Randomized Study Contrasting Behavioral and Naturalistic Approaches to Inducing Speech in Prelinguistic Children with Autism Spectrum Disorders: Preliminary Analysis

Background:

Autism and related disabilities are severe disorders of development, disrupting social relationships, communication, play, adaptive skills, and academic skills. These disruptions often lead to life-long disability. The development of functional spoken language by the end of preschool is known to be related to improved outcomes in this syndrome. Although many different approaches to developing speech in prelinguistic children with autism have emerged, there is a lack of systematic research comparing these approaches.

Objectives:

This poster presents early findings from a study comparing the effectiveness of two intervention strategies (behavioral and naturalistic) in children with autism spectrum disorders (ASD). The behavioral approach (i.e., direct speech-focused treatment) to be studied is Rapid Motor Imitation Training (RMIT; Tsiouri & Greer, 2002), and the naturalistic approach is Prelinguistic Milieu Teaching (PMT; Yoder & Warren, 2002).

Methods:

Participants were randomly assigned to one of the two treatments. The following inclusion criteria were used: (a) children had a diagnosis of an ASD, (b) child was between 36 - 72 months-old, (c) produced fewer than 10 different words in spontaneous speech, (d) could imitate simple motor actions, and (e) had expressive communication levels below 18 months. Treatment sessions were delivered by a SLP 3 times per week for 12 weeks. Treatment fidelity was continuously monitored throughout treatment sessions by off-site experts, and remained high across interventionists and sessions.

Results:

Preliminary data analyses of pre- and post-treatment measures consisting of 3 participants from each group were conducted. Analyses of the children’s scores on the MacArthur-Bates Communication Inventories-3^rd Edition (Fenson et al., 2007), the Communication and Symbolic Behavior Scales (Wetherby & Prizant, 2002), and the Mullen Scales of Early Learning (Mullen, 1995) were conducted. In examining the difference between the pre-treatment and post-treatment assessments, all children receiving treatment made improvements during the course of the treatment. Improvements were seen in the frequency and diversity of words spoken during the assessment session, the diversity of words parents reported the child was using, and the number of words the parents reported the child understood. Anecdotal records also indicated the children receiving treatment increased their ability to imitate gestures and simple actions, which is often considered a prerequisite skill for the acquisition of spoken language. Results of six-month follow-up assessments are pending, and will be presented. An additional comparison with a no treatment contrast group consisting of 3 individuals not meeting the motor imitation inclusion criteria are also being analyzed, and these data will also be presented.

Conclusions:

Given the preliminary nature of the data, it is too early to determine the superiority of one treatment. However, the results suggest multiple types of treatment delivered with high fidelity can be beneficial to young children with autism with limited verbal communication skills.