No AccessJournal of Speech, Language, and Hearing ResearchResearch Article1 Aug 2006

A Randomized Comparison of the Effect of Two Prelinguistic Communication Interventions on the Acquisition of Spoken Communication in Preschoolers With ASD

    Purpose

    This randomized group experiment compared the efficacy of 2 communication interventions (Responsive Education and Prelinguistic Milieu Teaching [RPMT] and the Picture Exchange Communication System [PECS]) on spoken communication in 36 preschoolers with autism spectrum disorders (ASD).

    Method

    Each treatment was delivered to children for a maximum total of 24 hr over a 6-month period. Spoken communication was assessed in a rigorous test of generalization at pretreatment, posttreatment, and 6-month follow-up periods.

    Results

    PECS was more successful than RPMT in increasing the number of nonimitative spoken communication acts and the number of different nonimitative words used at the posttreatment period. Considering growth over all 3 measurement periods, an exploratory analysis showed that growth rate of the number of different nonimitative words was faster in the PECS group than in the RPMT group for children who began treatment with relatively high object exploration. In contrast, analogous slopes were steeper in the RPMT group than in the PECS group for children who began treatment with relatively low object exploration.

    References

    • Alpert, C., & Rogers Warren, A. (1985). Communication in autistic persons: Characteristics and intervention.In S. Warren, & A. K. Rogers-Warren (Eds.), Teaching functional language: Generalization and maintenance of language skills (pp. 123–156). Austin, TX: Pro-Ed.
    • Bates, E. (1979). Intentions, conventions, and symbols.In E. Bates, L. Benigni, I. Bretherton, L. Camaioni, & V. Volterra (Eds.), The emergence of symbols: Cognition and communication in infancy (pp. 33–68). New York: Academic Press.
    • Bondy, A. S., & Frost, L. A. (1994). PECS: The Picture Exchange Communication System training manual. Cherry Hill, NJ: Pyramid Educational Consultants.
    • Bryk, A., & Raudenbush, S. (1992). Hierarchical linear models. Newbury Park, CA: Sage.
    • Charlop-Christy, M. H., Carpenter, M., Le, L., LeBlanc, L., & Kellet, K. (2002). Using the Picture Exchange Communication System (PECS) with children with autism: Assessment of PECS acquisition, speech, and social-communication behavior, and problem behavior.Journal of Applied Behavior Analysis, 35, 213–231.
    • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
    • Cohen, J., & Cohen, P. (1984). Applied multiple regression/correlation analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
    • Cronbach, L. J. (1972). The dependability of behavioral measurements: Theory of generalizability for scores and profiles. New York: Wiley.
    • Cronbach, L. J., & Furby, L. (1970). How we should measure change—or should we?.Psychological Bulletin, 74, 68–80.
    • DeMyer, M. K., Barton, S., DeMyer, W., Norton, J., Allen, J., & Steele, R. (1973). Prognosis in autism: A follow-up study.Journal of Autism and Childhood Schizophrenia, 3(3)199–246.
    • Department of Health and Human Services. (2004). Congressional appropriations committee report on the state of autism research. Retrieved from http://www.nimh.nih.gov/autismiacc/CongApprCommRep.pdf
    • Fey, M. E., Warren, S. F., Brady, N., Finestack, L., Bredin-Oja, S., & Fairchild, M. (2005). Early effects of Prelinguistic Milieu Teaching and Responsive Education for children with developmental delays and their parents. Unpublished manuscript, The University of Kansas
    • Ganz, J., & Simpson, R. L. (2004). Effects on communicative requesting and speech development of Picture Exchange Communication System in children with characteristics of autism.Journal of Autism and Developmental Disorders, 34, 395–409.
    • Gillberg, C., & Steffenburg, S. (1987). Outcome and prognostic factors in infantile autism and similar conditions: A population-based study of 46 cases followed through puberty.Journal of Autism and Developmental Disorders, 17, 273–287.
    • Kaiser, A. P., Yoder, P. J., & Keetz, A. (1992). Evaluating milieu teaching.In S. F. Warren (Ed.), Causes and effects in communication and language intervention: Communication and language intervention series, Vol. 1(pp. 9–47). Baltimore, MD: Brookes.
    • Kobayashi, R., Murata, T., & Yoshinaga, K. (1992). A follow-up study of 201 children with autism in Kyushu and Yamaguchi areas, Japan.Journal of Autism and Developmental Disorders, 22(3)395–411.
    • Lifter, K. (2001). Linking assessment to intervention for children with developmental disabilities or at-risk for developmental delay: The developmental play assessment (DPA) instrument.In K. Gitlin-Weiner, A. Sandgrund, & C. Schafer (Eds.), Play diagnosis and assessment (pp. 228–260). New York Wiley.
    • Lloyd, L. L., Fuller, D. R., & Arvidson, H. H. (1997). Augmentative and alternative communication: A handbook of principles and practices. Boston: Allyn & Bacon.
    • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., & DiLavore, P. C. (2000). The Autism Diagnostic Observation Schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism.Journal of Autism and Developmental Disorders, 30(3)205–223.
    • Miller, J., & Chapman, R. (1993). Systematic Analysis of Language Transcripts [Computer software]. Madison, WI: University of Wisconsin.
    • Mullen, E. M. (1992). Mullen Scales of Early Learning. Los Angeles, CA: Western Psychological.
    • Ousley, O. (1997). The relations of social approach, attention shifting, and executive function skills to social turn-taking skills in young children with pervasive developmental disorders. Unpublished dissertation, Vanderbilt University
    • Prizant, B., Wetherby, A., & Rydell, P. (2000). Communication intervention issues for children with autism spectrum disorders.In A. Wetherby, & B. Prizant (Eds.), Autism spectrum disorders: A transactional developmental perspective, Vol. 9(pp. 193–224). Baltimore, MD: Brookes.
    • Raudenbush, S., Bryk, A., Cheong, Y., & Congdon, R. (2001). HLM5: Hierarchical Linear and Nonlinear Modeling [Computer software]. Lincolnwood, IL: Scientific Software International.
    • Rosenthal, R., & DiMatteo, M. R. (2001). Meta-analysis: Recent developments in quantitative methods for literature reviews.Annual Review of Psychology, 52, 59–82.
    • Rutter, D. R., & Lockyer, L. (1967). A five to fifteen year follow-up of infantile psychosis: II. Social and behavioral outcomes.British Journal of Psychiatry, 113, 1169–1182.
    • Singer, J. (1998). Using SAS PROC MIXED to fit multilevel models, hierarchical models, and individual growth models.Journal of Educational and Behavioral Statistics, 24, 323–355.
    • Singer, J., & Willett, J. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. New York: Oxford University Press.
    • Sussman, F. (2001). More than words: Helping parents promote communication and social skills in children with autism spectrum disorders. Toronto, Ontario, Canada: Hanen Centre.
    • Tapp, J., & Yoder, P. (2001). Turn-taker [Computer software]. Nashville, TN: Vanderbilt University.
    • Tapp, J., & Yoder, P. (2003). Play Coder (Version 1.1.2) [Computer software].Nashville, TN: Vanderbilt University.
    • Venter, A., Lord, C., & Schopler, E. (1992). A follow-up study of high-functioning autistic children.Journal of Child Psychology and Psychiatry, 33, 489–507.
    • Warren, S. F. (1991). Enhancing communication and language development with milieu teaching procedures.In E. Cipani (Ed.), A guide to developing language competence in preschool children with severe and moderate handicaps (pp. 68–93). Springfield, IL: Charles C. Thomas.
    • Wilcox, M. J., & Shannon, M. (1998). Facilitating the transition from prelinguistic to linguistic communication.In A. Wetherby, S. F. Warren, & J. Reichle (Eds.), Transitions in prelinguistic communication, Vol. 7(pp. 385–416). Baltimore, MD: Brookes.
    • Yoder, P. J., & Compton, D. (2004). Identifying predictors of treatment response.Mental Retardation and Developmental Disabilities Research Reviews, 10, 162–168.
    • Yoder, P. J., & Munson, L. J. (1995). The social correlates of coordinated attention to adult and objects in mother–infant interaction.First Language, 15, 219–230.
    • Yoder, P. J., & Warren, S. F. (1998). Maternal responsivity predicts the prelinguistic communication intervention that facilitates generalized intentional communication.Journal of Speech, Language, and Hearing Research, 41, 1207–1219.
    • Yoder, P. J., & Warren, S. F. (1999). Self-initiated proto-declaratives and proto-imperatives can be facilitated in prelinguistic children with developmental disabilities.Journal of Early Intervention, 22, 337–354.
    • Yoder, P. J., & Warren, S. F. (2001). Intentional communication elicits language-facilitating maternal responses in dyads with children who have developmental disabilities.American Journal on Mental Retardation, 106, 327–335.
    • Yoder, P. J., & Warren, S. F. (2002). Effects of prelinguistic milieu teaching and parent responsivity education on dyads involving children with intellectual disabilities.Journal of Speech, Language, and Hearing Research, 45, 1158–1174.

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