Using Telehealth-Delivered Procedures to Collect a Parent-Implemented Expressive Language Sampling Narrative Task in Monolingual and Bilingual Families With Autism Spectrum Disorder: A Pilot Study

Language impairments are frequent, severe, and of prognostic value in autism spectrum disorder (ASD). Unfortunately, the evaluation of the efficacy of treatments targeting the language skills of those with ASD continues to be hindered by a lack of psychometrically sound outcome measures. Expressive Language Sampling (ELS) procedures offer a promising alternative to norm-referenced standardized tests for assessing expressive language in treatment studies. Until now, however, research on the validity and utility of ELS as outcome measures has been limited to administrations by a trained professional in a clinic setting and to use with English-speaking families. These limitations are a barrier for many families accessing the benefits of participation in treatment studies. The current study examines the feasibility of teaching native English-speaking parents (NESP) and native Spanish-speaking parents (NSSP) how to administer the ELS narrative task (ELS-N) to their sons and daughters with ASD (between ages 6 and 21) at home through telehealth-delivered procedures. The parent training was provided in the primary language of the participating parent (i.e., 11 NSSP and 11 NESP) and administered by the parent to the youth in the language that the parent reported to use to communicate with the youth at home (i.e., 9 Spanish and 13 English). Families were able to choose between using their own technology or be provided with the technology needed for participation. Of the 19 parents who completed the training, 16 learned to administer the ELS-N procedures. In addition, strong test-retest reliability and no practice effects over the 4-week interval were observed for ELS-N derived youth outcome measures (i.e., talkativeness, vocabulary, syntax, dysfluency, and intelligibility) for both NSSP and NESP. Results from this pilot study suggest that the home-based parent-implemented ELS-N procedures can be learned and administered at acceptable levels of fidelity by parents, with good test-retest reliability and limited practice effects observed in terms of outcome measures for youth with ASD. Implications for treatment studies and future directions are discussed.

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Expressive language sampling as a source of outcome measures for treatment studies in fragile X syndrome: feasibility, practice effects, test-retest reliability, and construct validity

Journal of Neurodevelopmental Disorders ◽

10.1186/s11689-020-09313-6 ◽

2020 ◽

Vol 12 (1) ◽

Cited By ~ 4

Author(s):

Leonard Abbeduto ◽

Elizabeth Berry-Kravis ◽

Audra Sterling ◽

Stephanie Sherman ◽

Jamie O. Edgin ◽

...

Keyword(s):

Construct Validity ◽

Outcome Measures ◽

Symptom Severity ◽

Fragile X ◽

Expressive Language ◽

Practice Effects ◽

Full Sample ◽

Retest Reliability ◽

Language Sampling ◽

Test Retest Reliability

Abstract Background The evaluation of treatment efficacy for individuals with fragile X syndrome (FXS) or intellectual disability (ID) more generally has been hampered by the lack of adequate outcome measures. We evaluated expressive language sampling (ELS) as a procedure for generating outcome measures for treatment research in FXS. We addressed: (a) feasibility, (b) practice effects over two administrations, (c) test-retest reliability over the repeated administrations, and (d) construct validity. We addressed these issues for the full sample as well as for subgroups defined by age, IQ, and ASD status. Methods Participants were 106 individuals with FXS between ages 6 and 23 years who had IQs within the range of intellectual disability (IQ < 70). ELS procedures for collecting samples in conversation and narration were followed and analyzed separately. Five measures were derived from transcripts segmented into C-units (i.e., an independent clause and its modifiers): number of C-units per minute (talkativeness), number of different word roots (vocabulary), C-unit length in morphemes (syntax), percentage of C-units containing dysfluency (utterance planning), and percentage of C-units that were fully or partly unintelligible (articulatory quality). ELS procedures were administered twice at 4-week intervals for each participant. Standardized tests and informant reports were administered and provided measures for evaluating construct validity of ELS measures. Results We found low rates of noncompliance, suggesting the task can be completed meaningfully by most individuals with FXS, although noncompliance was higher for younger, lower IQ, and more autistic participants. Minimal practice effects and strong test-retest reliability over the 4-week interval were observed for the full sample and across the range of ages, IQs, and autism symptom severity. Evidence of convergent construct validity was observed for the measures of vocabulary, syntax, and unintelligibility for the full sample and across the range of IQ and autism symptom severity, but not for participants under age 12. Conversation and narration yielded largely similar results in all analyses. Conclusions The findings suggest that the ELS procedures are feasible and yield measures with adequate psychometric properties for a majority of 6 to 23 years with FXS who have ID. The procedures work equally well regardless of level of ID or degree of ASD severity. The procedures, however, are more challenging and have somewhat less adequate psychometric properties for individuals with FXS under age 12.

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Correction to: Expressive language sampling as a source of outcome measures for treatment studies in fragile X syndrome: feasibility, practice effects, test-retest reliability, and construct validity

Journal of Neurodevelopmental Disorders ◽

10.1186/s11689-020-09314-5 ◽

2020 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Leonard Abbeduto ◽

Elizabeth Berry-Kravis ◽

Audra Sterling ◽

Stephanie Sherman ◽

Jamie O. Edgin ◽

...

Keyword(s):

Construct Validity ◽

Fragile X Syndrome ◽

Outcome Measures ◽

Fragile X ◽

Expressive Language ◽

Practice Effects ◽

Original Publication ◽

Retest Reliability ◽

Language Sampling ◽

Test Retest Reliability

In the original publication of this article [1], the author name Leonard Abbeduto was misspelled as Leonardkk Abbeduto. The original article has been corrected.

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Enhancement of behavioral and linguistic outcome measures in autism spectrum disorder through neuro-navigated transcranial magnetic stimulation: A pilot study

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2020.02.005 ◽

2020 ◽

Vol 74 ◽

pp. 151-154

Author(s):

Mitra Assadi ◽

Jennifer Dave ◽

Paola Leone ◽

Navid Redjal ◽

Adrian Curtin

Keyword(s):

Autism Spectrum Disorder ◽

Transcranial Magnetic Stimulation ◽

Pilot Study ◽

Outcome Measures ◽

Magnetic Stimulation ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Navigated Transcranial Magnetic Stimulation

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Spoken language outcome measures for treatment studies in Down syndrome: feasibility, practice effects, test-retest reliability, and construct validity of variables generated from expressive language sampling

Journal of Neurodevelopmental Disorders ◽

10.1186/s11689-021-09361-6 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Angela John Thurman ◽

Jamie O. Edgin ◽

Stephanie L. Sherman ◽

Audra Sterling ◽

Andrea McDuffie ◽

...

Keyword(s):

Construct Validity ◽

Outcome Measures ◽

Expressive Language ◽

Spoken Language ◽

Practice Effects ◽

Short Term ◽

Retest Reliability ◽

Language Sampling ◽

Language Outcome ◽

Test Retest Reliability

Abstract Background The purpose of this study was to evaluate expressive language sampling (ELS) as a procedure for generating spoken language outcome measures for treatment research in Down syndrome (DS). We addressed (a) feasibility, (b) practice effects across two short-term administrations, (c) test-retest reliability across two short-term administrations, (d) convergent and discriminant construct validity, and (e) considered comparisons across the conversation and narration contexts. Method Participants were 107 individuals with DS between 6 and 23 years of age who presented with intellectual disability (IQ < 70). The utility of ELS procedures designed to collect samples of spoken language in conversation and narration were evaluated separately. Variables of talkativeness, vocabulary, syntax, utterance planning, and articulation quality, derived from transcripts segmented into C-units (i.e., an independent clause and its modifiers), were considered. A 4-week interval was used to assess practice effects and test-retest reliability. Standardized direct assessments and informant report measures were collected to evaluate construct validity of the ELS variables. Results Low rates of noncompliance were observed; youth who were under 12 years of age, had phrase-level speech or less, and had a 4-year-old developmental level or less were at particular risk for experiencing difficulty completing the ELS procedures. Minimal practice effects and strong test-retest reliability across the 4-week test-retest interval was observed. The vocabulary, syntax, and speech intelligibility variables demonstrated strong convergent and discriminant validity. Although significant correlations were found between the variables derived from both the conversation and narration contexts, some differences were noted. Conclusion The ELS procedures considered were feasible and yielded variables with adequate psychometric properties for most individuals with DS between 6 and 23 years old. That said, studies of outcome measures appropriate for individuals with DS with more limited spoken language skills are needed. Context differences were observed in ELS variables suggest that comprehensive evaluation of expressive language is likely best obtained when utilizing both contexts.

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