Autism and Developmental Language Impairments最新文献

Background and aims: Many children with Developmental Language Disorder (DLD) develop reading difficulties. The purpose of this study is to better understand variation in the reading outcomes of children with DLD using a person-centered approach.

Method: 87 monolingual Dutch children diagnosed with DLD performed at ages 5 or 6 years nine tests of nonverbal IQ, oral language proficiency, phonological memory (PM) and executive functioning (EF). Two years later, the same children were tested on single (non-)word reading. Latent profile analyses were conducted to identify profiles based on oral language proficiency, phonological memory and executive functioning at age 5-6 years, which, in turn, were related to nonverbal IQ and to single-word reading two years later.

Results: Four profiles were identified and labelled relative to their position within the DLD-sample: 1. Weak performance overall, 2. Strong EF-average language and PM, 3. Mild working memory (WM) deficiencies-average language and PM, 4. Strong development overall. Profiles 1 and 3 had below average nonverbal IQ scores and were associated with low word reading outcomes two years later.

Conclusions: Within the group of children with DLD, children with relatively weak oral language, phonological memory and executive functioning, or children with working memory deficiencies are most at risk for developing reading difficulties. The findings support a multiple risk framework and confirm that a person-centered approach is promising in predicting reading outcomes in DLD.Implications: Research into individual differences in DLD is dominated by variable-centered approaches. This study illustrates how a person-centered approach, which views variables as properties of individuals, captures variation in the DLD-population. Using this bottom-up approach, the study highlights how an individual's strengths and weaknesses across different developmental domains can be combined into profiles that relate to later reading outcomes. As such, it can provide an example for future DLD research.

Background and aims: Children with developmental language disorder (DLD) often perform below their typically developing peers on verbal memory tasks. However, the picture is less clear on visual memory tasks. Research has generally shown that visual memory can be facilitated by verbal representations, but few studies have been conducted using visual materials that are not easy to verbalize. Therefore, we attempted to construct non-verbalizable stimuli to investigate the impact of working memory capacity.

Method and results: We manipulated verbalizability in visual span tasks and tested whether minimizing verbalizability could help reduce visual recall performance differences across children with and without developmental language disorder. Visuals that could be easily verbalized or not were selected based on a pretest with non-developmental language disorder young adults. We tested groups of children with developmental language disorder (N = 23) and their typically developing peers (N = 65) using these high and low verbalizable classes of visual stimuli. The memory span of the children with developmental language disorder varied across the different stimulus conditions, but critically, although their storage capacity for visual information was virtually unimpaired, the children with developmental language disorder still had difficulty in recalling verbalizable images with simple drawings. Also, recalling complex (galaxy) images with low verbalizability proved difficult in both groups of children. An item-based analysis on correctly recalled items showed that higher levels of verbalizability enhanced visual recall in the typically developing children to a greater extent than the children with developmental language disorder.Conclusions and clinical implication: We suggest that visual short-term memory in typically developing children might be mediated with verbal encoding to a larger extent than in children with developmental language disorder, thus leading to poorer performance on visual capacity tasks. Our findings cast doubts on the idea that short-term storage impairments are limited to the verbal domain, but they also challenge the idea that visual tasks are essentially visual. Therefore, our findings suggest to clinicians working with children experiencing developmental language difficulties that visual memory deficits may not necessarily be due to reduced non-verbal skills but may be due to the high amount of verbal cues in visual stimuli, from which they do not benefit in comparison to their peers.

Background: Studies involving autistic adults have often focused on negative outcomes and quality of life ratings.

Aims: This study provides a different viewpoint by examining the perspectives of autistic men who consider themselves to be successful.

Methods: Data were gathered from 10 men who shared their experiences and perceptions regarding their journey to achieve success. Self-determination theory provided a useful lens for examining the men's narratives and understanding the factors that led to their success.

Results: Analysis of interviews revealed four main themes: (1) being my own self, (2) a competent professional, (3) solving problems in a neurotypical world, and (4) relating and connecting. These themes reflect the men's perception of their own self-determination including their autonomy, competence, and relatedness with others.

Conclusions: The men's sense of success was derived from their ability to achieve competence in their work, act without help or influence from others and demonstrate a high level of self-awareness and self-reflection. Despite this, many continued to experience difficulty in the social areas of their lives.Implications: These findings suggest that self-determination theory may present an alternative and more positive means of enacting support programs for autistic individuals, and males in particular.

Background and aims: Children with autism spectrum condition often have specific difficulties understanding that pictorial symbols refer to real-world objects in the environment. We investigated the influence of labelling on the symbolic understanding and dual representation of children with autism spectrum condition.

Methods: Children with autism spectrum condition and typically developing children were shown four coloured photographs of objects that had different functions across four separate trials. The participants were given either a novel label alongside a description of the object's function or a description of the object's function without a label. Children were then given 30 seconds to interact with an array of stimuli (pictures and objects) in a mapping test and in a generalisation test for each trial. This exploration phase allowed for spontaneous word-picture-referent mapping through free-play, providing an implicit measure of symbolic understanding.

Results: We found no significant difference in word-picture-referent mapping between groups and conditions. Both groups more often performed the described action on the target object in the exploration phase regardless of condition.

Conclusions and implications: Our results suggest that a spontaneous measure of symbolic understanding (such as free-play) may reveal competencies in word-picture-referent mapping in autism spectrum condition.

Background and aims: Children with autism spectrum condition often have specific difficulties with narrative comprehension, a skill which has a strong association with both concurrent and longitudinal reading comprehension. A better understanding of narrative comprehension skills in autism spectrum condition has the potential to provide insight into potential later reading comprehension difficulties and inform early targeted intervention. In the current study, the main objective was to investigate how differences in the medium of story presentation (paper-book vs. e-book) and differences in story narration (adult narration vs. in-app narration) would influence narrative comprehension in general, and between groups (autism spectrum condition and a receptive language-matched control group). We were also interested in how task engagement (visual attention and communication) differed between group and conditions and whether task engagement was related to narrative comprehension.

Method: Forty-two children with autism spectrum condition and 42 typically developing children were read a story either via a paper-book or an e-book with interactive and multimedia features. The e-book was either narrated by the experimenter (adult narrated iPad condition) or narrated by an in-app voiceover (e-book narrated iPad condition). Children's behaviour during storybook reading was video recorded and coded for engagement (visual attention and communication). They then completed two measures of narrative comprehension: multiple-choice questions (measuring recall of literal information) and a picture ordering task (measuring global story structure).

Results: Contrary to predictions, we did not find any significant group or condition differences on either measure of narrative comprehension, and both groups demonstrated a similar level of narrative comprehension across the three conditions. We found differences in engagement between conditions for both groups, with greater visual attention in the e-book conditions compared to the paper-book condition. However, visual attention only significantly correlated with narrative comprehension for the typically developing group.

Conclusion: Overall, this study suggests that children with autism spectrum condition are just as able as language-matched peers to comprehend a narrative from storybooks. Presenting a story on an iPad e-book compared to a paper-book does not influence narrative comprehension, nor does adult narration of the story compared to in-app narration. However, on-task engagement is linked to narrative comprehension in typically developing children.Implications: Taken together, our findings suggest that e-books may be more successful than paper-based mediums at encouraging visual attention towards the story, but no better at supporting narrative comprehension and eliciting communication.

Background and aims: Practice-based research holds potential as a promising solution to closing the research-practice gap, because it addresses research questions based on problems that arise in clinical practice and tests whether systems and interventions are effective and sustainable in a clinical setting. One type of practice-based research involves capturing practice by collecting evidence within clinical settings to evaluate the effectiveness of current practices. Here, we describe our collaboration between researchers and clinicians that sought to answer clinician-driven questions about community-based language interventions for young children (Are our interventions effective? What predicts response to our interventions?) and to address questions about the characteristics, strengths, and challenges of engaging in practice-based research.

Methods: We performed a retrospective chart review of 59 young children who had participated in three group language interventions at one publicly funded community clinic between 2012 and 2017. Change on the Focus on the Outcomes of Communication Under Six (FOCUS), a government mandated communicative participation measure, was extracted as the main outcome measure. Potential predictors of growth during intervention were also extracted from the charts, including type of intervention received, attendance, age at the start of intervention, functional communication ability pre-intervention, and time between pre- and post-intervention FOCUS scores.

Results: Overall, 49% of children demonstrated meaningful clinical change on the FOCUS after their participation in the language groups. Only 3% of participants showed possibly meaningful clinical change, while the remaining 46% of participants demonstrated not likely meaningful clinical change. There were no significant predictors of communicative participation growth during intervention.

Conclusions: Using a practice-based research approach aimed at capturing current practice, we were able to answer questions about the effectiveness of interventions delivered in real-world settings and learn about factors that do not appear to influence growth during these interventions. We also learned about benefits associated with engaging in practice-based research, including high clinical motivation, high external validity, and minimal time/cost investment. Challenges identified were helpful in informing our future efforts to examine other possible predictors through development of a new, clinically feasible checklist, and to pursue methods for improving collection of outcome data in the clinical setting.Implications: Clinicians and researchers can successfully collaborate to answer clinically informed research questions while considering realistic clinical practice and using research-informed methods and principles. Practice-based research partnerships between researchers and clinic

Background and aims: This exploratory study aims to examine the relative contribution of language and intentional communication to internalizing and externalizing problem behavior.

Methods: Twenty-nine Dutch-speaking children (age range 24-46 months) referred with language difficulties participated in this study. For the majority of children, these early language difficulties appeared to be part of a broader neurodevelopmental disorder, mainly autism spectrum disorder. Parent ratings on the Achenbach Child Behavior Checklist 1½-5 were predicted from children's language level and intentional communicative abilities, the latter being assessed by both parent report and direct observation. In all series of hierarchical regression analyses, chronological age and nonverbal mental age were included as covariates.

Results: Parents commonly reported withdrawal, emotionally reactive behavior, attention problems, and aggressive behavior. Parent-rated intentional communication was the most important predictor of internalizing problem behavior and played an important role in the prediction of aggressive behavior as well. However, chronological age and/or nonverbal mental age also predicted parent-rated levels of externalizing problem behavior, especially attention problems.

Conclusions: The relation between language difficulties and problem behavior may be influenced by maturation and children's ability to communicate intentionally.Implications: Language proficiency should, therefore, be independently assessed from children's intentional communicative abilities which, in turn, may differ across contexts.

Background and aims: We evaluated a naturalistic language intervention (NLI) targeting expanded forms of expressive communication (e.g., two-word phrases) for elementary-aged children with autism spectrum disorder (ASD) and/or intellectual disability (ID). This study extends the findings of a previous study that evaluated an NLI for preschool-aged children who displayed social communication delays. In the previous study, one child was considered a non-responder to the original intervention; children with similar pre-intervention profiles to the non-responder were recruited for this study to evaluate a modified version of the NLI with a new participant group.

Methods: The NLI was evaluated within the context of a multiple probe design across children, with sessions conducted in a public school classroom. The modifications to the NLI resulted in varying dosages of the intervention provided across sessions and children. To analyze the moderating influence of the variation in dosage, we graphed each dosage variable to allow for a formative analysis of changes within and across study conditions.

Results: Results indicated increases in the target behavior for all three children when compared to probe sessions; however, for one child the consistency of changes were variable and, as such, may not be socially significant.

Conclusions and implications: This study extends the literature on conducting NLIs with minimally verbal children with ASD and ID in dynamic settings, like classrooms. Educators and related professionals can capitalize on natural opportunities for social communication in children who are minimally verbal but imitative by using naturalistic procedures to promote verbalizations during age-appropriate activities.