Laurie McLay

Comparing acquisition of and preference for manual signs, picture exchange, and speech-generating devices in nine children with autism spectrum disorder

Abstract Objective: To compare how quickly children with autism spectrum disorder (ASD) acquired manual signs, picture exchange, and an iPad®/iPod®-based speech-generating device (SGD) and to compare if children showed a preference for one of these options. Method: Nine children with ASD and limited communication skills received intervention to teach requesting preferred stimuli using manual signs, picture exchange, and a SGD. Intervention was evaluated in a non-concurrent multiple-baseline across participants and alternating treatments design. Results: Five children learned all three systems to criterion. Four children required fewer sessions to learn the SGD compared to manual signs and picture exchange. Eight children demonstrated a preference for the SGD. Conclusion: The results support previous studies that demonstrate children with ASD can learn manual signs, picture exchange, and an iPad®/iPod®-based SGD to request preferred stimuli. Most children showed a preference for the SGD. For some children, acquisition may be quicker when learning a preferred option.

Preference-Enhanced Communication Intervention and Development of Social Communicative Functions in a Child With Autism Spectrum Disorder:

Individuals with autism spectrum disorder (ASD) who exhibit limited speech can learn to communicate using augmentative and alternative communication (AAC) systems. We describe the case of Ian, a 10-year-old boy with ASD who had learned to use an Apple iPod®- and iPad®-based speech-generating device (SGD)Note 1, picture exchange (PE), and manual signing (MS) for functional communication (e.g., requesting), but had difficulty in using these AAC systems for spontaneous and socially oriented functions of communication. His difficulties were originally conceptualized as reflecting the social interaction and communication deficits characteristic of ASD. Alternatively, we suggest that the intervention did not allow for the development of more advanced communication. A preference-enhanced intervention was introduced with Ian’s chosen AAC system only, that is the iPad®-based SGD. Opportunities for communication were created using highly motivating activities and behavioral strategies. Results suggest that the approach facilitated development of spontaneous and socially oriented communication.

Undergraduates' perceptions of three augmentative and alternative communication modes

Abstract Objective: To assess undergraduates’ perceptions of three augmentative and alternative communication (AAC) modes. Method: We showed 104 undergraduates a video clip of a person using each of the three AAC modes and asked them to rate each option in terms of perceived (a) intelligibility, (b) ease of acquisition, (c) effectiveness/acceptability, and (d) preference. The three AAC modes shown were (a) manual signing, (b) picture exchange, and (c) speech-generating device. Results: Mean ratings for perceived intelligibility and effectiveness/acceptability were significantly higher for the speech-generating device. The speech-generating device and manual signing options were rated as being more preferred over picture exchange. Picture exchange was rated significantly higher on perceived ease of acquisition. Conclusion: Speech-generating devices were perceived to have greater social validity than manual signing and picture exchange.

Acquisition, Preference and Follow-up Comparison Across Three AAC Modalities Taught to Two Children with Autism Spectrum Disorder

Abstract Identifying an augmentative and alternative communication (AAC) method for children with autism spectrum disorder (ASD) might be informed by comparing their performance with, and preference for, a range of communication modalities. Towards this end, the present study involved two children with ASD who were taught to request the continuation of toy play by: (a) signing MORE, (b) exchanging a picture card representing MORE, and (c) touching a MORE symbol from the screen of a speech-generating device. The children were also given opportunities to choose among the three modalities to identify their preferred method of communication. Both children performed better with picture exchange and the speech-generating device than with manual signing, but had variable performance during follow-up. Both children more often chose the speech-generating device, suggesting a preference for that modality. We conclude that concurrent intervention across several communication methods can generate data to inform the selection of an AAC modality.

Empirical research evaluating the effects of non-traditional approaches to enhancing sleep in typical and clinical children and young people

This paper examines the effects of non-traditional (non-behavioural and non-prescription pharmaceutical) approaches to sleep in children and young people (0-18 y). A systematic search identified 79 studies that met inclusion criteria. Seventeen percent of the studies were rated as having a conclusive level of evidence, forty-two percent with preponderant evidence and forty-one percent with only suggestive evidence. There were promising indications, with certain populations only, for aromatherapy, ketogenic diets, an elimination diet (few foods diet), elimination of cows milk, avoidance of caffeine, tryptophan with adenosine and uridine, omega-3 and omega-6, valerian, music, osteopathic manipulation and white noise. Bright light therapy and massage returned some positive results. All of these interventions warrant further, more rigorous research. There was limited or no evidence to support acupressure or acupuncture, other diets or dietary supplements, exercise or weighted blankets. Caution is needed in interpreting some studies because poorer quality studies were more likely to return positive results. Suggestions are made for the improvement of large and smaller scale research, especially conceptualization around multiple physiological measures of sleep and the adoption of research methods which are of use in clinical settings.

Variables affecting the emergence of untaught equivalence relations in children with and without autism

Abstract Objective: This study examined the formation of equivalence classes among children with ASD and typically developing children. Design: A single-subject AB and BA design was used. Methods: Two of the six equivalence relations were taught. Participants were then tested to determine whether the remaining four equivalence relations were acquired without teaching. Half of the children were taught naming responses first, then selecting responses. Half were taught in the reverse order. Results: Five out of 10 participants with ASD demonstrated the emergence of all four untaught relations. The remaining five participants showed variability. Nine of the 10 typically developing children demonstrated emergence of all untaught relations. Variation in teaching conditions had no significant effect on outcomes. Conclusions: Many children with ASD are capable of generalising to untaught equivalence relations. The results fail to support the claim that acquisition of naming responses is a pre-requisite for the emergence of untaught equivalence relations.

Intensive toilet training targeting defecation for a child with Autism Spectrum Disorder

ABSTRACTIndependent toileting is a critical functional life skill. Unfortunately, acquisition of this skill is often delayed in children with Autism Spectrum Disorder. Interventions based on behavioural principles are often used to toilet train children. Methods that incorporate behavioural components, including systematic prompting and reinforcement contingencies, have yielded positive results for teaching toileting skills to children with disabilities. The purpose of the present study was to determine whether selected procedures based upon a behavioural model would be effective in teaching an 8-year-old boy with autism independent toileting skills, including in-toilet defecation. A secondary goal of the intervention was to reduce interfering behaviours associated with toileting. In-toilet defecation increased as a result of the intervention.

Using Functional Behavioral Assessment to Develop a Multicomponent Treatment for Sleep Problems in a 3-Year-Old Boy With Autism:

A large number of children with autism spectrum disorder (ASD) and their families are affected by sleep disturbance. Given the concomitant negative effects of sleep problems, it is essential to identify effective treatments. This case study exemplifies the use of Functional Behavioral Assessment (FBA) to develop treatments for sleep problems in a 3-year old boy with ASD. A function-based, multicomponent intervention resulted in the elimination of nighttime breastfeeding, a reduction in the frequency of curtain calls, and the frequency and duration of nighttime awakenings, although not all gains were maintained at follow-up. This case study highlights the importance of FBA in the assessment of sleep problems for each individual, and the need to develop treatments that address the unique function of sleep disturbance for each individual. Further research into the assessment and treatment of sleep problems in children with ASD is required.

Research note: attitudes of teachers and undergraduate students regarding three augmentative and alternative communication modalities

Abstract The social validity of different communication modalities is a potentially important variable to consider when designing augmentative and alternative communication (AAC) interventions. To assess the social validity of three AAC modes (i.e., manual signing, picture exchange, and an iPad®-based speech-generating device), we asked 59 undergraduate students (pre-service teachers) and 43 teachers to watch a video explaining each mode. They were then asked to nominate the mode they perceived to be easiest to learn as well as the most intelligible, effective, and preferred. Participants were also asked to list the main reasons for their nominations and report on their experience with each modality. Most participants (68–86%) nominated the iPad-based speech-generating device (SGD) as easiest to learn, as well as the most intelligible, effective, and preferred. This device was perceived to be easy to understand and use and to have familiar and socially acceptable technology. Results suggest that iPad-based SGDs were perceived as more socially valid among this sample of teachers and undergraduate students. Information of this type may have some relevance to designing AAC supports for people who use AAC and their current and future potential communication partners.

Response to name and its value for the early detection of developmental disorders: Insights from autism spectrum disorder, Rett syndrome, and fragile X syndrome. A perspectives paper

BACKGROUND Responding to ones own name (RtN) has been reported as atypical in children with developmental disorders, yet comparative studies on RtN across syndromes are rare. AIMS We aim to (a) overview the literature on RtN in different developmental disorders during the first 24 months of life, and (b) report comparative data on RtN across syndromes. METHODS AND PROCEDURES In Part 1, a literature search, focusing on RtN in children during the first 24 months of life with developmental disorders, identified 23 relevant studies. In Part 2, RtN was assessed utilizing retrospective video analysis for infants later diagnosed with ASD, RTT, or FXS, and typically developing peers. OUTCOMES AND RESULTS Given a variety of methodologies and instruments applied to assess RtN, 21/23 studies identified RtN as atypical in infants with a developmental disorder. We observed four different developmental trajectories of RtN in ASD, RTT, PSV, and FXS from 9 to 24 months of age. Between-group differences became more distinctive with age. CONCLUSIONS AND IMPLICATIONS RtN may be a potential parameter of interest in a comprehensive early detection model characterising age-specific neurofunctional biomarkers associated with specific disorders, and contribute to early identification.