published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy

Thesis (M.Sc.)--Victoria University of Wellington, 2009. / Includes bibliographical references.

Skinner (1957) suggested that different verbal operants are acquired independently of each other and establishing a verbal operant as a mand will not necessarily result in the appearance of a tact having the same response form and vice versa. Recent empirical research has found that newly acquired mands and tacts can be transferred to different relations without direct training. The present study investigated 1) how verbal responses taught as pure mands affect untrained tact relations; 2) how verbal responses taught as pure tacts affect untrained mand relations; 3) how the size of mand and tact repertoires relate to speed of acquisition of new mands and tacts; and 4) how size of entering repertoires affect the transfer of mand topographies to tacts and vice versa. Two vocal-verbal children with autism were taught three novel responses as mands and three other responses as tacts. Mand topographies transferred to tact relations and tact topographies transferred to mand relations for both participants. Overall acquisition as well as transfer of mands and tacts was faster for the participant with a higher entering repertoire.

Purpose: The occurrence of similar speech and non-speech behaviors in some children with autism and Childhood Apraxia of Speech (CAS) calls for the consideration of CAS in some children with autism. The majority of research on CAS has been conducted with children who are otherwise typically developing. The purpose of this study was to determine whether and to what extent children with autism are being diagnosed with or suspected to have CAS as well as what assessment and treatment methods are currently being used with these children. Method: A nationwide survey of speech-language pathologists (SLPs) working with children ages 0-6 years was distributed through snowball sampling, e-mail distribution lists and Facebook discussion pages. The survey requested information on numbers of children served with autism and suspected CAS as well as the criteria used to identify CAS in children with autism and the treatment methods being used in intervention. Results: 132 surveys were received and analyzed. SLPs from across the United States participated in the study. The mean number of children with autism currently served per participant was 6 children and the mean number of children with autism and suspected CAS per participant was 1. Participants reported suspected CAS in 16% of children with autism. SLPs working in the field the longest and those serving more total children with autism were suspecting CAS in children with autism more often than other participants. Of the total participants, 80% indicated that they would begin assessment for CAS in a child with autism as soon as they notice specific signs of CAS. The most common markers used were difficulty combining and sequencing phonemes and inconsistent production of speech sounds. Participants reported using a wide range of assessment tools to assess for CAS in a child with autism. Participants tended to rely upon informal assessment measures for this population; the most common assessment tool was a connected speech sample. The most commonly used intervention technique with this population was AAC; participants also reported high familiarity with PROMPT as a treatment for CAS. The least commonly used intervention technique was integral stimulation; 62% of the participants indicated that they have no knowledge of the technique. Conclusion: Results revealed that on average, SLPs are suspecting CAS in approximately 1 in 5 children with autism but much fewer children with autism have a second diagnosis of CAS. The decision of when to assess a child with autism for CAS as well as the assessment tools used varied greatly across participants. Participants reported using up to 22 different diagnostic markers to identify CAS in a child with autism. It was also discovered that not all of the traditional diagnostic markers for CAS should necessarily be considered diagnostic markers of CAS in a child with autism (e.g. suprasegmental abnormalities). With no scientific research to date regarding treatment efficacy for the treatment of CAS in children with autism, SLPs are forced to rely on anecdotal data when selecting a treatment to target CAS in a child with autism; SLPs may not be using the most effective treatment methods for this population. Results of the study support continued investigation of CAS in children with autism. There is a strong need for the development of clear diagnostic guidelines for CAS in a child with autism as well as reliable assessment tools that should be used. Further studies are needed to identify the most effective treatment approach for children with CAS and autism and how an SLP should incorporate that treatment into an overall comprehensive treatment approach for autism.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-09-26T10:04:35Z No. of bitstreams: 1 Rosângela de Faria Correia.pdf: 808290 bytes, checksum: 71d83be864732bf2d2b6d9f46cea6724 (MD5) / Made available in DSpace on 2018-09-26T10:04:35Z (GMT). No. of bitstreams: 1 Rosângela de Faria Correia.pdf: 808290 bytes, checksum: 71d83be864732bf2d2b6d9f46cea6724 (MD5) Previous issue date: 2018-08-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This dissertation aims to do a reflection, from the clinical-institutional experience, together with a children diagnosed with autism. The crucial point of this study is about the clinical enigma, caused during the meeting with the patient, especially about difficults in language acquisition and absence of voice. In the autisms we can identify phenomena that reveal a difficult for the children to occupy the enunciation place, resulting a position of segregation. This way, considering the relation between the children with their objects, and more specifically with voice object, this research looks for presenting a clinical-theoric reading, articulating the concepts of subjective constitution, body constitution and establishment of pulsional circuits, emphasizing the importance of the voice as an object connected to the desire / A presente dissertação tem como objetivo fazer uma reflexão a partir da experiência clínica-institucional junto a uma criança com o diagnóstico de autismo. O eixo fundamental desse estudo passa pelo enigma clínico provocado durante os encontros com o paciente, especialmente sobre as dificuldades de aquisição da linguagem e a ausência da voz. Nos autismos, é possível identificar fenômenos que marcam um impedimento da criança em ocupar o lugar de enunciação, o que a coloca, muitas vezes, em uma posição de segregação. Dessa forma, considerando a relação da criança com seus objetos, e, mais especificamente, o objeto voz, essa pesquisa pretende apresentar uma leitura teórico-clínica, articulando os conceitos de constituição subjetiva, constituição do corpo e o estabelecimento dos circuitos pulsionais, enfatizando a importância da voz como objeto vinculado ao desejo

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[Truncted abstract] A number of studies have provided evidence that individuals with autism have poor semantic processing of verbal information, instead gaining greater meaning from pictorial information. The aims of this thesis were, to firstly, investigate the verbal and pictorial encoding abilities of children with autism, and secondly, to determine the extent to which limitations in the use of inner speech may drive any encoding differences. The first study investigated the notion that children with autism have an atypical verbal processing style, showing poor semantic but enhanced phonological encoding of verbal stimuli. The experiment compared the performance of children with autism and ability-matched controls (N = 20 in each group) on a novel explicit verbal recall task that contained 20 word stimuli. Recall performance could be benefited through, in one condition, an understanding of the semantic links between the stimuli, and in another condition, an understanding of the phonological similarities between the stimuli. The design of the recall task controlled for the possibility that children with autism have poor retrieval strategies (by providing either a semantic or phonological retrieval cue) and hence maximized the likelihood that any between-groups differences in performance would be related to problems at the encoding stage. There was no difference between the two groups. Follow up comparisons revealed that the performance of the autism group was consistent with that of typically developing children of the same chronological age. The idea that individuals with autism have increased facility for processing pictorial information (Kamio & Toichi, 2000) was then investigated.

The focus of this study was three fold. First, modeling and feedback were investigated as a training package for social interactions between siblings. Second, the effects of social phrases taught to the sibling with autism were investigated. Third, the magnitude of these social phrases was measured by timing duration of parallel play. The experimental design is an A-B-A1-A2 design conducted in a clinic, with a probe for generalization in the home environment. This intervention was replicated across an additional sibling dyad to indicate its effectiveness. This study ascertained that the sibling with autism was a viable participant in learning new social skills that could function as a behavioral cusp and increase sibling interactions.

Behavior analysis, and more specifically the study of verbal behavior, has been used to empirically measure how parents and children interact for decades using single-subject research methods. Developmental psychology utilizes similar measures to describe these interactions across large samples of dyads, but findings across these two fields are rarely integrated due to differences in terminology and application. In order to integrate the literature of these fields, we must identify measures which can describe behavior of a large sample while still being sensitive enough to individual change from behavioral intervention. In particular, these measures must include the function of behavior, or the effect behavior has on the environment, in order to truly capture the strength of the interaction. In two studies, I seek to align measures of parent-child verbal interactions across both perspectives and describe how a variety of contextual, parent, and child characteristics affect parent-child interactions for families of children with autism. In Study 1, I apply a coding paradigm which utilizes aligned measures of parent and child verbal behavior across behavioral and developmental perspectives to remotely recorded video sessions across structured and free-play contexts. I further identify how verbal behavior changes as a function of the level of the child’s verbal development and parent characteristics. I found that parent verbal behavior is not sensitive to the verbal behavior development of their child, nor is it sensitive to the context of the interaction. However, parent behavior was associated with their report of how severe they perceived their child’s maladaptive behavior to be. Furthermore, parent report of their child’s maladaptive behavior was not associated with rates of maladaptive behavior observed in the sessions, but it was positively correlated with measures of child verbal development such that parents of children who demonstrated more complex verbal behavior reported them as exhibiting more maladaptive behavior. In Study 2, I report the effects of a parent training intervention in which I taught parents to accurately identify and consequate their child’s behavior in order to teach their child a new skill. All parents implemented the strategies with fidelity and reported positive changes in their interactions with their child in the home. However, parents did not independently generalize these skills to novel objectives or demonstrate changes to their verbal behavior in new contexts. All children learned these new academic skills, generalized them to the classroom setting, and maintained the skills 2 weeks following intervention. Results are discussed in terms of how functional measures and methods should be utilized across fields to bridge the gap between research and practice for families of children with autism.

A few studies have examined the effects of a remote control tactile device (RCT) as an unobtrusive prompting method used to promote skills such as verbal initiations and play behaviors in children with autism. To date, however, no published studies have investigated the effects of the RCT as a consequence to increase and maintain conversation skills. This study was designed to determine whether the RCT, in conjunction with common training techniques (i.e. roleplays, visual feedback, and sibling coaching), could be used as a discrete and unobtrusive feedback system to promote conversation skills in high functioning children with autism. Results found that the RCT and training packages were effective in initially increasing rates of target responses. The effects however, did not always maintain with a return to baseline. Programming "naturally" maintaining communities of reinforcement was found to be a critical factor in the maintenance of the conversational responses.