Communication Growth in Minimally Verbal Children with Autism

Very little is known about language and communication development in minimally verbal children with autism, especially those who remain minimally verbal past the age of five. This population is rarely reported on in research and although there is evidence that some children do learn to speak after the age of five, we lack information on the course and characteristics of their language development. Studies that do include this population generally focus on discrete incremental language skills without addressing broader communication and pragmatic skills. Due to the fact that communication and social deficits are both inherent to a diagnosis of autism, an examination of not only what discrete language skills are acquired but how those skills are used in communicative interchanges is relevant. Research on communication development in typically developing children includes attention to early pragmatic and interchange level language use. Information and methods from this body of literature can be used to guide our exploration of similar abilities in minimally verbal children with autism as they become more competent communicators over time. This study examined the interchange level communication development of 42 children with autism over the course of a six-month play and engagement based communication intervention. Communication interchanges between interventionists and children with autism were observed and characterized at seven time points over six months. Interchanges were coded for frequency, length and communicative function, as well as who (adult or child) initiated each interchange. Communication repair was examined in depth, documenting attempts, success rates and strategies employed by participants. Children were observed to engage in communication interchanges for a variety of communicative functions and these interchanges increased over the course of intervention in terms of frequency, length and the proportion initiated by the child. Children's level of joint engagement at the beginning of the study was positively related to their use of long interchanges over time. 55% of the participants were observed to repair at least once during the study. Most of these repairs were successful and children used a variety of strategies