Stephen Camarata

Multisensory Temporal Integration in Autism Spectrum Disorders

The new DSM-5 diagnostic criteria for autism spectrum disorders (ASDs) include sensory disturbances in addition to the well-established language, communication, and social deficits. One sensory disturbance seen in ASD is an impaired ability to integrate multisensory information into a unified percept. This may arise from an underlying impairment in which individuals with ASD have difficulty perceiving the temporal relationship between cross-modal inputs, an important cue for multisensory integration. Such impairments in multisensory processing may cascade into higher-level deficits, impairing day-to-day functioning on tasks, such as speech perception. To investigate multisensory temporal processing deficits in ASD and their links to speech processing, the current study mapped performance on a number of multisensory temporal tasks (with both simple and complex stimuli) onto the ability of individuals with ASD to perceptually bind audiovisual speech signals. High-functioning children with ASD were compared with a group of typically developing children. Performance on the multisensory temporal tasks varied with stimulus complexity for both groups; less precise temporal processing was observed with increasing stimulus complexity. Notably, individuals with ASD showed a speech-specific deficit in multisensory temporal processing. Most importantly, the strength of perceptual binding of audiovisual speech observed in individuals with ASD was strongly related to their low-level multisensory temporal processing abilities. Collectively, the results represent the first to illustrate links between multisensory temporal function and speech processing in ASD, strongly suggesting that deficits in low-level sensory processing may cascade into higher-order domains, such as language and communication.

Increasing Speech Intelligibility in Children with Autism

Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, reliably influence the effectiveness of language teaching interactions for children with autism. However, the effectiveness of this approach has not yet been assessed with respect to improving speech intelligibility. The purpose of this study was to systematically compare two intervention conditions, a Naturalistic approach (which incorporated motivational variables) vs. an Analog (more traditional, structured) approach, with developmentally similar speech sounds equated within and across conditions for each child. Data indicate that although both methods effectively increased correct production of the target sounds under some conditions, functional use of the target sounds in conversation occurred only when the naturalistic procedures were used during intervention. Results are discussed in terms of pivotal variables that may produce improvements in speech sounds during conversational speech.

Mild/Moderate Behaviorally Disordered StudentsA Population at Risk for Language Disorders

The purpose of the present investigation was to examine the language skills of a group of 38 mildly to moderately behavior-disordered students. At issue was whether such students suffer from language disorders as has been reported for Children with more severe behavior disorders such as autism. The results from the Test of Language Development-Intermediate (TOLD-I) (Hammill & Newcomer, 1982) revealed that 37 of the children (97%) fell a minimum of one standard deviation below the normative mean on one or more of the TOLD-I subtests. These findings are offered in support of the notion that the mildly to moderately behavior-disordered child is at risk for language disorders.

Pragmatic language deficits in attention-deficit hyperactivity disorder (ADHD)

The nature of Attention Deficit-Hyperactivity Disorder (ADHD) as described in the Fourth Edition of the Diagnostic and Statistical Manual [DSM-IV, American Psychiatric Association, 1994] indicates a potential association with language disorder, particularly in the area of social language skills (pragmatics). However, to date there have been relatively few studies examining this language-behavior relationship in children with ADHD. The purpose of this paper is to provide a description of social/pragmatic language deficits and to present a theoretical model of potential associations between pragmatic language deficits and ADHD. Previous studies of language skills in children with ADHD are examined within this theoretical framework and the clinical implications of the proposed association are discussed. MRDD Research Reviews 1999;5:207–214.

Treatment efficiency as a function of target selection in the remediation of child language disorders

A number of studies appearing in the recent literature examined the effectiveness of treating language impairments using indirect, conversationally based interventions. However, such studies have been difficult to interpret, due, in part, to a lack of direct comparisons of treatment types. The present study was designed to compare directly elicited imitation treatment and conversational treatment using linguistic targets matched for structural stage and assigned randomly to treatment condition. These treatments were applied to four specifically language-impaired children (age range 4;9 to 5;11) during a 16-week training period. Spontaneous productions occurred following significantly fewer presentations within the conversational treatment. Additionally, the results indicated that both kinds of treatments were effective and that certain individual targets were acquired more rapidly within the elicited imitation treatment. These findings are discussed in terms of the differing approaches to treatment and in terms of more general theories of language learning.

Early identification and early intervention in autism spectrum disorders: Accurate and effective?

Abstract Over the past decade, there has been increased interest in identifying autism and autism spectrum disorder (ASD) in toddlers. Although there is a strong rationale for identifying ASD early and delivering effective intervention, a recent report in the journal Pediatrics raises important questions about the scientific evidence currently available supporting early intervention. In addition, the British National Health Service (NHS) has not adopted universal screening for autism, even though the American (US) Academy of Pediatrics endorsed a recommendation that all toddlers be screened for ASD by the age of 24 months (in 2007). The goal of this initiative is to identify and, where indicated, provide early intervention for autism and ASD. Although it is inarguable that this is a worthwhile and laudable goal, the systematic study of this goal is confounded by the inherent difficulty in reliably identifying autism in 24-month-old toddlers. It is challenging to demonstrate intervention effects in the absence of randomly assigned control groups in an increasingly heterogeneous ASD population. The purpose of this paper is to examine the current literature on early identification and early intervention in autism and ASD and to provide a framework for examining these issues.

Analysis of the Expressive and Receptive Language Characteristics of Emotionally Handicapped Students Served in Public School Settings.

Until the past few years, language characteristics of students receiving services for mild/moderate behavior disorders (BD) have been neglected for research on the language of the more severely disturbed population. However, recent investigations of the language characteristics of mild/moderately BD students have produced sufficient evidence to warrant further study. The purpose of the present study was to examine the language skills (i.e., morphology, syntax, and semantics) of a group of 30 mild/moderately BD students served in public school, resource classrooms. Overall results from the Test of Language Development-Intermediate (TOLD-I) (Hammill & Newcomer, 1982), the Test for Auditory Comprehension of Language-Revised (TACL-R) (Carrow-Woolfolk, 1985), the Peabody Picture Vocabulary Test-Revised (PPVT-R) (Dunn & Dunn, 1982), and the Expressive One Word Vocabulary Test (EOWVT) (Gardner, 1979) revealed that the BD students fell a minimum of one standard deviation below the normative mean on all but one (i.e., Word Classes and Relations subtest of the TACL-R) of the measures. Further within subject analyses indicated the students were having difficulty with both receptive and expressive language. These findings substantiate the fact that mild/moderate BD students should be considered at risk for language disorders.

Using Teacher-Implemented Instruction to Increase Language Intelligibility of Children with Autism

Abstract: This study examined the feasibility of an intervention using naturalistic language teaching procedures for communication problems of individuals with autism conducted by the childs general education teacher in collaboration with the childs language clinician. The results of a multiple baseline study across children indicate successful implementation of naturalistic language teaching procedures in the school settings by all general education teachers and improved intelligibility of the language skills of all the children with autism in generalized spontaneous language use. These results are discussed in terms of previous research demonstrating the effectiveness and benefits of naturalistic teaching procedures and in terms of the implications for educational practices involving children with autism.

Factors accounting for the ability of children with SLI to learn agreement morphemes in intervention

The aim of this study was to uncover factors accounting for the ability of children with specific language impairment (SLI) to learn agreement morphemes in intervention. Twenty-five children with SLI who participated in a six-month intervention program focused on teaching third person singular -s or auxiliary is/are/was showed a wide range of use of the target morpheme after intervention. Regression analyses showed that age and two factors expected to be related to agreement--the use of noun plural -s and subject/verb constructions prior to intervention--significantly predicted progress in the acquisition of agreement morphemes. In contrast, the pretreatment use of morphemes hypothesized to be unrelated to agreement was not a significant predictor of progress. The results indicate that the ability of children with SLI to learn agreement morphemes relies on their prior ability to use noun plural and subject/verb constructions.

Treatment Effects on Speech Intelligibility and Length of Utterance in Children with Specific Language and Intelligibility Impairments

This purpose of this randomized group experiment was (a) to test the post-treatment (i.e., immediately after treatment) and follow-up (i.e., 8 months after the end of treatment) efficacy of a treatment designed to facilitate both sentence length and speech intelligibility (i.e., broad target recast), and (b) to explore whether pretreatment speech accuracy predicted response to treatment in children with severe phonological and expressive language impairment. The results support the conclusion that broad target recast facilitated follow-up speech intelligibility in children whose speech accuracy was relatively low prior to treatment.