Caregiver Language Input Supports Sentence Diversity in Young Children With Autism Spectrum Disorder

Abstract

Purpose: Sentence diversity is a measure of early language development that has yet to be applied to individuals with autism spectrum disorder (ASD). The primary aim of this study was to identify whether children with ASD show change in sentence diversity over 6 months of treatment with Naturalistic Developmental Behavioral Intervention (NDBI). The secondary aim was to examine possible predictors of changes in children's sentence diversity, including caregiver use of NDBI strategies, naturally occurring instances of caregiver Toy Talk, and child characteristics. Method: Fifty children with ASD (ages 2–4 years) and their caregivers, who were receiving NDBI, engaged in two 10-min video-recorded play interactions, 6 months apart. Child speech was transcribed and coded for sentence diversity. Caregiver input was transcribed and coded for naturally occurring Toy Talk . Zero-inflated negative binomial mixed models were used to explore predictors of change in child sentence diversity. Results: Children's sentence diversity improved over time. Changes in caregiver NDBI strategy use and caregiver baseline Toy Talk were significant predictors of changes in sentence diversity, as were baseline age, nonverbal ratio IQ, and child sex. Additionally, a significant interaction of caregiver baseline Toy Talk and change in caregiver NDBI strategies emerged; the effect of caregiver baseline Toy Talk on children's sentence diversity change was stronger when NDBI strategy use improved. Conclusions: Sentence diversity is a developmentally sensitive measure of language development in ASD. NDBI strategies that facilitate reciprocal social communication, combined with input composed of declarative sentences with noun or third-person pronoun subjects, may provide optimal support for children's sentence development.

Parent Responsivity, Language Input, and the Development of Simple Sentences

“…First, our sample size of only 20 parent-child dyads may have been too small to detect facilitative input effects for declaratives, an infrequent structure in naturally-occurring parent-child interaction. In previous studies where associations between use of parent declaratives and later child sentence diversity have been detected, sample sizes have been larger, ranging from 28 to 50 dyads (Clark-Whitney et al, 2022;Hadley et al, 2017b;Rispoli et al, 2018). Second, our desire to code the intersection of responsive and linguistic features at the level of the individual utterance led to using a frequency measure of declaratives in parent input rather than the diversity of noun subjects (Hadley et al, 2017a) or the diversity of subject-verb combinations (Rispoli et al, 2018) in active declarative sentences.…”

“…Therefore, we recommend retaining diversity measures in future studies of linguistic input and using alternative methods for exploring how responsive and linguistic features of input work together to promote child language outcomes. The recent study by Clark-Whitney et al (2022) provides an example of an alternative approach. Recall they combined ratings of caregiver responsivity over time with the baseline frequency of toy talk sentences (i.e., third person declarative sentences about objects and events in the play environment).…”

“…Recent intervention research aligns with this hypothesis. Clark-Whitney, Klein, Hadley, Lord, and Kim (2022) examined the unique contributions of caregiver responsivity following six months of naturalistic developmental behavioral intervention and declarative input to child sentence diversity outcomes for 50 preschoolers with autism spectrum disorder. Caregiver responsivity was assessed by rating 21 aspects of responsive strategy use, effectiveness, and missed opportunities.…”

Natural language acquisition and gestalt language processing: A critical analysis of their application to autism and speech language therapy

“…In brief, recommendations to avoid single words (stage 1), use lots of contractions that obscure the boundary between subject and predicate (stage 2), and model isolated words without regard to grammar while also avoiding verbs (stage 3), do not square with existing research examining the properties of linguistic input that predict and support language development in NT and autistic children (e.g. Butler et al, 2023 ; Clark-Whitney et al, 2022 ; Hadley et al, 2018 ; Naigles et al, 2011 ). In fact, it is not obvious how NLA stage-specific recommendations would follow from even the raw material view of delayed echolalia on which NLA is founded.…”

Mapping the Active Ingredients and Mechanisms of Change of a Naturalistic Developmental Behavioral Intervention Using Mixed Methods

“…In addition, NDBIs have been shown to support expressive language gains via growth in child imitation and intentional communication (Yoder et al, 2021a), providing support for the idea that directly targeting early social communication skills has downstream effects on other developmental outcomes. Indeed, supporting social engagement may enable children to learn optimally from their environment; recent work found that caregiver language modeling was more strongly associated with children’s sentence diversity when caregivers’ NDBI strategy use increased (Clark-Whitney et al, 2022).…”