scholarly journals Feasibility of an app-based parent-mediated speech production intervention for minimally verbal autistic children: development and pilot testing of a new intervention

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Jo Saul ◽  
Courtenay Norbury
Keyword(s):  
Speech Production ◽  
Intervention Studies ◽  
Pilot Trial ◽  
Small Scale ◽  
Autistic Children ◽  
Minimally Verbal ◽  
Experimental Control ◽  
Schedule Time ◽  
Children Development ◽  
Phase Design

Abstract Background Training speech production skills may be a valid intervention target for minimally verbal autistic children. Intervention studies have explored various approaches albeit on a small scale and with limited experimental control or power. We therefore designed a novel app-based parent-mediated intervention based on insights from the video modelling and cued articulation literature and tested its acceptability and usage. Methods Consultation with the autism community refined the initial design and culminated in a pilot trial (n = 19) lasting 16 weeks. Participants were randomly allocated an intervention duration in an AB phase design and undertook weekly probes during baseline and intervention via the app. We evaluated the acceptability of the intervention via feedback questionnaires and examined the usability variables such as adherence to the testing and intervention schedule, time spent on the app and trials completed during the intervention phase. Results High acceptability scores indicated that families liked the overall goals and features of the app. Ten participants engaged meaningfully with the app, completing 82% of the test trials and uploading data in 61% of intervention weeks; however, of these, only three met the targeted 12.5 min of intervention per week. Conclusion We discuss the possible reasons for variability in usage data and how barriers to participation could be surmounted in the future development of this intervention.

scholarly journals A Randomized Case Series Approach to Testing Efficacy of Interventions for Minimally Verbal Autistic Children

2021 ◽  
Vol 12 ◽  
Author(s):  
Jo Saul ◽  
Courtenay Norbury
Keyword(s):  
Speech Production ◽  
Effect Size ◽  
Single Case ◽  
Case Series ◽  
Randomization Test ◽  
Language Outcomes ◽  
Autistic Children ◽  
Minimally Verbal ◽  
Baseline Design ◽  
Case Effect

BackgroundRandomized Controlled Trials (RCTs) are the gold standard for assessing whether an intervention is effective; however, they require large sample sizes in order to detect small effects. For rare or complex populations, we advocate a case series approach as a more realistic and useful first step for intervention evaluation. We consider the importance of randomization to such designs, and advocate for the use of Randomization Tests and Between Case Effect Sizes to provide a robust and statistically powerful evaluation of outcomes. In this tutorial, we describe the method, procedures, and analysis code necessary to conduct robust single case series, using an empirical example with minimally verbal autistic children.MethodWe applied a pre-registered (https://osf.io/9gvbs) randomized baseline design with between-case effect size to a case series (n = 19), to test the efficacy of a novel, parent-mediated, app-based speech production intervention (BabbleBooster) for minimally verbal autistic children. Parent-rated probe scores were used to densely sample performance accuracy over time.ResultsParents were able to reliably code their children’s speech productions using BabbleBooster. A non-significant Randomization Test and small Between-Case Effect Size (d = 0.267), suggested there was no evidence that BabbleBooster improved speech production in minimally verbal autistic children, relative to baseline scores, during this brief period of intervention.ConclusionThe current analyses exemplify a more robust approach to examining treatment effects in rare or complex populations, where RCT may be difficult or premature to implement. To facilitate adoption of this method by researchers and practitioners, we provide analysis code that can be adapted using open source R packages. Future studies could use this case series design to evaluate interventions aiming to improve speech and language outcomes for minimally verbal autistic children, and other heterogeneous and hard to reach populations.

scholarly journals Maternal toxoplasmosis and the risk of childhood autism: serological and molecular small-scale studies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jamila S. Al Malki ◽  
Nahed Ahmed Hussien ◽  
Fuad Al Malki
Keyword(s):  
Neurodevelopmental Disorders ◽  
Repetitive Behavior ◽  
Saudi Arabian ◽  
Childhood Autism ◽  
Small Scale ◽  
Autistic Children ◽  
High Prevalence ◽  
Life Threatening ◽  
The Relationship ◽  
Delayed Language Development

Abstract Background Toxoplasmosis resulting from infection with the Toxoplasma parasite has become an endemic disease worldwide. Recently, a few studies have reported a high prevalence of Toxoplasmosis infections among Saudi Arabian women. This disease could become life threatening for pregnant women and for immunodeficient people. There is evidence that infections during pregnancy, especially in the early stages, are associated with neurodevelopmental disorders. Autism disorder represents one of the most common neurodevelopmental disorders worldwide; it is associated with delayed language development, weak communication interaction, and repetitive behavior. The relationship between prenatal toxoplasmosis and autism in childhood remains unclear. The present study aims to report a link between maternal toxoplasmosis and autistic offspring among Saudi Arabian women. Method Blood samples (36 maternal, 36 from their non-autistic children, and 36 from their autistic children) were collected for serological and molecular evaluation. Results A toxoplasmosis infection was reported for 33.34% of participants using an ELISA assay (5.56% IgG+/IgM+, 11.11% IgG−/IgM+, and 16.67% IgG+/IgM-); however, a nested PCR assay targeting B1 toxoplasmosis specific genes recorded positive tests for 80.56% of the samples. In addition, the present study detected several points of mutation of mtDNA including NADH dehydrogenase (ND1, ND4) and Cyt B genes and the nDNA pyruvate kinase (PK) gene for autistic children infected with toxoplasmosis. Conclusion Considering previous assumptions, we suggest that a maternal toxoplasmosis infection could have a role in the development of childhood autism linked to mtDNA and nDNA impairment.

scholarly journals Inclusive school practices supporting the primary to secondary transition for autistic children: pupil, teacher, and parental perspectives

2018 ◽  
Vol 4 (4) ◽  
pp. 184-196 ◽  
Author(s):  
Keri Hoy ◽  
Sarah Parsons ◽  
Hanna Kovshoff
Keyword(s):  
Young People ◽  
Secondary School ◽  
School Transition ◽  
Effective Practices ◽  
Small Scale ◽  
Autistic Children ◽  
Content Type ◽  
Secondary School Transition ◽  
Practical Implications

Purpose The primary to secondary school transition can have a significant and long-lasting impact on young people. Autistic children are particularly vulnerable to negative transition experiences; however, there is a lack of research examining effective practices and provision for these pupils. This case study involves a mainstream secondary school in the South of England, which has a dedicated Learning Support base. The purpose of this paper is to collect qualitative data on experiences of the primary to secondary school transition from multiple stakeholders. Design/methodology/approach A photovoice activity followed by a semi-structured interview was conducted with five autistic pupils aged 12–16 years; semi-structured interviews were also carried out with six parents and four teachers. Findings Five key themes emerged from the data in relation to effective practices: inclusion, child-centred approach, familiarisation, visual supports and communication and consistency. Research limitations/implications As a small-scale case study, there are limitations regarding generalisation. However, this research illuminates transition practices that are experienced as effective by autistic children, their families and teachers. Practical implications Practical implications related to each of these themes are highlighted. These implications are important in the context of the mandatory responsibilities of schools in England to include the voices of children and young people with special educational needs in decisions about their education. Originality/value The findings challenge a rights-based approach to inclusion and illustrate the importance of a needs-based approach which appropriately recognises and understands what autism means for children, their families and the teachers who support them.

scholarly journals Trajectories and perceptual precursors of intelligence in minimally verbal autistic children from preschool to school age

2021 ◽  
Author(s):  
Dominique Girard ◽  
Valérie Courchesne ◽  
Catherine Cimon-Paquet ◽  
Claudine Jacques ◽  
Isabelle Soulières
Keyword(s):  
Preschool Age ◽  
School Age ◽  
Autistic Children ◽  
Minimally Verbal ◽  
Verbal Iq ◽  
Time Points ◽  
Embedded Figures Test ◽  
Intellectual Abilities ◽  
Embedded Figures ◽  
Perceptual Abilities

Abstract Background The question of cognitive prognosis is frequently asked at the time of autism diagnosis, often at preschool age. It remains however difficult to answer this question at such a young age, given the considerable heterogeneity of cognitive development trajectories and the challenges associated with intellectual assessment in autistic children, particularly among minimally verbal children. Methods The current prospective cohort study investigated whether early perceptual abilities measured at preschool age could predict later intellectual abilities at school age in a group of 41 autistic (9 girls, 32 boys) and 57 neurotypical children (29 girls, 28 boys). Participants were assessed at three time points during the childhood period (between the age of 2 and 8 years old) using the Wechsler Preschool and Primary Scales of Intelligence – Fourth edition as a measure of full-scale IQ and the Raven’s Colored Progressive Matrices as a measure of non-verbal IQ. The performance on two perceptual tests (Visual Search and Children Embedded Figures Test) as well as the frequency of perceptual behaviors served as predictors of later intellectual abilities. Results Early performance on perceptual tests measured at preschool age was positively related to later full-scale IQ in both autistic and neurotypical children. Furthermore, both perceptual behaviors and performance on perceptual tests measured at preschool age were associated with later non-verbal IQ in the autistic group. In contrast, only the performance on Children Embedded Figures Test was associated with later non-verbal IQ in the neurotypical group. Limitations: The sample size was relatively modest, with some attrition across time points, as expected in a sample including preschool minimally and non-verbal children. Conclusions Our findings support the important role of perception in autistic cognition. Early perceptual abilities may be a valid avenue for estimating general intelligence and non-verbal abilities at preschool age, particularly for minimally verbal autistic children.

scholarly journals Does phonetic repertoire in minimally verbal autistic preschoolers predict the severity of later expressive language impairment?

Autism ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1217-1231 ◽  
Author(s):  
Jo Saul ◽  
Courtenay Norbury
Keyword(s):  
Language Development ◽  
Speech Production ◽  
Joint Attention ◽  
Expressive Language ◽  
Speech Sounds ◽  
Minimally Verbal ◽  
Communicative Intent ◽  
Response To Joint Attention ◽  
Language Growth ◽  
Expressive Language Development

Trajectories of expressive language development are highly heterogeneous in autism. Yoder et al. found that parental responsiveness, child response to joint attention, child communicative intent and consonant inventory were unique predictors of expressive language growth in minimally verbal preschoolers 16 months later ( n = 87). This study applied these predictors to an independent sample, over a 12-month period ( n = 27). A broader measure of phonetic repertoire, combining reported, elicited and observed speech sounds, was included to further understand the contribution of speech production skills. Expressive language growth was highly variable: 65% remained minimally verbal at mean age 5;2, while 7% gained over 340 words. Contrary to expectations, communicative intent, parent responsiveness and response to joint attention were not found to predict expressive language growth or outcome. In contrast, both consonant inventory and phonetic repertoire were significant predictors (adjusted R2 = 0.29 and 0.45). These results underscore the contribution of speech production abilities to expressive language development in this population, which may reflect an additional deficit rather than a consequence of core autism symptoms. Future work should include those with the most persistently limited expressive language, so that findings can be generalized and additional barriers to communication identified and addressed. Lay abstract What is already known about the topic? Language skills vary enormously in autism: while some autistic individuals can engage in sophisticated conversations, many remain minimally verbal, meaning they use few or no words regularly for communication. We do not know what causes this variation, but we do know that certain child and family characteristics can be measured when a child is young, and this information can improve our prediction of how expressive language might develop over time. What this article adds? We examined four characteristics, which have already been found to predict language development in young minimally verbal autistic children. We followed the expressive language progress of 27 minimally verbal children, aged three to five, for a year. One-third no longer met the minimally verbal criteria at the end of the study. In this sample, only one factor predicted language progress, which was the child’s initial speech skills (the number of different speech sounds that the child made during an interaction). This finding adds to the evidence that speech skills contribute to language development in autism. In some cases, persistent and severe expressive language difficulties may reflect an additional deficit in speech production, rather than a consequence of core autism features. Implications for practice, research or policy Our findings suggest that there are factors other than social skills that influence language development in autism. Careful assessment of speech production should be considered when language does not develop as expected. Future research should evaluate speech skills interventions for minimally verbal autistic individuals, as well as promoting the use of alternative communication systems.

scholarly journals Teacher’s Communication Model in Learning Islamic Education for Autism Children

AL-TA LIM ◽  
2020 ◽  
Vol 27 (3) ◽  
pp. 306-317
Author(s):  
Mustari Bosra Bosra ◽  
Hanif Cahyo Adi ◽  
Greget Annisa Syawaliani
Keyword(s):  
Religious Education ◽  
Verbal Ability ◽  
Communication Model ◽  
Autistic Children ◽  
Islamic Religion ◽  
Psychological Difficulties ◽  
Main Thing ◽  
Children Development ◽  
Communication Methods ◽  
Education Process

The communication model in the education process is the main thing—no exception in education for children who experience psychological difficulties such as children. The material, methods, and learning media needed are supported by a useful communication model to help the progress of religious education for autistic children. This study uses teacher communication methods in learning Islamic Religious Education (PAI). Data collection uses interviews with the support of documentation in the form of photos, videos, and event support during field monitoring. Relevant research results in the study show that the communication model applied in the teaching of Islamic religion in special autistic school children, Bina Anggita Yogyakarta, uses two models: 1 (one) Direction and 2 (two) Directions. One-way communication is used for children whose verbal ability has not yet appeared. While 2-Way communication is used for autistic children who are able to communicate verbally. Strategies in learning use the concept of one teacher, one child. While education is done using the ABA and PECS methods. This method is useful in training and training students in expressing their desires. Based on the findings in this study, the communication model applied in special autism children development schools can be used as a learning model in other schools that manage autistic children.

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