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A Communication-Based Intervention for Nonverbal Children with Autism: What Changes? Who Benefits?

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Title: A Communication-Based Intervention for Nonverbal Children with Autism: What Changes? Who Benefits?
Language: English
Authors: Gordon, Kate, Pasco, Greg, McElduff, Fiona
Source: Journal of Consulting and Clinical Psychology. Aug 2011 79(4):447-457.
Availability: American Psychological Association. Journals Department, 750 First Street NE, Washington, DC 20002-4242. Tel: 800-374-2721; Tel: 202-336-5510; Fax: 202-336-5502; e-mail: order@apa.org; Web site: http://www.apa.org/publications
Peer Reviewed: Y
Physical Description: PDF
Page Count: 11
Publication Date: 2011
Document Type: Journal Articles
Reports - Research
Education Level: Elementary Education
Descriptors: Intervention, Speech Communication, Naturalistic Observation, Autism, Language Impairments, Expressive Language, Children, Predictor Variables, Pictorial Stimuli, Augmentative and Alternative Communication, Elementary School Students, Outcomes of Treatment
DOI: 10.1037/a0024379
ISSN: 0022-006X
Abstract: Objective: This article examines the form and function of spontaneous communication and outcome predictors in nonverbal children with autism following classroom-based intervention (Picture Exchange Communication System [PECS] training). Method: 84 children from 15 schools participated in a randomized controlled trial (RCT) of PECS (P. Howlin, R. K. Gordon, G. Pasco, A. Wade, & T. Charman, 2007). They were aged 4-10 years (73 boys). Primary outcome measure was naturalistic observation of communication in the classroom. Multilevel Poisson regression was used to test for intervention effects and outcome predictors. Results: Spontaneous communication using picture cards, speech, or both increased significantly following training (rate ratio [RR] =1.90, 95% CI [1.46, 2.48], p less than 0.001; RR = 1.77, 95% CI [1.35, 2.32], p less than 0.001; RR = 3.74, 95% CI [2.19, 6.37], p less than 0.001, respectively). Spontaneous communication to request objects significantly increased (RR = 2.17, 95% CI [1.75, 2.68], p less than 0.001), but spontaneous requesting for social purposes did not (RR = 1.34, 95% CI [0.83, 2.18], p = 0.237). Only the effect on spontaneous speech persisted by follow-up (9 months later). Less severe baseline autism symptomatology (lower Autism Diagnosis Observation Schedule [ADOS] score; C. Lord et al., 2000) was associated with greater increase in spontaneous speech (RR = 0.90, 95% CI [0.83, 0.98], p = 0.011) and less severe baseline expressive language impairment (lower ADOS item A1 score), with larger increases in spontaneous use of speech and pictures together (RR = 0.62, 95% CI [0.44, 0.88], p = 0.008). Conclusion: Overall, PECS appeared to enhance children's spontaneous communication for instrumental requesting using pictures, speech, or a combination of both. Some effects of training were moderated by baseline factors. For example, PECS appears to have increased spontaneous speech in children who could talk a little at baseline. (Contains 3 figures and 2 tables.)
Abstractor: As Provided
Number of References: 45
Entry Date: 2011
Accession Number: EJ933775
Database: ERIC
FullText Text:
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  Data: A Communication-Based Intervention for Nonverbal Children with Autism: What Changes? Who Benefits?
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Consulting+and+Clinical+Psychology%22"><i>Journal of Consulting and Clinical Psychology</i></searchLink>. Aug 2011 79(4):447-457.
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  Data: American Psychological Association. Journals Department, 750 First Street NE, Washington, DC 20002-4242. Tel: 800-374-2721; Tel: 202-336-5510; Fax: 202-336-5502; e-mail: order@apa.org; Web site: http://www.apa.org/publications
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  Data: 10.1037/a0024379
– Name: ISSN
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  Data: 0022-006X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: This article examines the form and function of spontaneous communication and outcome predictors in nonverbal children with autism following classroom-based intervention (Picture Exchange Communication System [PECS] training). Method: 84 children from 15 schools participated in a randomized controlled trial (RCT) of PECS (P. Howlin, R. K. Gordon, G. Pasco, A. Wade, & T. Charman, 2007). They were aged 4-10 years (73 boys). Primary outcome measure was naturalistic observation of communication in the classroom. Multilevel Poisson regression was used to test for intervention effects and outcome predictors. Results: Spontaneous communication using picture cards, speech, or both increased significantly following training (rate ratio [RR] =1.90, 95% CI [1.46, 2.48], p less than 0.001; RR = 1.77, 95% CI [1.35, 2.32], p less than 0.001; RR = 3.74, 95% CI [2.19, 6.37], p less than 0.001, respectively). Spontaneous communication to request objects significantly increased (RR = 2.17, 95% CI [1.75, 2.68], p less than 0.001), but spontaneous requesting for social purposes did not (RR = 1.34, 95% CI [0.83, 2.18], p = 0.237). Only the effect on spontaneous speech persisted by follow-up (9 months later). Less severe baseline autism symptomatology (lower Autism Diagnosis Observation Schedule [ADOS] score; C. Lord et al., 2000) was associated with greater increase in spontaneous speech (RR = 0.90, 95% CI [0.83, 0.98], p = 0.011) and less severe baseline expressive language impairment (lower ADOS item A1 score), with larger increases in spontaneous use of speech and pictures together (RR = 0.62, 95% CI [0.44, 0.88], p = 0.008). Conclusion: Overall, PECS appeared to enhance children's spontaneous communication for instrumental requesting using pictures, speech, or a combination of both. Some effects of training were moderated by baseline factors. For example, PECS appears to have increased spontaneous speech in children who could talk a little at baseline. (Contains 3 figures and 2 tables.)
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  Data: 2011
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  Label: Accession Number
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  Data: EJ933775
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        Value: 10.1037/a0024379
    Languages:
      – Text: English
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        PageCount: 11
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      – SubjectFull: Intervention
        Type: general
      – SubjectFull: Speech Communication
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      – SubjectFull: Naturalistic Observation
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      – SubjectFull: Augmentative and Alternative Communication
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      – SubjectFull: Elementary School Students
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      – SubjectFull: Outcomes of Treatment
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      – TitleFull: A Communication-Based Intervention for Nonverbal Children with Autism: What Changes? Who Benefits?
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