A Linguistic Perspective on Pragmatic Comprehension in Children with Autism Spectrum Disorder: A Narrative Review

Abstract

Pragmatic comprehension, or the ability to interpret context-dependent meaning, is identified to be an area of difficulty for children with autism spectrum disorder (ASD). Although a substantial body of research has explored this area, most studies have focused monolingual children, and their relevance to multilingual settings such as Malaysia remains unclear. This narrative review synthesises international research on pragmatic comprehension in children with ASD from a linguistic perspective and considers its implications for Malaysia. A structured search of Scopus and Web of Science, supplemented by Google Scholar, identified 17 studies published between 2015 and 2025, together with foundational studies. These studies were synthesised thematically across three areas: the nature of pragmatic comprehension difficulties, the cognitive mechanisms underlying these difficulties, and the role of language and cultural context. Findings suggest that difficulties become more apparent as inferencing and spontaneous reasoning demands rise. As such, pragmatic comprehension does not reflect an absolute deficit but appears to be selective and context-dependent, often reflecting a gap between understanding meaning and being able to use or explain it appropriately. Theory of mind (ToM) emerged as the most consistent contributing factor, while structural language and general cognitive ability played supporting and, at times, compensatory roles. While similar patterns were observed across languages, evidence from multilingual settings was rather scarce, and pragmatic comprehension in children with ASD in Malaysia remains largely unexamined. These findings highlight the need for research grounded in Malaysia's multilingual context.