Purpose A subset of children with autism spectrum disorder (ASD) has speech sound disorders, including childhood apraxia of speech (CAS). To date, virtually all speech treatment studies consider ASD an exclusionary criterion, resulting in little scientific evidence for treatment of CAS for children who also have ASD. This study proposes and tests a novel approach, Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS), as a theoretically and clinically informed speech treatment option for this population. Method Using a multiple-baseline design within and across participants, three children with co-occurring ASD and CAS received 11–18 treatment sessions. Treatment targets were individually designed and matched with untreated control words. Probes were administered at the start of each session to assess speech production accuracy perceptually. Changes in production accuracy were examined through visual inspection and quantified with effect sizes. Results Findings were mixed, with one child showing significant gains for half of the treated targets at follow-up and two children showing no clear improvement. Conclusions Preliminary evidence suggests potentially positive treatment effects for ACT4CAS when implemented as intended, although treatment intensity and disorder severity likely influence treatment outcome. Replication and comparison of ACT4CAS to other speech treatments is needed. Supplemental Material https://doi.org/10.23641/asha.14110445

Purpose Understanding variability sources in early language interaction is critical to identifying children whose development is at risk and designing interventions. Variability across socioeconomic status (SES) groups has been extensively explored. However, SES is a limited individual clinical indicator. For example, it is not generally directly modifiable. The purpose of this study was to examine if child language ability, input quantity and quality, and dyadic interaction were associated with modifiable caregiver characteristics—self-efficacy and developmental knowledge. Method We conducted secondary analyses using the baseline data ( n = 41 dyads enrolled, n = 30 analyzed) from a longitudinal study. Mothers and children (1;0–2;3 [years;months]) in low-income households completed demographic questionnaires, self-efficacy and developmental knowledge measures, child language assessments, and interaction samples. We used linear regression models to examine the relationship between self-efficacy, developmental knowledge, and outcomes. Results Child receptive and expressive language scores were significantly associated with mothers' self-efficacy, knowledge, and Efficacy × Knowledge interaction. Specifically, maternal self-efficacy was positively associated with child language only in the context of high developmental knowledge. Neither self-efficacy nor developmental knowledge was significantly associated with the number of total or different words mothers produced. However, self-efficacy was significantly and positively associated with the rate of child-initiated conversational turns per minute, controlling for the number of child utterances. Mothers with higher self-efficacy responded more readily to their children than those with lower self-efficacy. Conclusions Child language ability and interaction quality vary based on modifiable parent characteristics. Modifiable individual characteristics should be considered in early language interaction within and across SES groups.

Purpose: Quantity and quality of early at-home reading shape literacy outcomes. At-home reading frequency is a common outcome measure in interventions. This single measure may not fully capture the quality of early reading interactions, such as parent and child references to print, an important contributor to language and literacy outcomes. This study aims to evaluate if and how reported reading frequency and duration are associated with parent and child print referencing, controlling for perceived parenting self-efficacy, developmental knowledge, and child sex. Method: This study is a secondary analysis of baseline data from a treatment study with parents ( N = 30) and children (1;1–2;3 [years;months]) from underresourced households. Parents reported weekly reading episode frequency and duration (in minutes). We coded parent–child book-sharing interactions to quantify use of print references. Results: Negative binomial regression modeling suggested that parents who reported more weekly reading episodes tended to use more print references during interactions. However, reported reading time in minutes was not significantly associated with parents' print referencing. Parents' print references were also associated with perceived self-efficacy, developmental knowledge, and child sex. In our sample, parents used more print references with male children. Neither reading frequency nor reading time was associated with increased print referencing from children. Conclusions: Duration of reading did not positively predict children's use of print references. However, weekly reading frequency positively predicted parents' use of print references. Parent perceived self-efficacy and knowledge may predict early interaction quality similarly to quantity of reading. Supplemental Material: https://doi.org/10.23641/asha.20669094

The COVID-19 pandemic has upended traditional models of education and health care. Despite having a well-established evidence base, videoconferencing and related technology (i.e., “teletechnology”) were rarely utilized by most speech-language pathologists (SLPs) prior to March 2020. As operations were forced to move online, there was a rapid, unprecedented, and near-universal adoption of teletechnology for service delivery and clinical education. However, there was little time for program modification and training. Nine months later, we have settled into the transition and are able to reflect on the evidence base and potential benefits of operating through a new modality. This report begins by outlining commonalities in theoretical models of clinical supervision and early intervention service delivery. We discuss how teletechnology fits into—and potentially enhances—the framework. Next, we summarize the historical use of technology in SLP clinical training and service delivery, specifically, how it can be leveraged to support access, processes, and outcomes. Although SLPs are trained to serve the full range of clinical populations, we focus on their role in early intervention (i.e., services for children from birth to age five). Then, we expand upon the current research evidence with a practical discussion of quickly-developing anecdotal support for innovative practices, including “screenless coaching” and “silent supervision.” Although there are significant benefits to teletechnology, we conclude by recognizing potential limitations and discussing needs for future research. This report is written from the perspective of two experienced SLPs; however, the discussion is relevant to other therapeutic fields.

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