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Your Dollars@Work: Helping Nonverbal Children Speak – Part I

April 17, 2014

Researchers funded by Autism Speaks are using iPads to encourage speech among minimally verbal gradeschoolers affected by autism


This month, the Journal of the American Academy of Child & Adolescent Psychiatry will be publishing the promising results of a study, funded by Autism Speaks, on the effectiveness of using speech-generating devices to encourage minimally verbal school children with autism to actually speak.

Last year, the study’s preliminary results created tremendous excitement at the International Meeting of Autism Research. They did so, in part, because they countered the belief that if children don’t acquire reasonably fluent language by age 5, they never will. Around a third of children with autism speak few words when they enter school.

In their study, educational psychologist Connie Kasari and her team used speech-generating devices in a play-based behavioral therapy for autism. In all, 61 minimally verbal children with autism participated in the study. They ranged in age from 5 to 8 years and were using fewer than 20 words at the start of the six-month intervention.

Device enhances progress
All the children received the play-based therapy, which encouraged engagement and conversation with the therapist. To measure the added benefit of a speech-generating device, the researchers used it with half the children from the start. Three months in, the researchers added the communication device to the therapy of the children who were making little progress without it.

While all the children in the study made some gains in language and communication, those who began the treatment with the speech device made greater, earlier and more-rapid progress.

Personalizing therapy to each child’s needs
Beyond testing the usefulness of speech-generating devices, the researchers were evaluating their method of adapting therapy based on a child’s progress. As mentioned, children who started the study without the device were provided one at the midway mark if their progress was slow without it. The researchers likewise enhanced the therapy of children who were making slow progress even with the device. They received additional therapy sessions each week.

“The goal of this novel research strategy is to develop guidelines for how, when or for which children something different is needed to maximize progress,” says co-investigator Daniel Almirall, of the University of Michigan. Dr. Almirall is currently working with Dr. Kasari on an expanded study.

“One of the things we’re trying to do,” he says, “is figure out concrete ways for therapists to identify children in need of additional treatment and provide guidelines for how they can select the right enhancement. It could be a speech-generating device, parent training or simply more therapy sessions.”  

Thanks to the success of her Autism Speaks pilot study, Dr. Kasari received a $13 million grant from the National Institutes of Health to expand her research into a five-year, multisite clinical trial. This is an example of how Autism Speaks “seed grants” help researchers leverage larger investments from government or private industry.

Such multi-million dollar investments are often necessary to deliver a much-needed therapy program, medicine or device to the autism community.

Autism Speaks has further built on the success of Dr. Kasari’s research with a Weatherstone Predoctoral Fellowship for graduate student Stephanie Patterson Shire. Shire’s research project evaluated whether parents could be trained to effectively work with nonverbal children using the strategies that professional therapists used in the original study. Read about the preliminary results of Shire’s Weatherstone research project in next week’s installment of the “Your Dollars@Work” blog.

Learn more about the research team’s strategies for using iPads and other assistive-communication devices to help children with autism learn spoken language here.