Elizabeth R. Crais

Analysis of Social Interaction Gestures in Infants with Autism.

This study analyzes the emergent use of gestures used among 9–12-month-old infants with autism and typical development using retrospective video analysis. The purpose of the present investigation was to examine the frequency, initiation, prompting, and diversity of types of gestures used for social interaction purposes. It was hypothesized that a restricted variety in type(s) of gestures as well as fewer child-initiated gestures and more prompted gestures would be associated with later diagnosis of autism. Logistic regression analysis found that decreased variety in type of gestures used was significantly associated with autism status. Neither number of total gestures nor initiation of gestures (child-initiated vs. prompted) was significantly associated with autism status.

The need for more effective father involvement in early autism intervention: A systematic review and recommendations

Fathers of children with autism spectrum disorders (ASD) are underrepresented in both early intervention and research. However, fathers have unique interaction styles that make important contributions to the language and symbolic play development of typically developing children. Fathers may make similar contributions to the development of their children with ASD, who struggle with social-communicative deficits, particularly in the areas of language and symbolic play. This article provides a theoretical rationale for enhancing father—child involvement in early autism intervention that may lead to improved outcomes in child communication and symbolic play and have cascading benefits for families in reducing stress and enhancing coping mechanisms. To support this rationale, systematic reviews of the literature were conducted to (a) identify the extent of father involvement in parent training programs for children with autism, (b) identify the contributions of parents to the symbolic play outcomes of their children with ASD and other disabilities, and (c) examine differences in stress and coping experienced by mothers and fathers of children with ASD. Finally, possible barriers to father participation in early autism intervention are discussed and recommendations are offered for making parent-implemented early intervention for children with ASD more amenable to fathers.

The First Year Inventory: a longitudinal follow-up of 12-month-old to 3-year-old children:

The First Year Inventory is a parent-report measure designed to identify 12-month-old infants at risk for autism spectrum disorder. First Year Inventory taps behaviors that indicate risk in the developmental domains of sensory–regulatory and social–communication functioning. This longitudinal study is a follow-up of 699 children at 3 years of age from a community sample whose parents completed the First Year Inventory when their children were 12 months old. Parents of all 699 children completed the Social Responsiveness Scale–Preschool version and the Developmental Concerns Questionnaire to determine age 3 developmental outcomes. In addition, children deemed at risk for autism spectrum disorder based on liberal cut points on the First Year Inventory, Social Responsiveness Scale–Preschool, and/or Developmental Concerns Questionnaire were invited for in-person diagnostic evaluations. We found 9 children who had a confirmed diagnosis of autism spectrum disorder from the sample of 699. Receiver operating characteristic analyses determined that a two-domain cutoff score yielded optimal classification of children: 31% of those meeting algorithm cutoffs had autism spectrum disorder and 85% had a developmental disability or concern by age 3. These results suggest that the First Year Inventory is a promising tool for identifying 12-month-old infants who are at risk for an eventual diagnosis of autism spectrum disorder.

Oral Narratives in School-Age Children.

Oral narratives play an important part in the academic and social interactions of children during the school years. This article attempts to link assessment and intervention of oral narratives with current cultural and academic trends. Specifically, the article focuses on the changing demands from home to school use of narratives, the developmental changes expected in school-age children, differences between the narratives of children with and without language disorders, current assessment methods and the difficulties inherent in their use, and alternative assessment and intervention techniques that address some of the cultural and theoretical issues raised.

The impact of the Advancing Social-communication And Play (ASAP) intervention on preschoolers with autism spectrum disorder:

This study evaluates an intervention targeting social-communication and play skills (Advancing Social-communication And Play; ASAP) implemented by school staff in a public preschool setting. With increases in enrollment of children with autism spectrum disorder (ASD) in school systems, establishing the effectiveness and feasibility of interventions implemented in school settings is important. In clinical settings, interventions targeting social-communication and play behaviors have increased these skills and impacted later language abilities. Results of this single-case design study indicated the ASAP intervention had a positive impact on social-communication and play skills for three preschoolers with ASD. All participants showed either increases in frequency or more stability in targeted behaviors. Social validity results provide additional support for the use of ASAP with preschoolers with ASD.

Preliminary Efficacy of Adapted Responsive Teaching for Infants at Risk of Autism Spectrum Disorder in a Community Sample

This study examined the (a) feasibility of enrolling 12-month-olds at risk of ASD from a community sample into a randomized controlled trial, (b) subsequent utilization of community services, and (c) potential of a novel parent-mediated intervention to improve outcomes. The First Year Inventory was used to screen and recruit 12-month-old infants at risk of ASD to compare the effects of 6–9 months of Adapted Responsive Teaching (ART) versus referral to early intervention and monitoring (REIM). Eighteen families were followed for ~20 months. Assessments were conducted before randomization, after treatment, and at 6-month follow-up. Utilization of community services was highest for the REIM group. ART significantly outperformed REIM on parent-reported and observed measures of child receptive language with good linear model fit. Multiphase growth models had better fit for more variables, showing the greatest effects in the active treatment phase, where ART outperformed REIM on parental interactive style (less directive), child sensory responsiveness (less hyporesponsive), and adaptive behavior (increased communication and socialization). This study demonstrates the promise of a parent-mediated intervention for improving developmental outcomes for infants at risk of ASD in a community sample and highlights the utility of earlier identification for access to community services earlier than standard practice.

Expanding the Repertoire of Tools and Techniques for Assessing the Communication Skills of Infants and Toddlers

In recent years, professionals and families alike have expressed dissatisfaction over the tools and techniques used to evaluate and assess the communication skills of infants and toddlers (Campione, 1989; Crais, 1992a, 1993; Neisworth & Bagnato, 1992; Wetherby & Prizant, 1992). These dissatisfactions are often the result of a number of features that characterize many standardized tools and the limitations inherent in their use. In addition, ideas related to the ecological framework within which assessment should take place have altered our thinking about both the context and procedures employed. This article discusses several of the issues related to the growing dissatisfaction with current assessment tools and provides an overview of tools and techniques developed within the last several years that address some of these issues.

A culturally and linguistically responsive vocabulary approach for young Latino dual language learners

PURPOSE This study examined the role of the language of vocabulary instruction in promoting English vocabulary in preschool Latino dual language learners (DLLs). The authors compared the effectiveness of delivering a single evidence-informed vocabulary approach using English as the language of vocabulary instruction (English culturally responsive [ECR]) versus using a bilingual modality that strategically combined Spanish and English (culturally and linguistically responsive [CLR]). METHOD Forty-two DLL Spanish-speaking preschoolers were randomly assigned to the ECR group (n=22) or CLR group (n=20). Thirty English words were presented during small-group shared readings in their preschools 3 times a week for 5 weeks. Multilevel models were used to examine group differences in postinstruction scores on 2 Spanish and 2 English vocabulary assessments at instruction end and follow-up. RESULTS Children receiving instruction in the CLR bilingual modality had significantly higher posttest scores (than those receiving the ECR English-only instruction) on Spanish and English vocabulary assessments at instruction end and on the Spanish vocabulary assessment at follow-up, even after controlling for preinstruction scores. CONCLUSIONS The results provide additional evidence of the benefits of strategically combining the first and second language to promote English and Spanish vocabulary development in this population. Future directions for research and clinical applications are discussed.

Interdisciplinary Personnel Preparation: Graduates' Use of Targeted Practices

Interdisciplinary personnel preparation in early intervention is viewed by many as critical to the implementation of the Individuals with Disabilities Education Act (IDEA) and to providing exemplary services to children with special needs and their families. Recent work has shown that the extent to which students take part in interdisciplinary preservice preparation predicts the degree to which they will provide interdisciplinary, collaborative services once they graduate. Despite the fact that the early intervention literature provides various descriptions of interdisciplinary personnel preparation programs, little information is available documenting the extent to which program graduates utilize the interdisciplinary practices targeted in these programs. The current study used a self-evaluation methodology to survey graduates of 2 interdisciplinary early intervention specialization programs at the University of North Carolina at Chapel Hill. The results indicted that the graduates were utilizing most of the targeted practices in their current job settings and did so on a fairly frequent basis. In addition, when the graduates were asked about the extent to which they were exposed to specific interdisciplinary practices (eg, interacting with students from other disciplines during coursework), the opportunities within their specialization program were rated as occurring much more frequently than within their traditional program. The results have implications for programs offering (or seeking to offer) interdisciplinary specializations. The follow-up methodology may be beneficial as a model for documenting the use of specific interdisciplinary practices by graduates.

Designing Studies to Evaluate Parent-Mediated Interventions for Toddlers With Autism Spectrum Disorder

Given recent advances in science, policy, and practice of early identification in autism spectrum disorder (ASD), questions about the effectiveness of early intervention have far-reaching service and policy implications. However, rigorous research evaluating the efficacy and effectiveness of intervention programs for toddlers with ASD faces a multitude of novel scientific challenges. The Autism Speaks Toddler Treatment Network (ASTTN) was formed in 2007 to provide an infrastructure for ongoing communication between the investigators of eight research projects evaluating parent-mediated interventions for toddlers with ASD. The present article describes and compares the research studies of the ASTTN; highlights specific challenges with regard to research design, participants, recruitment, eligibility criteria, enrollment, and intervention approach; and outlines practical considerations that may guide the next generation of parent-mediated intervention studies involving toddlers with ASD.