Girls vs. Boys: Communication differences in autism

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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 9–10-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. 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

Developmental, naturalistic options for preschoolers with autism

There are many, many options for teaching pragmatic skills to children with autism, varying from structured discrete trial training (DTT) to more naturalistic, child-led interventions. Often we think of behavioral and naturalistic approaches to therapy as an either/or. In reality, though, the majority of the interventions available for young children with autism use a naturalistic approach, based on developmental principles, while also pulling in elements of behavioral theory (recently, autism researchers coined the term “naturalistic developmental behavioral intervention,” or NBDI, to reflect these nuances).

This systematic review focuses on developmental social pragmatic (DSP) interventions (similar to NBDIs, but not including any explicit prompting, which is a more behavioral strategy). The researchers carefully defined DSP interventions using a core set of criteria to make sure they pulled just the right group of studies. DSP interventions:

  • Are based on developmental principles (hence the name!)

  • Use natural/play-based settings in therapy

  • Follow the child’s lead

  • Emphasize environmental arrangement and natural communication opportunities, and

  • Avoid explicit prompting (“Say ‘More Blocks’!”)

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Although DSP interventions (like NDBIs) incorporate some behavioral principles, they are not DTT—we’re talking about less structured learning opportunities here. Need examples? Think SCERTS (social communication, emotional regulation, transactional support intervention), DIR (developmental, individual difference, relationship-based intervention), PACT (parent-mediated communication-focused treatment), and More Than Words.

There are a few ways you might use a review like this. Have an intervention in mind and want to see if it made the list? Want to learn more about the evidence base for the intervention your school or clinic is already using? Or maybe you want to look into a new and different intervention for preschoolers with ASD? Whatever your purposes, keep in mind that (as with many systematic reviews and meta analyses) it’s a bit apple-and-oranges to compare the kids’ language outcomes across studies— we need more research to be able to say which DSP interventions lead to the biggest language gains. The results show us, though, that these interventions in general had positive effects on attention, engagement in social interactions, and initiations for preschoolers with ASD. Parent interaction styles improved, too, becoming less directive and more responsive. We love seeing outcomes like that! Overall, this article is a nice place to start organizing your thoughts on the many developmental social pragmatic options available for treating preschoolers with autism. 

Binns, A. V., & Oram Cardy, J. (2019). Developmental social pragmatic interventions for preschoolers with autism spectrum disorder: A systematic review. Autism and Developmental Language Impairments. doi:10.1177/2396941518824497

And more

Hwa-Froelich & Matsuo found that children who were adopted internationally had pragmatic skills within the average range, yet their scores were lower than their non-adopted, typically-developing peers. Understanding the language skill profiles of children adopted internationally is important so that we don’t over-refer or misdiagnose these kids. P.S. We’ve reviewed this team’s research with this same population before here.

In the largest study of its kind to date, Potter, Nievergelt, & VanDam found that children with speech sound disorders have similar tongue strength as their typically-developing peers. This study adds to the evidence base that disputes the use of non-speech oral motor exercises in speech therapy.

Rivera Pérez et al. wondered whether monolingual SLPs could use audio prompting (i.e., pre-recorded stimuli in the home language) to facilitate vocabulary learning in Spanish–English bilingual preschoolers with typical language abilities. Children were taught vocabulary in either English only or in both English and audio prompt-delivered Spanish. All children learned English vocabulary, and only the group receiving audio prompting improved on Spanish vocabulary measures, suggesting audio prompting may help improvement in the home language. We should note that their design didn’t compare the English-only and English-plus-audio-prompting conditions and participants were typically developing children taught by SLPs. Still, more research like this could help identify ways SLPs can better serve their bilingual students. Exciting! 

Roberts et al. found positive effects of teaching preschoolers (including some dual language learners) letter name and letter–sound correspondence. No surprise there—we know how important that skill is! It is interesting that they found no advantage for teaching letter names before letter sounds: the jury’s still out on whether one should be taught before the other.

A study by Sue et al. reminds us to consider generalization not only across contexts but across receptive–expressive language modalities. In a single case design on vocabulary training in children with ASD, where children were taught a set of words either receptively or expressively, they found that some but not all of those words taught were acquired in the untrained modality. More expressive-to-receptive transfer was noted—which makes a lot of sense. There are still open questions about the optimal teaching order (if there is one) and what the implications are for dosage.

 

Hwa-Froelich, D. A., & Matsuo, H. (2019). Pragmatic language performance of children adopted internationally. American Journal of Speech–Language Pathology. doi:10.1044/2018_AJSLP-18-0075

Potter, N. L., Nievergelt, Y., & VanDam, M. (2019). Tongue strength in children with and without speech sound disorders. American Journal of Speech–Language Pathology. doi:10.1044/2018_AJSLP-18-0023

Rivera Pérez, J. F., Creaghead, N. A., Washington, K., Guo, Y., Raisor-Becker, L., & Combs, S. (2019). Using Audio Prompting to Assist Monolingual Speech–Language Pathologists to Teach English–Spanish Vocabulary to English Learners. Communication Disorders Quarterly. doi:10.1177/2F1525740118819659

Roberts, T. A., Vadasy, P. F., & Sanders, E. A. (2019). Preschoolers’ alphabet learning: Cognitive, teaching sequence, and English proficiency influences. Reading Research Quarterly. doi:10.1002/rrq.242

Su, P. L., Castle, G., & Camarata, S. (2019). Cross-modal generalization of receptive and expressive vocabulary in children with autism spectrum disorder. Autism & Developmental Language Impairments. doi:10.1177/2F2396941518824495

And more...

Chester et al. enrolled school-aged children with ASD in group social skills training that included play (unstructured or semi-structured) for 8 weeks. They found that participants gained social skills (as rated by parents, teachers, and the children themselves) compared to waiting controls.  

Conlon et al. looked at narratives (via the ERNNI) produced by 8-year-old boys and girls with ASD and average nonverbal intelligence. While we know that children with ASD often struggle with narratives in general, there may be important gender-related differences. This study found that girls’ stories were more complete, included more information about characters’ intentions, and were easier to follow (i.e. they had better referencing).

Joseph used word boxes (a low-tech method using drawn rectangles and letter tiles) to teach sound segmentation, word identification, and spelling skills to three third graders with autism, and found that all children improved on sound segmentation and word ID and two children improved on spelling. 

Montallana et al. studied inter-rater reliability of the VB-MAPP Milestones and Barriers assessments. The VB-MAPP is commonly used to assess and plan intervention for children with ASD, but we haven’t known much about its psychometrics. While the milestones section had largely moderate to good reliability, agreement between raters on barriers was poor to moderate.  

Thirumanickam et al. found that a video-based modeling intervention was effective in increasing conversational turn-taking in a small number of adolescents with ASD who used AAC—BUT, only when provided with additional instruction (least-to-most prompting). They stated that for students with ASD, some level of prompting is likely required to engage in video-based interventions.

 

Chester, M., Richdale, A. L., & McGillivray, J. (2019). Group-Based Social Skills Training with Play for Children on the Autism Spectrum. Journal of Autism and Developmental Disorders. Advance online publication. doi:10.1007/s10803-019-03892-7

Conlon, O., Volden, J., Smith, I. M., Duku, E., Zwaigenbaum, L., Waddell, C., … Pathways in ASD Study Team. (2019). Gender Differences in Pragmatic Communication in School-Aged Children with Autism Spectrum Disorder (ASD). Journal of Autism and Developmental Disorders. Advance online publication. doi:10.1007/s10803-018-03873-2

Joseph, L. M. (2018). Effects of word boxes on phoneme segmentation, word identification, and spelling for a sample of children with autism. Child Language Teaching and Therapy34(3), 303–317.

Montallana, K. L., Gard, B. M., Lotfizadeh, A. D., & Poling, A. (2019). Inter-Rater Agreement for the Milestones and Barriers Assessments of the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP). Journal of Autism and Developmental Disorders. Advance online publication. doi:10.1007/s10803-019-03879-4

Thirumanickam, A., Raghavendra, P., McMillan, J. M., & van Steenbrugge, W. (2018). Effectiveness of video-based modelling to facilitate conversational turn taking of adolescents with autism spectrum disorder who use AAC. Augmentative and Alternative Communication, 34(4), 311–322.

And more...

  • Briley & Ellis found that 52% of children who stutter (CWS; ages 3–17) also had at least one additional developmental disability, compared to just 15% of children who do not stutter (CWNS), per parent report gathered in a large-scale survey. Specifically, CWS had significantly higher odds of having intellectual disability, learning disability, ADHD/ADD, ASD, or another delay than CWNS.

  • Deevy and Leonard found that preschoolers with DLD were less sensitive to number information (i.e. is vs. are) in sentences with fronted auxiliary verbs than younger, typically developing children. “Is the nice little boy running?” is an example of this form (note the auxiliary “is” at the front of the sentence). The authors suggest children with DLD might need explicit instruction to understand tense and agreement markers—in other words, it might not be enough to just practice producing them correctly.

  • Duncan & Lederberg examined the ways that teachers of K–2nd grade deaf/hard of hearing children communicated in the classroom and related it to the students’ language outcomes. They found that explicitly teaching vocabulary predicted improvements in both vocabulary and morphosyntax over the school year, and that reformulating/recasting children’s statements also predicted vocabulary growth.

  • Kelly et al. interviewed teenagers with high-functioning autism, who reported their perceptions of their own social communication skills. They shared individual experiences with challenges with verbal and nonverbal communication, managing challenging feelings during communication with peers, and feelings of isolation and rejection.

  • Mandak et al.* added to the evidence on Transition to Literacy (T2L) features in AAC software with visual scene displays (VSDs). They found that when digital books were programmed with these features—hotspots that, when touched, would speak the target word and display it dynamically—and used in therapy for preschool-aged children with autism, the children made gains in the ability to read targeted sight words.

  • Goodrich et al. administered three subtests of the Test of Preschool Early Literacy (TOPEL) to 1,221 preschool children, including 751 who were Spanish-speaking language-minority children. Despite the TOPEL being written in English, they found that it provided reliable and valid measures of Spanish-speaking preschoolers’ early literacy skills in English.

*Disclosure: Kelsey Mandak is a writer for The Informed SLP. She was not involved in the selection or review of this article.  

Briley, P. M., & Ellis, C., Jr. (2018). The Coexistence of Disabling Conditions in Children Who Stutter: Evidence From the National Health Interview Survey. Journal of Speech, Language, and Hearing Research. Advance online publication. doi:10.1044/2018_JSLHR-S-17-0378

Deevy, P., & Leonard, L. (2018). Sensitivity to morphosyntactic information in preschool children with and without developmental language disorder: A follow-up study. Journal of Speech, Language, and Hearing Research. Advance online publication. doi:10.1044/2018_JSLHR-L-18-0038

Duncan, M. K., & Lederberg, A. R. (2018). Relations Between Teacher Talk Characteristics and Child Language in Spoken-Language Deaf and Hard-of-Hearing Classrooms. Journal of Speech, Language, and Hearing Research. Advance online publication. doi:10.1044/2018_JSLHR-L-17-0475

Goodrich, J. M., Lonigan, C. J., & Alfonso, S. V. (2019). Measurement of early literacy skills among monolingual English-speaking and Spanish-speaking language-minority children: A differential item functioning analysis. Early Childhood Research Quarterly. doi: 10.1016/j.ecresq.2018.10.007

Kelly, R., O’Malley, M., Antonijevic, S. (2018). ‘Just trying to talk to people… it’s the hardest’: Perspectives of adolescents with high-functioning autism spectrum disorder on their social communication skills. Child Language Teaching and Therapy. doi:10.1177/0265659018806754

Mandak, K., Light, J., & McNaughton, D. (2018). Digital Books with Dynamic Text and Speech Output: Effects on Sight Word Reading for Preschoolers with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. Advance online publication. doi: 10.1007/s10803-018-3817-1

Throwback (2013): Grammar intervention for… social & literacy skills?

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Children with language disorders often struggle with social skills and literacy. While their IEPs might reflect grammatical deficits, we must consider how language issues might impact other areas of student’s lives. Is there a way to sneakily incorporate social and literacy skills into our grammatical interventions in an evidence-based way? The short answer is... yes!

Washington (2013) hypothesized that expressive grammar intervention could naturally support preschoolers to improve their social interaction and print concepts. In this intervention, preschoolers were asked to engage in a sentence-building task aimed at forming subject-verb-object sentences given various prompts. However, in addition to typical language-related prompting, SLPs integrated social and print concept features throughout therapy. Some of the techniques included:  

  • Guidance for listening and turn taking

  • Modeling appropriate toy play

  • Facilitating interactions with peers

  • Use of visuals to highlight morphemes

  • Pointing to words and letters while turning pages of a book

  • Highlighting book conventions such as directionality and orientation

These are things that many of us probably do without thinking during various types of therapy. However, this study provided evidence that purposefully adding elements of social and literacy skills can lead to significant, broad-based enrichment of social skills and emergent literacy. Children even maintained these social and literacy improvements for three months post-intervention. Your students with language disorders can get a three-for-one deal, just by attending your therapy sessions!

 

Washington, K. N. (2013). The association between expressive grammar intervention and social emergency literacy outcomes for preschoolers with SLI. American Journal of Speech-Language Pathology, 22, 113–125.

And more...

Brinton et al. found that five elementary-age children with DLD rarely described characters’ mental states (responses, plans, emotions) when generating stories and struggled to answer direct questions about characters’ mental states. The authors suggest that children with DLD may have difficulty with social and emotional concepts. 

Chenausky et al. found that baseline phonetic inventory and ADOS scores were most predictive of speech target approximations post-speech therapy in minimally verbal children with autism (more than IQ, language, age). And that’s not terribly surprising (except the age part—cool that they made good speech gains in older elementary children!). Perhaps the more interesting thing about this study, though, is what they did in speech therapy. It’s called “auditory motor map training”, and is basically the addition of rhythm (tapping drums) and intonation (singing the speech targets) to speech therapy. The researchers are finding that adding these tactile and auditory cues is better than not having them; so worth trying! 

Cooke and Millard asked school-aged children who stutter what they considered to be the most important therapy outcomes. The children reported increased fluency, independence, and confidence, as well as others knowing how to support them and how to make communication situations feel easier. This study serves as a good reminder that stuttering is more than dysfluent speech. The cognitive (thoughts and attitudes) and affective (feelings) components should also play a role in how we evaluate therapy outcomes.  

Dyson et al. taught 20 vocabulary words to elementary-age children with low vocabulary scores using examples, games, and worksheets. After 10 weeks of 20-minute small-group sessions, children learned five new words on average; significantly more than children in a control group. (Email the authors for free materials!)

Giusto and Ehri found that third-graders with poor decoding and average listening comprehension benefitted from a partial-read aloud test accommodation with pacing (PRAP). When examiners read aloud only directions, proper nouns, and multiple choice questions, the students improved their reading comprehension of the test passages. Although you may not be directly assessing these students, these findings may be helpful if you’re ever in the position to recommend accommodations for this subset of children.

Gough Kenyon et al. found that, compared to typical peers, 10- to 11-year-olds with developmental language disorder (DLD) struggled with making elaborative inferences (drawing on background knowledge not stated) but not cohesive inferences (linking information given) after reading a passage. They suggest targeting elaborative inferencing to boost reading comprehension for children with DLD.

Millard et al. add to the evidence base for Palin Parent–Child Interaction Therapy for young children who stutter, finding a reduction in stuttering severity and improvements in both parent and child attitudes and confidence following a year of participation in the program.

Sabri & Fabiano-Smith analyzed a case study and found that, given early implantation and support in both languages, a bilingual child with cochlear implants can acquire two phonological systems, although likely at a slower rate than other bilingual children.

Using (and maybe struggling with) the Lidcombe Program with your young clients who stutter? Van Eerdenbrugh et al. studied the challenges clinicians have with implementing the program and surveyed experts to come up with solutions.

 

Brinton, B., Fujiki, M., & Asai, N. (2018). The ability of five children with developmental language disorder to describe mental states in stories. Communication Disorders Quarterly. Advance online publication. doi: 10.1177/1525740118779767.

Chenausky, K., Norton, A., Tager-Flusberg, H., & Schlaug, G. (2018). Behavioral predictors of improved speech output in minimally verbal children with autism. Autism Research. Advance Online Publication. doi: 10.1002/aur.2006.

Cooke, K., & Millard, S. K. (2018). The most important therapy outcomes for school-aged children who stutter: An exploratory study. American Journal of Speech-Language Pathology, 27(3S), 1152.

Dyson, H. , Solity, J. , Best, W. and Hulme, C. (2018), Effectiveness of a small‐group vocabulary intervention programme: evidence from a regression discontinuity design. International Journal of Language & Communication Disorders, 53: 947-958. doi:10.1111/1460-6984.12404

Giusto, M., & Ehri, L. C. (2018). Effectiveness of a partial read-aloud test accommodation to assess reading comprehension in students with a reading disability. Journal of Learning Disabilities. Advance online publication. doi:10.1177/0022219418789377

Gough Kenyon, S. M., Palikara, O., & Lucas, R. M. (2018). Explaining reading comprehension in children with developmental language disorder: The importance of elaborative inferencing. Journal of Speech, Language, and Hearing Research, 61(10), 2517–2531. 

Millard, S. K., Zebrowski, P., & Kelman, E. (2018). Palin Parent–Child Interaction Therapy: The Bigger Picture. American Journal of Speech–Language Pathology, 27(3S), 1211–1223.

Sabri, M. & Fabiano-Smith, L. (2018). Phonological Development in a Bilingual Arabic–English-Speaking Child With Bilateral Cochlear Implants: A Longitudinal Case Study. American Journal of Speech–Language Pathology. Advance online publication. doi: 10.1044/2018_AJSLP-17-0162.

Van Eerdenbrugh, S., Packman, A., O'Brian, S., & Onslow, M. (2018). Challenges and Strategies for Speech-Language Pathologists Using the Lidcombe Program for Early Stuttering. American Journal of Speech–Language Pathology, 27(3S), 1259–1272.

Preschool peer-mediated video modeling

Much of the early childhood school day involves play or peer interactions. We’ve talked before about peer-mediated interventions for preschoolers with autism (e.g., here, here, and here). It’s no surprise to SLPs that there’s also a growing evidence base for using video modeling with this population. Since preschoolers with autism may need structured opportunities to learn and practice social skills, you could use video modeling or you could include a typically developing peer in intervention, or… you could use both (aka: joint video modeling)!

Including a peer is what makes joint video modeling different. Since we’re talking about preschoolers here, the authors needed to do some structured training with those peers. First, the preschool director and head teacher selected “play partners”—peers with age appropriate social skills and good interactions with classmates with autism. The authors showed the play partner a picture of the other child, explained the difficulties the child had during play, and read a book about understanding differences. Then, through role play and video modeling, the play partners learned how to initiate during play. 

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Now on to the joint video modeling intervention: The four-year-old dyads jointly (sitting next to each other listening via split headphones) watched a 30-second video model twice on an iPad. Cool note about the video models: Although they showed adults’ hands manipulating toys, they were based on typically developing preschoolers’ play with those same toys. So if you need some inspiration, you may need to look no further than peers in the classroom! 

After intervention, the children with autism used more scripted verbalizations (from the videos) and unscripted verbalizations (even better!) during pretend play—and generalized the skills with other peers even after the videos were taken away. We still need more information on how the skills were maintained, and to help explain the individual differences within the participants’ performance, but joint video modeling is definitely showing promise.

 

Dueñas, A. D., Plavnick, J. B., & Bak, M. Y. S. (2018). Effects of Joint Video Modeling on Unscripted Play Behavior of Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-018-3719-2