Quantifying unintelligible speech

Evaluations for children with speech sound disorders (SSDs) are pretty standard across the board. We take a speech sample through imitated words, picture naming, and/or free conversation. We measure which consonants they produce correctly vs. incorrectly, do an oral mech exam, and call it a day. But when children have long stretches of unintelligible speech, things can get complicated. How can we analyze speech if we have no idea what the child is saying? Öster et al. attempts to help us quantify unintelligible speech using a measure called percentage of intelligible correct syllables (PICS).  

4.png

SLPs measured intelligible correct syllables by listening to a short sample of connected speech in children ages 4–10 with SSD (approximately 100 words). Since syllables are still evident in unintelligible speech, the SLPs were able to measure the number of accurate syllables divided by the total number of syllables in the sample to obtain the percentage of correct syllables. Furthermore, children’s’ PICS scores were correlated with their percentage of correct consonants (PCC) showing us that PICS can be used as a valid measure for assessing speech sounds. For those tricky children who are unintelligible more often than not, PICS could provide a baseline from which to measure progress.  

These researchers also used a novel method for collecting a connected speech sample. Using concurrent commenting, children watched a silent video, typically a clip from a children’s TV episode, and were instructed to describe the ongoing events of the video to a listener. This procedure allows SLPs to gain a sample of narration, which usually contains more linguistically complex and longer utterances compared to conversational speech. The video also provides contextual clues for the SLP to use when transcribing the sample.

Ready to jump in? Check out the article for even more details on how to assess a child using PICS and concurrent commenting. Both are handy tools to consider using when assessing highly unintelligible children.

 

Öster, C.A.M., Ode, C., & Strömbergsson, S. (2019). Dealing with the unknown—addressing challenges in evaluating unintelligible speech. Clinical Linguistics and Phonetics. doi:10.1080/02699206.2019.1622787.

Shifting and switching from Spanish to English

5.png

In the US, children who speak Spanish at home often begin learning English when they start school, and their dominant language shifts from Spanish to English over time. To get a better idea of how this happens, the authors of this study looked at the change in grammatical accuracy (percent grammatical utterances or PGU*) in Spanish and English narrative retells from kindergarten to second grade.  

As expected, children’s PGU in English went up over time, while PGU in Spanish went down. The researchers compared children in bilingual (English–Spanish) vs. English-only classrooms. For children in bilingual classrooms, the decrease in Spanish PGU was slower, but the increase in English PGU was slightly slower also.  

The researchers also looked at a subgroup of the children who had lower PGU in Spanish at the outset. They called this group “low grammaticality” because they didn’t have enough measures to confidently diagnose developmental language disorder (DLD). Children in this group showed a different pattern, with Spanish PGU holding steady for those in bilingual classrooms, suggesting that they benefited from bilingual teaching.

For a brief time (around age 8), English and Spanish PGU scores for the low grammaticality group looked similar to the rest of the children, which means that if we assessed them at this point, we might not be able to tell who does and doesn’t have DLD. The authors encourage us to assess children in their home language early on, before this shift happens.

So as if assessing English language learners wasn’t hard enough, we also need to consider the type of instruction children are getting and their skills in each language over time.  Ideally, we’d assess children in their home language right when they start school. When that’s not possible, dynamic assessment might help us to differentiate language disorders from normal language dominance shifting during the early school years. For other resources on diagnosing DLD in English language learners, see reviews here, here, and here.

 

*Remember that higher PGU means more accurate use of grammar.

Castilla-Earls, A., Francis, D., Iglesias, A., & Davidson, K. (2019). The impact of the Spanish-to-English proficiency shift on the grammaticality of English learners. Journal of Speech, Language, and Hearing Research. doi: 10.1044/2018_JSLHR-L-18-0324.

And more...

Esmaeeli et al. found that family history is the biggest predictor of reading disorders in children at the end of second grade, but emergent literacy and oral language skills also played a role. As SLPs, we should always be taking family history into account when screening or testing for reading disorders.

Two studies this month looked at standardized language tests for Spanish–English bilingual children. Fitton et al. studied the sentence repetition task from the Bilingual English–Spanish Assessment (BESA) and found that it was a valid measure of morphosyntax in both Spanish and English. Wood & Schatschneider studied the Peabody Picture Vocabulary Test (PPVT-4) and found that it was biased against Spanish–English dual language learners (see also this review).

Méndez & Simon-Cereijido looked at Spanish–English bilingual preschoolers with developmental language disorder* (DLD) and found that children with better Spanish vocabulary skills also had better English grammar skills. They suggest targeting vocabulary in students’ home language to support English learning.

In a survey of nearly 3000 children, Reinhartsen et al. found that children with autism are significantly more likely to have higher expressive language skills than receptive. Children with this profile tended to have more severe delays and more significantly impaired language overall compared to children without this profile.

Rudolph et al. studied the diagnostic accuracy of finite verb morphology composite (FVMC) scores. Unlike previous studies, they found that FVMC wasn’t good at identifying 6-year-olds with developmental language disorder (DLD). The difference might be due to a larger, more representative sample of children. (NOTE: “The FVMC is derived from a spontaneous language sample, in either a free-play or elicited narrative scenario, and reflects the percent occurrence in obligatory contexts of eight T/A morphemes: regular past tense –ed, 3S, and present tense uncontracted and contracted copula and auxiliary BE forms (am, is, are).” ~Rudolph et al., 2019)

Verschuur et al. studied two types of parent training in Pivotal Response Treatment (PRT), finding that both group and individual training improved parents’ ability to create communication opportunities and increased children’s initiations. Furthermore, group training had additional benefits for parents’ stress levels and feelings of self-efficacy. The authors suggest that combining group and individual sessions might be a good way to build parents’ skills while conserving resources.

Venker et al. surveyed SLPs about their use of telegraphic speech. The vast majority of SLPs reported using telegraphic input for commenting on play, prompting for verbal imitations, and giving directions. However, only 18% of SLPs reported that they felt telegraphic speech is useful, which doesn’t make much sense! More research is needed to help align SLP practices and perspectives for use of telegraphic input. (Editors’ note = Perhaps it’s just a habit that’s hard to break? Even culturally influenced?)

 

*Note: The children in this study were those with Specific Language Impairment (SLI), which refers to children with Developmental Language Disorder (DLD) and normal nonverbal intelligence. We use DLD throughout our website for consistency purposes (read more here).

 

Esmaeeli, Z., Kyle, F.E., & Lundetræ, K. (2019). Contribution of family risk, emergent literacy and environmental protective factors in children’s reading difficulties at the end of second-grade. Reading and Writing. doi:10.1007/s11145-019-09948-5.

Fitton, L., Hoge, R., Petscher, Y., & Wood, C. (2019). Psychometric evaluation of the Bilingual English-Spanish Assessment sentence repetition task for clinical decision making. Journal of Speech, Language, and Hearing Research. doi:10.1044/2019_JSLHR-L-1

Méndez, L. I., & Simon-Cereijido, G. (2019). A view of the lexical-grammatical link in young latinos with specific language impairment using language-specific and conceptual measures. Journal of Speech, Language, and Hearing Research. doi:10.1044/2019_JSLHR-L-18-0315

Reinhartsen, D.B., Tapia, A.L., Watson, L., Crais, E., Bradley, C., Fairchild, J., Herring, A.H., & Daniels, J. (2019). Expressive dominant versus receptive dominant language patterns in young children: Findings from the study to explore early development. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-03999-x

Rudolph, J. M., Dollaghan, C. A., & Crotteau, S. (2019). Finite verb morphology composite: Values from a community sample. Journal of Speech, Language, and Hearing Research. doi:10.1044/2019_JSLHR-L-18-0437 

Venker, C.E., Yasick, M., & McDaniel, J. (2019). Using telegraphic input with children with language delays: A survey of speech-language pathologists’ practices and perspectives. American Journal of Speech–Language Pathology. doi:10.1044/2018_AJSLP-18-0140

Verschuur, R., Huskens, B. & Didden, R. (2019). Effectiveness of Parent Education in Pivotal Response Treatment on Pivotal and Collateral Responses. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-04061-6

Wood, C., & Schatschneider, C. (2019). Item bias: Predictors of accuracy on Peabody Picture Vocabulary Test-Fourth Edition items for Spanish-English-speaking children. Journal of Speech, Language, and Hearing Research. doi: 10.1044/2018_JSLHR-L-18-0145  

Language deficits in preschoolers born premature: How should we assess?

By now, it’s fairly well known that prematurity is a major risk factor for language delays in toddlerhood and beyond. But what do those language deficits look like and how can we assess them adequately?

This study examines these questions by comparing preschoolers born preterm* with their typically developing, full term counterparts. They examined both groups’ expressive language skills, nonverbal IQ, and attention skills, as well as parental reports of hyperactivity and attention problems.

A standardized language assessment (CELF-Preschool 2) and language sample analysis were used to assess expressive language skills, with some interesting results. The only significant difference in CELF-P2 results was the Recalling Sentences subtest, but every measure of semantic and grammatical skills was significantly lower in the language samples of the preterm group. Attentional difficulties partially explained these skill differences, but not hyperactivity or nonverbal IQ. Keep in mind that these results don’t necessarily match those of previous studies of children born preterm, but the authors of this study do a thorough job of explaining possible reasons for this in the discussion section.

What are the takeaways for evaluating preschoolers born preterm?

  1. Don’t forget the value of standardized sentence recall tasks as an indicator of language disorder.

  2. Language sample analysis is worth taking the time to complete. Structured, standardized language assessments don’t always adequately measure deficits in conversational language skills.

2.png

Check out our previous reviews (there are so many of them!) if you’re feeling stuck on where to begin with language sample analysis. But if you’re involved in research or just curious about the details, be sure to click over to the article for an interesting discussion of which measures the authors chose to use and why.

*before 36 weeks gestation; also, the researchers excluded children with diagnoses that further increased their risk of delays (issues such as chromosomal abnormalities, meningitis, or grade III/IV intraventricular hemorrhage)

 

Imgrund, C. M., Loeb, D. F., & Barlow, S. M. (2019). Expressive Language in Preschoolers Born Preterm: Results of Language Sample Analysis and Standardized Assessment. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_jslhr-l-18-0224

What’s driving our clinical decision-making?

We know a lot about what types of assessment tools SLPs tend to use (see here, here, and here, for example), but we don’t know much about how we synthesize and prioritize the information we gather in those assessments to come up with a diagnosis (or lack thereof). How do we reconcile inconsistent results? What factors tend to carry the most weight? How much do outside influences (i.e. policies and caseload issues) affect our decisions? Two different studies this month dive into the minds of SLPs to begin answering these questions.

Fulcher-Rood et al. begin by pointing out that school-based SLPs receive conflicting information on how to assess and diagnose language disorders from our textbooks, our federal/state/local guidelines and policies, and the research. So how do we actually approach this problem in real life? To learn more, they used a pretty cool case study method, where lots of assessment results were available for each of five, real 4–6-year-olds (cognitive and hearing screenings, parent/teacher questionnaires, three different standardized tests and two different language samples, transcribed and analyzed against SALT norms), but the 14 experienced SLPs who participated only saw the results they specifically asked for to help them make their diagnoses. This better reflects actual practice than just giving the SLPs everything upfront, because in school settings you’re for sure not going to have SPELT-3 scores or LSA stats to consider unless you’re purposefully making that happen. The case studies were chosen so that some showed a match between formal and informal results (all within or all below normal limits), whereas some showed a mismatch between formal and informal testing, or overall borderline results. Importantly, SLPs were instructed not to consider the “rules” of where they work when making a diagnosis.

Here were some major findings:

  • Unsurprisingly, when all data pointed in the same direction, SLPs were unanimous in determining that a disorder was or wasn’t present.

  • When there was conflicting information (standard scores pointed one direction, informal measures the other), almost all the SLPs made decisions aligning with the standardized test results.

  • Across cases, almost all the SLPs looked at CELF-P2 and/or PLS-5 scores to help them make a diagnosis, and in most cases they asked for parent/teacher concerns and language sample transcripts as well. A third of the SLPs didn’t ask for LSA at all.

  • Only a few SLPs used SPELT-3 scores, and no one asked for language sample analyses that compared performance to developmental norms.

These results reinforce what we learned in the survey studies linked above: SLPs use a lot of standardized tests, combined with informal measures like parent/teacher reports, and not so much language sampling. What’s troubling here is the under-utilization of tools that have a really good track record at diagnosis language disorders accurately (like the SPELT-3 and LSA measures), as well as over-reliance on standardized test scores that we know can be problematic—even when there’s tons of other information available and time/workplace policies aren’t a factor.

The second study, from Selin et al., tapped into a much bigger group of SLPs (over 500!), to ask a slightly different question:

5.png

Under ideal conditions, where logistical/workplace barriers are removed, how are SLPs approaching clinical decision-making? And what about the children, or the SLPs themselves, influences those decisions? 

Their method was a little different from the first study. SLPs read a paragraph about each case, including standard scores (TOLD-P:4 or CELF-4, PPVT-4, GFTA-2, and nonverbal IQ) and information about symptoms and functional impairments (use of finiteness, MLU, pragmatic issues, etc.). Rather than giving a diagnosis, the SLPs made eligibility decisions—should the child continue to receive services, and if so, in what area(s) and what type of service (direct, consultation, monitoring, etc.)?

The survey method this team used yielded a TON of information, but we’ll share a few highlights:

  • Freed from the constraints of caseloads and time, SLPs recommended continued service more often than we do in real life. We know that workplace policies and huge caseloads can prevent us from using best practices, but it’s helpful to see that play out in the research. It’s not just you!

  • Six cases were specifically set up to reflect the clinical profile of Specific Language Impairment*, but when determining services and goal areas, SLPs choices didn’t consistently align with that profile. So, even when a case was consistent with SLI, services weren’t always recommended, and when they were, the goals didn’t necessarily correspond with the underlying deficits of that disorder. So as a group, our operational knowledge of EBP for language disorders has a lot of room for improvement. Unlike with speech sound disorders, SLPs were not sensitive to clinical symptoms of SLI (tense/agreement errors, decreased MLU) when making eligibility decisions.

  • Yet again, SLPs relied heavily on standardized scores, even when other evidence of impairments was present.  

So what can you do with all this information? First of all, think about what YOU do in your language assessments. What tools do you lean on to guide your decisions, and why? Are you confident that those choices are evidence-based? Second, keep doing what you’re doing right now—learning the research! There is tons of work being done on assessment and diagnosis of language disorders, use of standardized tests, and LSA (hit the links to take a wander through our archives!). Taking a little time here and there to read up can add up to a whole new mindset before you know it.  

*SLI, or developmental language disorder (DLD) with average nonverbal intelligence.

 

Fulcher-Rood, K., Castilla-Earls, A., & Higginbotham, J. (2019). Diagnostic Decisions in Child Language Assessment: Findings From a Case Review Assessment Task. Language, Speech, and Hearing Services in Schools. doi:10.1044/2019_LSHSS-18-0044

Selin, C. M., Rice, M. L., Girolamo, T., & Wang, C. J. (2019). Speech-Language Pathologists’ Clinical Decision Making for Children With Specific Language Impairment. Language, Speech, and Hearing Services in Schools. doi:10.1044/2018_LSHSS-18-0017

And more...

Recently, we reviewed a study showing that young children with less-developed self-regulation skills needed more time in fluency therapy, and the authors recommended addressing self-regulation concurrently with fluency. But how do you do that? Druker et al. (the team behind that other study) are back with one possible way: training parents to deliver intervention in resilience. Children whose parents received this training reduced emotional and behavioral issues compared to a group who only received fluency therapy. Check out the appendices for examples of the resilience-boosting activities parents were trained to use.  

Ebert et al. studied the relationships among bilingualism, developmental language disorder (DLD), and attention. They found that bilingualism was not related to improved attention (so, no evidence for a hypothesized “bilingual cognitive advantage”), but that DLD was associated with poorer attention skills in both mono- and bilingual children.

Gremp et al. found that children who are DHH have difficulty with nameable visual sequencing tasks (think: the circle handheld Simon game that lights up) compared to hearing peers, which positively predicted receptive vocabulary scores. This highlights the difficulty with both sequencing and describing abstract concepts often experienced by this population. Keep in mind that these were DHH children in primarily spoken English environments, with little-to-no ASL access. The discussion section dives into a deeper discussion of possible causes of these deficits.

Herman et al. examined the literacy skills of oral deaf (OD) children and compared them with another group known to struggle with reading—hearing children with dyslexia. In both groups, letter sound knowledge, phonological skills, and rapid automatic naming abilities were helpful measures for identifying poor readers. Compared with the hearing group, OD children’s skills in phoneme deletion and vocabulary were lower, and also useful for predicting literacy outcomes. The authors discuss implications for literacy assessment and intervention, so check out the full article if you work with this population.

Hessling & Brimo studied the micro- and macrostructure of narrative retells produced by children with Down Syndrome. They describe general patterns of strengths and weaknesses across the children, and found that narrative measures were correlated with both word-level reading and reading comprehension skills. They recommend narrative analysis as a useful assessment and intervention-planning tool for this population.

Nonword repetition is thought to be a non-biased task with high clinical utility for diagnosing language disorders. But if you’re using this task to assess speakers of non-mainstream dialects, McDonald & Oetting suggest you measure the density of non-mainstream forms (through language sampling, an assessment like the DELV, or listener judgments) as part of your assessment, because their new study shows that dialect density can affect nonword repetition scores.

Robinson & Norton examined US national data from 2004–2014 and determined that black American students were disproportionately classified as speech or language impaired in three-quarters of the states. In most cases, these students were over-represented, but some states (those with a larger density of black residents) were likely to under-represent.

 

Druker, K. C., Mazzucchelli, T. G., & Beilby, J. M. (2019). An evaluation of an integrated fluency and resilience program for early developmental stuttering disorders. Journal of Communication Disorders. doi:10.1016/j.jcomdis.2019.02.002

Ebert, K. D., Rak, D., Slawny, C. M., & Fogg, L. (2019). Attention in Bilingual Children With Developmental Language Disorder. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-18-0221

Gremp, M. A., Deocampo, J. A., Walk, A. M., & Conway, C. M. (2019). Visual sequential processing and language ability in children who are deaf or hard of hearing. Journal of Child Language. doi:10.1017/s0305000918000569

Herman, R., E. Kyle, F., & Roy, P. (2019). Literacy and Phonological Skills in Oral Deaf Children and Hearing Children With a History of Dyslexia. Reading Research Quarterly. doi:10.1002/rrq.244

Hessling, A., & Brimo, D. M. (2019). Spoken fictional narrative and literacy skills of children with Down syndrome. Journal of Communication Disorders. doi:10.1016/j.jcomdis.2019.03.005

McDonald, J. L., & Oetting, J. B. (2019). Nonword Repetition Across Two Dialects of English: Effects of Specific Language Impairment and Nonmainstream Form Density. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-18-0253

Robinson, G. C., & Norton, P. C. (2019). A Decade of Disproportionality: A State-Level Analysis of African American Students Enrolled in the Primary Disability Category of Speech or Language Impairment. Language, Speech, and Hearing Services in Schools. doi:10.1044/2018_LSHSS-17-0149

The kids missing from our caseloads

10.png

Kids with developmental language disorder (DLD) can fly under the radar for years without anyone flagging their language weaknesses, including their parents. Hendricks et al. looked into whether parents of first and second graders (6–9-year-olds) with DLD were concerned about their children’s language skills and whether a quick, whole-class screening could distinguish children with and without DLD accurately.

For the language screening, children heard 16 sentences from the Test for Reception of Grammar (TROG-2) and circled picture responses in a booklet. This method meant that it only took 15–20 minutes to screen each class of kids. Children also completed additional language and reading testing, and their parents filled out a questionnaire.

The researchers found that parents of children with DLD rarely reported concerns about their language skills—although parents of children with DLD were twice as likely to have concerns if their children struggled with reading, too. Also, the quick, whole-class screener showed promise for identifying DLD. At the best cutoff score, 76% of children with DLD were correctly flagged, while 25% of children without DLD were incorrectly flagged. While these values aren’t quite at an acceptable level, the trade-off of spending 20 minutes or fewer to screen an entire class of children means that the screener warrants more research.

In summary, if we wait for parents of children with DLD to raise concerns about their language, we might be waiting too long, and parents of children with DLD and average reading skills are especially unlikely to notice that anything is wrong. Screening all children’s language could help identify them sooner; fortunately, efficient screeners show promise!

 

Hendricks, A. E., Adlof, S. M., Alonzo, C. N., Fox, A. B., & Hogan, T. P. (2019). Identifying children at risk for developmental language disorder using a brief, whole-classroom screen. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-18-0093

Girls vs. Boys: Communication differences in autism

16.png

If you work with students with autism, chances are you’ve noticed some communication differences between the boys and girls on your caseload. But how do you quantify these differences? Do they impact treatment? Are they even real?

We’ve touched on this topic before, but there isn’t loads of research on it at the moment. This preliminary study by Sturrock et al. takes a deeper dive into examining the language and communication profiles of females and males with autism.

The study explored the language and communication skills of 9–11-year-old children with ASD and IQ scores in the average range*, compared to age and gender matched peers with typical development (TD). Within both groups, female and male performance were examined separately. Note that each of the four groups was relatively small (13 children per group). Overall, though, they found some surprising (and not so surprising) differences among the groups.

The ASD group as a whole scored about the same as the TD group on measures of expressive and receptive language. However, the authors did see a subtle deficit in the ASD group when it came to narrative language tasks (an issue we’ve discussed before).

But what about those gender-related differences? Well, it turns out that within the ASD group, females outperformed males in pragmatic language and semantic language tasks. However, females with ASD still lagged behind matched females with TD. Another interesting difference? Girls in general consistently scored better than boys on “language of emotion” tasks (like listing as many feeling/emotion words as possible in one minute).

So what we do with these preliminary findings? Primarily, this study can help you consider potential areas of strength and weakness to look out for during evaluation and treatment of children with ASD. Young females with ASD may need some pretty high-end support with pragmatic and narrative skills to communicate effectively with peers (and that support may further require careful attention to that child’s social group— hello, individualization!)

Additionally, the authors make the case that by increasing our awareness of the female ASD profile, a historically under-diagnosed and misdiagnosed condition, we may be able to help these girls get identified and get access to services sooner rather than later.

*The authors refer to this as High-Functioning Autism.

 

Sturrock, A., Yau, N., Freed, J., Adams, C. Speaking the same language? A preliminary investigation comparing the language and communication skills of females and males with High-Functioning Autism. Journal of Autism and Developmental Disorders. doi: 10.1007/s10803-019-03920-6.

And more...

  • Accardo and colleagues provide an overview of effective writing interventions for school-age children with ASD. Most interventions took place in the classroom and used mixed approaches, combining “ingredients” like graphic organizers, video modeling, and constant time delay—a prompting strategy borrowed from ABA. Within the review, Tables 1 and 2 give an idea of what each one looked like, so check that out.

  • Baker & Blacher assessed behavior and social skills in 187 13-year-olds with ASD, intellectual disabilities (ID), or both. They found that having ID along with ASD was not associated with more behavior problems or less developed social skills as compared with ASD only.

  • Cerdán et al. found that eighth graders who had poor comprehension skills correctly answered reading comprehension questions more often when the question was followed by a rephrased, simplified statement telling them exactly what they needed to do.

  • Curran et al. found that preschool-aged children who are DHH and receive remote microphones systems in their homes have significantly better discourse skills (but no better vocabulary or syntax skills) than otherwise-matched children who don’t get those systems.

  • Facon & Magis found that language development, particularly vocabulary and syntax comprehension, does not plateau prematurely in people with Down Syndrome relative to people with other forms of intellectual disability. Language skills continue to show growth in both populations into early adulthood. (We’ve previously reviewed specific interventions that have resulted in language gains among older children and teens with Down Syndrome. )

  • Hu et al. suggest that computer-assisted instruction (CAI) can improve matching skills in school-age children with autism and other developmental disabilities. Although techy and exciting, CAI on its own isn’t enough—evidence-based instructional strategies like prompting and reinforcement have to be programmed in, too. This CAI used discrete trial training, and was more efficient (fewer prompts and less therapy time were needed for mastery!) than a traditional, teacher-implemented approach with flashcards.

  • Lim et al. found that the literacy instruction program MULTILIT was effective with school-age children with Down syndrome. MULTILIT combines phonics and sight word recognition instruction, geared toward children with students who are “Making Up Lost Time in Literacy” (MULTILIT; get it?). The program was implemented 1:1 for 12 weeks, and the students made gains in phonological awareness, word reading and spelling. MULTILIT has been investigated by the developers, but this is the first time it’s been studied by other researchers—and with kids with Down syndrome in particular.  Note: This article wasn’t fully reviewed because the training (provided only in Australia) is not available to the majority of our readers.

  • Muncy et al. surveyed SLPs and school psychologists and found that, in general, these professionals are underprepared to assess and treat children with hearing loss and other, co-occurring disabilities, and that they lack confidence in this area. Participants reported many barriers to valuable collaboration with other professionals, like audiologists (hint: there aren’t enough of them!), and that they want more training in this area.

  • Schlosser et al. found that 3–7 year old children with ASD accurately identified more animated symbols than static symbols. The animated symbols represented verbs; for example, depicting a person turning around versus a still line drawing of “turn around.” It makes sense to see action verbs—well—in action; however, researchers acknowledge we can’t make grid displays full of animated symbols since that could be overstimulating. The next step is to test the effects of animation on symbol identification with other more well-known symbols sets like PCS.

  • Scott et al. used science books and a signed dialogic reading program with an 11-year-old Deaf student, and found increases in the student’s ability to answer comprehension questions.

  • St John et al. found that 92% of their sample of children and adolescents with Klinefelter syndrome also had a communication impairment. Pragmatic, language, and literacy impairments were common, and the researchers described some speech impairments as well. Establishing a comprehensive communication profile for this group is important because we’re still learning about Klinefelter syndrome, which is caused by one or more extra X chromosomes.

  • Updates on PEERS, a structured social skills program for adolescents and young adults we’ve discussed before! Wyman & Claro used the school-based version of PEERS both with adolescents with ASD (the target audience) and those with intellectual disabilities (ID; an overlooked group in social skills research who may benefit nonetheless). Both groups of students improved their social knowledge, and the ID group (but not the ASD group) increased social interactions with friends outside of school. Meanwhile, Matthews et al. found that speeding up the traditional, clinic-based PEERS program, by offering it in 7 weeks (twice weekly sessions) instead of 14, didn’t reduce its effectiveness.

Accardo, A. L., Finnegan, E. G., Kuder, S. J., & Bomgardner, E. M. (2019). Writing Interventions for Individuals with Autism Spectrum Disorder: A Research Synthesis. Journal of autism and developmental disorders, 1-19. doi:10.1007/s10803-019-03955-9

Baker, B. L., & Blacher, J. (2019). Brief Report: Behavior Disorders and Social Skills in Adolescents with Autism Spectrum Disorder: Does IQ Matter? Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-03954-w

Cerdán, R., Pérez, A., Vidal-Abarca, E., & Rouet, J. F. (2019). To answer questions from text, one has to understand what the question is asking: Differential effects of question aids as a function of comprehension skill. Reading and Writing. doi:10.1007/s11145-019-09943-w

Curran, M., Walker, E. A., Roush, P., & Spratford, M. (2019). Using Propensity Score Matching to Address Clinical Questions: The Impact of Remote Microphone Systems on Language Outcomes in Children Who Are Hard of Hearing. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-ASTM-18-0238

Facon, B., & Magis, D. (2019). Does the development of syntax comprehension show a premature asymptote among persons with Down Syndrome? A cross-sectional analysis. American Journal on Intellectual and Developmental Disabilities. doi: 10.1352/1944-7558-124.2.131

Hu, X., Lee, G. T., Tsai, Y, Yang, Y., & Cai, S. (2019). Comparing computer-assisted and teacher-implemented visual matching instruction for children with ASD and/or other DD. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-03978-2

Lim, L., Arciuli, J., Munro, N., & Cupples, L. (2019). Using the MULTILIT literacy instruction program with children who have Down syndrome. Reading and Writing. doi:10.1007/s11145-019-09945-8

Matthews, N. L., Laflin, J., Orr, B. C., Warriner, K., DeCarlo, M., & Smith, C. J. (2019). Brief Report: Effectiveness of an Accelerated Version of the PEERS® Social Skills Intervention for Adolescents. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-03939-9

Muncy, M. P., Yoho, S. E., & McClain, M. B. (2019). Confidence of School-Based Speech-Language Pathologists and School Psychologists in Assessing Students With Hearing Loss and Other Co-Occurring Disabilities. Language, Speech, and Hearing Services in Schools. doi:10.1044/2018_LSHSS-18-0091

Schlosser, R. W., Brock, K. L., Koul, R., Shane, H., & Flynn, S. (2019). Does animation facilitate understanding of graphic symbols representing verbs in children with autism spectrum disorder? Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-18-0243

Scott, J. A., & Hansen, S. G. (2019). Comprehending science writing: The promise of dialogic reading for supporting upper elementary deaf students. Communication Disorders Quarterly. doi:10.1177/1525740119838253

St John, M., Ponchard, C., van Reyk, O., Mei, C., Pigdon, L., Amor, D. J., & Morgan, A. T. (2019). Speech and language in children with Klinefelter syndrome. Journal of Communication Disorders. doi:10.1016/j.jcomdis.2019.02.003 

Wyman, J., & Claro, A. (2019). The UCLA PEERS School-Based Program: Treatment Outcomes for Improving Social Functioning in Adolescents and Young Adults with Autism Spectrum Disorder and Those with Cognitive Deficits. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-03943-z