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Speech Therapy: Addressing language delays in the natural setting of DIR


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Evidence-Based research on Speech Therapy:

  • A randomized trial comparison of the effects of verbal and pictorial naturalistic communication strategies on spoken language for young children with autism.1 (subscription needed)
    This study compared two different approaches used to help young children with autism spectrum disorders (ASD) communicate. The children were nonverbal or minimally verbal in that they used less than nine different words. Thirty-nine children aged two to four years were randomly assigned to either Pivotal Response Training (PRT) or the Picture Exchange Communication System (PECS). PRT is a verbally-based naturalistic behavioral intervention that has been shown to improve speech imitation, labeling, and spontaneous speech. In contrast, PECS teaches children to exchange picture icons to communicate. Both programs are based on principals of Applied Behavior Analysis (ABA) and both use motivation, natural opportunities for communication, require a response from the children, and use direct reinforcement to increase response.

    Participants who received the iPod training prior to beginning their jobs required significantly fewer hours of job coaching support during their first 12 weeks than did those who received the training and iPods only after beginning work. However, functional performance was not significantly different between the two groups. The significant difference in hours of job coaching support persisted through the first 12 weeks of employment, when both groups then had iPods.

  • Reducing the need for personal supports among workers with autism using an iPod Touch as an assistive technology: delayed randomized control trial.2 (subscription needed)
    Fifty adults with Autism Spectrum Disorders (ASD) about to start job placement in Virginia were randomized to either receive immediate training by an Occupational Therapist in the use of an iPod touch as vocational aid or receive the training plus iPod after working 12 weeks. All participants were assigned a job coach. Common job placements included janitorial, stock clerk, mail room, and food preparation. IPod applications commonly used by participants included: (1) task reminders, (2) task lists, (3) picture prompts, (4) video-based task-sequencing prompts, (4)behavioral self-management adaptations, (5) navigation tools, and (6) communication with the job coach via Wi-Fi.

    In this study, a university based autism program delivered an average of 10 hours of either intervention per week for 23 weeks to each child in his or her home. Parents also received several hours of training each week. Children in both groups increased spoken language; there was no difference in effectiveness between the two programs. Parents were very satisfied with both programs.

  • Interaction of participant characteristics and type AAC with individuals with ASD: A meta analysis. 3

1 Schreibman L, Stahmer AC. A randomized trial comparison of the effects of verbal and pictorial naturalistic communication strategies on spoken language for young children with autism. Journal of autism and developmental disorders. May 2014;44(5):1244-1251.

2 Gentry T, Kriner R, Sima A, McDonough J, Wehman P. Reducing the need for personal supports among workers with autism using an iPod Touch as an assistive technology: delayed randomized control trial. Journal of Autism and Developmental Disorders. Mar 2015;45(3):669-684.

3 Ganz JB, Mason RA, Goodwyn FD, Boles MB, Heath AK, Davis JL. Interaction of participant characteristics and type AAC with individuals with ASD: A meta analysis. American Journal on Intellectual and Developmental Disabilities S2- American Journal of Mental Deficiency S2- American Journal on Mental Retardation. Nov, 2014 2014;119(6):516-535.

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