Teaching requesting and rejecting sequences: An important step in early communication programming

This is an Accepted Manuscript of an article published by Taylor & Francis in Evidence-Based Communication Assessment and Intervention on 2010-9-1, available online: http://www.tandfonline.com/10.1080/17489539.2010.529366. .Question: Can four children with severe developmental disabilities learn to produce a sequence of AAC responses aimed at rejecting one object and subsequently requesting another object in highly controlled settings

Relationships Between Early Gestures and Later Language in Children With Fragile X Syndrome

Purpose—The authors hypothesized that significant positive relationships would exist between early gesture use and later language attainments in children with fragile X syndrome (FXS), as has been reported in studies with other populations. Method—Participants were young children with FXS and limited expressive language (21 boys, 4 girls), divided into 2 subgroups based on the Childhood Autism Rating Scale (CARS; Schopler, Reichler, & Renner, 1988) scores. Data were collected when participants were about 2 years of age and again when they were about 5 years of age. Communication was assessed through the analysis of video samples obtained in the children's homes for both observation periods. Correlational analyses were completed between early prelinguistic communication and later verbal communication scores for all participants and for children with high (>30) versus low (<30) scores on the CARS. Results—Although no significant relationships were found between prelinguistic gesture use and language outcomes for the group of children as a whole, significant negative correlations were found for the group of children who had high CARS scores. Conclusions—These outcomes did not support the authors' initial hypotheses. It was concluded that extensive use of developmentally early gestures by children with FXS who also have many symptoms of autism may not be a positive indicator of later language

Task and Participant Variables Predict Communication Complexity Scores (CCS): Closer Examination of the CCS

Communication Complexity Scale (CCS) scores for 269 minimally verbal participants were examined to determine if communicator behavior and task and communicator characteristics were related to scores in a manner consistent with theoretical and research evidence expectations. Each participant completed an interactive assessment with 6 joint attention tasks and 6 behavior regulation tasks. Caregivers completed the Vineland Adaptive Behavior Scales. Results indicated (a) joint attention tasks yielded lower scores than behavior regulation tasks, (b) older participants had lower scores, (c) individuals with autism spectrum disorder scored more similarly than those without, (d) the difference between joint attention and behavior regulation scores was greater for the autism spectrum disorder group, and (e) adaptive behavior was significantly positively related to complexity scores.NIH R01 HD076903NIH U54 HD090216United States Department of Education, Institute of Educational Science (R324A160072

Effectiveness of Responsivity Intervention Strategies on Prelinguistic and Language Outcomes for Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Group and Single Case Studies

We conducted a systematic review to identify randomized controlled trials (RCTs) and single case research design (SCRD) studies of children with autism spectrum disorder that evaluate the effectiveness of responsivity intervention techniques for improving prelinguistic and/or language outcomes. Mean effect sizes were moderate and large for RCTs (33 studies; g = 0.36, 95% CI [0.21, 0.51]) and SCRD (34 studies; between-case standardized mean difference = 1.20, 95% CI [0.87, 1.54]) studies, respectively. Visual analysis (37 studies) revealed strong evidence of a functional relation for 45% of the opportunities and no evidence for 53%. Analyses of moderator effects and study quality are presented. Findings provide support for responsivity intervention strategies with more robust support for context-bound outcomes than more generalized outcomes

Developmental trajectory of communication repair in children with Fragile X Syndrome

This work is licensed under a Creative Commons Attribution 4.0 International License.Background and aims The development of communicative competence requires both language and social skills. The ability to repair following a communication breakdown is critical for continued conversational interchange and to ensure comprehension of bids for communication. Communication repair demonstrates adequate language and social skills. Children with Fragile X Syndrome have difficulty with language development and social skills, which may result in delays or deficits in repair. Repair may be additionally impaired in children with Fragile X Syndrome and co-morbid autism. This study examined the development of repair in children with Fragile X Syndrome from toddlerhood into middle childhood. Methods Fifty-five children with Fragile X Syndrome and their biological mothers participated. Data were collected during in-home visits approximately every 18 months. Videotaped mother–child interactions were collected, as well as standardized assessments of language, social skills, and autism symptomology. Results Children with Fragile X Syndrome acquired the ability to repair at 90% mastery by three-and-a-half years of age. Multilevel logistic regressions predicting probability of repair indicated marginally significant effects of mean length of utterance and number of different words, and significant effects of global social skills and autism symptomology. Effect sizes were small to moderate. Conclusions Ability to repair was measured in a naturalistic setting, which allowed children with Fragile X Syndrome to utilize repairs in their daily interactions. Although children with Fragile X Syndrome may have delayed development of repair relative to typically developing expectations, in general they nonetheless catch up and demonstrate a robust ability to repair by three-and-a-half years of age. However, this study provides evidence that individual differences in language and social skills may influence ability to repair in children with Fragile X Syndrome. Finally, the relationship between autism symptoms and repair remains unclear, necessitating further exploration. Implications: Given the noted delay in repair in young children with Fragile X Syndrome, clinicians working with this population should target development of this skill as early as possible to maximize successful social interactions. This may be particularly necessary for children with Fragile X Syndrome and co-morbid autism.NIH T32 DC000052NICHD R01 HD084563NICHD P30 HD003110P30 HD0253

Reading Instruction for Children who use AAC: Considerations in the Pursuit of Generalizable Results

Our purpose was to review evidence-based literacy instruction for children with severe speech impairment (SSI) who communicate with AAC. This review focuses on three issues important to researchers in this area: participant heterogeneity, assessment and instruction, and research design. We found 8 articles that reported attempts to teach phonological awareness and individual-word reading to a total of 26 children with SSI who used AAC. We evaluated these studies based on reporting of participant characteristics, assessment and instruction modifications, and the strength of research designs. We conclude by highlighting the need for standard assessments that can be used across studies, discussing strategies for facilitating metaanalyses, and suggesting the creation of an online database for researchers to share results on literacy instruction for this population

Symbolic Play of Preschoolers with Severe Communication Impairments with Autism and Other Developmental Delays: More Similarities than Differences

Children with autism are often described as having deficient play skills, particularly symbolic play. We compared the play of 35 children with autism to 38 children with other developmental delays. All children were preschool-age and produced less than 20 different words. Results indicated no significant differences across the two groups in their play. Children with autism engaged in more conventional play, that is, putting objects together according to how the toys were constructed (e.g., pieces in a puzzle, lid on a teapot). Results also indicated high correlations between play, language, and cognitive measures. Findings indicate that play relates to language and cognitive levels yet may not discriminate children with autism and children with other developmental delays early in their development

Communication in Young Children with Fragile X Syndrome: A Qualitative Study of Mothers’ Perspectives

Purpose: The purposes of the study were to provide descriptive and qualitative information about communication in young children with fragile X syndrome (FXS) and about how families react to and accommodate communication differences in their children. Method: In-depth interviews were conducted with 55 mothers of young children with FXS. Interviewers asked mothers to describe their children’s communication, strategies they used to help promote their children’s communication, communication-related frustrations, their expectations for their children and the roles that they perceive for themselves. Results: Over half the children were nonverbal and learning to communicate with augmentative or alternative communication (AAC). Mothers reported using strategies that were developmentally appropriate and recommended by early childhood experts, such as reading and talking to their children. Many mothers identified challenges faced in helping their child to communicate, and some cited difficulty obtaining speech-language services as a challenge. Mothers identified their roles as caregiver, teacher, therapist and advocate. Conclusions: The perspectives offered by mothers are valuable because they indicate how children with FXS communicate in natural contexts. Information about mothers’ expectations and roles may help clinicians to be sensitive to variables that will impact working with young children and their families.NIH P30 HD003110-38S1NIH P30 HD0252

Predicting language outcomes for children learning AAC: Child and environmental factors

Purpose To investigate a model of language development for nonverbal preschool age children learning to communicate with AAC. Method Ninety-three preschool children with intellectual disabilities were assessed at Time 1, and 82 of these children were assessed one year later at Time 2. The outcome variable was the number of different words the children produced (with speech, sign or SGD). Children’s intrinsic predictor for language was modeled as a latent variable consisting of cognitive development, comprehension, play, and nonverbal communication complexity. Adult input at school and home, and amount of AAC instruction were proposed mediators of vocabulary acquisition. Results A confirmatory factor analysis revealed that measures converged as a coherent construct and an SEM model indicated that the intrinsic child predictor construct predicted different words children produced. The amount of input received at home but not at school was a significant mediator. Conclusions Our hypothesized model accurately reflected a latent construct of Intrinsic Symbolic Factor (ISF). Children who evidenced higher initial levels of ISF and more adult input at home produced more words one year later. Findings support the need to assess multiple child variables, and suggest interventions directed to the indicators of ISF and input

The effect of sustained maternal responsivity on later vocabulary development in children with Fragile X Syndrome

Purpose The research question addressed was whether sustained maternal responsivity (a parent-child interaction style characterized by warmth, nurturance and stability as well as specific behaviors such as contingent positive responses to child initiations) was a significant variable predicting vocabulary development of children with FXS through age 9 years. Method Fifty-five mother-child dyads were followed longitudinally when children were between 2 and 10 years of age. Measures of maternal responsivity and child vocabulary were obtained at regular intervals starting at age 2.9 years. Sustained responsivity was indicated by the average responsivity measured over observations 2–5. Responsivity at the first time period, autism symptoms, and cognitive development were used as control variables. Results After controlling for development and autism symptoms, we found significant effects for sustained responsivity on receptive vocabulary, expressive vocabulary, and the rate of different words children produced through age 9. Conclusions Maternal responsivity, which is typically a variable of interest during early childhood, continues to be a significant variable, predicting vocabulary development through the middle childhood period. Thus, responsivity is a potential target for language interventions through this age period