Communication-based Intervention for non-verbal children with Autism

Gordon, Pasco, McElduff, Wade, and Howlin investigated how a classroom-based intervention, Picture Exchange Communication System (PECS training), aided in the refinement of impulsive communication abilities in nonverbal children with Autism Spectrum Disorder (ASD). This was driven by the fact that up to 25% of people with ASD were unable to communicate using speech sounds (Gordon et al., 2011). Consequently, the aim of the interventions, for children with autism, was to enhance their spontaneity in in everyday communication and PECS did that by providing a social context to teach kids how to communicate functionally and instinctively.

In this study there were eighty-four children; 74 of them being male while the rest were females. Their ages varied from 4-10 years (mean age = 6.8). For eligibility, children had to be of ages between 4-11, diagnosed with autism, have little to no functional ability of language but have working sensory functions, and they must not have been exposed to of PECS past the first stage. The authors assumed that PECS intervention led to improved instrumental request using the PECS cards and that the increased instrumental requesting would lead to increased spontaneous social communication.

The outcomes included three different communication modalities in regards to two different functions which were used to determine the impact on the spontaneity of the children’s communications using PECS training. Accordingly, baseline variables were tested for the moderating effect they had on intervention. These results answered the researchers’ query about PECS training and also showed that communication spontaneity was enhanced as a result of the intervention.

The study, furthermore, found out that even though PECS did not enhance speech development in children who already had vocalization, it gave them a means in which to communicate without being prompted. Having children with severe autism symptoms, enabled the researchers to find that there was, in fact, no effect of training for social purposes on these kids. It was also concluded that spontaneous social, non-instrumental communication might have been evident if longer, intense training had continued. Nevertheless, part of the success was that the classroom teachers had to incorporate the program into their teaching. This greatly motivated the learning process of the children and determined that this form of PECS training is a useful and practical means for children receiving intervention since it includes a one-on-one training that is inclusive of support from their school teachers.

Article Summary 2

Wan, Y.C., Bazen, L., Baars, R., Libenson, A., Zipse, et al. (2011). Auditory-motor Mapping

Training as an Intervention to Facilitate Speech Output in Nonverbal Children with Autism: A Proof of Concept Study. PLoS ONE, 6.

In this study Wan, Bazen, Baars, Libenson, Zipsie, Zuk, Norton and Schlaug used an intervention targeted at the rising and falling intonation patterns that are crucial for speech; and measured its effectiveness to facilitate nonverbal children with ASD to speak (Wan et al. 2011). In this, the therapist is intended to introduce particular words and phrases and matching them to the tone of the drums played. Although the progress of this study hugely depends on the therapist’s outlook of the child, it points out that the intonation-based procedure can indeed offer grounds to communicate for a child with autism.

The study consisted of six participants who were nonverbal children between ages 5-9 and had a diagnosis of autism. The diagnoses were confirmed using Childhood Autism Rating Scale (CARS). During this course of AMMT program, the children were required to maintain their regular classroom studies but were not to be exposed to any new treatment schedule (Wan et al. 2011). The design of the study included the children to have one-on-one training. The intervention occurred over an 8-week span, done five days a week which resulted in 40 sessions in total per participant. During the treatment period, the researchers conducted probe assessments starting at session 10 and later at every 5th session till the 40th one.

Each session had a set of 15 items, relevant to the child’s daily activities, to train on. This included practice on high-frequency words such as “mommy,” and other words and phrases that would be useful for communication between the child and the recipient of speech. The therapist was able to do this by introducing the target words in a song like a manner, on two tones while at that instance tapping the drums (with similar tones). Visual cues (i.e. Boardmaker pictures) were also used during sessions. It was noted that the child moved from speaking in scattered tonal variations and moved closer each time to pronouncing the particular words and phrases in the manner which would enable the child to communicate more.

One area of interest for the researchers was to see how the children’s production would change when presented with picture stimuli. What the results showed was that by 15 sessions of training, all of the participants showed improvement in their speech production. The aim of this study was to determine whether this new intervention program would facilitate speech. Ultimately, AMMT was suggested to be an effective method non-verbal autistic children could use to add more to the variety they had and in the complexity of their voice production. However, if a larger study were carried out that would include an adequate control group, then it would pose repercussions on the treatment of non-verbal children with autism. This is because a single subject design allows for each and every child to have control of their own that is beneficial to the children, individually. Results on the children’s vocal production, at the end of the study, showed improvement in vocalizing and production of speech sounds.