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My child is nonverbal – what are some intervention methods that might help my child communicate better?

October 29, 2010 11 comments

“Got Questions?” is a new weekly feature on our blog to address the desire for scientific understanding in our community.  We received over 3000 responses when we asked what science questions were on your mind. We answered a few here and will address the other themes we received in this weekly post.

Many individuals with autism do not use spoken language to communicate.  It is estimated that approximately 25% of individuals with ASD are nonverbal.  Despite early traditional approaches such as speech, occupational and behavioral therapy, some children still remain unable to communicate their wants and needs.  A recent study found that some children with ASD do not develop spoken language until after the age 5 years.  On-going speech and language intervention can promote the development of speech in nonverbal children who are of school age.  In addition, there exist specific intervention approaches that can be helpful for some individuals, such as PROMPT, an intervention approach especially designed for children with motor-speech disorders.

Speech and language specialists recommend a variety of alternative and augmentative communication (AAC) devices for individuals who are nonverbal.  A commonly used system is the PECS picture exchange system (PECS).   PECS has been used with individuals with ASD of all ages.  One advantage is that it doesn’t require expensive materials, relying on a set of picture symbols that can be used to make simple or complex requests and other statements.  The symbols are typically placed in a communication book.  After the child or adult learned to make spontaneous requests.  The individual can then learn to construct sentences.  . Other AAC methods include the following:

  • Gestures and sign language
  • Pencil and paper
  • Communication books or boards
  • Keyboards and other electronic devices

The iPhone and iPad are being used as ACC devices. These new interactive technologies have invited a wave of new applications to benefit individuals on the spectrum, especially those who are nonverbal.  Many of these applications incorporate the advantages of the PECS system of offering a stock of visual images as well as the ability to personalize using one’s own images.  Two of the most popular programs are Proloquo2go and iPrompts.

Although the use of these devices have not been tested in rigorous clinical trials, those trials are underway and early anecdotal reports are positive.  Connie Kasari, PhD. (UCLA) leads an Autism Speaks’ funded clinical trial comparing two different interventions for young nonverbal individuals.  Having previously used traditional keyboarding devices, Dr. Kasari has found that the iPad with speech generating software offers a great alternative to expensive AAC speech generating devices.  However Dr. Kasari also adds, that these devices “Work best in therapy sessions with a child who has not yet figured out that they can surf the web with it, too!”

Of course, this potential distraction is also an advantage. These new applications  are hosted on the multifunctional iPhone and iPad platforms.  HandHoldAdaptive, the creators of iPrompts, have launched AutismTrack, a new portable journaling tool that enables caregivers to track therapies, medication and behavior.  Developers continue to create new apps to address the challenges of those on the spectrum, making these new tools even more powerful for managing the everyday needs and desires for individuals on the spectrum.

Read a blog from Dr. Kasari about nonverbal autism and more information about Autism Speaks investments in nonverbal autism.   For more information about ACC, the following websites may be useful:

ACC Institute:   http://www.aacinstitute.org/

International Society for Augmentative and Alternate Communication

To locate a speech-language pathologist, visit http://www.asha.org/findpro/default.htm

What is the recurrence rate of autism spectrum disorder (ASD) in siblings of children with ASD?

October 13, 2010 6 comments

“Got Questions?” is a new weekly feature on our blog to address the desire for scientific understanding in our community.  We received over 3000 responses when we asked what science questions were on your mind.

Studies of sibling recurrence done in the past decades usually reported between 2-6% of younger siblings of children with autism were eventually diagnosed with autism.  However, it was thought that these numbers may be an underestimate, because they included low numbers of families and looked at just autism in the child and the younger sibling.

Because of the elevated risk of autism in younger siblings, new research designs have allowed for prospective, longitudinal research of individuals “at risk” for autism – that is they have an older sibling with an autism diagnosis.  Autism Speaks supports a consortium of these researchers known as the High Risk Baby Siblings Research Consortium or BSRC.  Using this design, the recurrence of autism as well as other disorders, including language problems, can be ascertained.  Recent reports have indicated that about 10-15% of younger siblings of children with autism are diagnosed with an ASD.  In addition,, a recently published study by a BSRC investigator working together with the Interactive Autism Network (IAN) found that 20% of siblings (without ASD) had delayed language development.   Together, this adds to evidence that autism and related developmental delays in language have a genetic component.  It is important to keep in mind that the information about ASD recurrence risk rates cited in this article are based on population-based statistics. The ASD recurrence risk rates for individual families vary.

Parents with who have a child with ASD who are concerned that a sibling may be showing symptoms of ASD should bring their concerns to their pediatrician or primary health care provider.  Other resources include the following:

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