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CLT0010.1177/0265659014530414Child Language Teaching and TherapyMelogno et al.

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Child Language Teaching and Therapy

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DOI: 10.1177/0265659014530414
child with autism spectrum clt.sagepub.com

disorder: A case study

Sergio Melogno, Maria Antonietta Pinto and Gabriel Levi

Sapienza University of Rome, Italy

Abstract
This study analyses the case of a gifted child (9;6 year) with autism spectrum disorder (ASD) who
had a particularly high verbal IQ (146) and a specific cognitive, linguistic, and metalinguistic profile.
A description of some salient behavioral characteristics of the child is provided. A metalinguistic
ability test assessing metagrammatical, metasemantic, and metaphonological abilities and a
metaphor comprehension test were administered. Both tests place high value on justifications of
responses, which permits investigators to grasp different levels of metalinguistic awareness. The
child gave poor metalinguistic responses in subtests assessing metasemantic abilities, contrary
to subtests assessing metagrammatical and metaphonological abilities. These discrepant results
are interpreted in terms of this child’s specific difficulty with ‘open’ linguistic systems, such as
semantics, in spite of his high ‘closed’ language capabilities. The discussion highlights the importance
of assessing the meta-level of the verbal competencies of gifted children with ASD.

Keywords
Asperger syndrome, autism spectrum disorder, giftedness, hypersystemizing, metalinguistic
abilities

I Introduction
Recently, some scholars (Assouline et al., 2009) have adopted case study methodology to examine
a particular type of twice-exceptionality, namely the combination of giftedness and autism spec-
trum disorder (ASD, according to the DSM V’ American Psychiatric Association, 2013). In fact,
this methodology leads to complex profiles that facilitate the understanding of both the apparent
contradictions and the inner consistency of the case under focus (Yin, 2003). Cases of children with

Corresponding author:
Sergio Melogno, Sapienza University of Rome, 108, Via dei Sabelli, Rome 00185, Italy.
Email: [email protected]

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2 Child Language Teaching and Therapy 

Asperger syndrome1 are especially challenging because of the discrepancy between their relatively
high cognitive/linguistic level and their social/communicative impairment (for a review, see
Woodbury-Smith and Volkmar, 2008). Nevertheless, even within the cognitive and linguistic
domains, in which individuals with Asperger syndrome can be very good, fine-grained assessment
can reveal other types of discrepancies that differentiate gifted people with Asperger syndrome
from normally developing gifted children; further, such assessments can illuminate core aspects of
the mental functioning of gifted children with Asperger syndrome. For instance, gaps can be found
between basic comprehension/production of language (which might be very good), on the one
hand, and reflection upon the outputs of these same abilities (i.e. metalinguistic awareness, which
might be poorer), on the other. Therefore, exploration on the meta-level could have a heuristic
value in revealing aspects of the mental functioning of gifted children with Asperger syndrome; it
is possible that these aspects, in turn, are associated with certain deficitary aspects of their social
functioning.
Over the past four decades there has been a plurality of definitions and developmental models
of metalinguistic awareness in typical development (Jessner, 2006; Pinto et al., 1999). Some of
these definitions point to very general characteristics, such as ‘reflection’ and ‘manipulation of the
structural features [of language] … treating language itself as an object of thought, in opposition to
using language for understanding and producing sentences’ (Tunmer et al., 1984: 12). Other schol-
ars deliberately avoid such general definitions and focus on metalinguistic ‘abilities’ that can be
measured as the results of specific metalinguistic ‘tasks’, which themselves assess the prevalence
of certain psycholinguistic processes such as ‘linguistic analysis’ and ‘control’ in Bialystok’s
developmental model (Bialystok, 1986). In this perspective, the ‘meta’ dimension stems from the
same principles that underlie all aspects of language development and appear as the endpoint of a
continuum that starts from the earliest oral skills. In addition to the distinction between general
cognitive and specific linguistic factors, scholars also propose different methods of distinction
between implicit and explicit forms of awareness (Karmiloff-Smith, 1992; Pinto et al., 1999;
Tunmer et al., 1984), which has led to relevant differences in the criteria by which (and the age at
which) behaviors are assigned metalinguistic status. While Clark and Andersen (1979) observed
that self-corrections, re-planning of discourse, and comments on someone else’s accent by very
young children (2–2.6 years of age) reflect significant forms of awareness, the majority of devel-
opmental psycholinguists focus on the passage from these intuitive early forms of awareness
towards more articulated representations of the structural features of language and the connections
between them (Bonnet and Tamine-Gardes, 1984; Gombert, 1990; Karmiloff-Smith, 1992; Tunmer,
et al. 1984).
Metalinguistic awareness can be further studied by following a domain-specific approach,
exploring specific metalinguistic abilities defined in terms of their corresponding language areas
(e.g. phonology, semantics, grammar, syntax, and pragmatics). Thus, psycholinguists study met-
aphonological, metasemantic, metagrammatical, metasyntactic, and metapragmatic abilities
(Gombert, 1990), each of which can be assessed using specific tasks. For instance, metagrammati-
cal ability can be assessed in terms of the capabilities of detecting errors where they occur, identi-
fying which rule has been violated, and understanding how such errors should be corrected. Such
types of ability are generally measured by acceptability tasks (Gombert, 1990; Hakes et al., 1980;
Pinto et al., 1999).
The study of metalinguistic awareness in ASD is a recent research area. Shifting the analysis of
language abilities from the comprehension/production level toward the metalinguistic level, one
can open promising horizons for a better understanding of the cognitive and linguistic phenotypes
within the subgroup of high-functioning children with ASD (Surian and Siegal, 2008;

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Melogno et al. 3

Tager-Flusberg, 2006). For instance, Lewis and colleagues analysed the metalinguistic abilities of
high-functioning children and adults with ASD (Lewis et al., 2007). Twenty children (16 male and
4 female; mean age: 11.6 years; SD: 2.0) of average intelligence were administered the TLC-E
(Test of Language Competence-Expanded Edition) by Wiig and Secord (1989), which includes
Ambiguous Sentences, Making Inferences, Recreating Sentences, and Figurative Language tasks.
Children with ASD had inferior performance on all metalinguistic tasks compared with normally
developing children except for Figurative Language, an outcome that strongly contrasts with previ-
ous findings. Since Happé’s pioneering studies (Happé, 1993, 1995), poor performance in figura-
tive language comprehension has been found repeatedly in high-functioning children with ASD
(Norbury, 2005; Rundblad and Annaz, 2010), supporting the idea that this language area is particu-
larly critical in children with ASD.
Although research has considered the role of possible factors responsible for these difficulties
in comprehension, such as theory of mind (Happé, 1993) or linguistic and semantic memory defi-
cits (Norbury, 2005), no conclusive consensus has been reached (for a review, see Melogno et al.,
2012) Overall, the exploration of the understanding of figurative language in children with ASD
significantly completes our picture of their meta-level functioning when conducted as part of a
comprehensive assessment of their metalinguistic abilities, as underlined by Lewis and colleagues
(Lewis et al., 2007). Within the twice-exceptionality condition of giftedeness and ASD, cognitive
profiles have been explored in depth (Assouline et al., 2009, 2012; Foley-Nicpon et al., 2012), dif-
ferently from metalinguistic profiles.
Based on the considerations of Lewis and colleagues (2007) regarding the appropriateness of
a comprehensive meta-level assessment in children with ASD, we analysed the linguistic and
metalinguistic profile of an Italian child with Asperger syndrome – conventionally called SC –
who fell into the moderately gifted range (IQ 130–144) according to the classification of Gross
(2004). As indicated above, one of the challenges posed by gifted children with Asperger syn-
drome is that, in addition to the already-known discrepancies between the cognitive and social
areas, other, less evident discrepancies can be revealed in the areas in which the child is the
strongest (i.e. the cognitive and linguistic areas). In obtaining a better understanding of these
discrepancies, the exploration of the meta-level of linguistic competencies was viewed through
a broad metalinguistic assessment as a helpful means for accessing core aspects of the child’s
mental functioning.

II Method
1 Participant: SC
a SC’s history. SC was a boy aged 9 years and 6 months who had been diagnosed with Asper-
ger syndrome following the DSM-IV-TR (American Psychiatric Association, 2000) criteria
when he came to the consulting center. His parents reported observing social difficulties and
‘strange behaviors … from the start’ which increased when SC started school. They described
their child as ‘overfocused on intellectual aspects but very childish in other respects, and
clumsy’. Case history revealed that SC was an early speaker and used to repeat the sentences
he heard from adults literally, although he could reuse them adequately in novel situations. The
child had always been indifferent to contact with others, but he developed spontaneous curios-
ity regarding numbers at age 3 years. For instance, he used to fill pages with numbers and spend
whole afternoons copying number patterns or staring at digital watches in order to learn about
numbers.

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4 Child Language Teaching and Therapy 

When he started playing piano, he was mainly attracted by the digital aspects of music, such as
the structure of notes and of pentagrams. SC’s parents started to worry about him because of his
nearly exclusive and repetitive concern for numbers and his difficulty in shifting his attention
toward other types of activities. At school, SC immediately manifested behavioral problems. He
would continuously stand up and write things on the blackboard (once, at the beginning of the
primary school, he drew the entire solar system on his bench), and these behaviors were accompa-
nied by difficulties interacting with peers. SC’s parents described their child as unable to put him-
self in others’ shoes, inflexible in his opinions, hardly capable of sharing, and ‘lacking in empathy’.
For instance, he could grasp changes in prosody, but at the same time, he was unable to explain the
meanings of such changes and stated that he disliked them. His social approach was assessed as
inadequate overall because, according to his parents, he would address everybody, and always
using a pedantic and overprecise language. For instance, when SC heard nonliteral expressions,
especially those including quantifiers, such as ‘I’ll be back in two minutes’ or ‘I haven’t seen you
in ages’, he reacted as if the underlying intentions of these utterances were literal. Other idiomatic
expressions provoked similar reactions. Furthermore, the child exhibited various ritualistic behav-
iors: for instance, at breakfast, he always wanted his milk in the same cup, drank it with a straw,
and started drinking only when his two brothers had finished. SC’s parents attributed their child’s
behaviors to the fact that he displayed both adult-like behaviors (such as his overdeveloped intel-
lectual and language capabilities) and ‘regressive’ behaviors (such as excessive emotional reac-
tions or unmotivated crying).

b The clinical assessment. To assess the presence of the classic characteristics of ASD, we used
Autism Diagnostic Observation Schedule (ADOS; Lord et al., 2003; Tancredi et al., 2005) and the
Krug Asperger Disorder Index (KADI; Krug and Arick, 2007). Intellectual ability was measured
by the WISC-III (Orsini and Picone, 2006; Wechsler, 1991). Neuropsychological functioning – for
what concerns the social perception domain – was assessed by NEPSY II (Korkman et al., 2007;
Urgesi et al., 2011).
During the assessment, the child was cooperative and exhibited the capability to take turns in
conversation, although he tended to discuss his preferred topics (numbers and planets) without
considering feedback from the tester. Eye contact between the child and the tester was relatively
discontinuous, and the child’s vocal and gestural expressions were poorly modulated. SC obtained
a standard score of 114 on the KADI, which corresponds to a high probability of Asperger syn-
drome. As for ADOS, the total Language and Communication score was 2, which is coincident
with the cut-off for ‘autistic spectrum’, and the Interaction score was 6, which is above this cut-off
(4). The total ADOS score was therefore 8, which is also above the cut-off (7).
The ADOS interviews revealed some insight on the social difficulties of SC, who tended to
systematically use quantitative and numerical criteria for treating issues having to do with social
relations. Figure 1 shows some of the schematizations spontaneously produced by the child during
the interview to describe the distinctive features of different types of relations. On the left side of
the figure, SC has represented his personal partnership scale, where each of his schoolmates is
labeled with a different number and graded. On the right side of the figure, the three sinuous lines
represent the quantified relationship between himself and his mother, which fluctuates within a
range of 8.75–10.
SC also completed the Social Perception tasks of NEPSY-II, the battery used to assess neu-
ropsychological functioning. The child obtained a scaled score of 7 on the Theory-of-Mind subtest,
which assesses the capability to understand mental states and intentions in order to interpret behav-
iors and linguistic use. SC obtained a scaled score of 3 in the Affect Recognition subtest, which
assesses the capability to recognize the expression of emotion in pictures of children’s faces. Both

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Melogno et al. 5

Figure 1. Two schematizations of SC’s social and affective relations.

Note. left = school mates; right = mother–child relation.

of these capabilities are strongly involved in a series of social skills. Both of SC’s scores on those
subtests were below age norms, of which Theory-of-Mind was at the border whereas Affect recog-
nition was much under norms.
SC’s cognitive functioning was assessed using the WISC-III.2 His Verbal IQ (VIQ), Performance
IQ (PIQ), and Full Scale IQ (FIQ) were 146, 117, and 136, respectively. The difference between
PIQ and VIQ is statistically significant (p < . 01). Table 1 reports the scores of each individual
subtest and the Factorial Quotients. Nearly all of SC’s scaled scores fall into the very superior or
gifted range, although with some dishomogeneities that are worthy of consideration.
A discrepancy can be noted between SC’s VIQ and Performance IQ (29 points, in favor of VIQ).
On the one hand, SC’s subtest scores on the Verbal scale are in the superior range (Vocabulary and
Comprehension) or the very superior range (Information, Similarities, Arithmetic, and Digit Span).
Thus, SC is strong in the areas of lexical definition, recalling general information, detection of
similarities, problem solving, mental arithmetic, and memory for digits (regardless of order). On
the other hand, SC’s scores the Performance scale ran the entire gamut from below average (Picture
Arrangement) to average (Coding, Object Assembly, and Picture Completion) to superior (Symbol
Search) to very superior (Block Design and Mazes). SC was weak in sequencing pictures to tell a
story, whereas his capabilities in terms of assembling puzzles or finding missing details in pictures
were average. Some of his areas of excellence were his capability to rapidly scan materials in order
to find identical symbols and his ability to put blocks together to make a design. In the Arithmetic
and Digit Span subtests, where numbers are of paramount importance, SC’s scores showed a ceil-
ing effect.
We will now consider SC’s position in relation to the four Factorial Quotients of the
WISC-III:

•• Verbal Comprehension (Information, Similarities, Vocabulary, and Comprehension);

•• Perceptual Organization (Figure Completion, Picture Arrangement, Block Design, and
Object Assembly);
•• Freedom from Distractibility (Arithmetic and Digit Span); and
•• Processing Speed (Coding and Symbol Search).

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6 Child Language Teaching and Therapy 

Table 1. WISC-III subtest and factorial quotient scores: Scaled scores.

Verbal:
Information 18
Similarities 17
Arithmetic 19
Vocabulary 15
Comprehension 15
(Digit span) 19

Performance:
Picture Completion 13
Coding 11
Picture Arrangement 8
Block Design 18
Object Assembly 12
(Symbol Search) 14
(Mazes) 16

Factorial quotients:
Verbal Comprehension 141
Freedom from Distractibility 155
Perceptual Organization 110
Processing Speed 115

Given the child’s exceptional performance in the Arithmetic and Digit Span subtests, his score for
the Freedom from Distractibility factor is also very high. Similarly, as SC’s verbal competencies
are well developed, his score in the Verbal Comprehension factor is correspondingly high. On the
contrary, the child obtained average scores in Perceptual Organization and Processing Speed. The
five subtests of the Performance scale, in which SC’s performance was the lowest, have time con-
straints (with extra points for quicker responses). As Lovecky (2004) noticed, this characteristic of
the tasks might penalize ‘reflective thinkers’, children with visual and motor difficulties, or those
who tend to have slower reactions on novel tasks. However, the meanings of these factors and the
inhomogeneities of his performance on the WISC-III will not be considered in the present study,
which focuses on the metalinguistic profile of this gifted child.

2 Materials
Metalinguistic abilities were measured by two validated Italian tests: the Test di Abilità
Metalinguistiche n. 2 (TAM-2; Pinto et al., 2003)3 and the Test di Comprensione di Metafore
(TCM; Pinto et al., 2006).4 The TAM-2 is a comprehensive battery for the assessment of metalin-
guistic abilities of different types (i.e. metasemantic, metagrammatical, metasyntactic, and met-
aphonological); it was devised for Italian children 9–14 years of age. The other test, the TCM,
assesses metaphor comprehension in children of the same age range as the TAM-2; it was also
devised for the Italian population. We will briefly describe these two tests and provide some exam-
ple items in Appendix 1.
The TAM-2 comprises six subtests: Comprehension, Synonymy, Acceptability, Ambiguity,
Grammatical Function, and Phonemic Segmentation. A distinctive aspect of this battery is the clear

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Melogno et al. 7

separation between two types of questions and responses. For each item, there is always a first
question that explores the global aspect of a given metalinguistic issue. For instance, for the
Synonymy subtest, the task is to determine whether two sentences can be phrased to convey the
same meaning in different ways; yes-or-no responses can be given. Task performance requires an
intuitive form of language awareness that demands reflection on meanings, but not in explicit
form. Immediately after the first question is answered, the experimenter poses the second question,
which asks for justification of the previous response. At this level, language awareness requires
explicit analysis of relevant elements. Conventionally, the first type of question is labeled as ‘lin-
guistic’ (henceforth L) and the second type as ‘metalinguistic’ (henceforth ML). Factor analysis
has confirmed the validity of this distinction, which is represented by two neatly separated factorial
components and two diverging levels of language processing.
These two types of questions are also different in terms of scoring. While the L score is dichoto-
mous (quantified as 0 or 1), corresponding to a yes-no or true-false response, the ML questions are
scored on a 3-point scale corresponding to three language-processing levels:

•• 0: no analysis or irrelevant response;

•• 1: partially relevant but insufficient analysis; and
•• 2: completely relevant analysis.

The TCM is composed of 12 metaphorical items presented as separate sentences; half are of
the physico-psychological type (they relate a psychological feature, such as ‘sweetness’ or ‘moral
rigidity’, etc., to a physical feature, such as ‘chocolate’ or ‘rock’), and the other half are of the
‘conceptual’ type (relating an abstract concept, such as ‘intelligence’ or ‘memory’, etc., to a mate-
rial entity, such as ‘skyscraper’ or ‘sieve’, respectively). Children are asked, ‘How can these
words [the metaphors included in the sentences] be interpreted?’ Responses are assessed on a
4-point scale:

•• 0: totally elusive responses (refusal, literal, or metonymical);

•• 1: responses based on partial analysis, but still too concrete;
•• 2: analyses that grasp the genuine metaphorical meaning, but are little elaborated;
•• 3: completely elaborated analyses.

The assessment therefore values explicit, relevant, and consistent analysis of the semantic features
that constitute the essence of the metaphorical item.
Both the TAM-2 and the TCM assessments place high value on explicit, analytical forms of
metalinguistic reflection. For interpreting the raw scores, in both tests there are T scores for each
age level (mean =50, sd = 10), subdivided into 5 ranges, from deficitary (0–30) to low-average
(31–40), average (41–60), upper-average (61–70) to superior (71–100). In both tests, the TAM-2
has high reliability (Cronbach’s alpha: .9347) and high interrater’s agreement (Kelly’s percentage:
92%). The TCM has also high reliability (Cronbach’s alpha: .70) and high interrater’s agreement
(Cohen’s Kappa: .75; kse: .027).

III Results
SC’s performances on the TAM-2 and TCM are reported in Tables 2 and 3. The results of the
metalinguistic test are inhomogeneous on two levels. SC’s total L scores – which express intui-
tive metalinguistic processes – are upper-average, whereas his total ML scores – which require
explicit metalinguistic processes – are simply average. On two subtests of the ML questions

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8 Child Language Teaching and Therapy 

Table 2. TAM-2 (Test di Abilità Metalinguistiche) L and metalinguistic (ML) scores and corresponding T
scores.

TAM-2 L T Range ML T Range

Comprehension 15 61 Upper-average 10 45 Average
Synonymy 4 41 Average 1 40 Low-average
Acceptability 26 59 Average 12 67 Upper-average
Ambiguity 5 49 Average 2 34 Low-average
Grammatical function 6 55 Average 7 49 Average
Phonemic segmentation 33 71 Superior 11 65 Upper-average
TAM-2 Total 89 67 Upper-average 43 51 Average

Table 3. TCM (Test di Comprensione di Metafore) scores for subparts and total, and corresponding T
scores.

TCM Score T Range

Physico-psychological 5 46 Average
Conceptual 6 49 Average
TCM Total 11 47 Average

(Synonymy and Ambiguity), SC’s performance is poorer than in other areas (i.e. below average).
On the other hand, his performance is upper-average on two other subtests (Acceptability and
Phonemic segmentation), and he performed at an average level on the remaining two subtests
(Comprehension and Grammatical function).
The three scores registered by SC on the TCM test are homogeneously average, but there are
important gaps and some marked idiosyncratic aspects in his responses to the 12 items. His
responses to seven of these items are at the lowest level (0), whereas those for the other five are
much better (i.e. level 2–3). In SC’s protocol, two types of 0-level responses can be found: refusals
and metonymical interpretations. In the first case, the legitimacy of the metaphor is denied, whereas
in the second, the two terms of the metaphor are associated on the bases of spatial or temporal
contiguity or causality instead of common attributes. For instance, SC interprets the item ‘My sis-
ter is a butterfly’ as ‘My sister loves butterflies.’
After the administration of the TCM, SC spontaneously established a personal hierarchy of the
12 metaphors prioritizing their supposed value. The child created a sheet subdivided into five col-
umns in which he wrote the item numbers from left to right, the corresponding ‘score’ assigned to
the ‘value’ of the metaphor (expressed in cardinals), its ‘ranking’ (expressed in ordinals), its ‘quali-
tative position’ (expressed in words, such as ‘excellent’, ‘not so good’, ‘horrible’, etc.), and a ‘cap-
tion’ (expressed in ranges: 90–100 were assigned as ‘excellent’, corresponding to the abbreviation,
‘ex’; and 30–40 were assigned as ‘not so good’, corresponding to the abbreviation, ‘nsg’).

IV Discussion
The present study analysed the case of an Italian boy aged 9 years 6 months who had been diag-
nosed with Asperger syndrome and whose intellectual functioning fell into the category of gifted-
ness. His FIQ was 136, and there was a marked discrepancy between his PIQ and VIQ (117 and
146, respectively). The level of SC’s verbal abilities, as manifested by his high VIQ, contrasted

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Melogno et al. 9

with his impaired communicative competencies. Besides verbal language, SC’s cognitive abilities
also expressed themselves in terms of numbers, which impressively absorb his attention and are
omnipresent in his representations and daily conversation.
Given the characteristics of this child’s cognitive functioning, it was interesting to explore his
metalinguistic abilities, which require reflection about the structural features of language and may
vary across individual linguistic domains: phonology, grammar, syntax, semantics, etc. On the
basis of his very high VIQ (146), SC might be expected to perform highly on metalinguistic tasks
(TAM-2, Pinto et al., 2003), because these require the use of language to describe and conceptual-
ize language. However, in fact, the results were inhomogeneous at different levels. In the TAM-2,
we observed a gap between SC’s performance on L questions, which gauged intuitive language
awareness (average–above average), and that on ML questions, which gauged analytic, explicit
language awareness (below average [Synonymy and Ambiguity]–above average [Acceptability
and Phonemic segmentation]). A limited comparison can be established with the inhomogeneous
results of this case study and those found in Lewis et al.’s study (2007), based on a group of chil-
dren namely the low performance in a similar metalinguistic task, Ambiguous Sentences.
Nevertheless, it is SC’s profile, based on the specific tasks that were chosen in this study that
requires to be interpreted. An interesting key for interpreting the distribution of SC’s ML scores at
the two extremes could be the concept of ‘hypersystemizing’ developed by Baron-Cohen (2002,
2009). In general terms, systemizing is the process of coming to understand closed systems and
their logic, which fosters excellent mathematical, constructional, mechanical, and spatial skills,
whereas empathizing leads to adequate mind reading, emotional processing, and openness to
uncertainty and variability (Baron-Cohen, 2002). By definition, a closed system entails the possi-
bility of having knowledge and control over all the variables present in a given field; in closed
systems, uncertainty is reduced to a minimum. Baron-Cohen and colleagues (Baron-Cohen et al.,
2009) hypothesized that individuals with autism and Asperger syndrome had attitudes oriented
toward hypersystemizing. This attitude is described as the capacity to detect regularities and rules
by identifying ‘if–then’ associations; it applies transversally to several areas (sensory, motoric,
spatial, numerical, verbal systematizing, etc.; Baron-Cohen, 2009). A series of studies (Baron-
Cohen and Hammer, 1997; Baron-Cohen et al., 2001; Lawson et al., 2004) showed that individuals
with autism and Asperger syndrome can be positioned at the extreme endpoints of the systemizing
continuum.
SC is a child with a marked tendency toward hypersystemizing in the numerical and verbal
areas. However, by definition, verbal language is composed of several subsystems organized on
different grounds to determine the number of relevant linguistic units and the correspondence
between form and meaning. SC’s poorest performances at the explicit metalinguistic level were on
two metasemantic subtests in which reflection operates in a language domain which is ‘open’ by
definition, i.e. semantics. In contrast, the two metalinguistic subtests on which SC performed best
involve metagrammatical and metaphonological abilities. Grammatical and phonemic segmenta-
tion/combination rules pertain to ‘closed’ language domains, in which linguistic units are well
defined and finite in number.
The scores obtained by SC on the metaphor comprehension test (TCM, Pinto et al. 2006) are
average on both subparts (Physico-psychological and Conceptual metaphors), but this global result
masks strong inner discrepancies between single items.
Given the nature of this test, which requires reflection on unconventional language use, these
results can be interpreted as a specific difficulty in handling signs pertaining to ‘open’ systems. SC
showed remarkable capabilities to detect common features on the Similarities subtest of the WISC-
III, where the word pairs that comprise the items (e.g. ‘guitar–piano’) have conventional meanings.
However, SC did not apply this type of abstraction to the metaphorical items of the TCM, in which

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10 Child Language Teaching and Therapy 

the similarities between the two terms of the metaphor (e.g. ‘My sister is a butterfly’) are not con-
ventionalized. As a possible solution to the task, the examiner suggested that the child compare
these two terms by introducing the phrase, ‘X is like Y.’ Instead of taking advantage of this prompt,
the child objected that the examiner did not tell him that ‘X was like Y’, but that ‘X was Y.’ This
reaction shows how tenaciously SC holds onto literal interpretations.
SC has high-level abstraction capabilities, which he could apply to both numerical (see his
results on the Arithmetic subtest of WISC-III) and linguistic signs. However, while numerical signs
can be conceptualized by means of one-to-one form–meaning mappings, linguistic signs are treated
differently across various domains of language. When SC had to address issues pertaining to closed
language domains such as grammar or phonology, he apparently behaved as if handling numerical
issues, imposing predefined and finite correspondences between form and meaning. When the
same child faced issues pertaining to open language domains, such as semantics and different lev-
els of uncertainty ranging from polysemy to metaphor (see the Synonymy and Ambiguity subtests
of the TAM-2 and the TCM), he lost control over meanings, and his responses became poorer. This
attitude typically emerged after the administration of the TCM, when SC built up the ‘metaphor
assessment sheet’ described earlier on which verbal evaluations (‘excellent’, ‘not so bad’, etc.)
were univocally mapped onto numerical ranges. In sum, SC’s difficulties are concentrated on open
linguistic subsystems, especially those where uncertainties are constitutive, such as metaphor and
communicative exchange, in that they are inherent to semantics.
We believe that this case study has elements of originality: it has addressed the meta-level by
using two tests that are quite demanding in terms of language awareness. These tests permitted us to
access discrepancies that were difficult to foresee on the basis of the cognitive assessment, particu-
larly those regarding verbal abilities. We observed a contrast between the intuitive level of aware-
ness – as measured by the L responses on the TAM-2 – and the explicit, articulated forms of language
awareness measured by the ML responses. The more demanding and explicit the level of awareness
required, the deeper the gaps between certain responses. However, at a more profound level, these
gaps can be interpreted as consistent with the overall mental functioning of this child. Actually, his
poorest and richest responses were coincident with the two endpoints of the open/closed system
distinction proposed by Baron-Cohen (2002).
Only recently has the importance of comprehensive metalinguistic assessment been underlined
in individuals with ASD (Lewis et al., 2007). The present work provides further methodological
suggestions for grasping the complexities of this meta-level in gifted children with ASD. However,
the type of assessment implemented in this case study did not explore the metapragmatic level
(Gombert, 1990), which is the locus of the intersection between language and social cognition.
This constitutes a limitation of the present study. Beyond analysis of the meanings and rules of
language, children like SC should be asked about their understanding of the communicative inten-
tions that underlie messages. A partial limitation is related to the metalinguistic test that has been
used in the present study, in that it has been validated only in Italian language, which, on the other
hand, is the language of the protagonist of this study, namely SC. However, as the distinction
between implicit and explicit forms of metalinguistic awareness has proved so relevant in reveal-
ing deep aspects of SC’s mental functioning, we think that it can be acknowledged per se, irrespec-
tive of a specific language.
In order to generalize the results emerging from this case study, future research could systemati-
cally explore the metalinguistic profiles of a sample of gifted children with ASD taking into account
different levels and linguistic domains of metalinguistic awareness.
The meta-level complexities revealed by the metalinguistic assessment of SC could also inspire
intervention strategies based on the strengths and weaknesses that characterize SC’s twice-exceptional
condition. Given the characteristics of SC’s metalinguistic profile, we believe that the intervention

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Melogno et al. 11

should establish multiple links between language and social cognition. Two critical points deserve
particular attention: SC’s difficulty with grasping others’ meanings and his tendency towards literal
interpretation, both of which represent serious obstacles against communication.

Declaration of Conflicting Interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publica-
tion of this article.

Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit
sectors.

Notes
1. In the present article, we refer to the diagnostic category of Asperger syndrome which was included in
the DSM-IV-TR (American Psychiatric Association, 2000) when the current study was being imple-
mented. We are aware that after the edition of the DSM-V in 2013 (American Psychiatric Association,
2013) the denomination for this diagnostic category has changed and has been included in the more
comprehensive category of ASD. In the current article, we keep referring to the case study we describe
in terms of Asperger syndrome.
2. When the present study was being conducted, the current version of the Wechsler Intelligence Scale for
Children (WISC) in Italy was the WISC III (Wechsler, 1991; see also Wechsler, 2003).
3. The TAM-2 was translated into English as the MAT-2 (Metalinguistic Ability Test n.2) and published in
a text by Pinto and colleagues (Pinto et al., 1999). However, only the Italian version of the test has been
validated.
4. The TCM was also translated into English as the MCT (Metaphor Comprehension Test) (Pinto et al.,
2011) but, as with the TAM-2, only the Italian version of the test has been validated.

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Appendix 1
Description of the Test di Abilità Metalinguistiche n. 2 (TAM-2) and Test di Comprensione di
Metafore (TCM) tests with example items.
Note. Owing to space constraints, we have reported only some examples of the subtests or the
subparts of the two metalinguistic tests used in the study, namely, the TAM-2 and the TCM.

The TAM-2
Comprehension: Two pairs of sentences are presented (Sentences A and B), and children are
asked to respond an L question (linguistic question or LQ) asking to indicate something about
the meaning of each sentence, and then to justify this first response (metalinguistic question or
MLQ).

A) The car crashed into a truck.

LQ: ‘What did the car crash into?’
MLQ: ‘What makes you sure of that?’
B) The truck crashed into the car.
LQ: ‘What crashed into the car?’
MLQ: ‘What makes you sure of that?’

Synonymy: Two pairs of sentences are presented, conveying the same meaning, but phrased differ-
ently. The children are asked to say if they mean the same thing or not (LQ) and to justify their
response (MLQ).

A) The boy fed the dog before he watched TV.

B) The boy watched TV after he had fed the dog.
LQ: ‘Do they mean the same thing?’
MLQ: ‘What makes you sure of that?’

Acceptability: Children are presented with sentences containing grammatical mistakes and asked
to say if these sentences are right or wrong; if they say they are wrong, they are asked where is the
mistake and how it should be fixed (LQ), and then to justify their response (MLQ).

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14 Child Language Teaching and Therapy 

Example: The soup is bad today.

LQ: ‘Is this right or wrong?’
‘If it’s wrong, where is the mistake?’
‘If you think it’s wrong, how should it be fixed?’
MLQ: ‘Why should it be like that?’

Ambiguity: Children are presented with sentences containing polysemic words. Each possible
meaning of these words restructures the overall meaning of the sentence. Children are asked to say
if they know more than one meaning for the words presented (LQ) and how the sentence meaning
varies according to each different word meaning (MLQ).
Example: To get a car. To get a haircut. To get old.
LQ: ‘Do you think the expression ‘to get’ has the same meaning in all three cases?’
MLQ: 
‘Try to say these sentences differently. For example: ‘To get a car’, ‘To get a
haircut?’, ‘To get old.’

Grammatical function: Children are presented with sentences and asked to indicate some gram-
matical functions, such as subject, object, predicate, etc. (LQ), and to justify their response (MLQ).
Example: The bread was cut into slices.
LQ: ‘What was cut into slices?’
MLQ: ‘What makes you sure of that?’

Phonemic segmentation
This subtest is composed of four parts: similarities and differences in minimal pairs, syllable scan-
sion, phoneme repetition, and word formation. Owing to space constraints, we will only give an
example of the first subpart.
Children are presented a word pair differing for only one phoneme and asked to indicate both
similarities and differences (LQ), and to define the meaning of each of these words (MLQ).
Example: Bound/Bond.
LQ: ‘What makes them similar?’
‘What makes them different?’
MLQ: ‘What do these words mean?’

The TCM
Directions
‘You are going to listen to some sentences where words are used in a slightly different way from
usual. Try to explain in what sense these sentences can be understood.’

Physico-psychological metaphors
Example: My sister is a butterfly.

Conceptual metaphors
Example: Memory is a sieve.

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