Comprehension abilities of idioms according to semantic types and familiarity in school-aged children with high-functioning autism spectrum disorder

Objectives: The purposes of this study were to investigate the differences in comprehension between children with high-functioning autism spectrum disorder (HFA) and children with typical development (TD) by type of idiom (emotion/action expression) and familiarity (high/low) and to investigate the proportion of misunderstood idioms (literal interpretation, idiom quote) within each group. Methods: Fifteen children with HFA and 15 age-matched children with TD were included in this study. An idiom comprehension task was developed for the study, which consisted of 40 items (10 emotion-familiar idioms, 10 emotion-unfamiliar idioms, 10 action-familiar idioms, and 10 action-unfamiliar idioms). Results: The idiom comprehension accuracy of children with HFA was significantly lower than children with TD. Children with HFA showed significantly lower accuracy than children with TD in comprehending emotion idioms. Both children with HFA and children with TD had significantly higher accuracy in familiar idioms than in unfamiliar idioms. For children with HFA, there was no significant difference in the proportion of misunderstanding between literal interpretation of idioms and idiom quote. Conclusion: Children with HFA showed lower accuracy in idiom comprehension than children with TD. Children with HFA had more difficulties in comprehending emotion idioms and unfamiliar idioms than children with TD. These results suggest that the type and familiarity of idioms should be considered in teaching idioms to children with HFA in speech-language therapy.