Comparing two types of augmentative and alternative communication systems for children with autism

This study compared acquisition and preference for two types of augmentative and alternative communication (AAC) systems in three pre-schoolers with autism. Acquisition of requesting behaviour using a picture-exchange system vs a voice-output communication aide (VOCA) was compared in an alternating treatments design. Following acquisition, both ACC systems were simultaneously available and the child could select which one of the two systems to use. There was little difference between picture-exchange and VOCA in terms of acquisition rates. Two children demonstrated a consistent preference for picture-exchange and the third showed a preference for the VOCA. Both speed of acquisition and system preference should be considered when designing AAC interventions for children with autism and related developmental disabilities.

Comparamos la adquisición y preferencia en relación a dos tipos de sistemas (AAC) de comunicación alternativa y aumentativa en 3 preescolares con autismo. Se comparó la adquisición de un comportamiento solicitado a través del uso de un sistema de intercambio de dibujos contra una ayuda de comunicación de producción de voz (VOCA), en un diseño de tratamiento alternativo. Después de la adquisición ambos sistemas AAC estuvieron disponibles en forma simultánea, y el niño podía seleccionar cuál de los dos sistemas usar. Hubo poca diferencia entre el intercambio de dibujos y VOCA en término de tasas de adquisición. Dos niños demostraron una preferencia consistente para el intercambio de dibujos y el tercero demostró una preferencia por la VOCA. Tanto la velocidad de adquisición como la preferencia por un sistema deberán ser consideradas cuando se diseñen intervenciones con AAC para niños con autismo y discapacidades en el desarrollo relacionadas.

Palabras Clave: comunicación alternativa y aumentativa, intercambio de dibujos, ayudas de comunicación de producción de la voz, adquisición, autismo.     

Evaluation of the iPad in the acquisition of requesting skills for children with autism spectrum disorder

The iPad® with the Proloquo2Go™ application is designed to function as a speech-generating device (SGD). This study evaluates whether children with autism spectrum disorder (ASD) can acquire requesting skills using the iPad® with the Proloquo2Go™ application. Participants included three children with ASD between the ages of three and five. A multiple probe design across participants was used. Intervention phases were adapted and modified from the picture exchange communication system (PECS) (Bondy and Frost, 1994, Frost and Bondy, 2002). Results of this study support that children diagnosed with ASD can acquire skills needed to request preferred items using the iPad® with the Proloquo2Go™ application with training of a picture-based communication system. In addition, vocal requesting increased for the participants during the training phases in comparison to baseline probes.     

Investigating the validity of a structured interview protocol for assessing the preferences of children with autism spectrum disorders

Purpose: To investigate the congruent validity of a structured interview protocol for assessing the preferences of seven children with autism spectrum disorder (ASD).

Method: Using the structured interview protocol described by Green et al., parents were asked to provide a rank ordering of their child's preferred foods, drinks, toys and sensory stimuli. The resulting rank order was then compared to the results of a multiple-stimulus without replacement preference assessment by calculating the Spearman rank order correlation coefficients.

Results: The results revealed a high level of correspondence between the rank orderings of both assessments for four of the six participants for food and drink items and four of the seven participants for play items and sensory stimuli.

Conclusion: Results support the use of the structured interview protocol to determine the preferences of children with ASD. Practical implications and directions for future research are discussed.     

Communication interventions involving speech-generating devices for children with autism: A review of the literature

Objective: The current review synthesizes communication intervention studies that involved the use of speech-generating devices (SGD) for children with autism.

Methods: Twenty-three studies were identified that met the inclusion criteria following systematic searches of electronic databases, journals and reference lists. Studies were evaluated in terms of: (a) participants, (b) setting, (c) mode of communication, (d) communication skill(s) taught to the participant, (e) intervention procedures, (f) outcomes, (g) follow-up and generalization, (h) reliability and treatment integrity and (i) design and certainty of evidence.

Results: Intervention, most commonly targeting requesting skills, was provided to a total of 51 children aged 3–16 years. Intervention strategies followed two main approaches: operant/behavioural techniques and naturalistic teaching procedures. Positive outcomes were reported for 86% of the studies and 78% of the studies were categorized as providing conclusive evidence.

Conclusion: The literature base suggests that SGDs are viable communication options for children with autism. However, several areas warrant future research.     

A further comparison of manual signing,picture exchange,and speech-generating devices as communication modes for children with autism spectrum disorders

We compared acquisition of, and preference for, manual signing (MS), picture exchange (PE), and speech-generating devices (SGDs) in four children with autism spectrum disorders (ASD). Intervention was introduced across participants in a non-concurrent multiple-baseline design and acquisition of the three communication modes was compared in an alternating treatments design. Children's preference for using MS, PE or the SGD was also assessed. With intervention, all four participants learned to make specific requests using at least one of the three communication modes. The children also showed a preference for one mode. These results extend previous studies by demonstrating (in four new children with ASD) differential acquisition of, and idiosyncratic preferences for, three commonly used alternative communication modes. The present results further suggest faster acquisition and better maintenance with the preferred mode. We conclude that children's preferences for MS, PE, and SGDs should be considered when designing and implementing augmentative and alternative communication interventions.     

Variability in adaptive behaviour in young children with autism spectrum disorder

ABSTRACT

Background Understanding adaptive behaviour variability in children with autism spectrum disorder (ASD) may have important implications for early intervention. The purpose of this study was to explore whether autism symptom severity and caregiver depression affected adaptive behaviour in young children with ASD.

Method Data were collected from 60 primary caregivers of children aged 2–6 years with ASD. A factorial multivariate analysis of covariance was conducted to investigate if different levels of autism symptom severity and caregiver depression affected communication, socialisation, and daily living skills, after controlling for child age.

Results Findings suggest that only autism symptom severity accounted for significant variance in adaptive behaviour, with socialisation being most impacted. Although more than half of the caregivers reported heightened depressive symptoms, caregiver depression was not related to adaptive behaviour.

Conclusions Findings highlight the level of functional impairment that young children with ASD experience in relation to autism symptom severity.     

Unique handwriting performance characteristics of children with high-functioning autism spectrum disorder

Knowledge about the handwriting performance characteristics of children with autism spectrum disorder (ASD) is scarce, despite this skill’s importance for their academic and social participation. The objective was to compare the handwriting process and product characteristics of children with high-functioning autism spectrum disorder (HFASD) to those of typically developing children to determine the best means of differentiation between the groups. Participants were 60 children, aged 9–12 years; 30 of them were diagnosed with HFASD, and 30 were aged and gender-matched typically developed controls. All participants performed three graded writing tasks on an electronic tablet, which is part of a computerized handwriting evaluation system (ComPET). Their paragraph copying product was then evaluated using the Hebrew Handwriting Evaluation (HHE). Significantly inferior handwriting performance among children with HFASD was found in both handwriting process and product measures. Significant correlations between these measures, supplemented with discriminant analysis and regression analysis results, emphasize unique handwriting performance dynamics among children with HFASD. Evaluation of the characteristics of both the handwriting process and product of children with HFASD may provide a more comprehensive picture of individual deficits. Identifying performance features may lead to more focused and adapted intervention and enhancement of school participation among these children.     

The predictors of distress in parents of children with autism spectrum disorder

Abstract

Background It is well recognised that parents of children with autism spectrum disorder (ASD) often experience clinically significant levels of stress and depression. This study examined which ASD characteristic best predicted parental distress.

Method Parents of 109 children aged between 4 and 12 (M age = 7.89, SD = 2.43) completed self-report measures of anxiety, depression, stress, and parenting-specific stress. They also completed rating scales regarding their child's ASD characteristics.

Results This study found that the child's behavioural and emotional impairments predicted the parents’ overall levels of distress (i.e., stress/tension, anxiety, and depression), but not the stress associated with parenting. Instead, the child's social impairment severity was found to predict parenting-specific stress.

Conclusion This study highlights the pervasive influence of ASD symptomatology on the mental wellbeing of the parents and the importance of assisting parents to cope with the behavioural and social impairments of their child.     

Magnetoencephalography in the study of children with autism spectrum disorder

Magnetoencephalography (MEG) is a non‐invasive neuroimaging technique that provides a measure of cortical neural activity on a millisecond timescale with high spatial resolution. MEG has been clinically applied to various neurological diseases, including epilepsy and cognitive dysfunction. In the past decade, MEG has also emerged as an important investigatory tool in neurodevelopmental studies. It is therefore an opportune time to review how MEG is able to contribute to the study of atypical brain development. We limit this review to autism spectrum disorder (ASD). The relevant published work for children was accessed using PubMed on 5 January 2015. Case reports, case series, and papers on epilepsy were excluded. Owing to their accurate separation of brain activity in the right and left hemispheres and the higher accuracy of source localization, MEG studies have added new information related to auditory‐evoked brain responses to findings from previous electroencephalography studies of children with ASD. In addition, evidence of atypical brain connectivity in children with ASD has accumulated over the past decade. MEG is well suited for the study of neural activity with high time resolution even in young children. Although further studies are still necessary, the detailed findings provided by neuroimaging methods may aid clinical diagnosis and even contribute to the refinement of diagnostic categories for neurodevelopmental disorders in the future.     

Examining the utilisation and usefulness of social support for mothers with young children with autism spectrum disorder

ABSTRACT

Background Social support has been described as a vital resource for families with children with disability. Although the benefits of social support have been described, little is known about the utilisation patterns in families of young children with autism spectrum disorder (ASD).

Method In a community sample of 78 American families with children (2–6 years) with ASD, this study examined the utilisation and usefulness of social support. Child, family, and service variables related to social support were explored.

Results Mothers of children with ASD reported using a combination of formal and informal supports, and these were perceived to be helpful. Sociodemographic variables, child behaviour problems, satisfaction with the autism diagnostic process, and access to information about ASD predicted social support utilisation.

Conclusion Social support utilisation varies as a function of different child, family, and service variables. Understanding these variables may help professionals guide families in access to and use of social support.     

The effects of item preference and token reinforcement on sharing behavior exhibited by children with autism spectrum disorder

The current studies evaluated variables affecting sharing exhibited by children with autism spectrum disorder. Study 1 evaluated the effects of manipulating item preference on the level of assistance needed to exhibit sharing behavior for 4 children with autism. Item preference clearly affected 2 participants’ percentage of independent sharing. Preference did not have as clear of an effect for a third participant. However, sharing a high-preference item generally required a higher level of prompting (e.g., vocal prompts) to share. The fourth participant's percentage of independent sharing was not influenced by preference, and his independent sharing behavior was similar across item preference. Study 2 assessed the effectiveness of a token reinforcement procedure as an intervention designed to increase independent sharing of high-preference items for the two participants who did not independently share those items during Study 1. Independent sharing increased for both participants when the token procedure was in place and decreased when it was removed.     

Amygdala subnuclei volumes and anxiety behaviors in children and adolescents with autism spectrum disorder,attention deficit hyperactivity disorder,and obsessive–compulsive disorder

Alterations in the structural maturation of the amygdala subnuclei volumes are associated with anxiety behaviors in adults and children with neurodevelopmental and associated disorders. This study investigated the relationship between amygdala subnuclei volumes and anxiety in 233 children and adolescents (mean age = 11.02 years; standard deviation = 3.17) with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and children with obsessive compulsive disorder (OCD), as well as typically developing (TD) children. Parents completed the Child Behavior Checklist (CBCL), and the children underwent structural MRI at 3 T. FreeSurfer software was used to automatically segment the amygdala subnuclei. A general linear model revealed that children and adolescents with ASD, ADHD, and OCD had higher anxiety scores compared to TD children (p < .001). A subsequent interaction analysis revealed that children with ASD (B = 0.09, p < .0001) and children with OCD (B = 0.1, p < .0001) who had high anxiety had larger right central nuclei volumes compared with TD children. Similar results were obtained for the right anterior amygdaloid area. Amygdala subnuclei volumes may be key to identifying children with neurodevelopmental disorders or those with OCD who are at high risk for anxiety. Findings may inform the development of targeted behavioral interventions to address anxiety behaviors and to assess the downstream effects of such interventions.     

Meaningful outcomes for enhancing quality of life for individuals with autism spectrum disorder

Background Autism spectrum disorder (ASD) is a developmental disorder that continues across the lifespan, but little research exists to examine interventions from both child and adult perspectives. The researchers in this study considered the perspectives of individuals with ASD and caregivers of children with ASD to determine interventions and outcomes perceived as meaningful for both children and adults.

Methods Grounded theory methodology was used to guide data collection and analysis. Participants included 5 parents of children with ASD and 5 adults with ASD. Data were collected through interviews.

Results A central theme of Intervention priorities for quality of life was supported. Individual themes identified from parents focused on future planning, community involvement, and scheduling and planning. Individual themes identified from the adults focused on misconceptions. Both groups shared the themes of acceptance; financial challenges; support, resources, and advocacy; skills learned; and socially and functionally based interventions.

Conclusion Results support interventions and resources for individuals with ASD focused on meaningful outcomes, including acceptance, community involvement, social success, independent living, and vocational/financial stability.     

Comparison between visual scene displays and exchange-based communication in augmentative and alternative communication for children with ASD

Visual scene displays are a novel type of augmentative and alternative communication that has recently been investigated as an alternative to traditional, grid-based systems. However, most of the limited research on visual scene displays has focused on typically developing populations. In addition, a limited range of communicative functions has been explored (i.e., requests). This study sought to expand on the existing literature on visual scene displays by investigating the differential impact that visual scene displays versus traditional, grid-based systems have on the number of spontaneous comments and correct answers to questions made by two male, preschool children with autism. The participants in the current study were exposed to two conditions during the reading of a book—a visual scene display condition and an exchange-based communication system. The results indicated that visual scene displays may have second effects on children who display echoic and matching-to-sample skills prior to being exposed to a visual scene display.