Improving communication skills in children with Autism

By
Yi Ma
Sherry Berry
Loretta Benjamin


April 29, 2008

Introduction

Autism occurs in varying degrees. Some persons with autism function very well and others do not. “Pervasive development disorders”, Individuals with pervasive developmental disorder (PDD) have a unique set of symptoms that affect three areas of domains”: communication, socialization, (interaction with others), and behavior.

Autism disorder and other PDDS are due in large part to genetic factors. In some instances, autism disorder is a feature of an identifiable genetic condition. More frequently, however, no underlying specific cause can be determined (that is called idiopathic autism meaning autism of unknown). There is a great deal of evidence that idiopathic is caused by changes or “mutations” in genes. However these genes have not yet been identified.

Autism disorder is a developmental disorder that effects a person’s ability to Communicate, form relationships with others, and respond appropriately to the
environment. Some people with autism are functioning, with speech and intelligence intact. Others may be nonverbal and/or mentally retarded. Autism is on the rise from labeling not epidemic. 1-150 children are diagnosed that one child every 20 minutes.

Several studies have been conducted on the effectiveness of various stimuli to teach children with autism how to communicate. These studies have included a variety of stimuli ranging from audio, visual with words, visual with pictures, social; nonverbal, verbal, home based treatments, and others.

In 1998, a project evaluation was published in the Journal of Autism and Developmental Disorders (Ozonoff & Cathcart). This report evaluated the fectiveness of a home based program intervention called TEACCH. The findings in this report suggested that children with autism improve significantly more when participating in a home based intervention program than do children who do not. Another article published in that same journal (Dawson, Meltzoff, Osterling, Rinaldi, and Brown, 1998) suggests that autistic children may not respond to social stimuli because they have a greater difficulty with shared attention. In this study three groups of children were studied. Autistic children where compared with children with Down syndrome and typical development. Children with autism performed significantly more errors on orienting tasks, both social and nonsocial, and shared attention tasks.

In 2006, a Randomized Comparison of the Effect of Two Prelinguistic Communication Interventions on the Acquisition of Spoken Communication in Preschoolers with ASD, (Yoder, Paul; Stone, Wendy L. Source: Journal of Speech, Language, & Hearing. Purpose: This randomized group experiment compared the efficacy of 2 communication Interventions (Responsive, Education and Prelinguistic Milieu Teaching (RPMT) and the picture exchange Communication System (PECS) on Spoken Communication of 35 preschoolers with Autism spectrum disorders (ASD) The findings in this report suggested that PECS was more successful than PRMT in increasing the number of different no imitative words used at the post treatment period. Another article published in the Journal of Autism and Developmental Disorders, Vol.30. No.6. 2000: Teaching Conversational Skills to Children with Autism: Effect on the Development of the Theory of Mind: The research examined whether children with Autism could be trained to improve their conversational skills and whether this led to changes in standard tests of theory of mind.

(ToM). Three high functioning Children with autism participated in a multiple baseline across participants design. The children were taught how to initiate a conversation, take turns during conversation, listen attentively, maintain a conversation topic, and change a conversation topic appropriately. The children were tested for ToM using false belief tasks before and after training sessions. Results indicate that the amount of shared interest exhibited by the children with autism during conversation with their caregivers increased during training sessions. The children also made more responses that were appropriate to the context of the conversations. Performance on the False Belief tasks remained constant throughout the study.

Over the years many explanations have been proposed and many hypotheses have been tested. Some studies have focused on causes while others have focused on treatment. While there is no known cure for autism there are many treatment methods that can be used to help autistic children function with their disability. In this study, we sought to examine several existing studies on children with autism to see if there was any consistency within one form of treatment that would improve the communication skills of children with autism. The primary hypothesis was that there is one universal stimulus that can be used to improve communication skills in children with autism. Our null hypothesis is that there is no universal stimulus that can be used to improve communication skills in children with autism.

Method

Participants
Participants for this report ranged in age of 0-10 years. The children were diagnosed with varying degrees of autism. Studies compiled for this study included a total of 173 children. The individual studies used in this report compared children of similar ethnic, social, and economical backgrounds. Although the gender breakdown was provided in most of the studies, it was not a significant factor in the results and therefore not used as a variable in this report.

Procedure
Data was collected from six studies done from 1993 to 2006. The studies used in this report were conducted using cluster analysis of children with similar demographics. Each study was a case study, not selected randomly. The majority of the studies were conducted by observations and interviews and videotaped
Results from these studies were compiled into a data based and analyzed based on the percentage of success of treatment. ‘Treatment’ was broken into four different stimulus categories; audio, visual with pictures, visual with words, and social.
Treatments are defined as follows:
Audio treatments engaged students in making conversation, listening, maintaining a conversation, and appropriately changing a topic. Participants were tested at home or a quiet place. Subjects were observed by independent raters who measured frequency of eye contact and turns during a conversation.
Visual with word treatments included studies that evaluated responses to simple words and phrases. Visual with pictures treatments included studies that evaluated responses to picture prompts.

Social treatments included social interactions with familiar evaluators and non-familiar evaluators, verbal and nonverbal. Home based programs were included in this definition of treatment as well.
Coding and scoring of success of treatment
Treatments were coded as 1) audio, 2) visual with words, 3) visual with pictures, 4) social. Success rates of the treatments were determined using the scores of the individuals in each study. Success rates were calculated by taking the pre-test and post-test data.
Results
Differences in stimuli was calculated by taking pre-test results and the post-test results and calculating the percent increase in correct answers. The calculated percent of increase for the participants in the audio treatment method was 40%. This was the lowest percent of increase of the four treatments analyzed for this study. This result was closely followed by visual with words at 43%. Social stimulus was 45% successful. The highest percent of increase was observed for the visual with pictures at 97%.
Normally in a Meta Analysis study a coefficient would be calculated by taking the coefficients of all studies. Because many of these studies compared other variables a coefficient could not? be calculated. Because we could not effectively input data into an SPSS file a standard deviation could not be correctly calculated. The stimulus of visual with pictures proved 97% effective. Since this success rate is significantly greater than the other three stimuli, our hypothesis of ‘one universal stimulus that can be used to improve communication skills in children with autism’.


Discussion

Our objective was to assess whether there was an effective method to help autistic children to improve their language skills. We examined the commonly used methods and on the base of literature review, we concluded four mainly adopted methods: script stimuli, picture stimuli, audio stimuli and social stimuli.
The results firstly show that visual stimuli have the most positive influence on autistic children. The autistic children, through training, did improve on their conversational ability. Specifically, the percentage of time the children spent in shared interest and the percentage of utterances that were contextually appropriate increased. Hence, the participants showed an improvement in the ability to maintain a conversation topic. In particular, the amount of “answer” utterances generally increased after training occurred.

The results confirm previous findings that high functioning children with autism are proficient at giving a direct answer to a direct question (Tager-Flusberg & Anderson, 1991). The most prevalent response to a question was a one-word, one-phrase, or one-sentence answer. The results suggest that the extent to which children with autism can improve on the type of utterances made, and therefore, their conversational competence after training, depends on the quality of their speech at baseline level. Our findings also suggest that a child’s quality of speech may develop from predominantly preservative responses to mainly answer responses and then to increased elaborate responses. Results of the study also show that children with autism exhibit a general impairment in orienting ability, and that this impairment is more severe for social stimuli. Children with autism often failed to orient to social stimuli. In addition, children with autism who did orient to the social stimuli were more likely to show a delayed response. Such results suggest that children with autism are particularly impaired in their ability to orient to social stimuli. Unless children with autism are taught that social stimuli are interesting, rewarding, and meaningful, they may not be as likely to acquire more complex communicative or social skills that require paying attention to others.

There are two phenomena that we may pay attention to. In our study, we found that previous researches that conducted by parents at home were more effective by those by researchers that autistic children were not familiar with. Also, instruments with fading out help were more effective. Parents first trained the autistic children and during the second part of study, they left the room and observed autistic children’s behavior. These findings suggest that children with autism may feel more comfortable with familiar people and environment, and they need sufficient time and preparation before they can fully participate in the study.

In summary, it would be erroneous to conclude that autistic children cannot improve their language skills. Our researches show that there are potential instruments for improving the language ability of children with autism. Our hypothesis that there is one effective method to improve autistic children's language skills is confirmed in the limited number of studies we examined. Our study suggests that autistic children have the highest reaction toward audio stimuli, and the lowest toward social stimuli.

Bibliography
Dawson, G., Meltzoff, A., Osterling,J., Rinaldi, J., & Brown, E. (1998) Children with Autism Fail to Orient to Naturally Occurring Social Stimuli, Journal of Autism and Development Disorders, Vol.28, No.6, 479-485
Hsiao, Y. & Bernard-Opitz, V. (2000) Teaching Conversational Skills to Children with Autism: Effect on the Development of a Theory of Mind, Journal of Autism and Developmental Disorders, Vol.30, No.6, 569-583
Krantz P. & McClannahan, L. (1993) Teaching Children with Autism to Initiate to Peers: Effects of a Script-fading procedure, Journal of Applied Behavior Analysis, Vol.26, 121-132
MacDuff, G., Krantz, P. & McClannahan, L. (1993) Teaching Children with Autism to Use Photographic Activity Schedules: Maintenance and Generalization of Complex Response Chains, Journal of Applied Behavior Analysis, Vol. 26, 89-97
Ozonoff, S.,& Cathcart, K. (1998) Effectiveness of a Home Program Intervention for Young Children with Autism, Journal of Autism and Developmental Disorders, Vol.28, No.1,25-32
Pierce, K. & Schreibman (1994), Teaching Daily Living Skills to Children with Autism in Unsupervised Settings through Pictorial Self-management, Journal of Applied Behavior Analysis, Vol. 27, 471-481
Veronica, S. & Anat, P. (2007) Predictors of Expressive Vocabulary Growth in Children with Autism, Journal of Speech, No.1, 149-160
Yoder, P. & Stone, W. (2006) A Randomized Comparison of the Effect of Two Prelinguistic Communication Interventions on the Acquisition of Spoken Communication in Preschoolers With ASD, Journal of Speech, No.4, 698-711

My 55 fiction

His hands began to sweat. The forest looked peaceful in the sunshine and she was enjoying the fall colors. She didn’t notice his anxiety.

“Sweetie”, he stopped and looked into her eyes, trying to reach the engagement ring in his pocket. “Nooooo!!!” She frowned.

His heart sank. Slowly, he turned around.

That’s why! A skunk!



This happened to my father-in-law when he proposed to his wife. Now they are still keeping a skunk toy at their house to memorize this event. As I was writing this story, I found it hard to keep the length exactly at 55 words. I had to cut some details so the story could move on within limit. I did consider putting the end of story at the beginning, but it’s even hard for me. It’s very fun to write this story and, even though I “struggled” during the work, I felt happy when it’s done.

What is "55 fiction"?

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By Brooke Ellen Peiffer