Validity of Vocal Communication and Vocal Complexity in Young Children with Autism Spectrum Disorder

Effects of a Contingent Responses Intervention on the Quantity and Quality of Vocalizations of Preschool Children with Autism Spectrum Disorder

Multiple contemporary theories emphasize the quantity and quality of child vocalizations for promoting spoken language acquisition. Yet, empirical evidence for facilitating vocal development is strikingly lacking including for children with autism spectrum disorder (ASD) who have difficulty developing language. We evaluate use of contingent responses and vocal enhancement strategies to increase the quantity and quality of child vocalizations to which adults can respond with language-facilitating input for children with ASD. Three preschool children with ASD and minimal verbal skills participated. Using an alternating treatments design embedded within a multiple probe across participants design, we compared using contingent responses with and without vocal enhancement strategies versus a non-contingent control condition. Based on visual analysis and effect sizes, all participants showed a functional relation between both active intervention conditions and quantity of vocalizations, as predicted. For quality of vocalizations, changes under the active intervention conditions were less pronounced than those observed for quantity. Two participants showed a functional relation between at least one quality variable and the active interventions. Our hypothesis that vocal enhancement strategies would exhibit a value-added effect was partially supported for quantity and quality. Findings support using contingent responses to improve the quantity and to some degree the quality of vocalizations in young children with ASD and minimal verbal skills. Support for the added value of vocal enhancement strategies was mixed. Refining the intervention strategies is warranted to meet the needs of the understudied population of children with ASD and minimal verbal skills.

Implementation of an Early Communication Intervention for Young Children with Cerebral Palsy Using Single-Subject Research Design

The implementation of an intervention protocol aimed at increasing vocal complexity in three pre-linguistic children with cerebral palsy (two males, starting age 15 months, and one female, starting age 16 months) was evaluated utilising a repeated ABA case series design. The study progressed until the children were 36 months of age. Weekly probes with trained and untrained items were administered across each of three intervention blocks. Successive blocks targeted more advanced protophone production and speech movement patterns, individualised for each participant. Positive treatment effects were seen for all participants in terms of a greater rate of achievement of target protophone categories and speech movement patterns. Tau coefficients for trained items demonstrated overall moderate to large AB phase contrast effect sizes, with limited evidence of generalisation to untrained items. Control items featuring protophones and speech movements not targeted for intervention showed no change across phases for any participant. Our data suggest that emerging speech-production skills in prelinguistic infants with CP can be positively influenced through a multimodal intervention focused on capitalising on early periods of plasticity when language learning is most sensitive.

The Influence of Communication Sample Length on Reliability and Convergent Validity of Vocal Measures Derived From the Communication Complexity Scale

PURPOSE

This study examines the effects of communication sample length on the reliability and convergent validity of six vocal measures for children with autism spectrum disorder (ASD) with minimal verbal skills. The results are expected to inform recommendations for the length of communication samples for clinical and research purposes.

METHOD

Participants included 31 children with ASD (24 boys and seven girls; M _age = 6;7 [years;months], SD = 17 months) with minimal verbal skills. We coded six vocal measures that focus on vocalizations and early word productions from the Communication Complexity Scale (CCS) scripted administration protocol. To evaluate reliability of different sample lengths, we calculated intraclass correlation coefficients between the full CCS sample and 1-, 3-, 7-, 10-, and 20-min samples. To examine convergent validity, we calculated correlations between the six vocal measures for each sample length.

RESULTS

When coded from 10-min samples from the beginning of the CCS, all of the vocal measures exhibit adequate reliability with the full CCS sample. Some vocal measures exhibit adequate reliability with samples as short as 3 min. For convergent validity, all of the correlations between the vocal measures exceed .40 and are statistically significant for the 10-min samples except for some of the correlations with the proportion of communicative vocalizations. Similar results were found for other sample lengths.

CONCLUSION

Findings support coding 10-min segments from the CCS scripted administration protocol to evaluate the vocal development skills of children with ASD with minimal verbal skills.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20999938.

The role of early social motivation in explaining variability in functional language in toddlers with autism spectrum disorder

LAY ABSTRACT

About one-third of children with autism spectrum disorder never develop the language that they need in different day-to-day situations. Identifying potential factors that can predict later language development is crucial to understanding why some children with autism spectrum disorder successfully develop language while others do not. This study sought to investigate one of the understudied predictors of language development, social motivation, and to test theories for why this association may occur. Testing the theories requires that we measure children's ability to deliberately and directly communicate with others (i.e. intentional communication) and children's language understanding between the measures of social motivation and later expressive language. We tested 87 children with autism spectrum disorder, aged 14-31 months, at four times over 24 months. We found that children with relatively stronger social motivation had relatively better language use 2 years later. This positive link was partly due to a child's ability to produce intentional communication and to understand language. Although we did not measure parents' talking to their children, a theory that inspired this study suggests that children who use frequent intentional communication probably motivate others to talk with them frequently, which facilitates children's language understanding which leads to the development of expressive language. This theory, if confirmed to be true, can provide guidance for parents who want to help their children learn to talk. Parents could look for intentional communication from their children and respond by talking to their children. Effective intervention on both parent and child targets will likely enhance treatment efficacy. Future work is needed to test these ideas.

Predicting Expressive Language From Early Vocalizations in Young Children With Autism Spectrum Disorder: Which Vocal Measure Is Best?

Purpose This study was designed to test the incremental validity of more expensive vocal development variables relative to less expensive variables for predicting later expressive language in children with autism spectrum disorder (ASD). We devote particular attention to the added value of coding the quality of vocalizations over the quantity of vocalizations because coding quality adds expense to the coding process. We are also interested in the added value of more costly human-coded vocal variables relative to those generated through automated analyses. Method Eighty-seven children with ASD aged 13-30 months at study initiation participated. For quantity of vocalizations, we derived one variable from human coding of brief communication samples and one from an automated process for daylong naturalistic audio samples. For quality of vocalizations, we derived four human-coded variables and one automated variable. A composite expressive language measure was derived at study entry, and 6 and 12 months later. The 12 months-centered intercept of a simple linear growth trajectory was used to quantify later expressive language. Results When statistically controlling for human-coded or automated quantity of vocalization variables, human-coded quality of vocalization variables exhibited incremental validity for predicting later expressive language skills. Human-coded vocal variables also predicted later expressive language skills when controlling for the analogous automated vocal variables. Conclusion In sum, these findings support devoting resources to human coding of the quality of vocalizations from communication samples to predict later expressive language skills in young children with ASD despite the greater costs of deriving these variables. Supplemental Material https://doi.org/10.23641/asha.12276458.