Will using intervention strategies help my child with ASD?
How parents can support spoken communication in minimally verbal children with ASD.
What we know
Communication can include spoken and nonverbal language such as gestures or signs. Spoken and nonverbal communication can be prompted, meaning the language was elicited by someone (e.g., asking the child a question, asking them to “say ___”) or spontaneous, meaning language occurred without support. Approximately 30% of children with autism spectrum disorder (ASD) are considered minimally verbal, meaning they have difficulty using spontaneous communication. In addition, minimally verbal children with ASD have a hard time with social communication such as making requests and sharing interests. In order to support spontaneous social communication in children with ASD there are various therapies, also known as interventions, to teach these types of communication skills.
We know from past research that including parents in intervention and teaching them strategies to use with their child helps children with ASD improve their spontaneous social communication skills. However, there is less research with minimally verbal children with ASD and training their parents. In addition, there is little research to show how well treatment strategies must be taught to parents in order to see a change in children’s skills.
The Shire, Shih and Kasari (2018) study trained parents of minimally verbal children with ASD how to use intervention strategies in order to increase their child’s spontaneous social communication skills. The intervention took place at a university clinic and included twenty-two male children, between ages 5-8, who were diagnosed with autism and had less than 20 spontaneous words. The intervention was 6-months long and play based. The parents learned treatment strategies such as: arranging the environment, modeling language, prompting language, establishing play routines, and expanding play routines.
For the first three months, parents learned the treatment strategies and observed how to use them as a therapist modeled them with their child during monthly sessions. The last three months, parents used the treatment strategies with their child and received coaching from the therapist during their monthly sessions. Each session was video recorded, and from those recordings researchers measured how often a child spontaneously communicated and how often they made social communication requests.
The researchers found a significant increase in children’s spontaneous language at the end of the six month study. This shows that parents are able to improve their minimally verbal children’s language skills by learning intervention techniques. In further analysis, they found that parents needed to use the strategies with at least 70% accuracy in order for the children to make a significant gain in their communication skills.
They also found that the most useful strategies the parents learned were how to establish play routines and how to expand those routines by adding a new step. These routines allowed children to share ideas through comments as well as requesting materials. It also allowed parents to engage in their children’s play and gave them more opportunities to respond and expand on their children’s spontaneous communication.
The current study shows parents that they can improve their children’s social communication skills even children with ASD who are minimally verbal in kindergarten and first grade. It also shows us that parents do not have to do the strategies as well as a therapist in order to help their children. Even if they are doing the strategies at 70% accuracy their children can still make progress.
Shire, S.Y., Shih, W., Kasari, C.J. (2018). Brief Report: Caregiver Strategy Implementation Advancing Spoken Communication in Children who are Minimally Verbal. Journal of Autism and Developmental Disorders, 1-7:https://doi.org/10.1007/s10803-017-3454-0