Commentary: achievements and future directions for intervention research in communication and autism spectrum disorders.
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Autistic Disorder↗
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Results for “Language Therapy”
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Comparisons of discrete-trial and normalized behavioral language intervention for young children with autism.
This critical review examined a series of 10 controlled studies in which traditional operant behavioral procedures were compared with more recently developed normalized interventions for teaching language to young children with autism. Main characteristics of the older treatments include highly structured direct teaching sessions of discrete trials, teacher initiation, artificial reinforcers, and response shaping. Normalized interventions consist of loosely structured sessions of indirect teaching with everyday situations, child initiation, natural reinforcers, and liberal criteria for presentation of reinforcers. The main conclusion was that in all eight studies with language criterion responses, normalized language training was more effective than discrete-trial training. Furthermore, in both studies that assessed parental affect, normalized treatment yielded more positive affect than discrete-trial training.
Autistic Disorder↗
Facilitated communication since 1995: a review of published studies.
Previous reviews of Facilitated Communication (FC) studies have clearly established that proponents' claims are largely unsubstantiated and that using FC as an intervention for communicatively impaired or noncommunicative individuals is not recommended. However, while FC is less prominent than in the recent past, investigations of the technique's efficacy continue. This review examines published FC studies since the previous major reviews by Jacobson, Mulick, and Schwartz (1995) and Simpson and Myles (1995a). Findings support the conclusions of previous reviews. Furthermore, this review critiques and discounts the claims of two studies purporting to offer empirical evidence of FC efficacy using control procedures.
Autistic Disorder↗
Teaching the illusion of facilitated communication.
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Child↗
Semantic fields in low-functioning autism.
Restricted semantic fields and resultant stimulus overselectivity are often thought to be typical of low-functioning autism, as is a strong visual processing preference. However, these conclusions may in part be an artifact of testing methodology. A 12-year-old, low-functioning and nonverbal autistic boy was tested on an auditory word-to-picture selection task. The picture foils were chosen to have visual features, semantic features, both, or neither in common with the correct answer. Errors were made more often to semantically than to visually related items, and he showed generalization to items that had not been explicitly trained. This is taken as evidence that his semantic fields are broader than otherwise apparent, and that he was capable of expanding his semantic representations independently of specific training.
Acoustic Stimulation↗
Procedures for teaching appropriate gestural communication skills to children with autism.
Four children with autism were taught to use gestures in combination with oral communication. Using a multiple-baseline across-responses design, intervention was introduced successively across three response categories containing gestures representative of attention-directing/getting, affective, and descriptive behavior. Although none of the participants displayed appropriate gestural and verbal responses during baseline, all participants acquired this skill with the systematic implementation of modeling, prompting, and reinforcement. Generalization measures indicated that the children learned to respond in the presence of novel stimuli and a novel setting. Social validity measures revealed that the participants' behavior appeared more socially appropriate at the completion of the study than at the start of the study, and that the participants' behavior was indistinguishable from that of their typically developing peers.
Autistic Disorder↗
Increasing speech intelligibility in children with autism.
Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, reliably influence the effectiveness of language teaching interactions for children with autism. However, the effectiveness of this approach has not yet been assessed with respect to improving speech intelligibility. The purpose of this study was to systematically compare two intervention conditions, a Naturalistic approach (which incorporated motivational variables) vs. an Analog (more traditional, structured) approach, with developmentally similar speech sounds equated within and across conditions for each child. Data indicate that although both methods effectively increased correct production of the target sounds under some conditions, functional use of the target sounds in conversation occurred only when the naturalistic procedures were used during intervention. Results are discussed in terms of pivotal variables that may produce improvements in speech sounds during conversational speech.
Articulation Disorders↗
Psychotherapy process research: progress, dilemmas, and future directions.
The first several decades of psychotherapy process research have produced advances in measure development and substantive findings of process-outcome relations. A recent paradigm shift toward sequentially patterned, significant change episodes is described, emphasizing segmentation of process by meaningful patterns wherever they occur. Theoretical, psychometric, and data analytic dilemma are reviewed. Strategies are offered that may enhance future research efforts. These include greater attention to construct validity of measures, the relation of process to phase-specific outcome criteria, and the continuing development of multivariate data analytic strategies that take into account Patient X Treatment interactions as well as the sequential dependency of process data. The development of a national archive of significant change events is recommended to advance modeling of the change process, segmentation, construct validation of measures, integration of qualitative and quantitative approaches, and development of a cross-theoretical language for therapy process.
Follow-Up Studies↗
Effects of language intervention on syntactic skill levels in preschoolers.
Questions concerning the role of input in the growth of syntactic skills have generated substantial debate within psychology and linguistics. The authors address these questions by investigating the effects of experimentally manipulated input on children's skill with the passive voice. The study involved 72 four-year-olds who listened to stories containing either a high proportion of passive voice sentences or a high proportion of active voice sentences. Following 10 story sessions, children's production and comprehension of passives were assessed. Intervention type affected performance--children who heard stories with passive sentences produced more passive constructions (and with fewer mistakes) and showed higher comprehension scores than children who heard stories with active sentences. Theoretical implications of these results for the understanding of the nature of syntactic skills and practical implications for the development of preschool materials are discussed.
Child Language↗
Stuttering, language, and cognition: a review and a model of stuttering as suprasegmental sentence plan alignment (SPA).
Extant models of stuttering do not account for the emergence of stuttering at the onset of productive language use; the greater incidence of stuttering during spontaneous speech, on complex sentences, and at sentence-initial positions; the greater incidence of stuttering in bilinguals' 2nd language; the apparent deficiency of stutterers in expressive and receptive language skills; the prevalence of spontaneous recovery from stuttering; and the lack of chronic physiological or articulatory deficits in stuttering children's fluent speech. The author presents a model of stuttering as points of suprasegmental sentence plan alignment (SPA). Such alignment processes occur when, due to on-line sentence production processes, SPAs adopted prior to utterance initiation need to be aligned with revised SPAs. This model parsimoniously accounts for the findings reviewed in the article.
Adult↗
The role of neuroscience in the remediation of students with dyslexia.
Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition, spelling and decoding abilities. Research findings agree that these and other observed behavioral manifestations largely result from a deficit in the phonological component of language. However, conflicting theories on the exact nature of the phonological deficit have given rise to divergent treatment approaches. Recent advances in functional brain imaging and genetics have allowed these theories to be examined more closely. If implemented appropriately, commercial programs can be effective in identifying dyslexia. Treatment of dyslexia has been advanced through neuroscience, yet further study is needed to provide rigorous, reproducible findings that will sustain commercial approaches.
Brain↗
Computer-supported phonological awareness intervention for kindergarten children with specific language impairment.
PURPOSE: The purpose of the present study was to determine whether kindergarten children with specific language impairment (SLI) could develop phonological awareness skills through computer intervention and whether speech manipulation (i.e., slowing speech rate and enhancing transitions) in instruction produced additional learning. METHOD: The effects of a computer-supported phonological awareness program on a variety of items, including word analysis, syllable analysis, rhyme, phoneme analysis, syllable synthesis, and phoneme synthesis, were tested following a pretest-posttest 1-posttest 2 design. Twenty-four kindergarten children with SLI in the Netherlands received 3.5 hr of phonological awareness intervention via a computer program using either normal speech (12 children) or manipulated speech (12 children). A control group of 12 kindergarten children with SLI played computer vocabulary games. RESULTS: The results showed positive effects of the intervention for the normal speech group. Eighteen weeks later, the effect size was still substantial; however, no additional effects of speech manipulation were found. CLINICAL IMPLICATIONS: The results suggest that kindergarten children with SLI benefit from computer intervention for phonological awareness skills.
Analysis of Variance↗
Description of a program for social language intervention: "if you can have a conversation, you can have a relationship".
Adolescents with impaired language comprehension and formulation skills often experience difficulty keeping up with the linguistic and social demands of peer interaction. This clinical exchange describes an individualized treatment program designed to increase the conversational skill of an adolescent male with language impairment. Treatment focused on increasing awareness of the listener's needs and on balancing the exchange of conversational turns. Clinical performance, parent report, and client report were used to assess outcomes.
Adolescent↗
"Do I know what I need to do?" A social communication intervention for children with complex clinical profiles.
PURPOSE: Speech-language pathologists frequently address social communication difficulties in children with diverse clinical profiles. The purpose of this study was to investigate the feasibility of a social communication intervention for a school-age child with a complex cognitive and behavioral profile secondary to diagnosis of a fetal alcohol spectrum disorder. METHOD: A case study is presented to describe the implementation of the intervention targeting mental state verb production and social cognitive skills. The intervention included group role play of social scripts and a checklist to elicit the participant's statements about others' perspectives and strategies for completing the social script. Treatment data monitored the participant's responses to the checklist questions. Probe sessions, consisting of theory of mind false belief tasks, were used to examine mental state verb use. RESULTS: Treatment data demonstrated that the participant stated more strategies in response to checklist questions. The participant did not produce any mental state verbs during baseline probes, but did produce mental state verbs during the treatment phase. CLINICAL IMPLICATIONS: The results support use of this intervention to change children's linguistic and social cognitive skills. Suggestions for extending this intervention to include a generalization plan targeting classroom social communication interactions are provided.
Behavior↗
Ten principles of grammar facilitation for children with specific language impairments.
Although they often have significant difficulties in other areas, most children with specific language impairment (SLI) have special difficulties with the understanding and use of grammar. Therefore, most of these children will require an intervention program that targets comprehension or production of grammatical form. Language interventionists are faced with the difficult task of developing comprehensive intervention programs that address the children's grammatical deficits while remaining sensitive to their other existing and predictable social, behavioral, and academic problems. The purpose of this article is to present and justify 10 principles that we regard as essential for planning adequate interventions for children with language-learning problems. These principles are relevant for all children with problems in the use of grammar, but they are especially appropriate for 3- to 8-year-old children with SLI. Although all of our examples are from English, the principles we have chosen are sufficiently broad to cut across many linguistic and cultural boundaries.
Child↗
Enhancing socially adaptive communicative repairs of beginning communicators with disabilities.
Young children with significant disability often have limited communicative repertoires. The means they have available to communicate with others might include natural gesturing, vocalizing, and occasionally challenging behavior. These forms frequently are unconventional, ambiguous, and idiosyncratic and are therefore difficult for partners to understand. As a result of these compromised repertoires, communication breakdowns are the rule rather than the exception and the children's capacity to repair these breakdowns becomes critical. This article focuses on communication breakdowns and repairs by (a) identifying and defining their variations, (b) providing a rationale for their importance (especially for children with substantial language delays), and (c) developing a conceptual framework to facilitate their assessment and to assist in the design of interventions that are logically related to the assessment results. Guidelines for conducting the assessments and for implementing the interventions are provided.
Child↗
The impact of aided language stimulation on symbol comprehension and production in children with moderate cognitive disabilities.
Over the past decade, aided language stimulation has emerged as a strategy to promote both symbol comprehension and symbol production among individuals who use graphic mode communication systems. During aided language stimulation, an interventionist points to a graphic symbol while simultaneously producing the corresponding spoken word during natural communicative exchanges. The purpose of this study was to determine the impact of aided language stimulation on children with moderate cognitive disabilities. Three preschool children with moderate cognitive disabilities who were functionally nonspeaking participated in the investigation. The investigator implemented a multiple-probe design across symbol sets/activities. Elicited probes were used to determine whether the children increased their comprehension and production of graphic symbols. Results indicated that all 3 children displayed increased symbol comprehension and production following the implementation of aided language stimulation.
Child, Preschool↗
Science and pseudoscience in communication disorders: criteria and applications.
PURPOSE: The purpose of this tutorial is to describe 10 criteria that may help clinicians distinguish between scientific and pseudoscientific treatment claims. The criteria are illustrated, first for considering whether to use a newly developed treatment and second for attempting to understand arguments about controversial treatments. METHOD: Pseudoscience refers to claims that appear to be based on the scientific method but are not. Ten criteria for distinguishing between scientific and pseudoscientific treatment claims are described. These criteria are illustrated by using them to assess a current treatment for stuttering, the SpeechEasy device. The authors read the available literature about the device and developed a consensus set of decisions about the 10 criteria. To minimize any bias, a second set of independent judges evaluated a sample of the same literature. The criteria are also illustrated by using them to assess controversies surrounding 2 treatment approaches: Fast ForWord and facilitated communication. CONCLUSIONS: Clinicians are increasingly being held responsible for the evidence base that supports their practice. The power of these 10 criteria lies in their ability to help clinicians focus their attention on the credibility of that base and to guide their decisions for recommending or using a treatment.
Communication Disorders↗