Helen Tager-Flusberg: Cracking the Code of Language Deficits in Autism

Helen Tager-Flusberg: Cracking the Code of Language Deficits in Autism

Why you should care

Because this researcher thinks one key to diagnosing and treating autism may lie in how kids with autism speak.

The girl shuffled clumsily into the room. She spoke rarely, and when she did, it was in a gruff, gravelly tone. And then suddenly, she leapt from her chair and twirled lithely around — and started to sing.

“She had the most beautiful, beautiful voice,” remembered psychology researcher Helen Tager-Flusberg. “The voice used for speaking was not the voice used for singing. It was such an enigma.”

Focusing on language can help autistic kids achieve the ‘most significant improvement.’

Besides repetitive behaviors and poor social engagement, many of the 70 million people who on the autism spectrum also display language deficits. Some don’t talk at all. Others start speaking late in life. Still others parrot speech.

Tager-Flusberg, a professor of psychology at Boston University and president of the International Society for Autism Research, wants to unravel — and eventually fix — these impairments. Studies on early interventions in children with autism have shown that focusing on language can help kids achieve the “most significant improvement,” Tager-Flusberg said.

Tager-Flusberg’s hypothesis: Verbal children with autism show the same linguistic abilities — such as grammatical accuracy, vocabulary, and pronunciation — as typically developed children. “The difference is in their ability to use language socially,” she said. Children with autism often fail to follow conversational norms; they might dominate the conversation, or fail to understand jokes or sarcasm.

Which means Tager-Flusberg’s field is ripe for study.

“If you asked somebody, ‘Who are the famous people studying language in autism?’ she’s the first name to come to mind,” Kenneth Wexler, professor of brain and cognitive science at the Massachusetts Institute of Technology told SFARI.org.

Children with autism used words referring to psychological states (like “believe,” “forget” and “figure”) less than typically developed children.

Tager-Flusberg has a soft, heavy-lidded gaze and speaks with a faint British accent. She grew up near London with her parents and sister, who suffers from an intellectual disorder that, like autism, limited her ability to speak. “I remember wanting to understand her,” Tager-Flusberg said.

After studying psychology at University College London in the 1970s, the hard-nosed Brit earned her Ph.D. in Harvard’s all-male experimental psychology department. For her thesis, she found that children with and without autism mention the subject before the object — challenging research at the time on language deficits in autism, which focused on the ability to process syntax, or the grammatical rules of languge.

So Tager-Flusberg looked beyond syntax, investigating other ways to characterize language impairments in autism. In a study published in Child Development more than two decades ago, she found that children with autism used words to describe psychological states less often than children other children. This further suggested that their language deficits weren’t linguistic, but stemmed from an inability to use language in a social context — to understand other people’s beliefs and emotions.

During Tager-Flusberg’s time as a junior faculty member at the University of Massachusetts, many found it “completely illegitimate” for her to study a disorder when she wasn’t a trained clinician. Still, she secured enough funding to launch her own research program on language deficits in autism.

That no-nonsense approach has also allowed Tager-Flusberg to juggle a number projects as director of Boston University’s Center for Autism Research Excellence. Today, she’s investigating language deficits in the roughly 30 percent of children with autism who may never develop functional language skills or learn to speak.

The earlier parents can identify autism risk, the better.

A major hurdle to studying these children is measuring how much language they actually understand — which, of course, they can’t convey verbally. So Tager-Flusberg is adapting comprehension assessments normally used with infants. In these assessments, clinicians might show infants pictures of a cat and a dog. Those who understand when the researcher says “dog” gaze longer at the picture of the dog.

Boy in plastic bubble in pool

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She’s also studying infant siblings of children with autism, who have a 1 in 5 risk of falling on the autism spectrum. Although most people process language in the left hemisphere of their brain, she’s found that even the non-autistic of these siblings process language in both hemispheres. Siblings who do go on to develop autism tend to process language primarily in the right hemisphere. Those findings might seem small, but they could one day be used as biomarkers to measure autism risk in the first year of life — long before behavioral symptoms appear at around 2 to 4 years of age.

The earlier parents can identify autism risk, the better. Research has shown that speech-language therapy and other interventions are most effective when begun at a young age, and might steer brain development toward a normal trajectory.

But Wexler wrote by email that he remains skeptical about her findings that the language deficit in autism is only social, pointing out that more recent studies have found that children with autism fail to understand passive sentences and many other “grammatical properties” unrelated to mental states or other indicators of social cognition, meaning they may have problems processing the inherent structure of language.

When Tager-Flusberg isn’t in the lab, she’s usually reading or knitting. She admits that she doesn’t have many hobbies. “Work is my hobby,” she said. “Until every child with autism acquires spoken language skills … my career won’t be done.”

Because to Tager-Flusberg, language is a basic human need. “Our ability to speak is really the single most significant gift that we have. It’s our way of being able to connect with other people,” she said. For parents whose kids can barely speak, “their single wish in life is to know what their kids are really thinking and feeling, to have a conversation with them.”

* Editor’s note: An earlier version of this article did not adequately credit its source. The story contains some reporting from SFARI.org.

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