A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism

Purpose: This randomized controlled trial evaluated the effectiveness of a play-based pragmatic language intervention for children with autism. Methods: A sample of 71 children with autism were randomized to an intervention-first group (n = 28 analyzed) or waitlist-first (n = 34 analyzed) group. Children attended 10, weekly clinic play-sessions with a typically developing peer, and parents mediated practice components at home. The Pragmatics Observational Measure (POM-2) and the Social Emotional Evaluation (SEE) evaluated pragmatics before, after and 3-months following the intervention. Results: POM-2 gains were greatest for intervention-first participants (p = 0.031, d = 0.57). Treatment effects were maintained at 3-month follow-up (p < 0.001–0.05, d = 0.49–0.64). POM-2 scores were not significantly different in the clinic and home settings at follow-up. Conclusion: Findings support the combination of play, peer-mediation, video-feedback and parent training to enhance pragmatic language in children with autism

Applying Item Response Theory (IRT) Modeling to an Observational Measure of Childhood Pragmatics: The Pragmatics Observational Measure-2

Assessment of pragmatic language abilities of children is important across a number of childhood developmental disorders including ADHD, language impairment and Autism Spectrum Disorder. The Pragmatics Observational Measure (POM) was developed to investigate children's pragmatic skills during play in a peer-peer interaction. To date, classic test theory methodology has reported good psychometric properties for this measure, but the POM has yet to be evaluated using item response theory. The aim of this study was to evaluate the POM using Rasch analysis. Person and item fit statistics, response scale, dimensionality of the scale and differential item functioning were investigated. Participants included 342 children aged 5-11 years from New Zealand; 108 children with ADHD were playing with 108 typically developing peers and 126 typically developing age, sex and ethnic matched peers played in dyads in the control group. Video footage of this interaction was recorded and later analyzed by an independent rater unknown to the children using the POM. Rasch analysis revealed that the rating scale was ordered and used appropriately. The overall person (0.97) and item (0.99) reliability was excellent. Fit statistics for four individual items were outside acceptable parameters and were removed. The dimensionality of the measure showed two distinct elements (verbal and non-verbal pragmatic language) of a unidimensional construct. These findings have led to a revision of the first edition of POM, now called the POM-2. Further empirical work investigating the responsiveness of the POM-2 and its utility in identifying pragmatic language impairments in other childhood developmental disorders is recommended

What’s the Evidence for Involving Parents in Intervention for Speech Sound Disorders?

This systematic overview examines the evidence base for parent involvement in intervention for phonology-based speech sound disorders. Of the 175 identified papers, 61 reported including parents and/or home-based tasks in intervention. However, insufficient detail reported within these papers limits replication and implementation. The clinical and research implications are discussed

The efficacy of training parents to deliver multiple oppositions intervention to children with speech sound disorders

Optimal outcomes for phonology-based speech sound disorders (SSDs) can be achieved when intervention is delivered at high frequencies, such as 3 x week. However, many speech pathologists (SLPs) in Australia are unable to deliver such frequent services, with intervention typically being delivered weekly. One strategy to overcome this intensity shortfall is to engage parents in completing practice at home. The efficacy of this strategy is unclear. The results of this study showed that combined parent-SLP delivery of multiple oppositions can be used to achieve the recommended dose frequency of intervention. Child outcomes were likely influenced by multiple factors, including dosage, fidelity, and the nature of the child’s SSD. Implications for clinical practice will be discussed

An International Comparison of Intervention Practices for Children with Speech Sound Disorder

Two-hundred and seven speech-language pathologists (SLPs) from the US and 335 SLPs from Australia were surveyed about the intervention, service delivery models and intensity of intervention that they provide to children with speech sound disorder. Differences in practices, and implications for evidence-based practice and clinical outcomes, are discussed

Evaluation of Parent- and Speech-Language Pathologist–Delivered Multiple Oppositions Intervention for Children With Phonological Impairment: A Multiple-Baseline Design Study

Purpose: Evidence for the multiple oppositions intervention approach indicates it should be delivered 3 times weekly; however, this high dose frequency is not provided by many speech-language pathologists worldwide. This study investigated whether parents could be involved in delivering phonological intervention to fulfill this intensity shortfall. Method: Five children with moderate-to-severe phonological impairment aged 3;3–5;11 (years;months) and 1 of their parents participated in this study using a multiplebaseline across participants design. Participants attended one 60-min clinic-based session per week for 8 weeks, and parents completed home practice 2 times per week over this period after receiving training. Parents also attended a 60-min training session prior to commencing intervention. Results: All children showed a treatment effect to treated words. Three of the 5 children demonstrated a large effect size for generalization to nontreatment words, with 1 child demonstrating a moderate effect and 1 child demonstrating no effect. However, all children showed qualitative changes to their speech system. Three of the 5 children experienced significant changes to communicative participation. Measures of treatment fidelity indicated that parents were able to competently deliver the intervention both within the clinic and at home. Conclusions: Combined parent-and speech-language pathologist–delivered multiple oppositions intervention is effective for some children with moderate-to-severe phonological impairment. The findings indicate that parents can be trained to competently and confidently deliver phonological intervention. Further evidence is needed to identify optimal child and parent characteristics most suited to this modified service delivery approach

Interactions between phonological and motor learning : insights from an intervention study

Background: Interventions for phonological impairment, such as minimal pairs and multiple oppositions, focus on children learning the contrastive function of phonemes. Although phonological teaching procedures are typified by requests for clarification (e.g., "do you mean key or tea?"), production practice remains integral to intervention success. However, relatively little is known about optimal conditions of practice (e.g., amount, distribution, schedule) for children with phonological impairment. Purpose: To explore how the principles of motor learning might guide our understanding and application of conditions of practice for children with phonological impairment characterized by collapses of phonemic contrast. Method: Using retrospective data from five children (aged 3;3 to 5;11) involved in an 8-week intervention study of the multiple oppositions approach, four conditions of practice (practice amount, distribution, schedule, and variability) were compared with each child’s response to intervention as measured by change in percent consonants correct (PCC), generalisation to non-treatment words and phonemes, and size of phonemic collapses pre- and one-month post-intervention. Results: Two of the five children had an impressive response to intervention, with widespread generalistion and increases in PCC of more than 20% post-intervention. The remaining three children showed varied responses to intervention, with increases in PCC of less than 5%, although all added at least one or more phones to their phonetic inventory. Post-hoc analyses revealed an interaction between conditions of practice—particularly practice amount and distribution of practice—and intervention outcomes. Conclusions: Principles of motor learning, including conditions of practice, would seem to be an important consideration in intervention for phonological impairment in children. Further research is needed to better understand how the principles of motor learning might be used to understand children's responses to intervention, and how phonological interventions might be tailored to meet individual children's needs

Applying Item Response Theory (IRT) Modeling to an Observational Measure of Childhood Pragmatics: The Pragmatics Observational Measure-2

Assessment of pragmatic language abilities of children is important across a number of childhood developmental disorders including ADHD, language impairment and Autism Spectrum Disorder. The Pragmatics Observational Measure (POM) was developed to investigate children’s pragmatic skills during play in a peer–peer interaction. To date, classic test theory methodology has reported good psychometric properties for this measure, but the POM has yet to be evaluated using item response theory. The aim of this study was to evaluate the POM using Rasch analysis. Person and item fit statistics, response scale, dimensionality of the scale and differential item functioning were investigated. Participants included 342 children aged 5–11 years from New Zealand; 108 children with ADHD were playing with 108 typically developing peers and 126 typically developing age, sex and ethnic matched peers played in dyads in the control group. Video footage of this interaction was recorded and later analyzed by an independent rater unknown to the children using the POM. Rasch analysis revealed that the rating scale was ordered and used appropriately. The overall person (0.97) and item (0.99) reliability was excellent. Fit statistics for four individual items were outside acceptable parameters and were removed. The dimensionality of the measure showed two distinct elements (verbal and non-verbal pragmatic language) of a unidimensional construct. These findings have led to a revision of the first edition of POM, now called the POM-2. Further empirical work investigating the responsiveness of the POM-2 and its utility in identifying pragmatic language impairments in other childhood developmental disorders is recommended

Consensus on Terminology for Describing Child Language Interventions: A Delphi Study

Purpose Language intervention for children with language disorder may be effective; however, lack of detailed and consistent terminology for describing language interventions poses barriers for advancement within the field. This study aimed to develop consensus from speech-language pathologists (SLPs) in Australia on a taxonomy with terminology for describing language interventions for school-aged children and investigate SLPs' application of taxonomy terminology when describing child language interventions. Method A taxonomy with terms for describing interventions was developed with reference to contemporary literature and presented to clinicians and researchers with expertise in child language disorders in a three-round Delphi study. We asked Delphi participants to indicate agreement with the taxonomy or propose changes. Application of the taxonomy was investigated by asking participants to use taxonomy terminology to describe interventions presented in two case studies. Results The taxonomy consists of five aspects across which interventions may be described: modality/domain, purpose, delivery, form, and teaching techniques. Consensus on the taxonomy was established in both Round 1 (55 participants) and Round 2 (43 participants), with 100% of SLPs strongly agreeing or agreeing with the overall structure of the taxonomy and at least 87.3% of SLPs strongly agreeing or agreeing with each aspect. In Round 3 (32 participants), consensus was reached on 45/54 taxonomy categories (4/12 of the components) for Case Study 1 and 45/54 taxonomy categories (7/12 of the components) for Case Study 2. Conclusions Consensus on a taxonomy with terminology for describing language interventions represents a significant advancement in the field of child language intervention. Future actions may be needed to facilitate consistent application of taxonomy terms. Supplemental Material https://doi.org/10.23641/asha.1643529

The pH-responsive PacC transcription factor of Aspergillus fumigatus governs epithelial entry and tissue invasion during pulmonary aspergillosis

Data Availability: The authors confirm that all data underlying the findings are fully available without restriction. Raw data have been deposited in the Gene Expression Omnibus (GEO) (http://www.ncbi.nlm.nih.gov/geo/) under accession number GSE54810. Funding: This work was supported in part by grants to EMB from the MRC (G0501164) and BBSRC (BB/G009619/1), to EMB and NDR from the Wellcome Trust (WT093596MA), to MB from Imperial College London (Division of Investigative Sciences PhD Studentship), to HH from the ERA-NET PathoGenoMics project TRANSPAT, Austrian Science Foundation (FWF I282-B09), to SGF from the National Institutes of Health, USA (R01AI073829). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD