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This study explored the use of focused stimulation as an intervention technique for a three-year-old boy diagnosed with autism spectrum disorder (ASD). His parents were trained to use focused stimulation to facilitate comprehension of what is x doing question forms. Responses to question probes were collected at both pre- and post-treatment intervals. At the beginning of the study, the child did not respond correctly to any of the target questions. Following intervention, the child made significant gains towards the target goal, but little change towards a control goal used for comparison. These findings provide preliminary support for the usefulness of focused stimulation as an intervention strategy for at least some children with ASD.

Background: Management of aphasia often focuses on training augmentative communication strategies such as communication books, computerised systems, gestures, writing, or drawing. Although many individuals are able to acquire a targeted skill in a structured format, many do not successfully use the trained skill in more functional situations. Training alternative communication strategies can be a time-consuming project; thus, it would be beneficial if speech-language pathologists could predict, a priori, how a patient may respond to this type of treatment approach. It has been hypothesised that use of augmentative communication strategies requires executive functioning, specifically cognitive flexibility, which may be impaired following brain damage. Therefore, assessment of cognitive flexibility may help clinicians determine which persons with aphasia would most likely benefit from training of augmentative communication strategies. Aims: The purpose of this study was to develop a measure of cognitive flexibility and to determine whether this measure predicted strategy usage during a functional communication task. Methods and Procedures: A novel scoring system for the Communicative Abilities in Daily Living (CADL) was developed to capture the degree of participants' cognitive flexibility. This score was correlated with the Wisconsin Card Sorting Test (WCST), to determine the validity of the scoring system. The CADL cognitive flexibility score was then correlated with performance on a referential communication task. A multiple regression analysis was conducted with severity of aphasia as an additional predictor variable. Outcomes and Results: There was a significant correlation between the cognitive flexibility score from the CADL and the WCST, confirming the validity of the scoring system as a measure of cognitive flexibility. Results of the regression analysis demonstrated a significant relationship between the cognitive flexibility score and strategy usage on a functional communication task. This relationship remained significant when the overall severity of aphasia was added to the regression analysis, suggesting that cognitive flexibility is a stronger predictor of strategy usage than severity of aphasia. These results may provide clinicians insight into which individuals would benefit most from the training of compensatory strategies, leading to the development of more appropriate goals and treatment methods.

Background: Before a school speech-language pathologist (SLP) utilises a standardised speech-language test with a student with intellectual disability (ID), the clinician should carefully consider the purpose of the test and whether the test includes students with ID in the normative group. Method: This project reviewed 49 tests published between 1994 and 2004 and their applicability to students with ID. Results: Students with mild ID were included in the norm group for 23 of the tests, but no tests included students with more significant ID. Separate norms for students with mild ID were included in 15 tests, but none met Salvia & Ysseldyke's (1995) suggested requirement that at least 100 students be included to represent a specific subgroup. A majority of the tests assessed receptive and expressive vocabulary, syntax, and grammar but no recent test measured a student's pragmatic communication. Conclusions: Clinicians are encouraged to supplement standardised tests with non-standardised procedures to document students' pragmatic, social, and functional communication abilities. © 2006 Australasian Society for the Study of Intellectual Disability Inc.

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.

Aphasia is a general language disorder resulting from brain damage, and alexia and agraphia are specific impairments in reading and writing, respectively. This article describes the symptoms associated with each disorder, the subtypes of each impairment, and the common causes. Assessment and management approaches consistent with the World Health Organization International Classification of Functioning (WHO-ICF) are briefly reviewed. © 2016 Elsevier Inc. All rights reserved.

Background: Clinicians often teach persons with aphasia (PWA) non-verbal strategies to compensate for reduced verbal communication. The manner in which they teach the strategies may have an impact on how well PWA generalise and use the strategies. Previously, multimodal communication treatment (MCT) taught multiple modalities simultaneously. While participants demonstrated some increase in the flexible use of strategies, many communication breakdowns continued to occur. Recent research suggests that intensive treatment protocols result in the greatest increase in skills.Aims: The purpose of this study was to determine whether intensive (2-3hours/day, 5 days/week, for 2 weeks) multimodality communication training for aphasia resulted in increased successful use of verbal and non-verbal communication modalities as well as increased successful communicative repairs during structured communication tasks.Methods & Procedures: Three participants with chronic aphasia completed four baseline sessions, 10 treatment sessions across two phases (i.e., five sessions per phase), and three post-treatment sessions.Outcomes & Results: Two of the three participants demonstrated gains in the acquisition of non-verbal strategies during training and increased use of strategies on a referential communication task.Conclusions: Although MCT delivered intensely resulted in increased use of non-verbal modalities for two out of three participants, the results were similar to that achieved through the use of a non-intensive treatment protocol. Therefore, future research is needed to examine other potential modifications to maximise the gains people with aphasia receive from multimodal interventions.

Children with speech sound disorders may perceive speech differently than children with typical speech development. The nature of these speech differences is reviewed with an emphasis on assessing phoneme-specific perception for speech sounds that are produced in error. Category goodness judgment, or the ability to judge accurate and inaccurate tokens of speech sounds, plays an important role in phonological development. The software Speech Assessment and Interactive Learning System, which has been effectively used to assess preschoolers' ability to perform goodness judgments, is explored for school-aged children with residual speech errors (RSEs). However, data suggest that this particular, task may not be sensitive to perceptual differences in school-aged children. The need for the development of clinical tools for assessment of speech perception in school-aged children with RSE is highlighted, and clinical suggestions are provided.

To develop a framework for further study of pragmatic behavior in young children from African American English (AAE) speaking backgrounds, one aspect of pragmatic behavior is explored in this article, specifically, speech acts. The aims of this article are to (1) examine examples of how external taxonomies (i.e., an “etic” or “outside-in” approach) have been applied to the speech act behavior of AAE child speakers and to note that etic approaches alone do not identify cultural characteristics that influence the presentation of speech acts in this population; (2) conceptualize a culture-sensitive framework where components of AAE speech act behaviors can be identified as gleaned from existing linguistic research; and (3) explain the utility of analyses of speech act behavior using taxonomies that have emerged from the cultural language style of AAE speakers, that is, an “emic” or “inside-out” approach.

Purpose: A systematic review and synthesis was performed on published articles and dissertations produced between 1970 and 2013 that focused on selected pragmatic language behaviors of African American children and adolescents. Methods: Electronic databases and hand searches of articles located in the databases were used to identify the published articles and dissertations. Each article or dissertation was reviewed by at least 2 of the authors to determine whether it met the criteria for inclusion in this study. Selected observations of the documents that met criteria for inclusion were recorded on the Primary Research Appraisal Tool (PRAT; DeJarnette, Hyter, & Rivers, 2012), a data gathering and analysis framework developed by the authors specifically for this systematic synthesis. Results: The literature search resulted in 92 research articles and dissertations, 37 of which were eliminated because they did not meet all of the inclusion criteria. The documents that met our inclusion criteria focused primarily on the structure and/or content of narrative discourse rather than speech acts, other forms of discourse (e.g., conversation, expository), and presupposition/perspective taking skills. Six major themes identified in the major findings are used to summarize studies reviewed for this systematic synthesis. Conclusions: We (a) explain the current state of knowledge about African American pragmatic language behaviors, (b) explain major findings and implications of the extant literature in this topical area and how it may inform speech-language pathology practice, and (c) identify directions for future research on pragmatic language of African American children and adolescents.

PURPOSE: The Index of Phonological Complexity and the Word Complexity Measure are two measures of the phonological complexity of a word. Other phonological measures such as phonological neighborhood density have been used to compare stuttered versus fluent words. It appears that in preschoolers who stutter, the length and complexity of the utterance is more influential than the phonetic features of the stuttered word. The present hypothesis was that in school-age children who stutter, stuttered words would be more phonologically complex than fluent words, when the length and complexity of the utterance containing them is comparable. School-age speakers who stutter were hypothesized to differ from those with a concomitant language disorder., METHODS: Sixteen speakers, six females and ten males (M age=12;3; Range=7;7 to 19;5) available from an online database, were divided into eight who had a concomitant language disorder (S+LD) and eight age- and sex-matched speakers who did not (S-Only)., RESULTS: When all stuttered content words were identified, S+LD speakers produced more repetitions, and S-Only speakers produced more inaudible sound prolongations. When stuttered content words were matched to fluent content words and when talker groups were combined, stuttered words were significantly (p<=0.01) higher in both the Index of Phonological Complexity and the Word Complexity Measure and lower in density ("sparser") than fluent words., CONCLUSIONS: Results corroborate those of previous researchers. Future research directions are suggested, such as cross-sectional designs to evaluate developmental patterns of phonological complexity and stuttering plus language disordered connections., EDUCATIONAL OBJECTIVES: The reader will be able to: (a) Define and describe phonological complexity; (b) Define phonological neighborhood density and summarize the literature on the topic; (c) Describe the Index of Phonological Complexity (IPC) for a given word; (d) Describe the Word Complexity Measure (WCM) for a given word; (e) Summarize two findings from the current study and describe how each relates to studies of phonological complexity and fluency disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

Perception of spoken language requires attention to acoustic as well as visible phonetic information. This article reviews the known differences in audiovisual speech perception in children with autism spectrum disorders (ASD) and specifies the need for interventions that address this construct. Elements of an audiovisual training program are described. This researcher-developed program delivered via an iPad app presents natural speech in the context of increasing noise, but supported with a speaking face. Children are cued to attend to visible articulatory information to assist in perception of the spoken words. Data from four children with ASD ages 8-10 are presented showing that the children improved their performance on an untrained auditory speech-in-noise task.

Purpose: The goals were to (a) test the efficacy of a motor-learning-based treatment that includes ultrasound visual feedback for individuals with residual speech sound errors and (b) explore whether the addition of prosodic cueing facilitates speech sound learning. Method: A multiple-baseline, single-subject design was used, replicated across 8 participants. For each participant, 1 sound context was treated with ultrasound plus prosodic cueing for 7 sessions, and another sound context was treated with ultrasound but without prosodic cueing for 7 sessions. Sessions included ultrasound visual feedback as well as non-ultrasound treatment. Word-level probes assessing untreated words were used to evaluate retention and generalization. Results: For most participants, increases in accuracy of target sound contexts at the word level were observed with the treatment program regardless of whether prosodic cueing was included. Generalization between onset singletons and clusters was observed, as was generalization to sentence-level accuracy. There was evidence of retention during posttreatment probes, including at a 2-month follow-up. Conclusion: A motor-based treatment program that includes ultrasound visual feedback can facilitate learning of speech sounds in individuals with residual speech sound errors.

Reading disability is a brain-based difficulty in acquiring fluent reading skills that affects significant numbers of children. Although neuroanatomical and neurofunctional networks involved in typical and atypical reading are increasingly well characterized, the underlying neurochemical bases of individual differences in reading development are virtually unknown. The current study is the first to examine neurochemistry in children during the critical period in which the neurocircuits that support skilled reading are still developing. In a longitudinal pediatric sample of emergent readers whose reading indicators range on a continuum from impaired to superior, we examined the relationship between individual differences in reading and reading-related skills and concentrations of neurometabolites measured using magnetic resonance spectroscopy. Both continuous and group analyses revealed that choline and glutamate concentrations were negatively correlated with reading and related linguistic measures in phonology and vocabulary (such that higher concentrations were associated with poorer performance). Correlations with behavioral scores obtained 24 months later reveal stability for the relationship between glutamate and reading performance. Implications for neurodevelopmental models of reading and reading disability are discussed, including possible links of choline and glutamate to white matter anomalies and hyperexcitability. These findings point to new directions for research on gene-brain-behavior pathways in human studies of reading disability. © 2014 the authors.

The purpose of the study was to identify structural brain differences in school-age children with residual speech sound errors. Voxel based morphometry was used to compare gray and white matter volumes for 23 children with speech sound errors, ages 8;6-11;11, and 54 typically speaking children matched on age, oral language, and IQ. We hypothesized that regions associated with production and perception of speech sounds would differ between groups. Results indicated greater gray matter volumes for the speech sound error group relative to typically speaking controls in bilateral superior temporal gyrus. There was greater white matter volume in the corpus callosum for the speech sound error group, but less white matter volume in right lateral occipital gyrus. Results may indicate delays in neuronal pruning in critical speech regions or differences in the development of networks for speech perception and production. Copyright © 2013 Elsevier Inc. All rights reserved.

Background: Individuals with acquired apraxia of speech (AOS) can lose precision of articulatory movements, including the ability to achieve correct production of specific sounds or sound sequences. Novel treatment approaches should be explored to enhance treatment outcomes.Aims: To evaluate the clinical feasibility of ultrasound visual feedback of the tongue for addressing errors on rhotics in a patient with AOS. Ultrasound visual feedback was used to provide knowledge of performance to the participant.Methods & Procedures: A multiple baseline single case report is presented to evaluate a treatment programme that uses visual feedback of the participant's tongue from real-time ultrasound images. A blocked practice schedule was implemented during 12 one-hour therapy sessions; 30 minutes involved ultrasound visual feedback (10 minutes of pre-practice and 20 minutes of practice) and 20 minutes involved non-ultrasound practice. Cues were provided to modify tongue shape to achieve perceptually accurate production of rhotics, along with practice trials with increasing levels of phonetic complexity. The feedback type (verbal knowledge of performance and knowledge of results) and feedback frequency (number of trials with feedback) were structured to adhere to principles of motor learning.Outcomes & Results: The participant demonstrated moderate evidence of acquisition of prevocalic rhotics and strong evidence of acquisition of postvocalic rhotics during treatment. There was evidence of retention and generalisation only for postvocalic rhotics. An untreated context was probed regularly and showed no evidence of improvement.Conclusion: The results provide preliminary support for the feasibility of this treatment approach for improving speech accuracy in adults with acquired AOS. The improvements in stimulability for the treated sound sequences could be used to foster further motor learning. © 2014 © Taylor & Francis Group.

Event-related potentials (ERPs) were recorded during a picture naming task of simple and complex words in children with typical speech and with childhood apraxia of speech (CAS). Results reveal reduced amplitude prior to speaking complex (multisyllabic) words relative to simple (monosyllabic) words for the CAS group over the right hemisphere during a time window thought to reflect phonological encoding of word forms. Group differences were also observed prior to production of spoken tokens regardless of word complexity during a time window just prior to speech onset (thought to reflect motor planning/programming). Results suggest differences in pre-speech neurolinguistic processes.