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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.

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.

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.

This study compared the performance of bilingual participants on the English and Spanish versions of the Hearing in Noise Test (HINT). The participants were divided into an early bilingual (EB) group and a late bilingual (LB) group based on age of second-language acquisition. All participants acquired Spanish as their first language (L1) and English as a second language (L2). Care was taken to ensure that all participants demonstrated at least a "good competence level" for self-rated speaking, understanding, reading, and writing skills in both English and Spanish. Results revealed superior performance on the Spanish HINT versus the English HINT in both quiet and in noise for both groups of participants. Significant differences in performance were noted for the EB versus the LB participants. A number of possible explanations for superior performance in L1 are provided, and implications for educating students in their L2 are discussed.

This study attempted to elicit distal gestures within dynamic assessment structured sampling events from six children with moderate to severe intellectual disability (ages 8-13). Using four communication temptations and a least-to-most prompting hierarchy across three sessions, three participants who had both pre-symbolic and preintentional communication demonstrated an initial distal gesture, often in response to a choice making temptation. Clinical implications are discussed with regard to the utility of dynamic assessment structured sampling activities. © 2008, SAGE Publications. All rights reserved.

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.

Rehabilitation programs strive to help patients become more independent in all aspects of daily living. Therefore, management of a patient's healthcare requirements should be an integral part of the rehabilitation program, including management of medications. Some rehabilitation programs implement self-medication programs (SMP); however, patients with cognitive deficits are often excluded. This study explored whether patients with cognitive deficits due to stroke could successfully complete an SMP using an interdisciplinary cognitive rehabilitation approach. Twenty-seven stroke patients and 36 debilitated patients with cognitive deficits participated in an SMP. A nurse and a pharmacist educated patients on their medications, and a speech-language pathologist provided cognitive rehabilitation to the stroke patients, which incorporated information from the SMP. Eighty-one percent of the stroke patients successfully completed the SMP, compared to 36% of the debilitated patients. Thus, an interdisciplinary approach to medication management for cognitively impaired stroke patients holds promise.

This study surveyed 25 siblings of persons with Down Syndrome to gain an ecological perspective about important communication competence indicators. Siblings favorably described persons with Down Syndrome as “effective” and “good” communicators who “communicate to potential. “ Siblings regarded social communication skills as especially important, i.e., being able to communicate without fear, being able to express wants, needs, opinions, and feelings, being able to ask questions, and alerting partners to communication breakdowns. Siblings also regarded language comprehension as an important skill. Favorable descriptive labels were often applied to adult-aged persons with mild ID and normal hearing. Clinical implications are discussed focused on functional communication planning and implementation that takes into account the perspectives of family members, teachers, and rehabilitation personnel.

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.

Symptoms of Autism Spectrum Disorders (ASD) begin to manifest during the first 2 years; there is limited evidence regarding type and timing of symptom onset. We examined factors related to parental age of recognition (AOR) of early abnormalities and the association between AOR and diagnosis and levels of functioning at 2 and 4 years in 75 toddlers with ASD. Results suggest significant differences between autism and PDD-NOS in the AOR and type of first concerns. Early social and motor delays as well as maternal age was associated with AOR. Later AOR was associated with poorer social-communicative and nonverbal cognitive functioning at 2 and 4. The findings are discussed in a context of identifying distinct developmental trajectories within the autism spectrum.

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.

In the crystal structure of the title compound, C28H44B2N2O2, the square-planar B2N2 ring is slightly puckered. One of the thexyl groups exhibits disorder over two positions. The site occupancies for the disordered thexyl groups refined to 0.611 (4) and 0.389 (4). © 2007 International Union of Crystallography.