Clinician Proposed Predictors of Spoken Language Outcomes for Minimally Verbal Children with Autism Spectrum Disorder

Trembath, David; Sutherland, Rebecca; Caithness, Teena; Dissanayake, Cheryl; Eapen, Valsamma; Fordyce, Kathryn; Frost, Grace; Iacono, Teresa; Mahler, Nicole; Masi, Anne; Paynter, Jessica; Pye, Katherine; Reilly, Sheena; Rose, Veronica; Sievers, Stephanie; Thirumanickam, Abirami; Westerveld, Marleen F.; Tucker, Madonna

doi:10.1007/s10803-020-04550-z

Cited by 6 publications

(4 citation statements)

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“…While inherently challenging for controlled design, embedding research in community settings offers the opportunity to build an empirical evidence base with direct relevance to clinical practice and rapid translational potential. Toward this end, (Trembath et al, 2021) undertook a qualitative study to delineate clinician-proposed predictors of spoken language outcomes for children on the autism spectrum. The sample of 14 speech pathologists, each working in early intervention settings, together identified 183 factors, including a range of child autism-specific and broader developmental characteristics (e.g., cognitive ability), specific social-cognitive factors (e.g., prelinguistic skills), and the presence of co-occurring conditions.…”

Section: Introductionmentioning

confidence: 99%

“…All aspects of the study methodology, including selection of factors that would be examined, were designed in accordance with an evidence-based practice framework, which combines the best available research evidence with evidence derived from clinical practice, along with the preferences and priorities of fully informed clients (Sackett et al, 1996). Accordingly, nine factors were selected through discussion involving the clinical representatives of each early intervention centre and the researchers in the team, that involved consideration of the following criteria: (a) identified relevance by speech pathologists engaged in community practice (Trembath et al, 2021), (b) clear theoretical relevance to spoken language development, (c) existing empirical evidence for a potential association with spoken language outcomes in children on the autism spectrum, and (d) capacity for feasible measurement during semi-structured play-based assessment undertaken in the context of community-based early intervention settings.…”

Section: Introductionmentioning

confidence: 99%

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Spoken Language Change in Children on the Autism Spectrum Receiving Community-Based Interventions

Trembath

Stainer

Caithness

et al. 2022

J Autism Dev Disord

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We assessed the spoken language of 73 preschool aged children on the autism spectrum receiving community-based early intervention at two time points, approximately 7 months apart. Using the Spoken Language Benchmarks, there was a small non-significant change in the proportion of children transitioning from below, to at or above, Phase 3 (word combinations). Using binomial regression, a model comprising seven of nine clinician-proposed child-related predictors explained 64% of the variance. None of the predictors were individually significant, although a large effect size (OR = 16.71) was observed for children’s baseline rate of communicative acts. The findings point to substantial unmet clinical need in children with minimal verbal language, but also the relevance of clinician-proposed predictors of their spoken language outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spoken Language Change in Children on the Autism Spectrum Receiving Community-Based Interventions

Trembath

Stainer

Caithness

et al. 2022

J Autism Dev Disord

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“…Other factors including cognition, prelinguistic communication skills, and comorbidities may also predict spoken language outcomes for preschool aged children with minimally verbal language. 63 Asta and Persico (2022) proposed that a child with ASD's social communication characteristics could be used to determine outcomes on the ESDM. 36 We did not reach the same conclusion, with MSEL expressive language scores on entry showing no significant predictive values for receptive or expressive communication, or social skills change scores on the ESDM Curriculum Checklist.…”

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confidence: 99%

Predicting Communication Skills Outcomes for Preschool Children with Autism Spectrum Disorder Following Early Intervention

Kauley,

John,

Barr

et al. 2024

NDT

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This study aims to assess changes in the receptive and expressive language skills and to determine if the baseline characteristics such as communication, cognitive and motor skills, predict outcomes in preschool children with Autism Spectrum Disorder (ASD) following early intervention. Methods: We recruited 64 children participating in the Early Start Denver Model (ESDM) early intervention program at an Autism Specific Early Learning and Care Center (ASELCC) in Australia. Baseline characteristics across various developmental domains was measured using the Mullen Scales of Early Learning (MSEL), Vineland Adaptive Behaviour Scales, 2nd Edition (VABS-II), and the ESDM Curriculum Checklist. Linear mixed-effects models were used to examine the effects of the intervention on outcomes. Fixedeffects such as time, groups (verbal and minimally verbal), and time-by-group interactions were assessed whilst adjusting for covariates. Further, multiple linear regression models were used to determine if the baseline characteristics were significant predictors of the outcomes following the early intervention. Results: Among the 64 children who participated in this study, 38 children were verbal, whereas 26 were deemed to have minimal verbal skills. The mean age of the sample was 4.1 years with a significant male predilection (83%) and from a culturally and linguistically diverse (CALD) background (64%). Findings of the linear mixed effects model showed significant within and between group differences in the ESDM subscales, indicating higher magnitude of changes in the verbal group compared to the minimally verbal group. Finally, the multiple linear regression models suggested that baseline MSEL visual reception and expressive language scores were predictive of changes in the ESDM receptive and expressive communication scores. Conclusion: Understanding a child's baseline skill levels may provide valuable clues regarding what interventions would work best, or which interventions may be less suitable for individual preschool-aged children with ASD.

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“…Accordingly, practitioners have proposed a range of child-related and delivery-related characteristics that may influence intervention effects, with the view to using this information to tailor supports to best accommodate the strengths, needs, and preferences of each child and family (e.g. Trembath et al, 2021). For this review, the child- and delivery-related characteristics were selected by the commissioning agency, not the authors.…”

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confidence: 99%

Non-pharmacological interventions for autistic children: An umbrella review

Trembath

Varcin

Waddington

et al. 2022

Autism

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The breadth of available non-pharmacological interventions for autistic children, with varying evidence for efficacy summarised in multiple systematic reviews, creates challenges for parents, practitioners, and policymakers in navigating the research evidence. In this article, we report the findings of an umbrella review of 58 systematic reviews of non-pharmacological interventions for autistic children (aged 0–12 years). Positive therapeutic effects were identified for Behavioural interventions, Developmental interventions, Naturalistic Developmental Behavioural Interventions, Technology-based interventions, and Cognitive Behaviour Therapy across several child and family outcomes. Positive effects for certain practices within Sensory-based interventions and ‘other’ interventions were limited to select child and family outcomes. Both inconsistent and null intervention effects were found for Treatment and Education of Autistic and related Communication-handicapped Children, and Animal-assisted interventions across outcomes. The possible influence of child (chronological age, core autism characteristics, and related skills) and delivery (agent, mode, format, and amount) characteristics on intervention effects was rarely examined, and inconsistent where reported. Twenty-seven systematic reviews (47%) were rated as ‘high’ quality. Few systematic reviews examined children’s participation and quality of life or adverse effects. The findings highlight the need for individualised evidence-based decision-making when selecting interventions for autistic children. Lay abstract What is already known about the topic? The delivery of evidence-based interventions is an important part of the clinical pathway for many autistic children and their families. However, parents, practitioners, and policymakers face challenges making evidence informed decisions, due to the wide variety of interventions available and the large, and often inconsistent, body of evidence regarding their effectiveness. What this paper adds? This is a comprehensive umbrella review, also known as a ‘review of reviews’, which examined the range of interventions available, the evidence for their effectiveness, and whether effects were influenced by factors relating to individual children (e.g. chronological age, core autism characteristics, and related skills) or the ways interventions were delivered (by whom and in what setting, format, mode, and amount). There was evidence for positive therapeutic effects for some, but not all, interventions. No single intervention had a positive effect for all child and family outcomes of interest. The influence of child and delivery characteristics on effects was unclear. Implications for practice, research, and policy The findings provide parents, practitioners, and policymakers with a synthesis of the research evidence to inform decision-making and highlight the importance of individualised approaches in the absence of clear and consistent evidence. The findings also highlight the need to improve consistency and completeness in reporting of research studies, so that the same questions may be answered more comprehensively in the future.

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Clinician Proposed Predictors of Spoken Language Outcomes for Minimally Verbal Children with Autism Spectrum Disorder

Cited by 6 publications

References 46 publications

Spoken Language Change in Children on the Autism Spectrum Receiving Community-Based Interventions

Spoken Language Change in Children on the Autism Spectrum Receiving Community-Based Interventions

Predicting Communication Skills Outcomes for Preschool Children with Autism Spectrum Disorder Following Early Intervention

Non-pharmacological interventions for autistic children: An umbrella review

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