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Generalized Effects of Naturalistic Social Communication Intervention for Minimally Verbal Children with Autism

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Abstract

JASP-EMT, the combined Enhanced Milieu Teaching (EMT) and Joint Attention, Structured Play, and Emotion Regulation (JASPER) interventions, has been found to be effective for promoting social communication in young children with autism (Kasari et al. in J Am Acad Child Adolesc Psychiatry 53(6):635–646, https://doi.org/10.1016/j.jaac.2014.01.019, 2014). The current study examined the effects of this naturalistic intervention on social language use in three children with autism who were in the early stages of language acquisition. Generalization to communication partners who did not utilize the intervention strategies was systematically examined using a multiple-baseline design. The results from this study indicate that this blended intervention is effective in increasing target social language for young children with autism, however, generalization to communication partners does not readily occur. Implications for practice and future research are discussed.

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References

  • Adamson, L. B., Bakeman, R., Deckner, D. F., & Romski, M. (2009). Joint engagement and the emergence of language in children with autism and Down syndrome. Journal of Autism and Developmental Disorders, 39(1), 84–96. https://doi.org/10.1007/s10803-008-0601-7.

    Article  PubMed  Google Scholar 

  • Anderson, D. K., Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., et al. (2007). Patterns of growth in verbal abilities among children with autism spectrum disorder. Journal of Consulting and Clinical Psychology, 75(4), 594–604. https://doi.org/10.1037/0022-006X.75.4.594.

    Article  PubMed  Google Scholar 

  • Bono, M. A., Daley, T., & Sigman, M. (2004). Relations among joint attention, amount of intervention and language gain in autism. Journal of Autism and Developmental Disorders, 34(5), 495–505. https://doi.org/10.1007/s10803-004-2545-x.

    Article  PubMed  Google Scholar 

  • Brignell, A., Morgan, A. T., Woolfenden, S., Klopper, F., May, T., Sarkozy, V., et al. (2018). A systematic review and meta-analysis of the prognosis of language outcomes for individuals with autism spectrum disorder. Autism & Developmental Language Impairments, 3, 2396941518767610.

    Article  Google Scholar 

  • Chow, J. C., & Hampton, L. H. (2019). Sequential Multiple-Assignment Randomized Trials: Developing and evaluating adaptive interventions in special education. Remedial and Special Education, 40(5), 267–276. https://doi.org/10.1177/0741932518759422.

    Article  Google Scholar 

  • Dunn, L. M., Dunn, L. M., Bulheller, S., & Häcker, H. (1965). Peabody picture vocabulary test. Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Dunn, P. L. M., & Dunn, P. D. M. (2007). Peabody picture vocabulary test, Fourth Edition (PPVT4)—FORM B (Fourth Edition). Pearson Assessments.

  • Fuller, E. A., & Kaiser, A. P. (2019). The effects of early intervention on social communication outcomes for children with autism spectrum disorder: A meta-analysis. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-019-03927-z.

    Article  Google Scholar 

  • Gast, D. L., & Ledford, J. R. (2014). Single case research methodology: Applications in special education and behavioral sciences. London: Routledge.

    Book  Google Scholar 

  • Goods, K. S., Ishijima, E., Chang, Y.-C., & Kasari, C. (2012). Preschool based JASPER intervention in minimally verbal children with autism: Pilot RCT. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-012-1644-3.

    Article  Google Scholar 

  • Gulsrud, A. C., Hellemann, G. S., Freeman, S. F., & Kasari, C. (2014). Two to ten years: Developmental trajectories of joint attention in children with ASD who received targeted social communication interventions. Autism Research, 7(2), 207–215.

    Article  Google Scholar 

  • Hampton, L. H., Harty, M., Fuller, E. A., & Kaiser, A. P. (2019). Enhanced milieu teaching for children with autism spectrum disorder in South Africa. International Journal of Speech-Language Pathology, 21(6), 635–645.

    Article  Google Scholar 

  • Hampton, L. H., & Kaiser, A. P. (2016). Intervention effects on spoken-language outcomes for children with autism: a systematic review and meta-analysis. Journal of Intellectual Disability Research, 60(5), 444–463.

    Article  Google Scholar 

  • Hampton, L. H., Kaiser, A. P., & Roberts, M. Y. (2017). One-year language outcomes in toddlers with language delays: An RCT follow-up. Pediatrics, 140(5), e20163646.

    Article  Google Scholar 

  • Kaiser, A. P., & Hampton, L. H. (2017). Enhanced Milieu teaching. In R. McCauley, M. Fey, & R. Gilliam (Eds.), Treatment of language disorders in children (pp. 87–119). Baltimore: Brooks Publishing Co.

    Google Scholar 

  • Kaiser, A. P., & Hester, P. P. (1994). Generalized effects of enhanced milieu teaching. Journal of Speech, Language, and Hearing Research, 37, 1320–1340.

    Article  Google Scholar 

  • Kaiser, A. P., & Roberts, M. Y. (2013). Parent-implemented Enhanced Milieu Teaching with preschool children who have intellectual disabilities. Journal of Speech, Language, and Hearing Research, 56(1), 295.

    Article  Google Scholar 

  • Kaiser, A. P., Scherer, N., Frey, J., & Roberts, M. Y. (2017). The effects of enhanced milieu teaching with phonological emphasis on the speech and language skills of young children with Cleft Palate: A pilot study. American Journal of Speech-Language Pathology, 26(3), 806–818.

    Article  Google Scholar 

  • Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611–620. https://doi.org/10.1111/j.1469-7610.2005.01567.x.

    Article  PubMed  Google Scholar 

  • Kasari, C., Gulsrud, A., Freeman, S., Paparella, T., & Hellemann, G. (2012). Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play. Journal of the American Academy of Child & Adolescent Psychiatry, 51(5), 487–495. https://doi.org/10.1016/j.jaac.2012.02.019.

    Article  Google Scholar 

  • Kasari, C., Gulsrud, A. C., Wong, C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40(9), 1045–1056. https://doi.org/10.1007/s10803-010-0955-5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kasari, C., Kaiser, A. P., Goods, K., Nietfeld, J., Mathy, P., Landa, R., et al. (2014a). Communication interventions for minimally verbal children with autism: A sequential multiple assignment randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 53(6), 635–646. https://doi.org/10.1016/j.jaac.2014.01.019.

    Article  Google Scholar 

  • Kasari, C., Lawton, K., Shih, W., Barker, T. V., Landa, R., Lord, C., et al. (2014b). Caregiver-mediated intervention for low-resourced preschoolers with autism: An RCT. Pediatrics, 134(1), e72–e79.

    Article  Google Scholar 

  • Kasari, C., Siller, M., Huynh, L. N., Shih, W., Swanson, M., Hellemann, G. S., et al. (2014c). Randomized controlled trial of parental responsiveness intervention for toddlers at high risk for autism. Infant Behavior and Development, 37(4), 711–721.

    Article  Google Scholar 

  • Kasari, C., Paparella, T., Freeman, S., & Jahromi, L. B. (2008). Language outcome in autism: Randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology, 76(1), 125–137. https://doi.org/10.1037/0022-006X.76.1.125.

    Article  PubMed  Google Scholar 

  • Kaufman, N. R. (1995). Kaufman speech praxis treatment kit for children: Basic level. Detroit: Wayne State University Press.

    Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P., & Risi, S. (2002). Autism diagnostic observation schedule: ADOS: Manual. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Lord, C., Wagner, A., Rogers, S., Szatmari, P., Aman, M., Charman, T., et al. (2005). Challenges in evaluating psychosocial interventions for autistic spectrum disorders. Journal of Autism and Developmental Disorders, 35(6), 695–708.

    Article  Google Scholar 

  • Miller, J. F. (1981). Assessing language production in children: Experimental procedures (Vol. 1). Univ Park Press.

  • Miller, J., & Chapman, R. (2008). Systematic analysis of language transcripts. Baltimore: University Park Press.

    Google Scholar 

  • Mundy, P., Delgado, C., Block, J., Venezia, M., Hogan, A., & Seibert, J. (2003). Early social communication scales (ESCS). Coral Gables: University of Miami.

    Google Scholar 

  • National Research Council. (2001). Educating children with autism. Washington, DC: National Research Council.

    Google Scholar 

  • Paul, R. (2008). Interventions to improve communication in autism. Child and Adolescent Psychiatric Clinics of North America, 17(4), 835–856.

    Article  Google Scholar 

  • Rogers, S. J., Hepburn, S. L., Stackhouse, T., & Wehner, E. (2003). Imitation performance in toddlers with autism and those with other developmental disorders. Journal of Child Psychology and Psychiatry, 44(5), 763–781.

    Article  Google Scholar 

  • Roid, G. H., & Miller, L. J. (1997). Leiter international performance scale-revised (Leiter-R). Wood Dale, IL: Western Psychological Services.

    Google Scholar 

  • Rutter, M. (1978). Diagnosis and definition. In Autism (pp. 1–25). Springer. https://doi.org/10.1007/978-1-4684-0787-7_1.

  • Schreibman, L., & Stahmer, A. C. (2014). A randomized trial comparison of the effects of verbal and pictorial naturalistic communication strategies on spoken language for young children with autism. Journal of Autism and Developmental Disorders, 44(5), 1244–1251. https://doi.org/10.1007/s10803-013-1972-y.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tager-Flusberg, H., & Kasari, C. (2013). Minimally verbal school-aged children with autism spectrum disorder: The neglected end of the spectrum. Autism Research, 6, 468–478. https://doi.org/10.1002/aur.1329.

    Article  PubMed  Google Scholar 

  • Tager-Flusberg, H., Rogers, S., Cooper, J., Landa, R., Lord, C., Paul, R., et al. (2009). Defining spoken language benchmarks and selecting measures of expressive language development for young children with autism spectrum disorders. Journal of Speech, Language, and Hearing Research, 52(3), 643–652.

    Article  Google Scholar 

  • Tasker, S. L., & Schmidt, L. A. (2008). The “dual usage problem” in the explanations of “joint attention” and children’s socioemotional development: A reconceptualization. Developmental Review, 28, 263–288. https://doi.org/10.1016/j.dr.2007.07.001.

    Article  Google Scholar 

  • Toth, K., Munson, J., Meltzoff, A. N., & Dawson, G. (2006). Early predictors of communication development in young children with autism spectrum disorder: Joint attention, imitation, and toy play. Journal of Autism and Developmental Disorders, 36(8), 993–1005. https://doi.org/10.1007/s10803-006-0137-7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ungerer, J. A., & Sigman, M. (1984). The relation of play and sensorimotor behavior to language in the second year. Child Development, 55, 1448–1455.

    Article  Google Scholar 

  • Wolery, M. (2013). A commentary: Single-case design technical document of the What Works Clearinghouse. Remedial and Special Education, 34(1), 39–43.

    Article  Google Scholar 

  • Wright, C. A., Kaiser, A. P., Reikowsky, D. I., & Roberts, M. Y. (2012). Effects of a naturalistic sign intervention on expressive language of toddlers with down syndrome. Journal of Speech, Language, and Hearing Research: JSLHR., 56(3), 994–1008.

    Article  Google Scholar 

  • Yoder, P. J. (2006). Predicting lexical density growth rate in young children with autism spectrum disorders. American Journal of Speech-Language Pathology, 15(4), 378–388.

    Article  Google Scholar 

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Acknowledgments

Thank you Dr. Mark Woolery for his guidance of the study design.

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All of the authors contributed to the design and analysis of the study. LHH and AK contributed to the execution of the study, and JPN and APK provided intervention and fidelity training and supervision. LHH and APK prepared the manuscript. The final manuscript has been edited and approved by all the authors.

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Correspondence to Lauren H. Hampton.

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Hampton, L.H., Kaiser, A.P., Nietfeld, J.P. et al. Generalized Effects of Naturalistic Social Communication Intervention for Minimally Verbal Children with Autism. J Autism Dev Disord 51, 75–87 (2021). https://doi.org/10.1007/s10803-020-04521-4

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