Measuring Small but Important Changes in Minimally Verbal Children with ASD

Background:  Few measures are available that reflect changes in the quality of prelinguistic communication. Brady and colleagues have been developing and testing a scale called the Communication Complexity Scale (CCS) designed to reflect qualitative changes in the forms and functions of prelinguistic communication by individuals with severe ID (Brady et al., 2012).

Objectives:  The current study focuses on how different scores that can be derived from the CCS compare to scores from other measures, and predict changes over time.

Methods:  125 individuals with ASD between the ages of 3-60 years were concurrently assessed with the CCS and two other measures of early communication- the Communication Matrix (Rowland & Fried-Oken, 2010) and the Communication Subscales from the Vineland II (Sparrow, Cicchetti, & Balla, 2005). 110 additional children with ASD were assessed with the CCS and the Early Social Communication Scales (ESCS) (Mundy, Hogan, & Doehring, 1996) pre and post intervention.

Results: 1. Scores derived from the three best communication attempts during the CCS (Optimal) correlate higher with scores from the Matrix and VABS2 than modal scores. 2. Significant changes pre-post intervention were detected after 6 months of intervention with CCS scores and the rate of joint attention communication. Only changes in rates of behavior regulation were significant for children in shorter interventions. 3. Changes measured with the CCS were similar to those measured with rates of joint attention and behavior regulation measured during the ESCS.

Conclusions:  The CCS picked up changes in the quality of prelinguistic communication including advancements in gestures, eye gaze and functions of communication. These changes paralleled changes in quantity of communication.