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This article reviews a range of social communication interventions that have been developed for students with autism at the preschool, school age, and adolescent level. Adult-mediated and peer-mediated methods that use highly structured, child-centered, and hybrid methods are examined. Programs that provide information on generalization and maintenance are identified. A set of recommendations for programs that would seem to be most appropriate for students with Asperger syndrome is presented.

This study examines the temperamental characteristics of children who were identified at age two as being slow in expressive language development, and those of peers with normal language history. When the children were in first grade (approximately age six), parents and clinicians rated subjects' temperamental characteristics, using a standardized temperament assessment instrument. Subjects with a history of slow expressive language development were rated significantly lower on Approach/Withdrawal-indicating shyness, aloofness, or reduced outgoingness-than peers with normal language history. Approach/Withdrawal scores were significantly correlated with average sentence length in spontaneous speech, and this measure also predicted Approach/Withdrawal scores in regression analyses. The clinical and theoretical implications of these findings for early language delay are discussed.

Thirty-seven children 15-25 months of age received clinical diagnoses of autism spectrum disorder (ASD) and were re-evaluated two years later. All subjects were judged to have retained a diagnosis of ASD at the follow-up evaluation. Communication scores for the group as a whole during the first visit were significantly lower than nonverbal IQ. However, by the second visit, verbal and nonverbal scores were no longer significantly different. The group was divided into two subgroups, based on expressive language (EL) outcome at the second visit. The two groups were similar in the second year of life in terms of expressive communication skills and autistic symptoms, except for a trend toward more stereotypic and repetitive behavior in the worse outcome group. By the second visit, however, the groups differed significantly on all standard measures of expression and reception, as well as on autistic symptomotology and nonverbal IQ. When assessed during their second year, children who ended up in the better outcome group showed higher average nonverbal cognitive level, receptive language (RL) scores, number of sounds and words produced, use of symbolic play schemes, and response to joint attention bids. Regression analysis revealed that the variables for which significant differences between the two outcome groups in their second year of life were found provided significant prediction of EL outcome at age four. Stepwise regression identified RL and presence of stereotypic and repetitive at the first visit as significantly associated with EL outcome. Implications of these findings for early identification and intervention are discussed.

Objectives: Increasing numbers of young children referred for a differential diagnosis of autism spectrum disorders (ASD) necessitates better understanding of the early syndrome expression and the utility of the existing state-of-the art diagnostic methods in this population. Method: Out of 31 infants under the age of 2 years referred for a differential diagnosis, 19 were diagnosed with autism, and 9 with pervasive developmental disorder-not otherwise specified (PDD- NOS) when reassessed at 3 years. We examined 1) the symptoms of ASD in the second year and changes in the syndrome expression by the age of three; 2) relationship between expert-assigned clinical diagnosis and diagnostic classification based on Autism Diagnostic Observation Schedule-Generic (ADOS-G) and Autism Diagnostic Interview-Revised (ADI-R) in the second year; 3) the relationship between direct observation and parental report of ASD symptoms. Results: Symptoms of autism and PDD- NOS in the second year were pronounced and stability of the clinical diagnosis was high. The agreement between clinician-assigned autism but not PDD- NOS diagnosis and the ADOS-G was high. However, sensitivity of the ADI-R diagnostic classification of autism was poor. Comparison of concurrent parental report and direct observation revealed discrepancies in severity ratings of key dyadic social behaviors. Changes in communication reflected acquisition of language accompanied by the emergence of unusual language characteristics. Symptoms of social dysfunction were relatively stable over time, and so was the severity of stereotyped behaviors. Conclusions: The study provides support for stability of clinical diagnosis and syndrome expression in the second year and highlights advantages and limitations of the ADI-R and ADOS-G for diagnosing and documenting symptoms of ASD in infants.

Twenty-nine youth with autism spectrum disorders and 26 with typical development between 12 and 18 years of age were engaged in structured interviews (ADOS). The interviews were videotaped and rated for atypical conversational behaviors by trained raters, using the Pragmatic Rating Scale (Landa et al. Psychol Med 22:245-254, 1992). The ASD group was divided into AS and HFA/PDD-NOS subgroups. Significant differences were found among groups on approximately one-third of the PRS items. These items involved primarily the management of topics and information, reciprocity, intonation, and gaze management. The only differences to reach significance between the AS and HFA/PDD-NOS group were a greater tendency for overly formal speech on the part of the AS group, and more difficulty with gaze management on the part of the group with HFA/PDD-NOS. The implications of these findings for understanding and treating conversational deficits in ASD are discussed., (C) Plenum Publishing Corporation 2009. All Rights Reserved.

This article presents an introduction to psycholinguistic models of speech development. Two specific types of models are addressed: box-and-arrow models and connectionist or neural network models. We review some historical and some current models and discuss recent applications of such models to the management of speech impairment in children. We suggest that there are two ways in which a psycholinguistic approach can influence clinical practice: by directly supplementing a speech-language pathologist's repertoire of assessment and treatment approaches and by offering a new way to conceptualize speech impairment in children.

Speakers with autism spectrum disorders (ASD) show difficulties in suprasegmental aspects of speech production, or prosody, those aspects of speech that accompany words and sentences and create what is commonly called "tone of voice." However, little is known about the perception of prosody, or about the specific aspects of prosodic production that result in the perception of "oddness." The present study examined the perception and production of a range of specific prosodic elements in an experimental protocol involving natural speech among speakers with ASD between 14 and 21 years of age, in comparison with a typical control group. Results revealed ceiling effects limiting interpretation of findings for some aspects of prosody. However, there were significant between-group differences in aspects of stress perception and production. The implications of these findings for understanding prosodic deficits is speakers with autism spectrum disorders, and for future research in this area, are discussed.

This article discusses the integration of various aspects of the child's development, particularly the development of language and communication and the way in which these developments interact to enable the child to construct a coherent sense of self. Multiplex developmental disorder is presented as an example of a disorder that affects several of these crucial strands of development. Recent research and controversies regarding the diagnostic descriptions of multiplex and other pervasive developmental disorders are presented. This discussion is used to illustrate the ways in which such disorders affect not only the individual aspects of development, but the child's ability to form a cohesive sense of self. The implications of these difficulties in self-definition for treating children with disorders that affect a variety of aspects of development are also discussed.

Purpose: This study tests the hypothesis that toddlers with autism spectrum disorders (ASD) will show differences from contrast groups in preferences for attending to speech. Method: This study examined auditory preferences in toddlers with ASD and matched groups of (a) typical age-mates, (b) age-mates with nonautistic developmental disabilities, and (c) younger children matched for language age. The experimental procedure measured time spent oriented to auditory stimuli that were created to exemplify language patterns that had been studied in typically developing infants. Results: Findings suggest that toddlers with ASD show a reduced preference for child-directed speech, compared with typical age-mates, but few differences from children with nonautistic developmental disorders. Correlational analysis revealed that time spent listening to child-directed speech by children with ASD was related to their concurrent receptive language ability as well as to receptive language abilities 1 year later. This relationship did not hold for the other groups. Conclusion: The present study supports the hypothesis that children with ASD perform differently from typical peers in auditory preference paradigms and that performance in these tasks is related to concurrent and later language development.

Background: Younger siblings of children with autism spectrum disorders (ASD) are at higher risk for acquiring these disorders than the general population. Language development is usually delayed in children with ASD. The present study examines the development of pre-speech vocal behavior in infants at risk for ASD due to the presence of an older sibling with the disorder. Methods: Infants at high risk (HR) for ASD and those at low risk, without a diagnosed sibling (LR), were seen at 6, 9, and 12 months as part of a larger prospective study of risk for ASD in infant siblings. Standard clinical assessments were administered, and vocalization samples were collected during play with mother and a standard set of toys. Infant vocal behavior was recorded and analyzed for consonant inventory, presence of canonical syllables, and of non-speech vocalizations, in a cross-sectional design. Children were seen again at 24 months for provisional diagnosis. Results: Differences were seen between risk groups for certain vocal behaviors. Differences in vocal production in the first year of life were associated with outcomes in terms of autistic symptomotology in the second year. Conclusions: Early vocal behavior is a sensitive indicator of heightened risk for autistic symptoms in infants with a family history of ASD.

This paper reports a study of the ability to reproduce stress in a nonsense syllable imitation task by adolescent speakers with autism spectrum disorders (ASD), as compared to typically developing (TD) age-mates. Results are reported for both raters' judgments of the subjects' stress production, as well as acoustic measures of pitch range and duration during stressed and unstressed syllable production. Results reveal small but significant differences between speakers with ASD and typical speakers in both perceptual ratings of stress and instrumental measures of duration of syllables. The implications of these findings for understanding prosodic deficits in ASD are discussed. (C) 2007 Elsevier Ltd. All fights reserved.