Word Learning in Children With Autism



Status:Recruiting
Conditions:Cognitive Studies, Psychiatric, Psychiatric
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:5 - 10
Updated:6/30/2018
Start Date:November 1, 2016
End Date:May 31, 2021
Contact:Nancy C Brady, PhD
Email:nbrady@ku.edu
Phone:785-864-0762

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Word Learning in Children With Autism (Kansas Intellectual and Developmental Disabilities Research Center Project I)

The project highlights one of the primary areas of research within the KIDDRC— language and
communication. The focus is on language and communication in children with autism and minimal
verbal skills (less than 20 spoken words). Remaining nonverbal past the age of 5 years has
been considered a poor prognostic indicator for future language developments, yet few
interventions have been developed to address this problem. The Specific Aims for this project
are (1) to further investigate a multimodal intervention for school-age children with minimal
verbal skills—defined as less than 20 words spontaneously spoken, signed, or selected via
graphic symbol selection—and (2) to identify significant covariates associated with
differential responding to the intervention. The research addresses an unmet need to promote
spoken word production in children who remain essentially nonverbal well past the ages
associated with speech acquisition. The project is also innovative because: a) it
investigates a multimodal intervention based on principles of phonotactic probability and
neighborhood density in combination with augmentative and alternative communication (AAC),
and b) it investigates novel predictors of treatment response that are obtained through
cutting-edge technologies. This intervention will have better success than past interventions
because the intervention will provide increased input through speech, digitized speech and
visual images and additional speech sound practice for words that are comprised of high
frequency sounds in the child's repertoire. Extant speech sounds in each participant's
repertoire will be identified using LENA™ digitized recordings. Vocabulary words will then be
selected based on a child's speech sound repertoire and principles of word learning—words
with high probability speech sound sequences will be selected and taught with either
multimodal intervention or a treatment as usual condition. Responses to these interventions
will be evaluated using a Sequential Multiple Assignment Randomized Trials (SMART) design.
Different outcomes may be associated with individual and environmental predictors identified
in our previous research. Individual predictors include verbal comprehension, imitation
skills, adaptive behavior, nonverbal speech sound repertoire, and communication complexity.
Communication complexity will be measured with the Communication Complexity Scale (CCS),
developed by the Principal Investigator. Environmental predictors include language input to
the child as measured with LENA™ recording devices. Results will determine if the multimodal
intervention is more successful than treatment as usual for teaching word productions.

Communication is an essential aspect of life for all individuals including children with
autism. Many children with autism are severely impaired in their verbal communication
development and there is a need for additional research demonstrating the effectiveness of
interventions that improve communication for participants with autism and severe
communication impairments. The proposed study directly follows from a recently published
pilot study demonstrating both the feasibility and importance of an intervention designed for
children with autism and minimal verbal skills (less than 20 words pre-intervention) (Brady
et al., 2015). The project will follow up this pilot study with a two stage SMART (Sequential
Multiple Assignment Randomized Trial) design that will allow comparison of results from an
experimental intervention to a treatment as usual condition, and compare two intensities of
multimodal intervention. Further, the project will investigate how proposed variables
measured at the outset of intervention predict responsiveness to the treatment conditions.

Aim 1. Investigate the effectiveness of a multimodal intervention aimed at teaching students
with autism and minimal verbal skills to produce new words with speech and augmentative
communication (AAC). Briefly, the multimodal approach combines joint book reading,
computerized instruction, and AAC. The AAC component teaches participants to select target
words on speech generating devices in communication routines. All components will focus on
teaching a set of vocabulary selected for each participant based on results from digitized
recordings of sounds produced over a 12-hour time period. Target vocabulary will be
one-syllable words that consist of sounds in each child's phonetic repertoire in sequences
that are highly represented in the English language (i.e., high phonotactic probability) and
determine if increasing intensity leads to better outcomes for participants who do not
respond to the initial intervention. Increased intensity or regular multimodal intervention
may be better for those who do not respond to treatment as usual. Primary outcome measures
include:

- Total number of words each child learns to say and the number of words each child learns
to produce with AAC during intervention.

- Total number of words each child says in generalization contexts. Generalization of word
use to classrooms and at home will be measured with recordings from generalization
probes conducted in homes and classrooms.

Aim 2. Investigate potential predictor variables for individual differences in learning
outcomes measured in Aim 1. Results from Brady et al. (2015) showed 5 of 10 participants were
"high responders" to multi-modal intervention - learning 18 or more new words over
approximately 2 months of intervention. However, three participants learned to say only a few
words and two participants essentially made no progress. The project will examine individual
predictors of differential responding and identify variables that will enable clinicians to
personalize intervention according to specific environmental and participant characteristics.
The proposed predictor variables are:

- Environmental variables: Based on previous research linking the amount and type of
environmental input to children's word acquisition, vocabulary input from parents and
teachers will be measured with automated speech recognition technology. Existing
technology available through LENA™ software (Warren et al., 2010) will be used to
measure total number of words produced by communicative partners and conversational
turns in home and school environments.

- Participant characteristics: Based on the pilot investigation as well as previous
longitudinal studies, the following specific child variables are proposed to be
predictive of responsiveness to one of the experimental interventions: verbal imitation,
receptive vocabulary, adaptive behavior, autism severity, and nonverbal communication
complexity measured with the Communication Complexity Scale (CCS; Brady et al., 2012).

Results will drive the development of more effective adaptive language interventions for
minimally verbal children with autism and related intellectual and developmental
disabilities.

Inclusion Criteria:

- Autism Diagnosis

- Communication Disorder(s)

Exclusion Criteria:

- Deafness

- Severe Physical Disability
We found this trial at
1
site
1301 Jayhawk Boulevard
Lawrence, Kansas 66045
Principal Investigator: Nancy C Brady, PhD
Phone: 785-864-0762
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from
Lawrence, KS
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