McDaniel Jena
Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, 1215 21St. Avenue South, MCE South Tower Suite 8310, Nashville, TN, 37232, USA.
J Autism Dev Disord. 2025 Apr;55(4):1187-1202. doi: 10.1007/s10803-024-06279-5. Epub 2024 Mar 21.
Multiple contemporary theories emphasize the quantity and quality of child vocalizations for promoting spoken language acquisition. Yet, empirical evidence for facilitating vocal development is strikingly lacking including for children with autism spectrum disorder (ASD) who have difficulty developing language. We evaluate use of contingent responses and vocal enhancement strategies to increase the quantity and quality of child vocalizations to which adults can respond with language-facilitating input for children with ASD. Three preschool children with ASD and minimal verbal skills participated. Using an alternating treatments design embedded within a multiple probe across participants design, we compared using contingent responses with and without vocal enhancement strategies versus a non-contingent control condition. Based on visual analysis and effect sizes, all participants showed a functional relation between both active intervention conditions and quantity of vocalizations, as predicted. For quality of vocalizations, changes under the active intervention conditions were less pronounced than those observed for quantity. Two participants showed a functional relation between at least one quality variable and the active interventions. Our hypothesis that vocal enhancement strategies would exhibit a value-added effect was partially supported for quantity and quality. Findings support using contingent responses to improve the quantity and to some degree the quality of vocalizations in young children with ASD and minimal verbal skills. Support for the added value of vocal enhancement strategies was mixed. Refining the intervention strategies is warranted to meet the needs of the understudied population of children with ASD and minimal verbal skills.
多种当代理论强调儿童发声的数量和质量对促进口语习得的作用。然而,令人惊讶的是,目前缺乏促进发声发展的实证证据,包括对语言发展有困难的自闭症谱系障碍(ASD)儿童。我们评估了使用偶然反应和发声增强策略来增加儿童发声的数量和质量,以便成年人能够用促进语言的输入对ASD儿童做出回应。三名患有ASD且语言能力极低的学龄前儿童参与了研究。采用跨参与者多探针设计中的交替治疗设计,我们比较了使用有和没有发声增强策略的偶然反应与非偶然控制条件。基于视觉分析和效应大小,正如预期的那样,所有参与者在两种积极干预条件与发声数量之间都显示出功能关系。对于发声质量,积极干预条件下的变化不如发声数量变化明显。两名参与者在至少一个质量变量与积极干预之间显示出功能关系。我们关于发声增强策略将表现出增值效应的假设在数量和质量方面得到了部分支持。研究结果支持使用偶然反应来提高ASD且语言能力极低的幼儿发声的数量,并在一定程度上提高发声质量。对发声增强策略增值作用的支持存在分歧。有必要改进干预策略,以满足对ASD且语言能力极低的儿童这一研究不足群体的需求。