Problem behavior in young children referred with language difficulties: Relations to language and intentional communication

Profiles of nonverbal skills used by young pre-verbal children with autism on the ADOS-2: Relation to screening disposition and outcomes

Autistic individuals exhibit differences in their use and understanding of nonverbal communication; however, individual patterns of nonverbal strengths and challenges vary significantly. This heterogeneity can complicate the diagnostic and screening processes and can result in delayed or missed diagnoses. In this study, we characterize various profiles of nonverbal communication skills among 215 pre-verbal children with autism (Mage = 36.27 months, range = 18-70) and explore how these profiles are related to screening outcomes, diagnostic certainty, and developmental and behavioral features. We conducted a latent class analysis of nine items assessing nonverbal communication skills from the Toddler Module and Module 1 of the Autism Diagnostic Observation Schedule, 2nd Edition. Five nonverbal profiles were identified that differentiated children based on the form, function, and frequency of their nonverbal communication skills. Furthermore, screening outcomes and clinician certainty in autism diagnosis varied by nonverbal profile. False negative screening outcomes based on parent report were highest for children who used a range of nonverbal skills but with limited frequency or consistency. Clinicians, on the other hand, tended to have high certainty in an autism diagnosis for children with this profile, and instead rated their lowest certainty in diagnosing children who demonstrated consistent integration of eye contact with their nonverbal communication. The profiles identified in this study could be clinically useful in helping to identify children at highest likelihood of being overlooked during the screening or diagnostic processes, providing an opportunity to improve early identification and intervention for autism.

Understanding Internalizing and Externalizing Behaviors in Autistic Toddlers

PURPOSE

The majority of autistic toddlers present with clinically significant levels of internalizing or externalizing behaviors. Despite the prevalence of internalizing and externalizing behaviors in caseloads, the overwhelming majority of speech-language pathologists (SLPs) have not received specialized instruction in how to support children with these behaviors. The purpose of this study was to identify which child and caregiver characteristics are most associated with internalizing and externalizing behaviors in autistic toddlers in order to consider how SLPs may tailor their treatment to better support the individual needs of autistic children.

METHOD

Participants included 109 mothers and their autistic children between 18 and 48 months of age. This study was a secondary analysis of data from a randomized clinical trial. Participants' baseline data included a variety of child (i.e., expressive language, receptive language, restricted and repetitive behavior [RRB], and nonverbal cognition) and caregiver (i.e., self-efficacy and responsiveness) characteristics. Seemingly unrelated regressions were conducted to determine which characteristics were associated with internalizing and externalizing behaviors in autistic toddlers.

RESULTS

Higher RRB scores were associated with both higher internalizing and externalizing behavior scores. A lower nonverbal cognition score was also associated with higher internalizing behavior scores but to a lesser extent than RRB.

CONCLUSION

These findings suggest that SLPs may support internalizing and externalizing behaviors in autistic children by taking RRBs and nonverbal cognition into consideration.

A Storytelling Approach on Vocabulary, Reading, and Letter Sound Fluency of Struggling First Graders With German as Second Language With and Without Behavioral Problems

The number of students learning German as a second language (L2) is steadily increasing. Unfortunately, studies reveal that less-proficient school performance affects a larger proportion of these students and additional behavioral problems can create even greater learning barriers. In order to master a language, the focus is not only on vocabulary, but also on reading, and studies show that multi-component intervention in reading and L2 acquisition is particularly promising. Therefore, this multiple baseline study focuses on a multi-component storytelling intervention on vocabulary, reading, and letter sound fluency of low-achieving first graders with German as L2 with and without behavioral problems (N = 7). The intervention was implemented 3 times a week over a 6-week period. Results show significant large to very large effects on vocabulary and moderate to large effects on letter sound fluency and reading, providing indication for the positive impact of storytelling on multiple aspects simultaneously for the focused sample.