A Two Time Point Study of Imitative Abilities in Children with Autism Spectrum Disorders

Background Researchers have used various paradigms to explore the universality and specificity of imitation deficits in children with autism spectrum disorders (ASDs). However, some issues still need to be investigated, especially for children with ASDs under the age of 4. Method Two studies were conducted to examine the imitative abilities of children with autism spectrum disorders. Study 1 examined immediate and deferred imitation abilities in 18 children with ASDs, 18 children with developmental delay (DD), and 19 typically developing children (mean ages of all groups were below 4 years). Four tasks were used to evaluate immediate imitation abilities: meaningful actions on objects, non‐meaningful actions on objects, manual movements, and oral‐facial movements. Eighteen months after study 1 was completed, study 2 examined advanced imitative abilities in 11 children with ASDs and 11 children with DD from study 1. Results The results of study 1 indicated that, compared to the two control groups, children with ASDs experienced significant difficulty in imitating non‐meaningful actions only. The findings of study 2 suggested that children with ASDs were still significantly impaired on the imitation of single non‐meaningful actions compared to children with DD. Conclusions The relationships between specific imitation deficits, executive functioning, and shared intentionality in children with ASDs are further discussed.     

Investigation of Autism Comorbidities and Associations in a School‐Based Community Sample

PROBLEM: Individuals with autism spectrum disorders (ASDs) have at least as many comorbidities as individuals with typical development may show, but sometimes with different presentations. METHODS: The study used a school‐based health survey related to children diagnosed with ASD in Tehran to determine the possibility of comorbid conditions. Ninety‐one children and adolescents with ASD between the ages of 6 and 14 years were included in the study, all from five schools of different districts of the city, using stratified random sampling. All of the subjects had received a clinical diagnosis of ASD (autism, Asperger, and pervasive developmental disorder‐not otherwise specified) by a child neurologist or psychiatrist. All of the schools had registered the subjects and were restricted to those with high‐functioning forms of ASD, and none were identified with co‐occurring mental retardation. FINDINGS: Results indicated that 72.5% had at least one comorbid condition. There was a trend of higher severity in autism symptoms in subjects with comorbidity. Results showed that attention‐deficit/hyperactivity disorder and epileptic disorders were the leading comorbidity in respective categories. CONCLUSION: Autistic individuals should be monitored regarding their comorbid profiles, with an emphasis on female subjects and those with more severe symptoms. Clinically, the current study has implications for school healthcare providers, including nurses, in addition to researchers and practitioners working with children diagnosed with ASDs.     

双唇音构音障碍的临床特点和语音训练

目的探讨双唇音构音障碍的临床特点和训练方法。方法分析92 例功能性构音障碍(FAD)患者和85 例腭裂术后构音障碍患者双唇音构音障碍的特点;再各选择20 例有双唇音构音障碍的患者进行语音训练。结果FAD患者中/p/置换成/b/占同类患者有双唇音构音错误总人数的78.8%,腭裂术后构音障碍患者中/b/脱落和置换分别占30.2%和60.4%。经过语音训练,两类患者双唇音构音错误的个数显著减少(P<0.001)。结论双唇音构音障碍在FAD患者中主要为/p/音的不送气化,在腭裂术后构音障碍患者中主要表现为/b/音的脱落和置换;语音训练效果显著。     

Social Skills Differences Between the Autism Spectrum Disorders

Social skills deficits are one of the core features of autism spectrum disorders (ASDs), with many believing that this symptom domain is the defining feature of individuals with ASDs. Presently, Asperger’s Disorder, Autistic Disorder, and PDD-NOS make up the spectrum, but future revisions to the Diagnostic and Statistical Manual of Mental Disorders propose that all of these disorders should be collapsed. Much debate has centered on this decision as some researchers believe the three ASDs to be uniquely different. As such, the purpose of the current investigation was to examine social skills differences between the three ASD groups. Participants were children ages 4 through 16 years who had been diagnosed with Asperger’s Disorder, Autistic Disorder, or PDD-NOS and who did not have comorbid intellectual disability. Their scores on the factors of the Matson Evaluation of Social Skills with Youngsters-II (i.e., Hostile, Adaptive/Appropriate, and Inappropriately Assertive/Overconfident) were compared. Children with Asperger’s Disorder demonstrated significantly greater adaptive/appropriate social skills when compared to children with Autistic Disorder, and they also exhibited greater impairments with respect to hostility. No other differences were noted between ASD groups. The implications of these findings are discussed.     

Supporting parents of children with autism spectrum disorders to become informed consumers of evidence on speech pathology practice

The aim of this pilot study was to evaluate the effectiveness of an intervention program designed to help parents of children with autism spectrum disorders (ASD) to become informed consumers of evidence for speech pathology services. The program comprised an interactive workshop and the provision of written materials aimed at increasing the participants’ knowledge of evidence-based practice (EBP) principles and confidence discussing EBP with their children's speech pathologists. Using a repeated measures within-group design (pre/post) and mixed methods of analysis, the results indicate that the participants’ knowledge and confidence increased following their participation in the program. Qualitative analysis revealed that parents differed with regard to which component (workshop or written information) was most helpful. The results provide preliminary evidence to support the further development and testing of intervention programs aimed at supporting parents of children with ASD to become informed consumers of evidence-based speech pathology services.     

Developmental surveillance of infants and toddlers by maternal and child health nurses in an Australian community-based setting: promoting the early identification of autism spectrum disorders

Although signs of autism spectrum disorders (ASDs) are evident during the first year of life, few children are diagnosed prior to 3 years. The objective in this article is to highlight the role that primary health care professionals can play in the early identification of ASDs by briefly outlining the successful implementation of The Social Attention and Communication Study. Maternal and child health nurses were trained on the early signs of ASDs, which enabled them to identify these children prior to 2 years. The training procedure used will be outlined, and the early signs that were monitored will be explained in detail. It is recommended that routine monitoring for ASDs in infancy and toddlerhood become standard practice among all primary health care professionals.     

Patterns of consonant deletion in typically developing children aged 3 to 7 years

Children with and without speech, language and/or literacy impairment, delete consonants when they name pictures to elicit single words. Consonant deletion seems to be more frequent in long words (words of three or more syllables) than in short words (words of one or two syllables). However, it may be missed in long words because they are not routinely assessed and, even if they are, there is little normative data about them. The study aims were (1) to determine if a relationship exists between consonant deletion and the number of syllables in words, (2) delimit variation in the numbers of children using it, its frequency of occurrence and the words it affects and (3) to discuss the application of these data to clinical practice. The participants were 283 typically developing children, aged 3;0 to 7;11 years, speaking Australian English with proven normal language, cognition and hearing. They named pictures, yielding 166 selected words that were varied for syllable number, stress and shape and repeatedly sampled all consonants and vowels of Australian English. Almost all participants (95%) used consonant deletion. Whilst a relationship existed between consonant deletion frequency and the number of syllables in words, the syllable effect was interpreted as a proxy of an interaction of segmental and prosodic features that included two or more syllables, sonorant sounds, non-final weak syllables, within-word consonant sequences and/or anterior-posterior articulatory movements. Clinically, two or three deletions of consonants across the affected words may indicate typical behaviour for children up to the age of 7;11 years but variations outside these tolerances may mark impairment. These results are further evidence to include long words in routine speech assessment.     

Electroencephalogram abnormalities in children with autism spectrum disorders.

Children with an autism spectrum disorder (ASD) often are evaluated with electroencephalogram (EEG) studies to assess their risk for seizures or other underlying abnormalities. Their risk is estimated at 7% - 42%. EEG studies were conducted on a subgroup of children while following established practice parameters for evaluating children for ASD. Abnormal EEG results were obtained in 85 (27%) of the 316 children evaluatedfor ASD. Within the subset of abnormal results, 64 children had autism, 10 had an ASD or milder presentation, 6 had another developmental disorder, 3 had Rett syndrome, had Down syndrome, and 1 had Wolf-Hirshhorn syndrome. The abnormal EEG findings included epileptiform abnormalities in 55 patients (65%), and slowing in only 13 patients (15%). The focality of the epileptiformfindings included 26 (30%) in the temporal areas, 24 (28%) in the central area, 20 (23%) in the frontal area, and 7 (8%) in the occipital area. These findings confirm the importance of ongoing medicalfollow-up for children with ASDs, especially for those with abnormal EEG results.     

Terminology and conception of the profession

Abstract

Twenty-four French-speaking children with developmental phonological disorders (DPD) were matched on percentage of consonants correct (PCC)-conversation, age, and receptive vocabulary measures to English-speaking children with DPD in order to describe how speech errors are manifested differently in these two languages. The participants’ productions of consonants on a single-word test of articulation were compared in terms of feature-match ratios for the production of target consonants, and type of errors produced. Results revealed that the French-speaking children had significantly lower match ratios for the major sound class features [+ consonantal] and [+ sonorant]. The French-speaking children also obtained significantly lower match ratios for [+ voice]. The most frequent type of errors produced by the French-speaking children was syllable structure errors, followed by segment errors, and a few distortion errors. On the other hand, the English-speaking children made more segment than syllable structure and distortion errors. The results of the study highlight the need to use test instruments with French-speaking children that reflect the phonological characteristics of French at multiple levels of the phonological hierarchy.     

Early detection of autism spectrum disorders: screening between 12 and 24 months of age

PURPOSE: The purpose of this article is to present nurse practitioners (NPs) with information on screening for autism spectrum disorders (ASDs) in children between 12 and 24 months of age. Recommendations are also provided for appropriate referrals and initiation of early intervention (EI). DATA SOURCES: Review of published literature about ASD. CONCLUSIONS: Children with ASD exhibit impaired social interaction, verbal and nonverbal communication deficits, and repetitive, restricted, and stereotyped patterns of behavior or interests. Studies show that these children benefit from beginning intensive EI as soon as possible. IMPLICATIONS FOR PRACTICE: Early detection enables children with suspected ASD to be evaluated by specialists and entered into treatment programs at the earliest possible opportunity. Because of the importance of early diagnosis of ASD, it is critical that NPs use established screening instruments to maximize time and increase the reliability of the assessment.     

Polysyllable productions in preschool children with speech sound disorders: Error categories and the Framework of Polysyllable Maturity

Abstract

Purpose: Children with speech sound disorders (SSD) find polysyllables difficult; however, routine sampling and measurement of speech accuracy are insufficient to describe polysyllable accuracy and maturity. This study had two aims: (1) compare two speech production tasks and (2) describe polysyllable errors within the Framework of Polysyllable Maturity.

Method: Ninety-three preschool children with SSD from the Sound Start Study (4;0–5;5 years) completed the Polysyllable Preschool Test (POP) and the Diagnostic Evaluation of Articulation and Phonology (DEAP-Phonology).

Result: Vowel accuracy was significantly different between the POP and the DEAP-Phonology. Polysyllables were analysed using the seven Word-level Analysis of Polysyllables (WAP) error categories: (1) substitution of consonants or vowels (97.8% of children demonstrated common use), (2) deletion of syllables, consonants or vowels (65.6%), (3) distortion of consonants or vowels (0.0%), (4) addition of consonants or vowels (0.0%), (5) alteration of phonotactics (77.4%), (6) alteration of timing (63.4%) and (7) assimilation or alteration of sequence (0.0%). The Framework of Polysyllable Maturity described five levels of maturity based on children’s errors.

Conclusions: Polysyllable productions of preschool children with SSD can be analysed and categorised using the WAP and interpreted using the Framework of Polysyllable Maturity.     

Tongue–palate contact during selected vowels in children with speech sound disorders

Abstract

There is evidence that complete tongue–palate contact across the palate during production of vowels can be observed in some children with speech disorders associated with cleft palate in the English-speaking and Japanese-speaking populations. Although it has been shown that this is not a feature of typical vowel articulation in English-speaking adults, tongue-palate contact during vowel production in typical children and English-speaking children with speech sound disorders (SSD) have not been reported in detail. Therefore, this study sought to determine whether complete tongue–palate contact occurs during production of five selected vowels in 10 children with SSD and eight typically-developing children. The results showed that none of the typical children had complete contact across the palate during any of the vowels. However, of the 119 vowels produced by the children with SSD, 24% showed complete contact across the palate during at least a portion of the vowel segment. The results from the typically-developing children suggest that complete tongue–palate contact is an atypical articulatory feature. However, the evidence suggests that this pattern occurs relatively frequently in children with SSD. Further research is needed to determine the prevalence, cause, and perceptual consequence of complete tongue–palate contact.     

Validity of Comorbid Psychiatric Disorders in Youngsters with Autism Spectrum Disorders

There is mounting evidence that the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides an appropriate conceptualization for psychiatric disorders in individuals with autism spectrum disorders (ASDs). The current study examined symptoms of disruptive behavior, anxiety, and mood disorders and how IQ and language skills impacted their manifestation in a sample of 61 children with ASD and significant emotional/behavioral problems. Subsyndromal presentation and the role of behavior equivalents were also explored. Analyses indicated that children with IQ < 70 had fewer reported symptoms than those with IQ ≥ 70. Symptoms endorsement also varied based on language levels. Individuals with IQ < 70 were more likely to be subsyndromal for Generalized Anxiety Disorder and nonverbal individuals were more likely to be subsyndromal for Oppositional Defiant Disorder. Only one of the seven behavior equivalents was associated with internalized disorders. Special considerations may be necessary when applying some DSM criteria to assess comorbid disorders in individuals with ASDs.     

Reliability and Factor Structure of the Autism Spectrum Disorders—Diagnosis Scale for Intellectually Disabled Adults (ASD—DA)

Most of the scale development work in autism spectrum disorders (ASD) to date has focused on instrumentation designed for one disorder, autism, and mainly focused on young children. Three hundred seventy-one staff were administered a newly developed assessment scale for adults with ID. The Autism Spectrum Disorders—Diagnosis Scale for Intellectually Disabled Adults (ASD—DA) was designed to quickly provide relevant information to establish a diagnosis for the most common ASD (autism, PDD-NOS, and Asperger’s syndrome). Staff completed the assessment for adults with ID (n = 192) some of which had a diagnosis of either autism or PDD-NOS (n = 107) or ID alone (n = 85). Inter-rater and test-retest reliability data were obtained. Item analysis reduced the scale to 31 items that were found to be both reliable and significantly differentiate between groups. A factor analysis with a three-factor solution was identified. The internal consistency of factor and total scale scores were found to be excellent.     

Transitions: Perspectives from Parents of Young Children with Autism Spectrum Disorder (ASD)

Individuals with autism spectrum disorders (ASD) frequently have difficulty with transitions, which can cause confusion and anxiety; consequently, planning for successful transitions is critical for children with ASD. Parental perspectives are a vital tool in successful transition planning. The purpose of this study was to investigate the perspectives and concerns of parents of young children with ASD related to transitions. Purposive sampling was used to identify participants. Data were collected through multiple interviews, observations, and documentation. A cross-case analysis method was used to analyze the data. Findings were confirmed using methods of triangulation, respondent validation, and member checking. Six major themes emerged from the data analysis: (a) transitions that parents considered to be effective were child-centered, (b) communication between school and home was a vital link for successful transitions, (c) preparation for transitions began with an understanding of the child, (d) parents identified barriers to successful transitions, (e) parents understood the different types of transitions but focused on horizontal transitions, and (f) parents identified effective transition strategies for their children. Recommendations for successful transitions are offered.     

Tantrums are Not Associated with Speech or Language Deficits in Preschool Children with Autism

Communication problems and tantrums are common in children with autism. It has long been postulated that lack of speech is a cause of these tantrums. The goal of our study is to determine if impaired speech is associated with tantrums in preschool children with autism. The relationship between language and tantrum frequency in 240 children with autism, 15 to 71 months of age was investigated. Children were administered standardized IQ and language tests, and mothers rated tantrum frequency and speech intelligibility on a 4-point scale on the Pediatric Behavior Scale. Verbal and nonverbal IQ, expressive and receptive language quotients and age equivalents, and speech intelligibility explained less than 3% of the variance in tantrum frequency. Children whose mental age was sufficient for verbal communication but who lacked speech did not have more tantrums than children with adequate speech. In fact, children with an expressive language age at or above 24 months had more tantrums than children whose speech skills were below 24 months. Our findings and those of others do not support the belief that preschool children with autism have tantrums because they cannot speak or because their speech is difficult to understand.     

孤独症谱系障碍患儿维生素D水平及其与临床症状关系的研究

[目的]了解孤独症谱系障碍(Autism Spectrum Disorders,ASD)患儿血清25羟维生素D[25 hydroxyvitamin D,25(OH)D]水平及其与临床症状的关系,为儿童孤独症的病因及治疗提供线索和依据.[方法]选择2014年6月至2016年6月于本院确诊的孤独症患儿60例作为观察组,选择同期在本院儿童保健科门诊体检正常的儿童60例作为对照组.采用酶联免疫吸附法(ELISA)检测两组儿童血清25(OH)D水平.根据儿童孤独症评定量表(Childhood Autism Rating Scale,CARS)评定孤独症患儿的疾病严重程度.比较两组间25(OH)D水平及其与CARS评分相关性,比较睡眠障碍及胃肠道紊乱发生率及其与25(OH)D水平的关系.[结果]观察组25(OH)D水平明显低于对照组,但其与CARS评分无显著相关性.观察组睡眠障碍及胃肠功能紊乱的发生率明显高于对照组(P＜0.001),但两者发生率与25(OH)D水平无显著相关性.[结论]观察组25(OH)D水平明显低于对照组,但其与ASD患儿疾病严重程度、睡眠障碍及胃肠功能紊乱发生率无明显相关性.     

A brief assessment for selecting communication modalities for individuals with Autism Spectrum Disorders

Individuals with autism spectrum disorders (ASD) have impairments in their ability to communicate with others. Estimates indicate that about 25–50% of children with ASD are nonvocal. To address these deficits, a number of augmentative and alternative communication strategies have emerged. Commonly used communication responses have included vocal speech, picture exchange, and manual signs. While these communication strategies have all been shown to be effective in specific clinical instances, the selection of communication topography has generally been based on philosophical preference, rather than on empirical analyses. Relatively little research has evaluated procedures to determine which modality represents a “best fit” with individual learning styles. The purpose of the current investigation was to design a brief assessment model to evaluate the rate of acquisition and preference for different communication modalities for three individuals with ASD. The results show that participants acquired different modalities of communication at different rates and displayed clear preferences for different styles of communication. These findings suggest that this procedure may help to empirically determine which communication system represents a best fit for individual learners.     

国外孤独症人士职业康复研究现状

随着孤独症患病率的不断提高,越来越多的孤独症人士从儿童期进入青少年和成年期,他们面临的主要发展问题是就业。职业康复不论是对孤独症就业,还是对孤独症的全面发展,都有重要意义。本文主要从孤独症人士就业状况、职业康复现状和职业康复策略技巧三个方面,探讨了国外孤独症人士职业康复研究现状,分析国外孤独症职业康复研究趋势,以期为我国今后建立孤独症职业康复模式提供理论支撑和实践依据。     

The natural history of speech impairment of 8-year-old children in the Avon Longitudinal Study of Parents and Children: Error rates at 2 and 5 years

This prospective longitudinal population study observed the speech of 741 children at the ages of 2, 5 and 8 years. At the age of 8, 132 children were categorized as speech impaired. There was strong evidence of differences between the case and control groups in speech sound error rate at the two earlier age points. The pattern of the proportion of errors was similar for cases and controls. There was evidence of a strong relationship between the child's error rate and expressive language at age 2 and between the child's error rate and sentence length at age 5. In multivariable analyses, adjusting for expressive language, parent's social status, maternal age, gender and child's exact age, the increase in odds of being a case as the proportion of errors increased disappeared at 2 years but remained at 5 years. At 5 years, the proportion of speech errors was predictive of ongoing speech errors at the age of 8 years; the adjusted odds of having speech errors at 8 years increased by between 21 and 44% with every 10% rise in the proportion of errors in the target patterns.