Friday, August 19, 2011

The curious case of the reversed pronoun

“You made a circle”, exclaimed Ethan, looking up from his drawing.

“You did make a circle”, his mum acknowledged, ignoring the fact that, not for the first time, Ethan had reversed the pronoun, saying “you” when he should have said “I”.

Ethan was one of six children from Providence, Rhode Island taking part in a study of child language development. Every couple of weeks, a researcher from Brown University would visit him and his mum at home, record, and then transcribe their conversations in painstaking detail. The transcriptions would show that Ethan was a prolific reverser of pronouns; frequently saying “you” when he meant “I” and “your” instead of “my” or “mine”. This curious habit began as soon as pronouns entered his vocabulary and he was still reversing pronouns when, just before his third birthday, the study came to an end.

Ethan’s language skills were otherwise exceptionally good. When assessed at 18 months, his scores put him in the top 1% for children his age. However, some years after the study finished, it transpired that Ethan had Asperger syndrome.

Pronoun reversal is common amongst children on the autism spectrum. Leo Kanner noted as much in the first systematic description of autism and, to this day, it is considered an important marker when conferring an autism diagnosis. But the underlying cause of this highly specific problem remains something of a mystery. Ethan’s diagnosis made sense of his pronoun reversal, but it didn’t exactly explain it.

While pronoun reversal is relatively common in autism, it certainly isn’t unique to the disorder. Deaf children in particular are prone to reversal, despite the fact that in many sign languages, pronouns simply involve pointing to the person in question. And while most typically developing children appear to have little difficulty with pronouns, there have also been several case reports of children who go through a prolonged phase of pronoun reversal.

By coincidence, Naima, one of the five other children in the Providence study, was one such child.

Aware of the serendipitous nature of their data, two of the researchers, Karen Evans and Katherine Demuth, returned to their transcriptions. Forensically re-examining the evidence, they tried to work out why the two children had encountered such difficulties with pronouns. The results of their enquiries provide some intriguing insights into the multiple challenges facing both typically and atypically developing linguists.


The pronoun problem

Personal pronouns represent an unusual problem for the young language learner. Most words they encounter will have a constant reference, at least within the context of the ongoing conversation. “Mummy” will refer to their own mother. “Dog” will refer to the animal that is sat on the carpet right in front of them. But the meanings of “I” and “you” change, depending on who it is that is speaking. My “you” is your “me”.

In Naima’s case, it seems that she simply failed to grasp this concept, thinking that “you” was really just another name for herself. It wasn’t that she sometimes got it right and sometimes got it wrong. Between the ages of 19 and 28 months, virtually every time she used “you” or “your”, she was actually referring to herself, sometimes with amusing results:
Naima: "I think you peed in your diaper."
Mother: "Just now?"
Naima: "I think you did."
Then, all of a sudden, something clicked. In Naima’s final two sessions at 29 and 30 months, every single pronoun was used correctly. But why did she make this mistake in the first place? And what happened for the penny to drop?

Are you experienced?

Yuriko Oshima-Takane, a psychologist at McGill University in Montreal, has argued that children can only deduce the principles of pronoun use by listening in on other people’s conversations. Pronoun reversers, she suggests, are children who, for one reason or another, have missed out on this vital linguistic experience.

Naima appears to be a perfect illustration of this theory. She was an only child at the time of the study and spent most of her time alone with either her mother or her father. As a result, most of the speech she heard was directed at her. This in turn meant that almost every time she heard the word “you” it referred to her. It would be perfectly understandable if she thought of "you” as simply another name for herself.

Evans and Demuth note that the abrupt end of Naima’s pronoun reversal coincided with a family holiday. They speculate that the time spent with both mum and dad is what gave her the learning experience necessary to finally grasp the concept of “you”.

Oshima-Takane suggests a similar explanation for the high rates of pronoun reversal in deaf and autistic children. For deaf kids, having to rely on visual communication or poor quality auditory input makes it much more difficult to follow other people’s conversations. For autistic kids, the argument goes, the problem is more that they are disinterested in other people and so fail to pay attention to their conversations. Like Naima, both groups of children will only learn from speech that directly engages them and will mistakenly jump to the conclusion that “you” only ever refers to themselves.

So could this explain Ethan’s difficulties? Evans and Demuth suggest not, pointing out that, although he often used “you” to refer to himself, he used it appropriately on enough occasions to demonstrate that he’d grasped the concept.

The trail led elsewhere.

Say it again


Kanner’s explanation for pronoun reversal in autism came from another observation - that children with autism often repeat entire phrases verbatim, inappropriately and out of context. This so-called ‘echolalia’ would lead to reversals as the pronouns are repeated exactly as heard. British child psychiatrist, Michael Rutter gave the example of a hungry child requesting a biscuit by echoing the phrase “Do you want a biscuit?” The pronoun was reversed but the biscuit was obtained.

Consistent with this explanation, Evans and Demuth noted that Ethan was indeed most likely to reverse pronouns when imitating an utterance that somebody else had previously made. “Dad gave me that ring”, for example, was clearly a reversal but was almost certainly something his mum had said previously.

Case closed one might think.

However, even using the most generous criteria, imitations accounted for less than half of Ethan’s recorded reversals. What’s more, in contrast to the child in Rutter’s example, he actually made relatively few reversals during requests. For example, when asking for his bottle, he said “I want bottle”, using “I” correctly (even though the sentence wasn’t fully formed).


An alternative perspective

Further analyses revealed two final clues. First, as well as using “you” to refer to himself, Ethan occasionally used “I” to refer to other people (something Naima very rarely did). Second, reversed pronouns were more likely to occur in sentences that contained multiple pronouns. For example, at aged 22 months, Ethan was recorded saying “I got you out” when he should have said “You got me out”.

These observations suggest that his problem lay, not in understanding the principles of which pronoun to use, but in applying those principles during a conversation. His problems were pragmatic rather than conceptual. More precisely, Evans and Demuth propose that Ethan’s pronoun reversal reflected difficulty in referential perspective taking - in choosing the right word given who was being referred to at any given moment in the conversation.

This account of Ethan’s pronoun reversal fits nicely with research suggesting that autistic children have difficulty with other linguistic terms that depend on the speaker’s perspective (Bartolucci & Albers, 1974).

In an intriguing study published last year, Peter Hobson and colleagues at University College London (Hobson et al. 2010) found that children with autism were competent at using “here” and “there” to refer to locations near or far from themselves. However, the same children struggled to follow similar instructions given by two other people – a task that required them to consider the speaker’s perspective to work out which locations “here” and “there” referred to.

Wrapping up

Whether  or not Evans and Demuth have solved the mystery of why these two particular children reversed their pronouns, their investigations demonstrate that, if you scratch beneath the surface, even a phenomenon as striking and specific as reversal of first- and second-person pronouns can have quite different underlying causes. In Naima’s case, it seems she misunderstood the meaning of “you”. In Ethan’s case, he appears to have grasped the concept but lacked the wherewithal to consistently choose the correct pronoun during a conversation.

Ethan’s case is particularly intriguing in the light of his Asperger syndrome diagnosis. However, it would be unwise to assume that he is representative of all individuals on the autism spectrum. His difficulties do not seem to be explicable in terms of either a lack of relevant linguistic experience or a tendency to echo phrases verbatim, but these may still be contributory factors, and could well explain pronoun reversal in other autistic individuals. Indeed, as noted earlier, Ethan’s error patterns are quite different to some other examples in the autism literature.

Perhaps the reason pronoun reversal is so common in autism is that there are several factors associated with autism that each contribute to the difficulties. Working out why a particular child reverses pronouns may require investigation on a case-by-case basis.


18 comments:

  1. Excellent post, very interesting.

    My 5 year old (almost 6 years old) has only just started to get pronouns correct more often than not (diagnosed autistic at 3, reasonably severe at time of diagnosis). The improvement happened so gradually that I'm only aware of how far its progressed in this past year, because my awareness is raised by posts like this one.

    His pronoun reversal was severe enough to pose a very serious challenge to his learning, behaviour (frustrations at being misunderstood in particular), and social interactions, when he started school at the beginning of this year. He had these probelms still despite a couple of years of speech therapy and kindergarten. Yet now - less than a year into his schooling - and the problem is almost all gone.

    Was it just the right timing developmentally? Did the teachers (one of whom is specifically trained for dealing with autistic children) crack the issue? I don't know the answer to that yet, or if I'll ever know the answer. But the consequences of having the problem were wider reaching than I think many people appreciate, and in turn the fixing of the problem has come hand-in-hand (coincidence, causal, related or accidental, I don't know) with a lot of other improvements.

    Thanks for your thought-provoking post.

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  2. As I was reading, and of course relating to my sons verbal development (he will be 3 in October) I thought that a combination of Oshima-Takane's ideas about not paying much attention, in combination with Kanners echolalia theory made some sense. I'm certain the echolalia factor had some influence on his pro noun reversal. Until 3 or 4 weeks ago all his pro nouns were reversed, then spontaneously, much like the child in the story, something 'clicked'. He suddenly started to use statements such as "I'm walking", or "give me that". He does not apply pro nouns correctly 100% of the time yet, but I feel confident that he will over time. I can only assume that this correct usage stems from some form of observation. Which lends some weight to Oshima-Takanes theory. Importantly I think, Harri is unusually interested in other people at least in comparison to other children on the spectrum.
    Even when he appears to not be paying attention he will do or say something to indicate that he is constantly absorbing the noise, and therefore conversations that are occurring near him. He also has a 6 year old (NT) sister, who is a bit if a chatterbox. Unlike the child in the study whose development in this regards could be linked to a family holiday, I think it's more likely Harri has been attentive enough and talked to often enough using 'normal' language that he has been able to notice the pattern in pro noun use. And then apply it. And on correct application received much positive reinforcement. Having said that he has myself and his therapists slightly dumfounded at how he has managed to work this out.

    I really like the fact your paper argues for multifactorial possibilities. I
    suspect my son is a bit of an anomaly in that at such a young age he has
    managed to work this pro noun issue out more often than not. So perhaps amongst the variables are, if or not the child is echolalic, as this may make pro noun reversal more a speech than perception problem. Then of course how withdrawn the child is. Harri is quite social, he is a sensory seeker and has worked out that people have value to that end. Therefore he has motivation to communicate. He is also a fast learner. IQ may be a factor also. Furthermore he's not usually overwhelmed by sensory overload therefore is not using up of lot of internal or mental/emotional resources trying to cope with too much sensory input. This allows him 'space' to be open to his surroundings and therefore learn from the natural environment. He's also not a big 'stimmer', so again is probably more plugged in to others than a child who is preoccupied with repetitive actions such as spinning or rocking.

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  3. Thanks so much for this wonderful post, Dr. "You". I read with interest each link out, and appreciate that "In solving a problem of this sort, the grand thing is to be able to reason backward."

    The most enlightening link was to the Kanner case study. I had never read any of his work. I was taken back. I had forgotten how it was with Ben, and how far we've come. It was a stark reminder.A matter of pragmatics, yes...Ben's only neurologist gave him a label of semantic-pragmatic disorder as he was too aware of others to be labelled autistic in his mind. "He will interact with me. He doesn't want to , but he will." The words have recently flooded back. "It will probably be manifested in a severe learning disability." Ben is both Dyscalculaic and Dysgraphic. I wonder if those with one of the Dyslexia's have a similar profile in language aquisition, or if Ben just had them in addition to the Semantic-Pragmatic Disorder. I always seemed to fit in better with the parent groups for ADHD than autism...although he had extreme difficulties, he also had extreme gifts. Twice exceptional, "2e", a genius level IQ in special ed...quite an interesting kid!

    There are always incidents that give me pause, that I hold in my mind/heart. When he was 3 the home we lived in had a huge bathroom type mirror, it was above his bed. I could not get him to look at himself, the boy in the mirror. You know how most kids make monkey faces as soon as they see a mirror. He didn't...nor could he be encouraged to try. I thought it was so strange, and the guilt crept in that I was so overwhelming him that he had no sense of self. (I didn't do it on purpose, you know.) It would be difficult to have a sense of other if you had no sense of independent self.

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  4. My son is 4, he was recently diagnosed with autism and he has had pronoun trouble in the past but seems to have learnt to use them correctly. However what he doesn't seem to be learning is he/she and him/her gender pronouns. We correct him everytime and discuss with him "she is a girl, he is a boy" and he knows who is a girl/woman and who is a boy/man but he almost always mixes up the pronouns he/she him/her. Is this the same thing as the pronoun reversal mentioned in the article, related, or something different? Is this also seen in autistic kids?

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  5. Thanks for mention on twitter :)

    Good luck to Dr. Demuth. Her study was very peceptive, another key to understanding.
    And to the future Dr. Neha Khetrapal; congratulations on obtaining such a progressive appointment!

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  6. I think the multiple factors issue is an important one.

    My guess is that there are two principal factors; the flexibility of pronouns and the amount of auditory information available in them.

    Pronouns are one of the shiftiest parts of grammar and lack of clarification of a pronoun’s antecedent (who or what it refers to) often leads to confusion and/or amusement even for people without autism e.g ‘I have a painful corn on my toe; I shall have to cut it off (corn or toe?)’ Given the difficulties autistic children have with tracking change in anything, it’s hardly surprising that tracking pronoun changes poses a particular linguistic problem.

    In addition, in many languages, pronouns contain little auditory information compared to nouns, verbs and proper names. Pronouns are often very short words, a significant part of which is a vowel sound; ‘I’, ‘he’, ‘il’ ‘er’, etc. For anyone with auditory processing problems, long suspected as being implicated in autism, pronouns give you very little in the way of information that allows you to identify pronouns and to discriminate between them.

    I’d expect pronoun confusion in autism to be found across all languages that use them, but that the degree of confusion will vary inversely with the amount of auditory information contained in the pronouns themselves.

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  7. I just want to say thanks to everyone for sharing their experiences. It's really helping to crystallize the questions we need to be asking and reassuring us that this is an important topic of investigation.

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  8. Any language related observation is going to be fruitful. Ask Dr. Demuth if she is old enough to remember, "it's the economy, stupid..." that won the presidency for Bill Clinton in 1992. I DON'T want you to take it personally, but for some researchers I just want to say, "It's the language, stupid." It's all about showing ,and not telling, too. At least it was for me.

    Emma, Sharon, Oughtisms, do you find it that way? I am looking back.

    I think our kids have to cross wire their brains to pick up language. Some never will. And some know far more than they can relate. Like strangers in a strange land.

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  9. Now that I think back, my now 6yo (with aspergers) who developed language very quickly and remains well above her age with it. Reversed pronouns when she was 2-3 because a lot of what she said was scripted or echolalic, I had forgotten this until recently when I saw a home video where she was reciting a script and in the middle of it said "you want porridge?" which is how she would ask for something to eat (she'd change the food item but always asked it exactly how I asked her if she wanted something).

    Usethebrains, I know what you're saying, even for those with above avg. language development using social language can be a confusing thing (and pronouns could be called a social aspect of language I guess) so in many ways it is like a second language for some of these kids, so they speak "broken english" I would love to know if these things are true in other languages (I wouldn't see why not if the structure is smilarly confusing, I always thought english was a rather messy language though with rules that don't always apply making it very confusing), I know several multi-lingual families actually and I'm going to ask.

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  10. usethebrains.. I'd love to answer the question but I don't quite understand it. My expressive communication is far better than my receptive :)

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  11. Sharon...if you are still around, is it primarily a "word blindness" initially?? My son was 18 months and could say "butterfly" when he saw a picture of it. But he was 4.5 years before he knew the difference between yes and no if I remember rightly. I think the ability to answer the question "What is your name?" preceeded that. His speech was echolalic until GRADE 4. It is almost beyond belief how he caught up, he has a loquacious vocabulary now at age 17. He was so delayed in comparison with his peers for using language as a communication tool. Yet, he has a far more sophisticated vocabulary now, as well as thought pattern.

    Different, wa-a-a-a-y different than any other kid I ever knew, with the exception of a special ed student. At 6th grade he topped out at college sophmore understanding...but the dude couldn't write, spell, or do math. My son's not quite that bright...but close. Same "learning disabilities". I wish I could have known Eddie, my student, in his early years, to know if he had a similar developmental trajectory.

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  12. Here I go...

    I think "word blindness" is a much more appropriate moniker than "mind-blindness".

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  13. Mmm it's a really interesting question, and I think would certainly apply to some. As for my own son, I'm really not sure. He is an enigma to me. His pro noun use is, just a couple of weeks since first posting here, now almost 100% accurate and diverse. Which as he is yet to turn three has us all baffled. How on earth did he work this out? It is something we have never addressed in therapy. Yet he can only name two colours consistently.
    But spread an array if 8 pics and ask him to give you the furniture and you can bet he will pick the correct item. So the idea of word blindness in my sons instance doesnt seem to quite explain what's going on.

    He sits for a WPPSI assessment next week. This may give some more insight into his thought processes.

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  14. Lots of psychobabble by psychiatry have been published for decades trying to interpet meaning for the phenomena of transient echolalia in verbal autism children.

    Language impairments of childhood and language impairments in autistic youngsters share many common impairments, however, the phenomenon of transient echolalia appears to be specific to ASD language impairment in contrast to shared specific or pragmatic language impairments in childhood. However, damaged neuronal circuitry at the extremes (ie autism)is associated with echolalia in stroke, brain tumor and Alzheimer's patients ( Blair et al 2007) ( Yang et al 1989) ( Endo et al 2001 ).

    http://www.ncbi.nlm.nih.gov/pubmed/17286881

    http://www.ncbi.nlm.nih.gov/pubmed/2473823

    http://www.ncbi.nlm.nih.gov/pubmed/11296406

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  15. My son is 5.5 with ASD. He was an early talker and always had a lot of language, but he still has pronoun reversal. We are always correcting him, but for him he doesn't seem to understand the concept. He says "I want carrier phrases b/c he has been taught to script them, but when he uses any spontaneous speech it is always with the wrong pronouns. It seems to be affecting his confidence in initiating conversations. Any suggestions and how to help fix it?

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  16. Thank you for this! I'll throw in my anecdotal 2 cents in support of Evans & Demuth: as an occupational therapist who works with a lot of children with autism, I have often observed this phenomenon. What I have always found fascinating is that, regardless of chronological age, the children begin self-correct when they develop a stronger sense of self, and, more specifically, a sense of (motoric) agency.

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  17. I'm 35 and still do pronoun reversal, it really annoys some people, I know why I do it. but I'm not going to tell you that's part of my research work.

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  18. English Pronouns is very important because its structure is used in every day conversation. The more you practice the subject, the closer you get to mastering the English language.

    Subject and Object Pronouns

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