Nancy C. Brady

Maternal Responsivity Predicts Language Development in Young Children With Fragile X Syndrome

The relationship between early maternal responsivity and later child communication outcomes in young children with fragile X syndrome was investigated. Data were obtained from 55 mother-child dyads over a 36-month period. Performance data were obtained at each measurement point from video observations of four different contexts. These were coded for (a) child communication behaviors, (b) parent responsivity, and (c) behavior management behaviors. Results indicate that early maternal responsivity predicts the level of four important child language outcomes at 36 months of age after controlling for child developmental level and autism symptomology.

Twenty Years of Communication Intervention Research With Individuals Who Have Severe Intellectual and Developmental Disabilities

This literature review was conducted to evaluate the current state of evidence supporting communication interventions for individuals with severe intellectual and developmental disabilities. We reviewed 116 articles published between 1987 and 2007 in refereed journals meeting three criteria: (a) described a communication intervention, (b) involved one or more participants with severe intellectual and developmental disabilities, and (c) addressed one or more areas of communication performance. Many researchers failed to report treatment fidelity or to assess basic aspects of intervention effects, including generalization, maintenance, and social validity. The evidence reviewed indicates that 96% of the studies reported positive changes in some aspects of communication. These findings support the provision of communication intervention to persons with severe intellectual and developmental disabilities. Gaps in the research were reported as were recommendations for future research.

Assessing the Minimally Verbal School‐Aged Child With Autism Spectrum Disorder

This paper addresses the issue of assessing communication, language, and associated cognitive and behavioral abilities of minimally verbal children with autism spectrum disorder (ASD), presenting a summary of a year‐long series of meetings held by a group of experts in the field of ASD and National Institutes of Health staff. In this paper, our goals were to first define the population and then present general guidelines for optimizing assessment sessions for this challenging population. We then summarize the available measures that can be used across a variety of behavioral domains that are most directly relevant to developing language skills, including oral motor skills, vocal repertoire, receptive and expressive language, imitation, intentional communication, play, social behavior, repetitive and sensory behaviors, and nonverbal cognition. We conclude with a discussion of some of the limitations in the available measures and highlight recommendations for future research in this area. Autism Res 2013, 6: 479–493.

Interventions Aimed at Improving Child Language by Improving Maternal Responsivity.

Maternal responsivity, or the ways in which mothers provide for, interact with, and respond to their children, helps to shape their childrens development, including language development. In this chapter, we describe maternal responsivity as a multilevel construct with different measures appropriate for each level. Molar responsivity refers to aspects of interaction style such as affect that can best be measured with rating scales. Molecular responsivity refers to contingent maternal behaviors that occur in response to child behaviors; and are best reflected by the frequencies of occurrence of these contingent behaviors. Results of many studies have demonstrated that both molar and molecular responsivity are related to important child outcomes such as language development. Children of more responsive mothers tend to have better outcomes. Based on these findings, interventions aimed at improving maternal responsivity and thereby child language outcomes have been developed and investigated through a number of studies. Results have shown positive outcomes for maternal responsivity and lesser secondary benefits to child language outcomes. Some of the qualities that appear associated with better outcomes include timing the interventions to co-occur with specific developments in child behaviors, teaching over a span of approximately 10-12 sessions, and designing lessons to be culturally sensitive to individual families.

Risk Factors for Self-Injury, Aggression, and Stereotyped Behavior Among Young Children At Risk for Intellectual and Developmental Disabilities

Before the 1990s, research on the early identification and prevention of severe behavior disorders (SBDs), such as aggression, self-injury, and stereotyped behavior, among young children with intellectual and developmental disabilities (IDD), was mostly done with children 3 years or older. More recent work suggests that signs of SBDs may occur as early as 6 months in some infants. The present study combined a cross-sectional and longitudinal approach to examine SBDs in 180 young children aged 4-48 months recruited through mass screening, then receiving an interdisciplinary evaluation and six-month follow-ups for one year. Twelve potential risk factors related to SBDs were examined. Eight of these risk factors, including age, gender, diagnosis, intellectual and communication levels, visual impairment, parent education, family income, were differentially related to scores for Aggression, SIB, and Stereotyped Behavior subscales on the Behavior Problems Inventory (BPI-01) at initial interdisciplinary evaluation. BPI-01 scores decreased over the year for 57% of the children and increased for 43%. The amount of decrease on each BPI-01 subscale varied with age, gender, and diagnosis.

Functional Analysis of Communicative Behaviors

Functional analysis is a methodology that has been used to assess the functions of aberrant or disruptive behaviors. The current article discusses how functional analysis may be useful for determining the functions of all communicative behaviors, whether they are aberrant or not. Two case studies are presented to illustrate the implementation of the three components of functional analysis: interviews, direct observation, and analog probes. Information from each of these three assessment sources contributes to the development of intervention plans addressing the unique communication needs of individuals with severe disabilities.

Emergent symbolic relations in speakers and nonspeakers.

Eight adults with developmental disabilities and four typically developing preschool children participated in an experiment studying emergent stimulus-stimulus relations after match-to-sample instruction. Participants were taught to match lexigrams (arbitrary graphic stimuli) to objects. Each object was functionally related to another object in the teaching set. For example, brush and comb were members of the teaching set. Most participants were able to select objects when the objects were named in pretests. Postteaching probes assessed emergent relations between spoken names and lexigrams. In addition, we included probes to detect emergent relations between related lexigrams. That is, would participants select the lexigram for comb when the experimenter displayed the lexigram for brush (without explicit teaching)? Two preschool children and five adults with developmental disabilities showed emergent relations between lexigrams and spoken words. However, only two preschool children showed the emergent lexigram to related lexigram relations.

Communication Services and Supports for Individuals with Severe Disabilities: Guidance for Assessment and Intervention.

The National Joint Committee for the Communication Needs of People With Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities.

Symbolic play of preschoolers with severe communication impairments with autism and other developmental delays: more similarities than differences.

Children with autism are often described as having deficient play skills, particularly symbolic play. We compared the play of 35 children with autism to 38 children with other developmental delays. All children were preschool-age and produced less than 20 different words. Results indicated no significant differences across the two groups in their play. Children with autism engaged in more conventional play, that is, putting objects together according to how the toys were constructed (e.g., pieces in a puzzle, lid on a teapot). Results also indicated high correlations between play, language, and cognitive measures. Findings indicate that play relates to language and cognitive levels yet may not discriminate children with autism and children with other developmental delays early in their development.

Increasing Communication in Children With Concurrent Vision and Hearing Loss

Nine children with complex communication needs and concurrent vision and hearing losses participated in an intervention program aimed at increasing intentional prelinguistic communication. The intervention constituted a pilot, descriptive study of an adapted version of prelinguistic milieu teaching, hence referred to as A-PMT. In A-PMT, natural gestures and vocalizations were targeted in child-focused, one-on-one activities conducted by a member of the project staff. Adaptations included using more physical prompts than in other forms of PMT and using means other than directed eye gaze to determine directionality of gestures. All nine participants increased their rates of initiated, intentional communication substantially during the course of intervention; in addition, each participant acquired new forms of natural gestures. Results were limited primarily to requests (as opposed to other communication functions). Discussion centers on how to promote more generalized communication developments in future implementations of the program.