2013 — 2016 |
Thiemann-Bourque, Kathy |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Peer-Mediated Aac Intervention For Children With Autism: Effects On Communication @ University of Kansas Lawrence
DESCRIPTION (provided by applicant): Many young children with autism have complex communication needs, and many do not develop functional speech. Deficits in reciprocal social interactions and restricted or repetitive play are also at the core of this developmental disorder. Communicative interactions involve reciprocity or give-and-take between each communication partner; thus, the success of using AAC is highly reliant on the skills of each partner (Kent- Walsh and McNaughton, 2005). AAC systems allow children the ability to communicate independently; however, to date, the majority of studies reporting AAC effectiveness involves adult partners and rarely includes peers without disabilities. The purpose of this project is to examine a social communication intervention for nonverbal or minimally verbal preschool children with autism that integrates peer-mediated (PM) approaches with alternative and augmentative communication (AAC) instruction, called PM-AAC. Given the empirical support for training peers to be responsive communication partners, and the reported effectiveness of using AAC to teach functional communication, integrating PM and AAC approaches is a logical and innovative next step to advance intervention research for this population. Approaches will target and improve the course of development in core features of autism - social reciprocity, communication, and play skills. We will examine the effects of PM-AAC on communication and social interactions between preschoolers with and without autism in inclusive settings, and how skills generalize and maintain in non-treatment settings. Effectiveness will be evaluated using a multiple-baseline (MB) comparative AB design using block randomization based on cognitive abilities to randomly assign 12 children with autism each year to a PM-AAC treatment group (n=6) or an AAC comparison group (n=6). The MB design will be replicated across a total of four cohorts of 12 participants with autism over four years (n=48 total), with repeated measures on functional communication collected for both treatment and comparison groups allowing for analysis of between group differences at the end of year 4. Each child with autism will have three trained peer partners, for a total of n=144 peers without disabilities. Trained peers will learn responsive social strategies from a published preschool program, and how to use a selected AAC system. Fidelity of teacher and peer implementation, quality of peer behaviors, and skill generalization also will be measured. A structured communication sample and a structured play sample will be used to evaluate secondary increases in communication complexity and developmental play behaviors with peers. Outcomes will be a peer-mediated AAC intervention developed to enhance outcomes in core developmental areas for nonverbal or minimally verbal children with autism, and that attends to peer characteristics. A manual for treatment implementation will be produced, as will a compilation of videos for parent and teacher training. This work will provide a strong basis for a subsequent RCT study comparing PM- AAC intervention approach to alternative communication interventions for children with autism.
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2021 |
Thiemann-Bourque, Kathy |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Exploring Predictors of Response to a Peer-Mediated Communication Intervention For Minimally Verbal Preschoolers With Asd @ University of Kansas Lawrence
PROJECT SUMMARY This R21 proposal will explore and examine individual child social variables that predict response to a peer-mediated intervention for preschoolers with autism spectrum disorder (ASD) and limited to no spoken communication. This subgroup of children with ASD present with a myriad of social and communication challenges that restrict participation in educational and social environments, and approximately 30% remain minimally verbal by the time they reach kindergarten. Peer-mediated interventions (PMIs) are a widely-used and evidence-based approach to teach social communication to young children with ASD. Recent reports have documented the benefits of incorporating augmentative and alternative communication (e.g., speech-generating devices) into PMIs to increase communication and social interactions with peers in inclusive setttings. Children's social competence with peers is considered a fundamental developmental process that contributes to later language, social-emotional development, and academic achievement. To date, we are not aware of studies identifying specific child variables that predict child response to PMIs. There is evidence of differences in social attention (i.e., visual attention/scanning of social stimuli) for children with ASD compared to typically-developing children. It is probable that among individuals with ASD, variability in performance on measures of social attention (i.e., visual attention to the face) and interest in peers (i.e., showing joint attention and imitation) may be important predictors of response to PMIs. Measuring proximal behaviors such as social attention and peer interest moves beyond prior efforts focusing on more global child variables (e.g., cognitive skills) and should allow for identifying those children who require tailoring of PMIs. The overall objective of this innovative study is to examine potential child variables that predict response to PMI for preschoolers with ASD (n=40) with limited to no spoken communication. Two peers without disabilities will be paired with each child with ASD (n=80 peers). All children will participate in a PMI developed and examined by the PI over a series of empirical studies. The specific aims are to: determine what social variables (i.e., social attention and peer interest) predict response to the PMI at 8 weeks post-treatment and in generalization probes, and to determine if variance in child communication gains, accounted for by the social variables, differs based on the pre-treatment measurement context (i.e., semi-structured peer assessment, naturalistic observations, and eye-tracking paradigms). The team is highly qualified to accomplish these aims as investigators have developed social interventions for children with ASD, created observational methods to assess child-peer communication, and have used eye-tracking technology to measure early attention and communication. Expected outcomes could have important clinical implications for optimizing PMIs (e.g., for children who have poor social attention and peer interest), and identifying stratification variables that could be incorporated into future intervention research for an understudied group of children with ASD.
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