Behavior Predictors of Language Development Over 2 Years in Children With Autism Spectrum Disorders

ArticleinJournal of Speech Language and Hearing Research 52(5):1106-20 · October 2009with32 Reads
Impact Factor: 2.07 · DOI: 10.1044/1092-4388(2009/07-0262) · Source: PubMed

This exploratory study examined predictive relationships between 5 types of behaviors and the trajectories of vocabulary and language development in young children with autism over 2 years. Participants were 69 children with autism assessed using standardized measures prior to the initiation of early intervention (T1) and 6 months (T2), 12 months (T3), and 24 months (T4) later. Growth curve modeling examined the extent to which behaviors at T1 and changes in behaviors between T1 and T2 predicted changes in development from T1 to T4. Regardless of T1 nonverbal IQ and autism severity, high scores for inattentive behaviors at T1 predicted lower rates of change in vocabulary production and language comprehension over 2 years. High scores for social unresponsiveness at T1 predicted lower rates of change in vocabulary comprehension and production and in language comprehension over 2 years. Scores for insistence on sameness behaviors, repetitive stereotypic motor behaviors, and acting-out behaviors at T1 did not predict the rate of change of any child measure over 2 years beyond differences accounted for by T1 autism severity and nonverbal IQ status. The results are discussed with regard to their implications for early intervention and understanding the complex factors that affect developmental outcomes.

  • [Show abstract] [Hide abstract] ABSTRACT: Eighty-seven preschoolers with autism spectrum disorders who were initially nonverbal (under 6 words in language sample and under 21 parent-reported words said) were assessed at five time points over 16 months. Statistical models that accounted for the intercorrelation among nine theoretically- and empirically-motivated predictors, as well as two background variables (i.e., cognitive impairment level, autism severity), were applied to identify value-added predictors of expressive and receptive spoken language growth and outcome. The results indicate that responding to joint attention, intentional communication, and parent linguistic responses were value-added predictors of both expressive and receptive spoken language growth. In addition, consonant inventory was a value-added predictor of expressive growth; early receptive vocabulary and autism severity were value-added predictors of receptive growth.
    Full-text · Article · Apr 2015 · Journal of Autism and Developmental Disorders
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    • "... 2 to 3 years. Data on the relevance of RRBs in response to treatment are scant and equivocal (52, 97, 98), so more research is needed to investigate how individual differences in the extent of RBRs af..."
      For example, Watt et al. (96) reported that prolonged engagement with RBBs was negatively related to social competence across the crucial developmental period from 2 to 3 years. Data on the relevance of RRBs in response to treatment are scant and equivocal (52, 97, 98), so more research is needed to investigate how individual differences in the extent of RBRs affect response to intervention.
    [Show abstract] [Hide abstract] ABSTRACT: Response to early intervention programs in autism is variable. However, the factors associated with positive versus poor treatment outcomes remain unknown. Hence the issue of which intervention/s should be chosen for an individual child remains a common dilemma. We argue that lack of knowledge on "what works for whom and why" in autism reflects a number of issues in current approaches to outcomes research, and we provide recommendations to address these limitations. These include: a theory-driven selection of putative predictors; the inclusion of proximal measures that are directly relevant to the learning mechanisms demanded by the specific educational strategies; the consideration of family characteristics. Moreover, all data on associations between predictor and outcome variables should be reported in treatment studies.
    Full-text · Article · Jun 2014 · Frontiers in Pediatrics
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  • [Show abstract] [Hide abstract] ABSTRACT: Background: Between 24 – 30% of children with autism spectrum disorders (ASD) do not use spoken communication by 5 years old. Spoken communication at 5 years predicts later adaptive outcomes in individuals with ASD. Identifying parsimonious predictive models of theory-guided predictors of vocabulary growth moves us towards understanding the variability in learning to communicate via speech within the ASD population. Parsimonious models include only predictors that account for significant variance in the outcome after statistically controlling for other predictors. Objectives: The incremental validity of eight putative predictors of growth curves of parent-reported expressive and receptive vocabulary was tested. Each putative predictor had empirical and theoretical grounds for selection. Methods: Eight-six initially nonverbal preschoolers with ASD were assessed 5 times in 4-month intervals over 16 months. Receptive and expressive vocabulary sizes were estimated using a parent report (i.e., the McArthur-Bates Communicative Development Inventory, Words and Gestures). The Communication and Symbolic Behavior Scale, Early Social Communication Scales, Motor Imitation Scale, Mullen Early Learning Scale, 2 parent-child interaction sessions, the Developmental Play Scale, and an oral motor assessment were used to measure putative predictors. Mixed level modeling was used to quantify individual vocabulary growth curves. The Time 5-centered intercept was selected as the parameter of interest because it is arguably the most interpretable parameter when quadratic or cubic models are needed to model growth (i.e., the best estimate of vocabulary size at Time 5). Putative predictors were measured at Times 1 or Time 2. To afford interpretable effect sizes, ordinary least square estimates of the intercepts for the growth curves were analyzed as the criterion variables in multiple regressions used to identify unique predictors (i.e., after controlling all other predictors in the model). Results: Quadratic models fit the data better than simple linear models. Except for IQ, all putative predictors predicted either expressive or receptive vocabulary. After controlling for other variables and after reducing the model to predictors with incremental validity, 3 predictors remained in each model. The number of parental linguistic responses to child leads at Time 2 (R2 change = .12), number of intentional communication acts at Time 1 and 2 (R2 change = .11), and number of different object play actions at Time 1 (R2 change = .04) added to account for 29% of the variance (adjusted R square) in expressive vocabulary. The number of words understood at Time 1 (R2 change= .27), number of object play actions at Time 1 (R2 change = .10), and number of parental linguistic responses to child leads at Time 2 (R2 change= .04) added to account for 49% of the variance in receptive vocabulary. Putative predictors without incremental validity were oral motor functioning, IQ, motor imitation, responding to joint attention, and consonant inventory. Conclusions: The results support selecting the unique predictors as goals for nonverbal children with ASD. The number of predictors, number of measurement periods, use of growth curves, long interval between predictor measurement and end-point of study, and large sample size make this study particularly important to the field.
    Full-text · Conference Paper · May 2014
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    • "...e findings have been reported in infants and toddlers with Autism Spectrum Disorders (Bopp, Mirenda, & Zumbo, 2009), as well as using similar longitudinal tracking studies with older children (Dice & Schwanenflugel..."
      They found that some (but not all) of their informationprocessing measures (memory and representational competence, but not attention and processing speed) correlated with language performance at 12 months and predicted subsequent language performance at 36 months, independent of birth status (see also Dixon & Smith, 2008; Kannass & Oakes, 2008; Snyder & Munakata, 2011). Comparable findings have been reported in infants and toddlers with Autism Spectrum Disorders (Bopp, Mirenda, & Zumbo, 2009), as well as using similar longitudinal tracking studies with older children (Dice & Schwanenflugel, 2012; Gathercole, Alloway, Willis, & Adams, 2006; Kegel & Bus, 2012). A number of groups have also used techniques such as Structural Equation Modelling (SEM) to explore possible mediators between early development and longer term cognitive outcomes in clinical populations, such as infants born preterm (Rose, Feldman, & Jankowski, 2005; Voigt, Pietz, Pauen, Kliegel, & Reuner, 2012; Weindrich, Jennen-Steinmetz, Laucht, & Schmidt, 2003).
    [Show abstract] [Hide abstract] ABSTRACT: Developmental psychopathology is increasingly recognizing the importance of distinguishing causal processes (i.e., the mechanisms that cause a disease) from developmental outcomes (i.e., the symptoms of the disorder as it is eventually diagnosed). Targeting causal processes early in disordered development may be more effective than waiting until outcomes are established and then trying to reverse the pathogenic process. In this review, I evaluate evidence suggesting that neural and behavioral plasticity may be greatest at very early stages of development. I also describe correlational evidence suggesting that, across a number of conditions, early emerging individual differences in attentional control and working memory may play a role in mediating later-developing differences in academic and other forms of learning. I review the currently small number of studies that applied direct and indirect cognitive training targeted at young individuals and discuss methodological challenges associated with targeting this age group. I also discuss a number of ways in which early, targeted cognitive training may be used to help us understand the developmental mechanisms subserving typical and atypical cognitive development.
    Full-text · Article · Feb 2014 · Child Neuropsychology
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    • "...portant prerequisite for language development over time (Bono, Daley, & Sigman, 2004; Bopp, Mirenda, & Zumbo, 2009; Tomasello, 1992). The quality of parent responsiveness has been found to be a valid predictor of th..."
      This study showed that the level of joint attention exhibited by children with ASD was a valid indicator of present-level language skills. Joint attention is considered an important prerequisite for language development over time (Bono, Daley, & Sigman, 2004; Bopp, Mirenda, & Zumbo, 2009; Tomasello, 1992). The quality of parent responsiveness has been found to be a valid predictor of the vocabulary development of children with ASD.
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  • [Show abstract] [Hide abstract] ABSTRACT: Attention impairments are well documented in children with autism spectrum disorders (ASD). Under associative accounts of early word learning, the attention impairments in children with ASD preclude them from developing effective learning strategies. In this study we examined whether children with ASD utilize the same attention cues for learning as their unaffected receptive-vocabulary mates. In a word-learning task, we asked: 1) whether hearing novel and attention-grabbing words cued children to shift their attention to the speaker, and 2) whether the children followed the gaze of the speaker to determine the speaker's focus of attention. We taught novel words in two conditions. One condition provided maximal social-attention scaffolding; the examiner followed the focus of the child's attention. The other was less scaffolded; the examiner directed the child's attention to the target using eye gaze. We manipulated the number of objects present during teaching, two versus four, to examine the effect of non-social attention scaffolding with scaffolding here defined as a reduction in distractions. Fifteen-children with ASD (ages 36-91 months) were matched to fifteen unaffected children (ages 16-92 months) on the basis of receptive vocabulary (RVM group). The ASD group's performance differed from the RVM group's performance on one measure: shifting attention to the speaker upon hearing a novel or attention-grabbing word on the initial trial. On all other measures, the ASD group's performance did not significantly differ from the RVM group's performance. Although there was not a significant effect of condition, closer analysis revealed that in the RVM and ASD groups, only the consistent-gaze followers' performed better than chance on the word-learning tasks. We hypothesize that, when all else is equal, providing a label does not make the target distinct enough to support word-referent pairings for children who are not consistently attending to the speaker. Overall, the ASD group demonstrated greater within group variability in their attention than the RVM group. Gaze following was variable across (and within) the ASD group. The within subject variability suggests some children with ASD are slow to appreciate eye gaze cues in unfamiliar contexts.
    Preview · Article · Jan 2010
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