Does Intelligibility Change As a Function of Increased Spontaneous Communicative Utterances

Does Intelligibility Change as a Function of Increased Spontaneous Communicative Utterances

 

Background:

Approximately 30% of children with autism qualify as minimally verbal as they transition to school at age 5 (Tager-Flusberg & Kasari, 2013). Many of the children from this population receive years of early intervention focused on increasing discrete language skills and overall speech intelligibility. Recently, an intervention focused on social communication has shown to increase spontaneous communicative utterances in minimally verbal children (Kasari et al., 2014). We have yet to examine how vocalizations, unintelligible and scripted language of minimally verbal children may change in the context of this intervention.

Objectives:

(1) To study the extent to which the total number of vocalizations and unintelligible utterances (TVUU) change over the course of an intervention targeting social attention, play and spoken language.

(2) To compare change in scripted language to change in total spontaneous communicative utterances (TSCU) and TVUU.

Methods:

Participants included twenty minimally verbal children with ASD from an intervention study, using a combination of two existing interventions- Joint Attention, Symbolic Play, Engagement and Regulation (JASPER) (Kasari et al, 2006) and Enhanced Milieu Teaching (EMT) (Kaiser, 1993). All children used fewer than twenty spontaneous, functional words and had received at least two years of prior intervention. Participants were randomized to Speech (spoken language only) or AAC (spoken language plus augmentative/alternative communication device) versions of the intervention. Data were selected from a naturalistic language sample at entry and exit time-points of the study, approximately six months apart. This assessment was transcribed and coded for TSCU, TVUU, and scripted utterances.

Results:

A one-way ANOVA was used to analyze change in TVUU over the course of intervention and between treatment groups. The results indicate that there is a significant difference in the mean change of TVUU between the two groups (f = 13.73, p = .001), with substantial improvement in the AAC treatment group. In addition, the Pearson Correlation revealed a statistically significant relationship between the change in TSCU and change in TVUU over the course of intervention (r = 0.478, p < 0.05). There was not a significant correlation between the change in scripted language and change in TSCU (r = 0.263, p > 0.05) or between the change in TVUU (r = 0.163, p > 0.05).

Conclusions:  

While increased spontaneous communicative utterances were found as a result of a social communication intervention (as noted in these site specific findings and the larger multi-site study; Kasari et al., 2014), scripted language did not significantly decrease as a result of social communication intervention. These findings denote that overall increases in communication are not related to a reduction in scripted language. Future studies may want to further investigate the function of unintelligible utterances and vocalizations for children who are minimally verbal, and similarly establish the long-term effects on a child’s academic and social outcomes.