Journal of Menial Deficiency Research, 1987, 31, 279-286

CASE REPORT

Computer-assisted linguistic analysis ofan autistic

adolescent's language: implications for the
diagnosis of Aspberger's syndrome and atypical
psychoses
K. KING, W. I FRASER AND P. F. THOMAS
University Department of Psychiatry, Royal Edinburgh Hospitaly Edinburgh, Scotland

ABSTRACT. This study illustrates the use of a computer-assisted linguistic analysis

technique to compare the spoken language ofan adolescent, diagnosed in childhood as
autistic, with that of normal and schizophrenic individuals. A distinctive profile, in
keeping with accounts in the literature of autistic speech, was noted to be radically
different from that found in linguistic analysis of schizophrenic speech. This distinctive
profile was mirrored by her written linguistic analysis. Changes indicative of some
improvement in language function were seen on re-recording after 5 years. Imphcations
of this technique for differential diagnosis of Aspberger's syndrome and atypical
psychoses are mentioned.

INTRODUCTION
The application of detailed objective linguistic analysis aided by the computational
swiftness of the computer has proved to be a powerful tool for exploring speech
development (Bishop, 1985). Recently the characteristics of psychotic speech have
also been examined in this way. Morice & Ingram (1982) claimed that measurable
syntactic changes occur in schizophrenia.
Samples of speech from patients admitted consecutively to an Australian hospital
were analysed by Morice using 'Psychlan', a programme which generated a linguistic
profile of 118 variables for each subject using an Apple 11 E Microcomputer (see
Appendix). These variables measure the complexity, variety, errors and fluency of
spoken language. The results showed that, compared with normal subjects,
schizophrenics showed less complex syntax, and more syntactical, morphological and
semantic errors. The results also suggested that discriminant function scores could be
used diagnostically.
These findings were replicated by Fraser ei al. (1986) on 77 schizophrenic (and 50
normal) Scots, aged 16-65. Using the Scots discriminant functions to classify subjects
back into their diagnostic groups, 75-5% correct allocation was achieved.
The language of autistics has also been noted by Baltaxe & Simmons (1977) to have
not only excessive syntactical, morphological and semantic errors, but also unusual

Correspondence: Dr W. 1. Fraser, University Department of Psychiatry, Royal Edinburgh

Hospital, Momingside Park, Edinburgh EHIO SHF, Scotland
279
280 K. King, W. I. Fraser and P. F. Thomas
pendular prosody, situational violation and meaningless insertions, constituting a
characteristic profile.
The authors are aware of the limitations of case study material. The purpose of this
study was to explore the use of computer-assisted Unguistic analysis with a young
woman who had been diagnosed as having early childhood autism, who had deviant
language and in whom low intelligence was not a confounding variable. It was
hypothesized that her linguistic profile would be distinct from and, over the years,
increasingly divergent from the speech of schizophrenic people.

CASE REPORT
K was diagnosed as having early childhood autism (I.C.D.: 299-0) at the age of 5 years
from a classical history of idiopathic onset, abnormal preoccupation with sameness
and preference for isolation. She developed her first words at the age of 5 years,
two-word utterances by the age of 8 years and, by 10 years, had acquired sentences.
Her IQ at 12 years was 93 (TM); at 17 years, verbal 70, performance 93, overall 88
(WAIS). She had the cardinal symptoms of autism: impaired emotional conduct with
people, impaired language development and obsessional patterns. As in most
follow-up studies of the few autistic children who manage to attend ordinary school,
she adapted poorly to work, was naive in her expression of sexuality and had a very
narrow range in interests. She became an isolated eccentric adolescent who had great
difficulty in making relationships. Her language was characterized by the features
noted by Baltaxe & Simmons (1977): namely, unusual prosody, situational violations,
confusing polite and informal address and redundant insertions, but especially by
apparent 'over-precision' and repetitiveness, particularly perseveration on topics such
as her diet and her height. She also produced violations of syntactic and semantic
constraints which were difficult to pinpoint without detailed grammatical analysis.
Her speech, in the form of a 20-min prompted monologue, was recorded in 1980,
when she was 17 years old, on a Sony cassette recorder, transcribed and analyzed after
the method of Morice & Ingram (1982) (Appendix). When she was 22-years-old in
1985, and somewhat more mature with wider interests and a boyfriend, her speech
was re-recorded, transcribed and analyzed after the method of Morice & Ingram
(1982) (Appendix). A written text (one of her countless unsolicited letters) written at
age 19 was selected at random and also analysed by this method.

Example of K's speech (1980)

'If any of the staff ever in my life stop me from helping myself to eat all the at least 12
ounces of raw cheese on its own all to myself from Saturday night just before I go to
bed until Sunday night just before I go to bed in my bedroom I will always in my life
want to be residential. If any of the staff ever in my life stop me from helping myself to
eat all the other lot of at least 12 ounces of raw cheese on its own all to myself for seven
nights just before I go to bed in the bedroom I will always in my hfe be very very
miserable and I never will in my life want to be residential.'
 Computerized linguistic analysis of an autistic adolescent 281

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282 K. King, W. I. Fraser and P. F. Thomas
Example of K's speech (1985)
'I always missed my boyfriend X whom I love very much (you see) I really always in
my life even when I'm (um) a very old lady want to have X as my I really always in my
life even when I am a very old lady want to have X as my darling boyfriend and I really
always in my life even when I am a very old lady want to be X's darling girlfriend and
I really always in my life even when I am a very old lady want X to put his arms right
round me every day and I really always in my life even when I'm a very old lady want
to put my arms right round X's shoulders every day and I really always in my hfe even
when I'm a very old lady want to kiss X and hug X on his face every day and I really
always in my life even when I'm a very old lady want X to kiss me and hug me on my
face every day and I really always in my life even when I am a very old lady want X to
lift me up high off the ground with me sitting in his arms every day and I really always
in my hfe even when I'm a very old lady want X to love me very much and I really
always in my life even when I'm a very old lady want to live with just X after I've been
in Ward four of the Lothian Hospital for a while.'

RESULTS
When K's linguistic variable scores (Table 1) are compared with the mean scores on
grammatical variables for normal jKrsons and acute and chronic schizophrenic

Table 1 A selection of K's 118 linguistic variables, expressed as mean scores, percentage
scores or sample counts, illustrating complexity, error, fluency and variety indices on two
recordings of speech (the maximum change on each of these variables on retesting normal
people after 5 years is bracketted in column 2)

First Second Written

recording recording text
(1980) (1985) (1980)

Complexity
Mean length of utterance 1300 19-00 (3-1) 45-4
Percentage of sentences with embedding 54-80 72-70 (3-7) lOO-O
Mean number of embedded sentences 1-96 2-00 (0-1) 3-7
Mean depth of embedded sentences 1-65 1-41 (0-29) 2-4
Error
Percentage of well-formed maior utterances 66-6 70-45 (4-0) 36-4
Percentage of syntactic errors 33-3 25-00 (5-0) 63-6
Percentage of semantic errors 4-80 8-10 (0-0) 9-1
Error score 18-00 15-00 (10-0) 10-0
Percentage of errors of omission 16-70 6-70 (6-0) 40-0
Percentage of errors of commission 61-10 66-70 (6-0) 60-0
Fluency
Dysflueney index 4-60 5-60 (0-25) 0-00
Variety
Percentage of non-declarative sentences 0 00 455 (32 Q-OO
 Computerised linguistic analysis of an autistic adolescent 283

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284 K. King, W. I. Fraser and P. F. Thomas
individuals (duration of illness less than 5 years and more than 10 years, respectively)
(Table 2), it can be seen that K has a markedly different profile. The variables which
are displayed in Tables 1 and 2 are those which best differentiated normal from
schizophrenic speech (Fraser et al, 1986). Her mean length of utterances are the
longest of all groups. Despite the fact that she is said by listeners to be 'over-precise'
in her language, she produces more syntactic and semantic errors than normals or
acute schizophrenics. Overall, her errors are mostly of commission rather than
omission.
She is slightly more fluent and her sentences more complex than the average normal
person, with a higher percentage of embedded sentences and greater depth of
embedding. She is also remarkable in that she produces (in the first recording) only
declarative type sentences (percentage of non-declarative sentence types: zero). Her
written text mirrors her speech, with further exaggerated length of utterances, more
and deeper embedding, and a reversed ratio of errors of omission to commission
compared with normal and schizophrenic populations (reflecting Baltaxe & Simmons'
(1977) 'meaningless insertions'). Her linguistic features show marginal change over 5
years. In contrast to schizophrenics' linguistic deterioration, with the passage of time
K shows a tendency towards a more 'normal' language output in the percentage of
well-formed utterances, more non-deciarative sentences, fewer errors and less densely
complex sentences.

DISCUSSION
Until this computer-assisted linguistic analysis technique is standardized on a large
sample of autistic individuals, it cannot be used diagnostically in this condition.
However, this case study illustrates that an individual, who has classical early
childhood autism and linguistic output, has a text whose linguistic variables differ
strikingly from those of normal and schizophrenic persons. The language of autistic
persons and persons who are suffering from schizophrenia may be confused. Both
conditions may sometimes co-exist. Both conditions may produce grammatical
abnormalities, neologisms, echolalia, abnormal prosody, present maior problems with
the pragmatics of language and may seem incoherent. The computer-assisted
linguistic analysis technique suggests that this autistic woman's linguistic profile is
distinctly different from that of schizophrenic individuals.
In mental illness, language output remains versatile: the patient asks questions and
interrogates, as well as making statements. K's autistic isolation, on the other hand,
makes her impervious to her listener's needs and her text consists of continuous prolix
declarations and statements.
There is evidence that schizophrenic speech deteriorates with the duration (Table
2) of the illness. K has a learning disability, not a mental illness, and while her
linguistic profile remains characteristically bizarre after 5 years, it has become
marginally less peculiar (less like written text) and more adapted to a listener's needs
insofar as she is no longer producing only statements but now has a normal percentage
of non-deciarative sentences, i.e. questions, exclamations, interrogatives and
comments. It has been hypothesized that Asperger's syndrome may be a milder form
 Computerized linguistic analysis of an autistic adolescent 285

of infantile autism, with later onset. The criteria (Wing & Gould, 1979) used for
defining the syndrome include: pedantic, aprosodic speech; clumsy communication
and interpersonal relatedness; deficit in empathy for others; repetitive activities;
adequate to excellent rote reading and circumscribed interest patterns. It is
distinguishable from autism by its later onset and improved outcome. This woman
was clearly diagnosable as autistic in early childhood, yet meets most criteria of
Asperger's syndrome in adolescence. The authors suggest that this technique may
help delineate the subgroups of the pervasive developmental disorders in DSM III
(American Psychiatric Association, 1980), and that this technique be further
developed where strange language complicates the differential diagnosis of psychosis
and autism, as an aid to accuracy in measuring and describing speech. No single case
study can be said to constitute a typical linguistic profile of a subject, especially in
autism. However, in complex or curious casessuch as occur in autism, atypical
psychosis, Fragile-X and mild/moderate mental handicap, with or without
superimposed psychosiscomputer-assisted linguistic analysis (even at this stage in
its development) can quite speedily create a useful hnguistic profile which specifies
and quantifies the grammatical problems, and be a guide to temporal change in
language.
Further studies of mentally impaired people of a range of intellect, with or without
superadded mental illness, are indicated but a major limitation at present is the cost.
Like similar programs, for example, Bishop's (1985) computer-assisted parsing and
clause analysis (which also uses and Apple II E), Psychlan is only semi-automated; it
takes 7-12 h of manual preparation per recording; unlike Bishop's LARSP computer
program, Psychlan is capable of analysing multi-clause sentences. The creation of the
equivalent of the Child Language Data Exchange System (CHILDES) (McWhinney
& Snow, 1985) for adults would enable extensive computerized databases to be
gathered for the mentally handicapped.

REFERENCES
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders,
3rd Edition.
Baltaxe C. & Simmons J. (1977) Language patterns of adolescent autistics: a comparison
between English and German. In: Research to Practice in Mental Retardation, Vol. II,
P. Mittler (ed.) pp. 267-79. Baltimore, University Park Press.
Bishop D. (1985) Semi-automated LARSP analysis software section.youma/o/C/iiWPyyc/iiatry
and Psychology 26, 1.
Fraser W., King K., Thomas P. & Kendell R. (1986) The diagnosis of schizophrenia by
language analysis. British Journal of Psychiatry 148, 275-8.
Morice R.D. & Ingram J.C. (1982) Language analysis in schizophrenia: Diagnostic
implications. Australian and New Zealand Journal of Psychiatry 16, 11-21.
McWhinney B. & Snow C. (1985) The child language data exchange system. Journal of Child
Language 12, 271-96.
Quirk R., Greenbaiun S., Leech G. & Swarbrick J. (1972)/! Grammar of Contemporary English,
Harlow, Longman.
Wing L. & Gould J. (1979) Severe impairment of social interaction and associated
abnormalities in children: epidemiology and classification. Journal of Autism and
Developmental Disorders 1, 1-29.
286 K. King, W. I. Fraser and P. F. Thomas
APPENDIX

Lirtguistic analysis procedure

Free speech samples of 1000 words were recorded for each subiect; unpunctuated
transcriptions were made from the tapes, sentence boundaries created and manual grammatical
analysis performed by trained research assistant with a coding manual based on the main
standard reference of English grammar (Quirk et al., 1972); manual analysis was performed as a
series of scans over each sentence, identifying low-level dysfluencies such as repeated words and
false starts, categorising each sentence as being well formed or 'deviant', and constructing a
syntax tree diagram for each analyzeable sentence; each clause was identified as a marked node
in the syntax tree and detailed structural indices, verb phrase markings and dependent clause
types identified. All linguistic information from the manual analysisthe original texts,
sentence classifications, dysfluencies, syntax trees and error identificationwas transferred
onto floppy disc on an Apple 11 E Microcomputer in form suitable for processing by a
programme package (Psychlan) capable of recognising and counting various grammatical
features and collating them into 118 measures of fluency, complexity, variety and integrity.

Received 19 February 1987