Speech and language profiles in 4- to 6-year-old children with early diagnosis of autism spectrum disorder without intellectual disability

Purpose: This study aimed to present speech and language data from a community-representative group of 4- to 6-year-old children with early-diagnosed autism spectrum disorder (ASD) without intellectual disability (ID). Methods: The study group comprised 83 children 4–6 years of age with ASD without ID. They had been diagnosed with ASD before age 4.5 years and had received intervention at a specialized habilitation center. At 2-year follow-up, their language abilities were evaluated comprehensively by two speech–language pathologists using a battery of assessments. Receptive and expressive language and phonology were examined. The phonology evaluation included measures of phonological speech production and of phonological processing. Results: Results revealed that almost 60% had moderate–severe language problems. Nearly half exhibited combined expressive and receptive language problems, of which a majority also had phonology problems. Phonological speech problems were found in 21% of the total group. Conclusion: The findings underscore the importance of considering speech/language disorders in children with ASD without ID, since they usually attend mainstream classes but need specific educational adaptations

Coexisting Disorders and Problems in Preschool Children with Autism Spectrum Disorders

Objectives. To analyze cooccurring disorders and problems in a representative group of 198 preschool children with autism spectrum disorders (ASD) who had had interventions at a specialized habilitation center. Methods. Parents and children were seen by a research team. Data were based on parental interviews, pediatric assessments, and tests of the child. Information on autistic symptoms, general cognitive function, speech and language, motor function, epilepsy, vision, hearing, activity level, behavior, and sleep was collected. Results. Three ASD categories were used: (1) autistic disorder (AD), (2) autistic-like condition (ALC) or Asperger syndrome, and (3) one group with autistic symptoms/traits but not entirely all its criteria met for ASD. Children with autism had a mean of 3.2 coexisting disorders or problems, the ALC/Asperger group had a mean of 1.6, and children with autistic traits had a mean of 1.6. The most common disorder/problems in the total group pertained to language problems (78%), intellectual disability (ID) (49%), below average motor function (37%), and severe hyperactivity/ADHD (33%). Conclusions. The results accord with the concept of early symptomatic syndromes eliciting neurodevelopmental clinical examination (ESSENCE), and highlight the need of considering ASD in a broad perspective taking also other cooccurring developmental disorders into account

Primary school teachers’ patterns in using communication-supporting strategies following a professional development program: lessons learned from an exploratory study with three teachers

Oral language skills underpin later literacy achievement and life prospects, and many children struggle with oral language for various reasons. Hence, it is crucial for teachers to provide a learning environment with rich opportunities for all children to practice their oral language. The aim of this exploratory study was to explore a professional development (PD) program designed to coach teachers in using communication-supporting strategies during verbal teacher-child interactions in regular classrooms. In focus were five strategies from the Communication Supporting Classroom Observation Tool. The study used a mixed-method case design with multiple observations across four time points over 10 weeks and a follow-up observation after two months. Outcome measures were collected at pre-and, post-intervention and at follow-up. The cases were two intervention teachers and one comparison teacher in second grade in Swedish primary schools. The teachers were directly observed and video-recorded during teacher-child structured small group conversations while discussing different texts with two groups of children each. The groups were mixed and comprised both children struggling with oral language as well as more typically developing children. To further understand the verbal interactions, the teachers’ amount of talk in relation to the children was analyzed in terms of the percentage distribution of the total number of words per minute. The overall patterns of strategy use showed that the two intervention teachers applied more varied strategies from the PD program during the intervention period, but this was not maintained at the follow-up. The amount of teacher talk appeared stable over time, with individual differences in the three teachers. We also discuss the teachers’ own insights and our experience in the design of the PD program, which may guide future research and applications of the PD program

Early intervention in 208 Swedish preschoolers with autism spectrum disorder

A B S T R A C T Early intervention has been reported to improve outcome in children with autism spectrum disorders (ASDs). Several studies in the field have been randomized controlled trials (RCTs). The aim of this study was to assess ASD outcome in a large naturalistic study. Two hundred and eight children, aged 20-54 months, with a clinical diagnosis of ASD were given intervention and monitored prospectively in a naturalistic fashion over a period of 2 years. The toddlers were considered representative of all but the most severely multiple disabled preschool children with ASD in Stockholm county. They fell into three cognitive subgroups: one with learning disability, one with developmental delay, and one with normal intellectual functioning. Data on intervention type and intensity were gathered prospectively in a systematic fashion. Intervention was classified into intensive applied behaviour analysis (ABA) and non-intensive, targeted interventions, also based on ABA principles. Children were comprehensively assessed by a research team before the onset of intervention, and then, again, 2 years later. Change in Vineland adaptive behaviour scales composite scores from intake (T1) to leaving the study (T2) was set as the primary outcome variable. The research team remained blind to the type and intensity of interventions provided. One hundred and ninety-eight (95%) of the original samples stayed in the study throughout the whole 2-year period and 192 children had a complete Vineland composite score results both at T1 and T2. Vineland composite scores increased over the 2-year period. This increase was accounted for by the subgroup with normal cognitive functioning. There was no significant difference between the intensive and nonintensive groups. Individual variation was considerable, but no child in the study was ''problem-free'' at follow-up. Our data do not support that children with ASD generally benefit more from the most intensive ABA intervention programs than from less intensive interventions or targeted interventions based on ABA.

Teachers’ application of communication supporting strategies in teacher-child verbal interactions

Introduction: Developing oral language skills is crucial to later school academic achievement. Children with speech, language and communication needs (SLCN) struggle with their oral language due to various reasons. Teachers may provide rich opportunities for children with SLCN, and for all children to practice oral language in the regular classroom by using communication supporting strategies (e.g. open-ended questions and extending utterances) in their teacher-child verbal interactions.  The aim of this study is to describe a professional development (PD) program designed to affect teachers’ verbal interactions with children in regular classrooms. The PD includes individual teacher coaching in using communication supporting strategies from the Communication Supporting Classroom Observation Tool (Dockrell et al., 2015).  Method: The participants are two intervention teachers in year 2 in Swedish compulsory school, receiving a 10-week PD program. A third teacher participates for comparison purposes. An exploratory design with multiple observations is used to collect data. The setting is teacher-child structured small group conversations based on discussions of texts. Both children with SLCN and typically developing children participate in the groups. For the analyses, the conversations are video recorded followed by transcriptions and coding using the CHAT guidelines (MacWhinney, 2000). The frequency of strategy use is calculated over time. Results: Preliminary results indicate that the teachers develop individual patterns of strategy use. All three teachers appear to be skilled in using open-ended questions. Over time, the intervention teachers appear to develop skills in using other strategies. However, some of the strategies might be more challenging to implement and may need more coaching.  Conclusions: Preliminary findings point to that individual coaching may support teachers in using more varied communication supporting strategies over time. However, text type appears to influence strategy use, suggesting that some strategies may be more important to apply within different contexts of the curriculum.

Teachers’ application of communication supporting strategies in teacher-child verbal interactions

Introduction: Developing oral language skills is crucial to later school academic achievement. Children with speech, language and communication needs (SLCN) struggle with their oral language due to various reasons. Teachers may provide rich opportunities for children with SLCN, and for all children to practice oral language in the regular classroom by using communication supporting strategies (e.g. open-ended questions and extending utterances) in their teacher-child verbal interactions.  The aim of this study is to describe a professional development (PD) program designed to affect teachers’ verbal interactions with children in regular classrooms. The PD includes individual teacher coaching in using communication supporting strategies from the Communication Supporting Classroom Observation Tool (Dockrell et al., 2015).  Method: The participants are two intervention teachers in year 2 in Swedish compulsory school, receiving a 10-week PD program. A third teacher participates for comparison purposes. An exploratory design with multiple observations is used to collect data. The setting is teacher-child structured small group conversations based on discussions of texts. Both children with SLCN and typically developing children participate in the groups. For the analyses, the conversations are video recorded followed by transcriptions and coding using the CHAT guidelines (MacWhinney, 2000). The frequency of strategy use is calculated over time. Results: Preliminary results indicate that the teachers develop individual patterns of strategy use. All three teachers appear to be skilled in using open-ended questions. Over time, the intervention teachers appear to develop skills in using other strategies. However, some of the strategies might be more challenging to implement and may need more coaching.  Conclusions: Preliminary findings point to that individual coaching may support teachers in using more varied communication supporting strategies over time. However, text type appears to influence strategy use, suggesting that some strategies may be more important to apply within different contexts of the curriculum.

Children with autism spectrum disorders who do not develop phrase speech in the preschool years

There is uncertainty about the proportion of children with autism spectrum disorders who do not develop phrase speech during the preschool years. The main purpose of this study was to examine this ratio in a population-based community sample of children. The cohort consisted of 165 children (141 boys, 24 girls) with autism spectrum disorders aged 4–6 years followed longitudinally over 2 years during which time they had received intervention at a specialized autism center. In this study, data collected at the 2-year follow-up were used. Three categories of expressive language were defined: nonverbal, minimally verbal, and phrase speech. Data from the Vineland Adaptive Behavior Scales-II were used to classify expressive language. A secondary objective of the study was to analyze factors that might be linked to verbal ability, namely, child age, cognitive level, autism subtype and severity of core autism symptoms, developmental regression, epilepsy or other medical conditions, and intensity of intervention. The proportion of children who met the criteria for nonverbal, minimally verbal, and phrase speech were 15%, 10%, and 75%, respectively. The single most important factor linked to expressive language was the child’s cognitive level, and all children classified as being nonverbal or minimally verbal had intellectual disability

Preschoolers with Autism Spectrum Disorder followed for 2 years: those who gained and those who lost the most in terms of adaptive functioning outcome

Clinical predictors of 2-year outcome in preschoolers with ASD were studied in a population-based group of very young children with ASD (n = 208). Children who gained the most (n = 30) and lost the most (n = 23), i.e., increased or decreased their adaptive functioning outcome according to the Vineland Composite Score between study entry (T1) and follow-up (T2), 2 years later were compared. Individual factors that differed significantly between the two outcome groups were cognitive level, age at referral, not passing expected milestones at 18 months, autistic type behavior problems and regression. However, logistic regression analysis showed that only cognitive level at T1 (dichotomized into IQ < 70 and IQ ≥ 70) made a unique statistically significant contribution to outcome prediction (p = <.001) with an odds ratio of 18.01. The findings have significant clinical implications in terms of information at diagnosis regarding clinical prognosis in ASD