"Um" and "Uh" Usage Patterns in Children with Autism: Associations with Measures of Structural and Pragmatic Language Ability.
Grace O Lawley, Steven Bedrick, Heather MacFarlane and 3 others
PMID 35499654WHAT IT FOUND
In children with autism, lower use of the filler "um" reflects weaker structural language skills, not social communication deficits.
Therapists should treat reduced "um" usage as a potential marker of language production difficulty rather than a lack of listener awareness.
Key findings
01Children with ASD used "um" significantly less frequently than typically developing peers, even after controlling for age, sex, and IQ.
02Within the ASD group, "um" usage was associated with caregiver-reported structural language ability, but not with social communication or pragmatic language scores.
03The difference in "uh" usage between groups disappeared once sex was accounted for, as female participants used "uh" less frequently regardless of diagnosis.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study only included children with fluent speech and an IQ of at least 70, so findings do not apply to minimally verbal children or those with intellectual disabilities. The sample was heavily male (83.8% of the ASD group), limiting the generalizability of sex-specific findings. Language samples were collected during semi-structured ADOS-2 interactions, which may not fully reflect naturalistic conversational contexts.
Declared interests
The authors have no conflict of interest to declare.
The easy way to misread this
Do not assume that a child with autism who rarely uses "um" has a specific deficit in social communication or listener awareness. The study found that "um" usage was linked to structural language ability, not pragmatic scores, suggesting the behavior may stem from language production difficulties rather than social intent.