Rose V, Trembath D, Keen D, Paynter J
Menzies Health Institute, Griffith University, Brisbane, Australia.
Autism Centre of Excellence, Griffith University, Brisbane, Australia.
J Intellect Disabil Res. 2016 May;60(5):464-77. doi: 10.1111/jir.12284.
Estimates of the proportion of children with autism spectrum disorder (ASD) who are minimally verbal vary from 25%to 35%. However, there is a lack of consensus in defining minimally verbal and few detailed reports of communication outcomes for these children following intervention. The aim of this study was to explore how minimally verbal children have been defined and to document the proportion of minimally verbal children in a group of children with ASD receiving a community based early intervention programme.
A longitudinal cohort design was used to examine the proportion of children who met criteria for minimally verbal in 246 children with ASD when they entered and exited an early intervention programme.
Overall, 26.3% of the children in this study exited the programme using 'fewer than five spontaneous and functional words' and 36.4% exited not using 'two word phrases' as indicated by direct assessment. However, our findings were mixed depending on measures and definitions used, with parent report indicating that as many as 29.4% of children were not 'naming at least three objects' consistently, and 43.3% not using 'phrases with a noun and verb' consistently at exit. More than half of the children who entered the programme with minimal speech exited the programme with a similar language profile. A small percentage of children (1.2%-4.7%) regressed in their language level over time.
Despite advances in early intervention, and access to services at a younger age, around a quarter of individuals with ASD in this study exited early intervention with significant communication needs. Our findings are considered in relation to the literature and clinical implications, and future research directions are discussed.
患有自闭症谱系障碍(ASD)的儿童中,语言能力极低的儿童比例估计在25%至35%之间。然而,在定义语言能力极低方面缺乏共识,并且对于这些儿童干预后的沟通结果也鲜有详细报告。本研究的目的是探讨语言能力极低的儿童是如何被定义的,并记录在接受社区早期干预项目的一组自闭症谱系障碍儿童中语言能力极低的儿童比例。
采用纵向队列设计,以检查246名自闭症谱系障碍儿童在进入和退出早期干预项目时符合语言能力极低标准的儿童比例。
总体而言,根据直接评估,本研究中26.3%的儿童在退出项目时使用的“自发且有功能的词汇少于五个”,36.4%的儿童在退出时未使用“双词短语”。然而,根据所使用的测量方法和定义,我们的研究结果不一,家长报告显示,多达29.4%的儿童不能持续“说出至少三个物体的名称”,43.3%的儿童在退出时不能持续使用“带有名词和动词的短语”。超过一半进入项目时语言极少的儿童在退出项目时语言水平相似。一小部分儿童(1.2%-4.7%)随着时间的推移语言水平出现倒退。
尽管早期干预取得了进展,且儿童能更早获得服务,但本研究中约四分之一的自闭症谱系障碍患者在退出早期干预时仍有显著的沟通需求。我们结合文献和临床意义对研究结果进行了考量,并讨论了未来的研究方向。