on objects triggered distinct visual attention patterns that did not differ between groups; (c) the autism group demonstrated reduced imitative precision for both types of imitation; and (d) duration of visual attention to the demonstrator's action was related to imitation precision for nonmeaningful gestures in the autism group.

Young children's communication has often been characterized as egocentric. Some researchers claim that the processing of language involves an initial stage that relies on egocentric heuristics, even in adults. Such an account, combined with general developmental difficulties with late-stage processes, could provide an explanation for much of children's egocentric communication. However, the experimental data reported in this article do not support such an account: In an elicited-production task, 5- to 6-year-old children were found to be sensitive to their partner's perspective. Moreover, in an on-line comprehension task, they showed sensitivity to common-ground information from the initial stages of language processing. We propose that mutual knowledge is not distinct from other knowledge relevant for language processing, and exerts early effects on processing in proportion to its salience and reliability.

This study examined two facets of the use of social cues for early word learning in parent–child dyads, where children had an Autism Spectrum Disorder (ASD) or were typically developing. In Experiment 1, we investigated word learning and generalization by children with ASD (age range: 3;01–6;02) and typically developing children (age range: 1;02–4;09) who were matched on language ability. In Experiment 2, we examined verbal and non-verbal parental labeling behaviors. First, we found that both groups were similarly able to learn a novel label using social cues alone, and to generalize this label to other representations of the object. Children who utilized social cues for word learning had higher language levels. Second, we found that parental cues used to introduce object labels were strikingly similar across groups. Moreover, parents in both groups adapted labeling behavior to their child's language level, though this surfaced in different ways across groups.

Are there consistent markers of atypical prosody in speakers with high functioning autism (HFA) compared to typically-developing speakers? We examined: (1) acoustic measurements of pitch range, mean pitch and speech rate in conversation, (2) perceptual ratings of conversation for these features and overall prosody, and (3) acoustic measurements of speech from a structured task. Increased pitch range was found in speakers with HFA during both conversation and structured communication. In global ratings listeners rated speakers with HFA as having atypical prosody. Although the HFA group demonstrated increased acoustic pitch range, listeners did not rate speakers with HFA as having increased pitch variation. We suggest that the quality of pitch variation used by speakers with HFA was non-conventional and thus not registered as such by listeners.

This study compared the object descriptions of school-age children with high-functioning autism (HFA) with those of a matched group of typically developing children. Descriptions were elicited in a referential communication task where shared information was manipulated, and in a guessing game where clues had to be provided about the identity of an object that was hidden from the addressee. Across these tasks, increasingly complex levels of audience design were assessed: (1) the ability to give adequate descriptions from one's own perspective, (2) the ability to adjust descriptions to an addressee's perspective when this differs from one's own, and (3) the ability to provide indirect yet identifying descriptions in a situation where explicit labeling is inappropriate. Results showed that there were group differences in all three cases, with the HFA group giving less efficient descriptions with respect to the relevant context than the comparison group. More revealing was the identification of distinct adaptation profiles among the HFA participants: those who had difficulty with all three levels, those who displayed Level 1 audience design but poor Level 2 and Level 3 design, and those demonstrated all three levels of audience design, like the majority of the comparison group. Higher structural language ability, rather than symptom severity or social skills, differentiated those HFA participants with typical adaptation profiles from those who displayed deficient audience design, consistent with previous reports of language use in autism.