Journal of Autism and Developmental Disorders

, Volume 45, Issue 3, pp 846–857 | Cite as

Measuring and Supporting Language Function for Children with Autism: Evidence from a Randomized Control Trial of a Social-Interaction-Based Therapy

  • Devin M. Casenhiser
  • Amanda Binns
  • Fay McGill
  • Olga Morderer
  • Stuart G. Shanker
Original Paper


In a report of the effectiveness of MEHRIT, a social-interaction-based intervention for autism, Casenhiser et al. (Autism 17(2):220–241, 2013) failed to find a significant advantage for language development in the treatment group using standardized language assessments. We present the results from a re-analysis of their results to illustrate the importance of measuring communicative language acts (formally called “speech acts”). Reanalysis confirmed that children in the MEHRIT group outperformed the community treatment group on measures of MLUm, number of utterances produced, and various speech act categories. The study underscores the importance of functional language measures in guiding and evaluating treatment for children with autism, and suggests that MEHRIT is effective in improving children’s use of language during parent–child interactions.


Autism Language development MEHRIT Speech acts Communicative acts 



This research was made possible by the generous support of the Harris Steel Foundation and the Harris family, which made it possible to create the Milton and Ethel Harris Research Initiative. We are also grateful for the support we have received from the Unicorn Foundation, Cure Autism Now, the Public Health Agency of Canada, and the Templeton Foundation. We also thank the families involved in the study as well as team members Narmilee Dhayanandan, Nadia Noble, and Alicia Alison for their hard work and dedication. We thank Eunice Lee, Ashley Abergel, Riti Dass, Heba Mouniemneh, Jasmine Dzeko, Farah Vali, and Lauren Mitchell for their perseverance in coding and transcribing the mountain of raw data, and we thank John Hoffman for his outstanding assistance with research and preparation of this manuscript. Finally, we thank the editor and three anonymous JADD reviewers whose comments substantially improved the quality of this manuscript.


  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.).Google Scholar
  2. Austin, J. L. (1962). How to do things with words. Cambridge, MA: Harvard University Press.Google Scholar
  3. Baker, G. P., & Hacker, P. M. S. (1980). Wittgenstein: Understanding and meaning. Oxford: Blackwell.Google Scholar
  4. Bates, E. (1974). Language and context: Studies in the acquisition of pragmatics. New York, NY: Academic Press.Google Scholar
  5. Bayley, N. (2005). Bayley scales of infant and toddler development (3rd ed ed.). New York: Pearson.Google Scholar
  6. Bloom, L., & Lahey, M. (1978). Language development and language disorders. Somerset, NJ: John Wiley and Sons Inc.Google Scholar
  7. Botting, N., Conti-Ramsden, G., & Crutchley, A. (1997). Concordance between teacher/therapist opinion and formal language assessment scores in children with language impairment. International Journal of Language and Communication Disorders, 32(3), 317–327.CrossRefGoogle Scholar
  8. Bruinsma, Y., Koegel, R. L., & Koegel, L. K. (2004). Joint attention and children with autism: A review of the literature. Mental Retardation and Developmental Disabilities Research Reviews, 10(3), 169–175.CrossRefPubMedGoogle Scholar
  9. Bruner, J. S. (1975). The ontogenesis of speech acts. Journal of Child Language, 2(1), 1–19.CrossRefGoogle Scholar
  10. Capps, L., Kehres, J., & Sigman, M. (1998). Conversational abilities among children with autism and children with developmental delays. Autism: The International Journal of Research and Practice, 2(4), 325–344.CrossRefGoogle Scholar
  11. Carter, A., Messinger, D., Stone, W., Celimli, S., Nahmias, A., & Yoder, P. (2011). A randomized controlled trial of Hanen’s ‘More than Words’ in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry, 52(7), 741–752.CrossRefPubMedGoogle Scholar
  12. Casenhiser, D. M., Shanker, S. G., & Stieben, J. (2013). Learning through interaction in children with autism: Preliminary data from a social-communication-based intervention. Autism, 17(2), 220–241.CrossRefPubMedGoogle Scholar
  13. Condouris, K., Meyer, E., & Tager-Flusberg, H. (2003). The relationship between standardized measures of language and measures of spontaneous speech in children with autism. American Journal of Speech-language Pathology, 12(3), 349–358.CrossRefPubMedCentralPubMedGoogle Scholar
  14. Dennis, M., Lazenby, A., & Lockyer, L. (2001). Inferential language in high-function children with autism. Journal of Autism and Developmental Disorders, 31(1), 47–54.CrossRefPubMedGoogle Scholar
  15. Dore, J. (1974). A pragmatic description of early language development. Journal of Psycholinguistic Research, 3(4), 343–350.CrossRefGoogle Scholar
  16. Dore, J. (1975). Holophrases, speech acts and language universals. Journal of Child Language, 2(1), 21–40.CrossRefGoogle Scholar
  17. Dunn, M., Flax, J., Sliwinski, M., & Aram, D. (1996). The use of spontaneous language measures as criteria for identifying children with specific language impairment. Journal of Speech and Hearing Research, 39, 643–654.CrossRefPubMedGoogle Scholar
  18. Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65–70.Google Scholar
  19. Jaswal, V., & Markman, E. (2001). Learning proper and common names in inferential versus ostensive contexts. Child Development, 27(3), 768–786.CrossRefGoogle Scholar
  20. Koegel, L. K., Koegel, R. L., & Smith, A. (1997). Variables related to differences in standardized test outcomes for children with autism. Journal of Autism and Developmental Disorders, 27(3), 233–243.CrossRefPubMedGoogle Scholar
  21. Lahey, M. (1988). Language disorders and language development. New York, NY: Macmillan.Google Scholar
  22. Lake, J. K., Humphreys, K. R., & Cardy, S. (2011). Listener vs. speaker-oriented aspects of speech: Studying the disfluencies of individuals with autism spectrum disorders. Psychonomic Bulletin and Review, 18(1), 135–140.CrossRefPubMedGoogle Scholar
  23. Lord, C., Risi, S., Lambrecht, L. K., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (1999). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.CrossRefGoogle Scholar
  24. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.CrossRefPubMedGoogle Scholar
  25. Loveland, K. A., Landry, S. H., Hughes, S. O., Hall, S. K., & McEvoy, R. E. (1988). Speech acts and the pragmatic deficits of autism. Journal of Speech and Hearing Research, 31(4), 593–604.CrossRefPubMedGoogle Scholar
  26. MacWhinney, B. (2000). The CHILDES project: Tools for analyzing talk (3rd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  27. Mundy, P., Delgado, C., Block, J., Venezia, M., Hogan, A., & Seibert, J. (2003). A manual for the abridged early social communication scales (ESCS). Coral Gables, FL: University of Miami.Google Scholar
  28. Ninio, A., & Wheeler, P. (1986). A manual for classifying verbal communicative acts in mother infant interaction. Transcript Analysis, 3(1), 1–82.Google Scholar
  29. Rogers, S. J., Hayden, D., Hepburn, S., Charlifue-Smith, R., Hall, T., & Hayes, A. (2006). Teaching young nonverbal children with autism useful speech: A pilot study of the Denver model and PROMPT interventions. Journal of Autism and Developmental Disorders, 36(8), 1007–1024.CrossRefPubMedGoogle Scholar
  30. Searle, J. R. (1969). Speech acts: An essay in the philosophy of language. London: Cambridge University Press.CrossRefGoogle Scholar
  31. Tager-Flusberg, H. (1994). Dissociations in form and function in the acquisition of language by autistic children. In H. Tager-Flusberg (Ed.), Constraints on language acquisition: Studies of atypical children (pp. 175–194). Hillsdale, NJ: Erlbaum.Google Scholar
  32. Tager-Flusberg, H. (2000). The challenge of studying language development in children with autism. In L. Menn & N. Bernstein Ratner (Eds.), Methods for studying language production (pp. 313–331). Mahwah, NJ: Erlbaum.Google Scholar
  33. Tager-Flusberg, H., & Anderson, M. (1991). The development of contingent discourse ability in autistic children. Journal of Child Psychology and Psychiatry and Allied Disciplines, 32(7), 1123–1134.CrossRefGoogle Scholar
  34. Tomasello, M. (2003). Constructing a language: A usage-based theory of language acquisition. Cambridge, MA: Harvard University Press.Google Scholar
  35. Turing, A. M. (1950). Computing machinery and intelligence. Mind, 59(236), 433–460.CrossRefGoogle Scholar
  36. Venker, C., McDuffie, A., Weismer, S. E., & Abbeduto, L. (2011). Increasing verbal responsiveness in parents of children with autism: a pilot study. Autism, 16(6), 568–585.CrossRefPubMedCentralPubMedGoogle Scholar
  37. Wechsler, D. (2002). Wechsler preschool and primary scale of intelligence (3rd ed.). San Antonio, TX: Pearson.Google Scholar
  38. Wilkinson, K. M. (1998). Profiles of language and communication skills in autism. Mental Retardation and Developmental Disabilities Research Reviews, 4(2), 73–79.CrossRefGoogle Scholar
  39. Wittgenstein, L. (1953). Philosophical investigations. G. E. M. Anscombe & R. Rhees (Eds.), (G. E. M. Anscombe, Trans.). Oxford: Blackwell.Google Scholar
  40. Yoder, P., & Stone, W. (2006). A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD. Journal of Speech, Language, and Hearing Research, 49, 698–711.CrossRefPubMedGoogle Scholar
  41. Zimmerman, I., Steiner, V., & Pond, R. (2006). Preschool language scale-4. New York: The Psychological Corporation and Harcourt Brace Jovanovich.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Devin M. Casenhiser
    • 1
    • 2
  • Amanda Binns
    • 1
  • Fay McGill
    • 1
  • Olga Morderer
    • 1
  • Stuart G. Shanker
    • 1
  1. 1.Milton and Ethel Harris Research InitiativeYork UniversityTorontoCanada
  2. 2.Department of Audiology and Speech PathologyUniversity of Tennessee Health Science CenterKnoxvilleUSA

Personalised recommendations