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Examining Language Outcomes from a Naturalistic Language Intervention for Minimally Verbal Children with Autism
The use of an Augmentative and Alternative Communication (AAC) device with minimally verbal children has shown to be successful in increasing spontaneous language during an naturalistic language intervention (Olive et al., 2006). It is crucial to the development of phrase speech and increased social communication to find an effective method for systematically teaching verbs so that children can develop phrase speech. Both Enhanced Milieu Teaching (EMT) and Joint-Attention, Structured-Play, Emotion Regulation (JASPER) paired with the use of an AAC device have been shown effective interventions for increasing spontaneous language (Kasari et al., submitted) . The current study examined the effects of these interventions with and without the use of an AAC device in relation to the amount of verbs gained with minimally verbal children.
Objectives:
The following questions were addressed in this study: (a) Do parents of children who receive intervention with the AAC report more language use and or verb use than parents of children participating in the spoken language intervention? (b) Is child verb use higher in a naturalistic language sample for children who received the intervention with the AAC versus children who received the spoken language intervention only?
Methods:
The participants included 20 minimally verbal children with autism (Mean age=6.46 years, SD=1.11). Participants were randomly assigned to either JASP-EMT with an AAC device or JASP-EMT with spoken language only. All participants received two 45-minute sessions each week for 12 weeks of intervention. Parents completed MacArther-Bates Communication Development Inventories (MCDI) at the pretest and at the end of the 12-week intervention. 20-minute language samples were transcribed and coded from prior to and following intervention.
Results:
Parents of children who received the JASP-EMT intervention with the AAC device during intervention reported more words produced and understood (M=58.8, SD=84.4) as compared to children who received JASP-EMT with spoken language alone (M=-44.6, SD=130, d=.95). The difference between the groups is approaching significance (t=1.9 p=0.068). Parents did not report differences between groups in verb use (t=13.1, p=0.677). However, across parents in both groups verb use improved by an average of 9.5 verbs in 12 weeks (SD=16.2). Children who received the intervention with the AAC did not produce significantly more verbs in the language sample than children who received spoken language alone (t=.901, p=.38).
Conclusions:
Parents of minimally verbal children with autism reported that their children produced and understood more words after an intervention using JASP-EMT with AAC device than children who received the JASP-EMT intervention using spoken language alone. Although parents did not report differences in verb use between groups, overall improvement in verb use was reported by parents in both groups. Children did not produce more verbs in a naturalistic language sample, indicating that the AAC did not facilitate verb use. Future research is necessary to examine specific teaching of different parts of speech for minimally verbal children with autism. Implications for practice include combining an AAC with naturalistic language strategies, which may increase words produced by minimally verbal children.