Dataset Information

Predicting Expressive Language From Early Vocalizations in Young Children With Autism Spectrum Disorder: Which Vocal Measure Is Best?

ABSTRACT: Purpose This study was designed to test the incremental validity of more expensive vocal development variables relative to less expensive variables for predicting later expressive language in children with autism spectrum disorder (ASD). We devote particular attention to the added value of coding the quality of vocalizations over the quantity of vocalizations because coding quality adds expense to the coding process. We are also interested in the added value of more costly human-coded vocal variables relative to those generated through automated analyses. Method Eighty-seven children with ASD aged 13-30 months at study initiation participated. For quantity of vocalizations, we derived one variable from human coding of brief communication samples and one from an automated process for daylong naturalistic audio samples. For quality of vocalizations, we derived four human-coded variables and one automated variable. A composite expressive language measure was derived at study entry, and 6 and 12 months later. The 12 months-centered intercept of a simple linear growth trajectory was used to quantify later expressive language. Results When statistically controlling for human-coded or automated quantity of vocalization variables, human-coded quality of vocalization variables exhibited incremental validity for predicting later expressive language skills. Human-coded vocal variables also predicted later expressive language skills when controlling for the analogous automated vocal variables. Conclusion In sum, these findings support devoting resources to human coding of the quality of vocalizations from communication samples to predict later expressive language skills in young children with ASD despite the greater costs of deriving these variables. Supplemental Material https://doi.org/10.23641/asha.12276458.

SUBMITTER: McDaniel J

PROVIDER: S-EPMC7842121 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Predicting Expressive Language From Early Vocalizations in Young Children With Autism Spectrum Disorder: Which Vocal Measure Is Best?

McDaniel Jena J Yoder Paul P Estes Annette A Rogers Sally J SJ

Journal of speech, language, and hearing research : JSLHR 20200513 5

Purpose This study was designed to test the incremental validity of more expensive vocal development variables relative to less expensive variables for predicting later expressive language in children with autism spectrum disorder (ASD). We devote particular attention to the added value of coding the quality of vocalizations over the quantity of vocalizations because coding quality adds expense to the coding process. We are also interested in the added value of more costly human-coded vocal vari ...[more]

PMID: 32402218

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Project description:BackgroundStudies estimate that 30% of individuals with autism are minimally verbal. Understanding what factors predict longer-term expressive development in children with language delays is critical to inform identification and treatment of those at-risk for persistent language impairments. The present study examined predictors of expressive language development in language-delayed preschoolers followed through later school-age and young adulthood.MethodsChildren using single words or less on the Autism Diagnostic Observation Schedule (ADOS) at approximately 3 years old were drawn from the Early Diagnosis (EDX) and Pathways in ASD longitudinal cohorts. Age-3 predictors of Age-19 ADOS language level were identified using Classification and Regression Trees (CART) in the EDX sample. Linear mixed models examined the effects of CART-identified predictors on Vineland expressive communication (VExp) trajectories from Age-3 to Age-19. The same linear mixed models were examined in the Pathways sample, identifying predictors of VExp from ages 3 to 10.5 years.ResultsSignificantly delayed fine motor skills (T-score < 20) was the strongest CART predictor of Age-19 language. In the linear mixed models, time, Age-3 fine motor skills and initiation of joint attention (IJA) predicted VExp trajectories in the EDX sample, even when controlling for Age-3 visual receptive abilities. In the Pathways sample, time and Age-3 fine motor skills were significant predictors of VExp trajectories; IJA and cognitive skills were not significant predictors.ConclusionsMarked deficits in fine motor skills may be a salient proxy marker for identifying language-delayed children with ASD who are at risk for persistent language impairments. This finding adds to the literature demonstrating a relation between motor and language development in ASD. Investigating individual skill areas (e.g., fine motor and nonverbal problem-solving skills), rather than broader indices of developmental level (e.g., nonverbal IQ) may provide important cues to understanding longer-term language outcomes that can be targeted in early intervention.

Project description:This study investigates the impact of a theatre-based vocal empowerment program on the vocal and language characteristics and the self-perceptions of young bilingual Egyptian women. The program used applied theatre, a dramatic practice that promotes civic action by utilizing improvisational techniques to engage participants in exploring solutions to self-identified community concerns. These techniques supported participants' pursuit of vocal empowerment: the ability to comfortably express their intended content with a clear audible voice, accompanied by the belief that what they had to say was worthwhile. The program was implemented in Alexandria and Aswan, two Egyptian cities in different regions of the country, with distinct socio-economic profiles. Thirty-six young women from Aswan and nineteen from Alexandria participated. The program was facilitated in Arabic, for 90 minutes per day over twelve consecutive days in 2018. Participants in both groups spoke Arabic as a home language and studied English in school settings but differed in their educational experiences and English proficiency. The vocal and language characteristics of each participant were tested in Arabic and English pre- and post- program using a spontaneous speech task and a reading aloud task. Their self-perceptions were evaluated through a vocal self-perception survey. Results indicated that participants responded differently in each city. In Alexandria, participants showed significant improvement in language skills (e.g., mean length of utterance). In contrast, participants in Aswan showed a significant change in fundamental frequency. Overall, the self-surveys indicated that all participants experienced an increased sense of confidence, a stronger belief in self-authorship, and an increased desire to voice their opinions clearly in public; however, there were subtle differences between the groups. In analyzing these results, we conclude that to design effective vocal empowerment outreach programs internationally, it is necessary to consider participants' cultural backgrounds, language diversity, and socio-economic status.

Project description:The range of outcomes for young adults with Autism Spectrum Disorders (ASD) and the early childhood factors associated with this diversity have implications for clinicians and scientists.This prospective study provided a unique opportunity to predict outcome 17 years later for a relatively large sample of children diagnosed with ASD at 2 years old. Diagnostic and psychometric instruments were administered between 2 and 19 with data from 2, 3, and 19 included in this study. Clinicians administered tests without knowledge of previous assessments whenever possible. Caregivers provided additional information through questionnaires.Significant intellectual disabilities at 19 were predicted by age 2 about 85% of the time from VIQ and NVIQ scores together, though prediction of young adult outcome for youths with average or higher intelligence was more complex. By 19, 9% of participants had largely overcome core difficulties associated with ASD and no longer retained a diagnosis. These youths with Very Positive Outcomes were more likely to have participated in treatment and had a greater reduction in repetitive behaviors between age 2 and 3 compared to other Cognitively Able youths (VIQ ?70) with ASD. Very Positive Outcome youths did not differ phenotypically from Cognitively Able ASD individuals at 2 but both groups differed from Cognitively Less Able individuals (VIQ <70).Those most at risk for intellectual disabilities and ASD can be reliably identified at an early age to receive comprehensive treatment. Findings also suggest that some cognitively able children with ASD who participate in early intervention have very positive outcomes, although replication with randomized, larger samples is needed. In order to improve understanding of very positive outcomes in ASD, future research will need to identify how variations in child characteristics and environmental factors contribute to the nature and timing of growth across individuals and areas of development.

Dataset Information

Predicting Expressive Language From Early Vocalizations in Young Children With Autism Spectrum Disorder: Which Vocal Measure Is Best?

Publications

Predicting Expressive Language From Early Vocalizations in Young Children With Autism Spectrum Disorder: Which Vocal Measure Is Best?

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