David Trembath

Peer-Mediated Teaching and Augmentative and Alternative Communication for Preschool-Aged Children with Autism.

Abstract Background The aim of this study was to assess the effectiveness of two communication interventions for preschool-aged children with autism. Method Six typically developing peers were taught to implement peer-mediated naturalistic teaching, with and without a speech generating device (SGD), during play sessions with 3 classmates with autism in three preschools. Generalisation probes were conducted during mealtimes at the preschools. A multiple baseline design was used to assess the outcomes of the two intervention conditions. Results All 3 children with autism increased their communicative behaviours immediately following the introduction of the two interventions, and generalised these increases to mealtime interactions with their peers. However, only 1 child maintained these increases in communication. Conclusion These results provide preliminary evidence for the effectiveness of combining peer-mediated naturalistic teaching with the use of SGDs for preschool-aged children with autism. Suggestions for improving the maintenance of intervention effects are provided.

Twelve tips for effective international clinical placements

As universities adopt an increasingly international focus, student health professionals are keen to gain clinical experiences in other countries. Such clinical placements provide students with the opportunity to share their knowledge and at the same time acquire new clinical and cultural skills. The experience gained will not only enhance their clinical practice overseas, but will also enhance it in their home country where they are likely to work with people from culturally, linguistically and clinically diverse backgrounds. Careful preparation and adequate supports are critical if students and the host institutions are to gain maximum benefit from cross-cultural clinical placements. The tips below are based on an ongoing collaboration between the Indian Institute of Cerebral Palsy, Kolkata, India and The University of Sydney, as well as recommendations from the burgeoning literature on international clinical placements. The authors are from both the sending and the receiving institutions, and have found that close collaboration between the home and host institutions along with student reflection, evaluation and the opportunity to integrate new knowledge with other clinical experiences are keys to a satisfactory outcome for all concerned.

The loneliness experiences of young adults with cerebral palsy who use alternative and augmentative communication.

Young adults with cerebral palsy who use augmentative and alternative communication (AAC) systems may be at increased risk of loneliness due to the additional challenges they experience with communication. Six young adults, aged 24–30 years, who used AAC and had cerebral palsy, participated in in-depth interviews to explore their experiences of loneliness as they made the transition into adulthood. A total of five major themes in the data were identified using the constant comparative method of analysis. Three of these themes were discussed by all participants: (a) Support Networks, (b) AAC System Use, and (c) Technology. The authors concluded that these three themes were most important in understanding the experiences of loneliness of the young adults with cerebral palsy who participated in this study.

The Experience of Anxiety in Young Adults with Autism Spectrum Disorders

Anxiety is known to be common among young adults with autism spectrum disorders (ASD), yet little is known about the nature of their experiences or the strategies they use to live and cope with their reported anxiety. In this qualitative study, we began to address this issue through two focus groups involving 11 young adults with ASD, and 10 parents and professionals. Participants in each group were asked to discuss the triggers for anxiety, the consequences of anxiety, and strategies they have used, would like to use, or have seen individuals with ASD use to manage their anxiety. The participants identified multiple personal and environmental sources of anxiety, noting the substantial impact they have on their everyday lives at home, work, university, and in the community. Their individual experiences and strategies for living and coping with anxiety are presented.

Vocabulary selection for Australian children who use augmentative and alternative communication

Abstract Background Augmentative and alternative communication (AAC)1 systems are commonly used to support children with complex communication needs in Australian preschools. However, such systems will only be effective if they contain words and messages that adequately meet these childrens communication needs. The aim of this study was to identify the words most frequently and commonly used by typically developing Australian preschool‐aged children, in order to inform the selection of vocabulary for their classmates who use AAC. Method Communication samples were collected from 6 typically developing children during regular preschool activities. The samples were analysed to determine the number of different words used by the children, the frequency with which each word was used, and the commonality of use across children. Results The children used a small core vocabulary comprising frequently and commonly used words, together with large and highly individualised fringe vocabularies. Conclusions The results are consistent with the findings of previous studies, and highlight the importance of providing both core and fringe vocabulary to preschool‐aged children who use AAC.

Problematic but predictive: individual differences in children with autism spectrum disorders.

Abstract Camarata highlights the impact that symptom hetereogeneity, overlap, and individual differences can have on the accurate early diagnosis of children with autism spectrum disorders (ASD) and measurement of treatment outcomes. Nevertheless, these individual differences may provide avenues for predicting individual responses to treatment with the view to prospectively matching children with ASD to treatments best-suited to meeting their individual needs. This commentary suggests that the behavioural characterstics that are critical to accurate early diferential diagnosis of ASD may be poor predictors of outcomes. However, factors that are not unique to ASD may in fact be good predictors of treatment outcomes. This commentary illustrates these points with reference to the results of recent studies demonstrating the problems, and possibilities, that individual differences currently present when it comes to understanding and promoting learning in children with ASD.

Cross-cultural practice and autism

Autism is among the most commonly occurring developmental disorders (Bristol, McIlvane, & Alexander, 1998). Although there is little evidence for an increase in the incidence of autism (Williams, Mellis, & Peat, 2005), the apparent increase in the prevalence of the condition has raised awareness of the needs of these children and their caregivers (Diggle, McConachie, & L, 2002). However, despite this increasing awareness, little is known about the impact of cultural and linguistic diversity on interventions used to support communication development in children with autism (Bridges, 2004; Dyches, Wilder, Sudweeks, Obiakor, & Algozzine, 2004). Interventions include the use of augmentative and alternative communication (AAC) systems (Mirenda, 2001) and the modification of the learning environment to enhance opportunities for communication (Koegel, Koegel, & Carter, 1998). Wilder, Dyches, Obiakor, and Algozzine (2004) noted that children with autism and their parents who are from non-dominant cultures face ‘‘...triplelayered problems – they are culturally different, they may be linguistically different, and they have exceptionality that is loaded with behavioural repertoires’’ (p. 105). If therapists and educators are to work effectively with the parents and carers of children with autism, including those from diverse cultural backgrounds, a greater understanding of the impact of culture on their communication and learning is required (Dyches et al., 2004; Wilder et al., 2004). Cultural diversity and AAC

Parents’ expectations, awareness, and experiences of accessing evidence-based speech-language pathology services for their children with autism

Abstract The aim of this study was to explore the expectations, awareness, and experiences of parents in their efforts to access evidence-based speech-language pathology (SLP) services for their children with autism spectrum disorders (ASD). Four focus groups were conducted with 20 parents of pre school aged children with ASD and transcripts were analysed using thematic analysis. Two themes emerged to account for the participants’ expectations, awareness, and experiences. The two themes, “Speech-language pathology: More than just a business”, and “Parents and power”, represented the complex interaction between factors including the parents’ access to information, their involvement in the therapy process, and their sense of empowerment. The parents in this study expressed a strong desire for evidence-based practice (EBP) to be employed. However, the parents had different views on how EBP should be achieved. The findings of this study demonstrate the importance of involving parents in therapeutic relationships as partners in the decision-making process. This means providing parents with comprehensive information, including research evidence to support the clinical decisions that need to be made, and respecting parents’ preferences in the therapy process.

Atypical monitoring and responsiveness to goal-directed gaze in autism spectrum disorder

We hypothesized that difficulty in understanding the goals of others’ actions in autism spectrum disorder (ASD) might be linked to a diminished attention and responsivity to relevant social cues. Using an eye-tracking paradigm, we investigated how 24 children with ASD and 24 matched children without ASD responded to the observation of uncompleted actions without a clear target (neutral condition) versus a condition in which the actor’s gaze direction indicated the target of the actions (head-turning condition). Children without ASD significantly increased their attention to the actor’s face and to the action’s target in the head-turning condition compared to the neutral condition, while this was not the case in the ASD group. Overall, our findings suggest a diminished monitoring and responsivity to social cues signalling goal-directedness, which might impact on the ability to understand other’s action goals in young children with ASD.

A Systematic Review of the Literature on Emergent Literacy Skills of Preschool Children With Autism Spectrum Disorder

A wealth of research has been conducted into emergent literacy (i.e., precursors to formal reading) skills and development in typically developing (TD) children. However, despite research suggesting children with autism spectrum disorder (ASD) are at risk of reading challenges, limited research exists on their emergent literacy. Thus, we aimed to systematically review emergent literacy research with this population. Database searches from 1995 to 2015 yielded three articles that met inclusion criteria. Results suggested both strengths and challenges in emergent literacy skills in children with ASD. Significant links between emergent literacy skills and both oral language and nonverbal cognition were also found. The findings highlight the need for further research; future directions and implications are discussed.