Communication interventions for autism spectrum disorder in minimally verbal children
Brignell, A., Chenausky, K. V., Song, H., Zhu, J., Suo, C. and Morgan, A. T.. (2018). Communication interventions for autism spectrum disorder in minimally verbal children. Cochrane Database of Systematic Reviews. 2018(11), p. CD012324. https://doi.org/10.1002/14651858.CD012324.pub2
|Authors||Brignell, A., Chenausky, K. V., Song, H., Zhu, J., Suo, C. and Morgan, A. T.|
Data collection and analysis
The FPI study took place in the USA and included 70 participants (64 boys) aged 32 to 82 months who were minimally verbal and had received a diagnosis of ASD. This intervention focused on developing coordinated toy play between child and parent. Participants received 12 in‐home parent training sessions for 90 minutes per session for 12 weeks, and they were also invited to attend parent advocacy coaching sessions. This study was funded by the National Institute of Child Health and Human Development, the MIND Institute Research Program and a Professional Staff Congress‐City University of New York grant. The PECS study included 84 minimally verbal participants (73 boys) aged 4 to 11 years who had a formal diagnosis of ASD and who were not using PECS beyond phase 1 at baseline. All children attended autism‐specific classes or units, and most classes had a child to adult ratio of 2:1. Teachers and parents received PECS training (two‐day workshop). PECS consultants also conducted six half‐day consultations with each class once per month over five months. This study took place in the UK and was funded by the Three Guineas Trust.
Both included studies had high or unclear risk of bias in at least four of the seven 'Risk of bias' categories, with a lack of blinding for participants and personnel being the most problematic area. Using the GRADE approach, we rated the overall quality of the evidence as very low due to risk of bias, imprecision (small sample sizes and wide confidence intervals) and because there was only one trial identified per type of intervention (i.e. verbally based or AAC).
Both studies focused primarily on communication outcomes (verbal and non‐verbal). One of the studies also collected information on social communication. The FPI study found no significant improvement in spoken communication, measured using the expressive language domain of the Mullen Scale of Early Learning expressive language, at postintervention. However, this study found that children with lower expressive language at baseline (less than 11.3 months age‐equivalent) improved more than children with better expressive language and that the intervention produced expressive language gains in some children. The PECS study found that children enrolled in the AAC intervention were significantly more likely to use verbal initiations and PECS symbols immediately postintervention; however, gains were not maintained 10 months later. There was no evidence that AAC improved frequency of speech, verbal expressive vocabulary or children's social communication or pragmatic language immediately postintervention. Overall, neither of the interventions (PECS or FPI) resulted in maintained improvements in spoken or non‐verbal communication in most children.
Neither study collected information on adverse events, other communication skills, quality of life or behavioural outcomes.
|Keywords||nonverbal communication; autism spectrum disorder; language development disorders; language tests; language therapy; parents; play therapy; randomized controlled trials as topic; school teachers; teacher training; treatment outcome|
|Journal||Cochrane Database of Systematic Reviews|
|Journal citation||2018 (11), p. CD012324|
|Publisher||John Wiley & Sons Ltd|
|Digital Object Identifier (DOI)||https://doi.org/10.1002/14651858.CD012324.pub2|
|Research or scholarly||Research|
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|Online||05 Nov 2018|
|Publication process dates|
|Deposited||29 Jun 2021|
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