Years of work with ASD (autism spectrum disorder) children still leave approximately 30% of them with minimal levels of verbal skills.
A three-year study conducted at UCLA, Los Angeles, explored different approaches to improving communication abilities among children with ASD and minimal verbal skills. The results have shown that a promising approach lies in the personalized interventions that are combined with the use of computer tablets.
UCLA professor Connie Kasari, the paper’s senior author, collaborated with researchers at Vanderbilt University and the Kennedy Krieger Institute, where they found that children’s language skills greatly improved with spoken- and social-communication therapy. The findings were published in the June issue of the Journal of the American Academy of Child and Adolescent Psychiatry. This therapy was tailored in accordance with children’s individual progress, and delivered with the help of electronic devices. Other study authors included Rebecca Landa of Kennedy Krieger and Johns Hopkins University, and Ann Kaiser of Vanderbilt. The study was funded by a High Risk High Impact grant from the Autism Speaks Foundation.
The trial included 61 children with ASD with the age range from 5 to 8 years. For the period of six months each child received communication therapy focusing on social communication gestures, such as pointing, as well as play skills and spoken language. Half of the sample was randomly selected to additionally use speech-generating applications on computer tablets for at least half of the time during the sessions. The tablets were programmed with audio clips of words the children were learning about during their therapy sessions and images of the corresponding objects. For instance, while working with a therapist, the child could tap a picture of a block and the tablet would play audio of the word “block.”
The research demonstrated that children who had access to the tablets during therapy were more likely to use language spontaneously and socially than the children who received the communication intervention alone. The researchers also stated that incorporating the tablets at the beginning of the treatment was more effective than introducing it later in the therapy.
“It was remarkable how well the tablet worked in providing access to communication for these children,” said Kasari, professor of human development and psychology in the UCLA Graduate School of Education and professor of psychiatry at UCLA’s Semel Institute for Neuroscience and Human Behavior. “Children who received the behavioral intervention along with the tablet to support their communication attempts made much faster progress in learning to communicate, and especially in using spoken language.”
Three months after the initial study period the researchers also conducted follow-up visits with the children where they found that the improvement in skills had been maintained during that time. Importantly, this study was the first ASD research that used a sequential multiple assignment randomized trial, or SMART, design. The approach, which enables researchers to tailor interventions according to how each child in the study responds, was designed by Daniel Almirall and Susan Murphy, biostatisticians at the University of Michigan, also members of the research team. In addition, it was the first randomized, controlled trial on this underserved population of children to use a computer tablet combined with an effective behavioral intervention.
Based on the pilot data gathered from the study, Kasari has also received a $13 million Autism Centers of Excellence (ACE) grant from the National Institutes of Health (NIH) to continue research involving minimally verbal children.
So what does this kind of research tell us as practitioners? Is it the time for us to look out of the square and enrich our intervention tools with new-age resources?