Is dosage important?: parent and child outcomes with project impact therapy

The primary purpose of this study was to compare both pre- and post- language and social communication outcomes between two different groups, receiving various dosages of ImPACT (Improving Parents as Communicative Partners) therapy. A secondary objective was to investigate the feasibility of parent adherence to the ImPACT strategies and levels of self-perceived parent competency in implementing the treatment. Parent-mediated therapy has been shown to be a successful form of facilitating social skills and language in children with ASD (Ingersoll, 2012). Specifically, Project ImPACT implemented as an “off the shelf” model has resulted in increased social-engagement and communication as well as decreased parental stress (Ingersoll and Wainer, 2015). Results demonstrated clinically significant gains in social-communication across both groups, particularly in children receiving a higher dose of treatment. Parents also demonstrated increased parental satisfaction. Overall, the study highlights (1) the feasibility of implementing an “off the shelf” approach of the manualized Project ImPACT intervention in a clinic setting, without prior formal training, (2) emphasizes the importance of implementing parent-mediated interventions for the purposes of increasing overall functional communication in children with an ASD. (Published By University of Alabama Libraries

Real-time prosodic aspects of text generated speech

The purpose of this study was to investigate the feasibility and effectiveness of a text to speech (TTS) device that allows the user to manipulate pitch and volume as speech is being generated. This device was intended to facilitate the communicative needs of individuals with complex communication needs (CCN) as a result of acquired neurological conditions such as dysarthria. An Android touchscreen tablet with a built-in speech engine was used as the hardware for the TTS device, and a post-audio signal processing approach was utilized to program the TTS device. Results were collected in two separate phases: auditory and use-based. During the auditory phase, participants listened to audio samples from the thesis TTS device, a typical TTS device, and human speech and then rated them based on perceived affect (positive vs. negative) or intent (question vs. statements) categories. During the use-based phase, participants provided feedback about the thesis TTS device after using it to communicate with the study investigator. Although auditory phase results indicated that the thesis device was currently not as effective as human speech when communicating emotion and intent, use-based findings were more promising. Use-based results revealed that the new features the thesis TTS provided (ability to manipulate pitch and volume) were considered beneficial. (Published By University of Alabama Libraries

Social influences on autonomic arousal in autism spectrum disorders

The purpose of this study was to gain new understanding of autonomic nervous system (ANS) dysfunction in familiar and unfamiliar social situations in children with autism spectrum disorder (ASD). Both Children with ASD and typically developing peers viewed three sets of stimuli on a computer screen: 1) a screensaver (initial and final baseline), 2) objects moving to music (attention), and 3) narratives produced by both a caregiver and a stranger (familiar and unfamiliar social situations). Physiological measures of heart rate and skin conductance were acquired to assess ANS functioning. It was expected that 1) ANS activity would differ between children with ASD and typically developing peers at baseline, 2) differences in ANS activity between the two groups would be greater in the attention vs. the baseline task, and 3) differences in ANS activity between the two groups would be greater in the unfamiliar vs. the familiar tasks. Results showed that sympathetic, but not parasympathetic, arousal was greater for children with ASD as compared to typically developing children, but these measures did not differ across tasks. Results are interpreted to suggest that children with ASD perceived the experimental conditions as more challenging as compared to children who are typically developing. (Published By University of Alabama Libraries

The relationship of developmental functioning to symptom presentation in young children with ASD

The present study examined the differences between young children with Autism Spectrum Disorders (ASD) and typical development (TD) on developmental skills and core symptoms of ASD. Further, the relationship between core symptoms of ASD and developmental functioning level were assessed. Specific symptoms, joint attention, symbolic play, gestures, and RSB, as well as general symptom categories were assessed in children with ASD (n=10) and children with typical developmental (n=10) who were matched on mental age and gender. Method: Measures of social communication, speech, symbolic play, gestures, and joint attention were obtained through the Communication and Symbolic Behavior Scales (CSBS: Wetherby and Prizant, 2002). Developmental level was measured using the Mullen Scales of Early Learning (MSEL: Mullen, 1992). Results: Children with ASD demonstrated decreased abilities in symbolic play and understanding, social communication, joint attention, and gestures compared to children with TD. Children with ASD also demonstrated more RSB with body and objects. Strong correlations among social, symbolic, speech, and gestural were observed. Speech and symbolic skills, as well as social and gestural skills were the only relationships to remain highly correlated even when developmental level was controlled. Conclusions: These findings highlight the diagnostic significance of developmental level to core symptoms of ASD. Research aims and the impact of these findings on the development of specific therapy goals are also discussed. (Published By University of Alabama Libraries

Common practices of speech-language pathologists in bilingual assessment and intervention

Research in the literature shows that the percentage of individuals who are multicultural and multilingual is steadily increasing in the United States (Shin & Kominski, 2010). This rise has led to the increase of children who are bilingual on the caseloads of speech-language pathologists (SLPs) in the United States (Caesar & Kohler, 2007; Kritikos, 2003). Research is beginning to delineate evidence-based practice (EBP) in assessment and intervention for bilingual children. However, recent survey studies have shown that most SLPs in the United States are not providing this type of evidence-based service to children who are bilingual (Caesar & Kohler, 2007; Kritikos, 2003). The current survey study sought to identify variables that influence SLPs' use of evidence-based practice and their confidence in culture and assessment, as well as the influence of treatment methods on reported therapy gains. The researcher created an online survey and distributed it to SLPs across the United States (n=435). Regression analysis revealed that years of experience inversely predicted use of some methods of EBP, and language skill and number of bilingual SLPs in the facility positively predicted the use of other methods. Experiential demographics influenced confidence in culture and assessment more than didactic factors, and confidence in treatment and assessment positively predicted therapy gains. (Published By University of Alabama Libraries

The effects of focused stimulation, vertical structuring, and expansions on verbal language in young minimally-verbal children with Autism Spectrum Disorder

Speech pathologists are often the first line of referral for young children at risk for an ASD. Often, SLPs, especially those who work in state-funded Early Intervention Programs (Part C-Early Intervention, IDEA, 2004), do not have access to training on autism-specific early intervention models (Stahmer, Collings, & Palinkas, 2005). In addition, children who are receiving Early Intervention in community settings often do not have available options for autism-specific interventions, which are offered in many university settings. As a result, the facilitation strategies of focused stimulation, vertical structuring, and expansions are often being implemented in therapy with these children. To our knowledge, no study has measured the effects of these commonly used language strategies on the verbal language in minimally verbal children with ASD. The purpose of this study was to measure the effects of focused stimulation, vertical structuring, and expansions on the acquisition of verbal language in minimally verbal children with ASD. Three toddlers diagnosed with autism were recruited for this study. Intervention took place twice a week for 20-minute sessions, followed by two-generalization probes 4 weeks post intervention. Two out of our three participants demonstrated gains in their verbal language inside of the intervention environment. Results of this study conclude that these intervention strategies are capable of being implemented in community-based intervention settings with successful outcomes. (Published By University of Alabama Libraries

Peer mediated intervention to improve social communication in young children with ASD

To date, no study has measured the effects of peer-mediated intervention (PMI) on autism symptoms in children under than four years of age. The current study examines the efficacy of the Stay, Play, Talk PMI (English, K., Shafer, K., Goldstein, H., & Kaczmerek, L., 1997) on the social communication skills of young children diagnosed with autism. The investigator paired three typically developing children (ages 3-5 years) each with a young child with autism (ages 3-4 years). These dyads played together during two to three, 20-minute weekly sessions for 6-8 weeks. A multiple baseline design across participants was implemented to measure the effectiveness of PMI on young children with autism's social initiations and responses characterized by non-coordinated gestures, gestures, and words. The investigator coded the frequency of each child's social initiations and responses to topics/conversations for each 20-minute play sessions. All three children with autism demonstrated increased social responses, though initiations remained variable. Typical peer buddies demonstrated increases in social initiations and responses. Results of this study support the usefulness of this intervention to improve social communication of young children with autism and contribute to limited knowledge of effective early social communication interventions for young children with autism. (Published By University of Alabama Libraries