Nonspeaking Children Research Articles

Assessing aspects of early social communication in non-speaking children with bilateral cerebral palsy

Purpose Research suggests that rates for autism may be higher in cerebral palsy than in the general population. For those with severe bilateral physical impairment (GMFCS level IV and V) and little or no speech, describing a profile of social communication skills has been difficult because there are currently no assessments for early social communication specifically tailored for these children. Our aim was to explore the assessment of aspects of joint attention and social reciprocity in this group of children with CP. Methods We compared the performance of children with bilateral CP on carefully designed assessments of joint attention and social responsiveness with groups of children with Down syndrome and autism. All three groups were matched for chronological age and mental age. Results Approximately 30% of the children with bilateral CP had early social communication scores similar to the autistic children. The remaining 70% of children with CP had a range of early social communication scores similar to the children with Down syndrome. Conclusion It is possible to assess key early social communication skills in non-speaking children with bilateral motor disability. This could provide insights to help clinicians and caregivers as they discuss abilities and explore potential areas for intervention.

Unconjugating Community with Fernand Deligny and Jean-Luc Nancy

This article takes as its point of departure unexpected similarities in the ways that the experimental educator, writer and filmmaker Fernand Deligny and Jean-Luc Nancy conceptualize community. Deligny is remembered for his alternative community for non-speaking children with autism, established in the Cévennes in 1967 and founded on the absence of language and relationality as it is commonly understood. This article probes the paradox that in this community we find a rapprochement with Nancy's relational ontology. Drawing on Deligny's theoretical responses to the dynamics he witnessed and the cartographical methods employed to trasce the movements of the children as they roamed, and placing these in dialogue with Nancy's texts on community through the decades, I suggest a kinship between the two thinkers which opens onto broader questions about the relationship between theories and practices of community.

A Randomized Controlled Trial Comparing Face-to-Face Versus Remote Delivery of Low-Tech Augmentative and Alternative Communication in Nonspeaking Children With Autism Spectrum Disorder.

Thirty percent of children diagnosed with autism spectrum disorder (ASD) do not develop spoken language. To provide a means of communication for this subset of the population, augmentative and alternative communication (AAC) systems are often utilized. Low-tech options have traditionally been delivered through the in-person modality. However, due to the COVID-19 pandemic, changes to service delivery models have been required. This randomized controlled trial was conducted in order to assess the efficacy of low-tech AAC delivered face-to-face versus remotely on communication outcomes in nonspeaking children with ASD. Both participant groups demonstrated similar gains in AAC proficiency, number and type of nonspeaking acts, and number of spoken communication acts. Remote delivery of low-tech AAC treatment is a viable alternative to face-to-face instruction.

Parent Perspectives on Assisted Communication and Autism Spectrum Disorder.

Parents of nonspeaking children with autism spectrum disorder (ASD) may present with complex challenges associated with communicating with their children. To explore the firsthand experiences of parents of children with ASD who use assisted communication (AC) to communicate, which has yet to be explored in the literature. Semistructured interviews with ten parents of individuals with ASD, age 15 to 36 yr, who use AC to communicate. Analysis of the data revealed four superordinate themes, each with two subthemes: (1) Relationship (subthemes: Involving the Child, Improved Relationship), (2) Future (subthemes: Hopes and Dreams, Planning), (3) Support (subthemes: Limited Availability of Service Providers, Underestimation), and (4) Understanding (subthemes: Communication, Understanding of the Child). The themes illustrated that using AC modalities improved the parent-child relationship (Relationship) and helped parents understand their child on a deeper level (Understanding). A positive outcome of having a new means of communication with their child was that parents could better plan for a future that reflects their child's innermost hopes and dreams (Future). Parents also reported that the lack of a consensus concerning using AC with nonspeaking children led to decreased support (Support) from professionals and educators, limiting the child's opportunities. This study provides phenomenological qualitative evidence that use of AC provides benefits to the parent-child relationship. Plain-Language Summary: This study investigated the lived experience of parents of children with autism spectrum disorder (ASD) and how the use of assisted communication (AC) affected their relationship with their child. Ten parents were interviewed. Four main topics emerged from the analysis of these interviews: (1) improved closeness in relationship, (2) improved ability to plan for the future, (3) wish for improved availability of service providers, and (4) improved understanding of who the child is as a person. Parents play a key role as team members in support of the child's performance in occupations. The results of this study suggest that AC plays an important role in supporting the parent-child relationship; therefore, AC programs should be considered when implementing and planning occupational therapy treatments for individuals who have communication impairments.

Reflect, Reframe, and Re-Imagine Theory and Practice in Speech, Language, and Hearing Sciences: Introduction to the Forum.

Reflect, Reframe, and Re-Imagine Theory and Practice in Speech, Language, and Hearing Sciences: Introduction to the Forum.

Word Learning With Orthographic Support in Nonspeaking and Minimally Speaking School-Age Autistic Children.

Previous research has demonstrated that typically developing children, verbal children with a diagnosis of autism, children with Down syndrome, children with developmental language disorder, and children with dyslexia can all benefit from orthographic support during word learning tasks. This study sought to determine if minimally speaking or nonspeaking children with a diagnosis of autism would also demonstrate an orthographic facilitation effect during a computer-based remote word learning task. Twenty-two school-age children with a diagnosis of autism and little to no spoken language learned four novel words by contrasting the words with known objects. Two novel words were taught with orthographic support present, and two were taught without orthographic support. Participants were exposed to the words a total of 12 times and then given an immediate posttest to assess identification. Parent report measures of receptive vocabulary, expressive vocabulary, autism symptomatology, and reading skills were also collected. During learning tasks, participants performed equally well whether orthographic support was given or not. For the posttest, however, participants performed significantly better for words that were taught with orthographic support. The presence of orthography improved accuracy and supported a greater number of participants to reach the passing criterion compared to the absence of orthography. Orthographic representations aided the word learning of those with lower expressive language significantly more than those with higher expressive language. Minimally speaking or nonspeaking children with a diagnosis of autism benefit from orthographic support when learning new words. Further investigation is warranted to determine if this effect holds during face-to-face interactions using augmentative and alternative communication systems. https://doi.org/10.23641/asha.22465492.

Toward a Model of Reciprocal Carryover: Learning From Communication Systems of Families of Nonspeaking Bilingual Children.

Children at the intersections of language learning, racialization, and dis/ability status experience systems of power in a very particular way. This work amplifies the "voices" of bilingual nonspeaking children and their families to upend the notion of educational and medical professionals as the experts. It positions familial ways of being and knowing as central to learning and offers educators tools to actively collaborate with and follow the lead of children and families to engage in "reciprocal carryover." This clinical focus article is built on a series of semistructured interviews and observations with caregivers, young children, and educators-specifically, two case studies of bilingual nonspeaking young children in the United States and their transnational families. Circumventing school and medical spaces and going directly to young children and families was a methodological choice to identify the family as the epicenter of languaging and learning. Each case study demonstrates a system that was created to bolster the communication of these historically subaltern families. From systems of social capital exchanges to intrafamilial nonverbal communication systems, the families in the study engage in and share systems they created to navigate the larger system of special education that so often positions multilingual, transnational families and their dis/abled children as nonknowers. The author offers strategies for educators to learn alongside children and families to engage in "reciprocal carryover." This work highlights the communication and languaging systems children and families co-construct beyond the bounds of formal education and supports educators in following their lead. It offers a roadmap for educators, families, and children to co-construct communication practices together.

System językowy w umyśle a ekspresja mowy – zastosowanie ruchomego alfabetu w terapii

Case studies of children with autism indicate that there are still many patterns in therapy and that assessing the abilities of non-speaking children is a huge problem. The search for individually-adapted communication strategies should be emphasised. Writing offers great opportunities for communication, however, it is often not offered to nonspeaking children, especially those with profound perceptual disorders.

Spoken language comprehension in children and adults with Angelman Syndrome

IntroductionObjective evaluation of receptive communication abilities in nonspeaking individuals using standardized behavioral measures can be complicated by co-occurring intellectual disabilities and motor difficulties. Eye tracking during listening may offer an informative complementary approach to directly evaluate receptive language skills. MethodThis study examined feasibility of eye gaze measures as an index of spoken language comprehension in nonspeaking children and adults with Angelman syndrome (AS; n = 23) using a looking-while-listening procedure. Typically developing children (n = 34) provided a reference data set. Primary caregivers of participants with AS completed standardized informant reports (MacArthur-Bates Communicative Development Inventory: Words and Gestures; Vineland Adaptive Behavior Scales-3; Aberrant Behavior Checklist-2) to characterize communicative skills and general adaptive functioning. ResultsGaze data in participants with AS, particularly in the individuals reported by caregivers to have larger receptive vocabularies and stronger adaptive communicative functioning, demonstrated the expected pattern of comprehension reflected by the increased probability of looks to the target images after vs. before they were named in a spoken sentence. However, processing speed (gaze reaction time) was significantly slower in participants with AS than in the typically developing group. ConclusionsGaze-based paradigms could be an informative measure of receptive communication processes in participants who are unable to complete traditional standardized behavioral assessments.

Mobilizing device-mediated contributions in interaction involving beginner users of eye-gaze-accessed speech-generating devices

Interaction mediated by speech-generating devices (SGDs) may promote participation and independence for non-speaking children, but developing skills to use the SGD is time consuming and demanding. The present conversation analysis study aimed to identify features of interactional projects that mobilized SGD-mediated responses by two children with intellectual disability who were beginner-level users. The children and their professional communication partners were video recorded when interacting in an institutional setting. The analysis shows that SGD-mediated responses were mobilized by multimodal and sequentially organized actions combining different types of spoken initiatives, SGD modelling, and embodied resources that facilitated SGD use and hence participation. These results indicate a need for communication partners to use a wide range of practices to facilitate SGD-mediated interaction.

Neurophysiological Synchrony Between Children With Severe Physical Disabilities and Their Parents During Music Therapy

Although physiological synchronization has been associated with the level of empathy in emotionally meaningful relationships, little is known about the interbrain synchrony between non-speaking children with severe disabilities and their familial caregivers. In a repeated measures observational study, we ascertained the degree of interbrain synchrony during music therapy in 10 child-parent dyads, where the children were non-speaking and living with severe motor impairments. Interbrain synchrony was quantified via measurements of spectral coherence and Granger causality between child and parent electroencephalographic (EEG) signals collected during ten 15-min music therapy sessions per dyad, where parents were present as non-participating, covert observers. Using cluster-based permutation tests, we found significant child-parent interbrain synchrony, manifesting most prominently across dyads in frontal brain regions within β and low γ frequencies. Specifically, significant dyadic coherence was observed contra-laterally, between child frontal right and parental frontal left regions at β and lower γ bands in empathy-related brain areas. Furthermore, significant Granger influences were detected bidirectionally (from child to parent and vice versa) in the same frequency bands. In all dyads, significant increases in session-specific coherence and Granger influences were observed over the time course of a music therapy session. The observed interbrain synchrony suggests a cognitive-emotional coupling during music therapy between child and parent that is responsive to change. These findings encourage further study of the socio-empathic capacity and interpersonal relationships formed between caregivers and non-speaking children with severe physical impairments.

Преодоление смыслового барьера и развитие способности к использованию коммуникативных средств Часть I. Проблема. Метод

The article is devoted to the problem of the functional structure of communicative action. Based on theoretical analysis and many years of pedagogical experience of working with children with affective pathology (autism spectrum disorders), the author recreates and refines the studies of cultural-historical theory and answers its main question — a method problem: the influence of holistic interfunctional analysis on overcoming semantic bias (central defect and syndrome-forming factor of psychopathology) and the development of a more universal communication form — verbal communication in non-speaking children with autism spectrum disorders in preschool age (by means of restructuring the way the impaired function is realized). The described conditions can be taken into account when constructing an intermediary (lively communicative action) both in the practice of general education (to prevent the occurrence of motivational disorders and increase the age limit) and in working with children with affective pathology (especially with children with autism spectrum disorders).

THE PREDICTORS OF SPEECH DEVELOPMENT AT CHILDREN WITH AUTISM

The article studies the predictors of speech development at 3-4-year old children with autism. The study included 50 children at the age of 3-4 years (10 girls and 40 boys) diagnosed “autism spectrum disorder”, including 9 non-speaking children and 12 weak-speaking children who could use several-word phrases. The study used the CARS method to determine autism and A.R. Luria’s neuropsychological method to determine the children’s psychophysical development. The average psychological age for non-speaking children was determined with the LEITER-3 method and with the A. Binet-T.Simon method. A good convergence of the examination results received by both methods was obtained for the children with autism (the validity criterion - Cronbach's alpha was 0.75), which indicated the possibility to use the LEITER-3 method for the determination of autistic children’s psychological age. We found that the average mental development of children with autism was below their biological age, ranging from 4 months to 3 years and 5 months. On the basis of neuropsychological study of children with autism by A.R. Luria’s method and the CARS method, the development of verbal and non-verbal communication of the studied children was identified. The development of verbal and non-verbal communications depended on an autism degree: the worse autism is, the less developed are children’s speech abilities. The performed correlation and factor analyses allowed us to determine the predictors of communicative competence development for early-age children with autism. In particular, we has determined that neuropsychological indicators such as body possession, movements and actions, orientation, dynamic praxis, activity level, imitation, acoustic gnosis, and intellectual development are the predictors of further non-verbal communication development. The predictors of verbal communication are the following indicators: acoustic gnosis, visual reaction, sensory, object use, and a child’s intellectual development. Taking into account the specifics of the sensory perception and the information processing characteristic for the examined disorder, the sequence of speech therapists’ actions aimed at speech correction of children with autism is proposed.

Development and testing of the eye-pointing classification scale for children with cerebral palsy

Purpose The aim of this study was to develop and test a new classification scale to describe looking behaviours (gaze fixations and gaze shifts) in relation to eye-pointing. Methods The Eye-pointing Classification Scale (EpCS) was developed and tested following established procedures for the construction and evaluation of equivalent scales, and involved 2 phases: Drawing on research literature, Phase 1 involved initial drafting of the scale through a series of multi-disciplinary group discussions; evaluation of the scale through a survey procedure, and subsequent expert group evaluation. Phase 2, was an examination of scale reliability and relationships between child characteristics and level of EpCS classification. Results In Phase 1, an initial draft of the scale was developed and then evaluated by 52 participants in 10 countries, leading to its refinement. Subsequent expert evaluation of content, style and structure indicated that no further refinement was required. In Phase 2, the scale achieved excellent levels of reliability in clinical testing. A significant relationship was identified between level of child motor ability and EpCS classification, and level of child language understanding and EpCS classification. Implications for rehabilitation Non-speaking children with severe bilateral cerebral palsy who have limited upper limb movement may communicate by using controlled looking behaviours to point to objects and people, referred to as eye-pointing. However, there is little consensus as to which looking behaviours represent eye-pointing and which do not. The Eye-pointing Classification Scale (EpCS) was developed to describe looking behaviours related to eye-pointing in this population of children The EpCS provides a new robust tool for clinical management and research with children with cerebral palsy.

Toward an Individualized Neural Assessment of Receptive Language in Children.

Purpose We aimed to develop a noninvasive neural test of language comprehension to use with nonspeaking children for whom standard behavioral testing is unreliable (e.g., minimally verbal autism). Our aims were threefold. First, we sought to establish the sensitivity of two auditory paradigms to elicit neural responses in individual neurotypical children. Second, we aimed to validate the use of a portable and accessible electroencephalography (EEG) system, by comparing its recordings to those of a research-grade system. Third, in light of substantial interindividual variability in individuals' neural responses, we assessed whether multivariate decoding methods could improve sensitivity. Method We tested the sensitivity of two child-friendly covert N400 paradigms. Thirty-one typically developing children listened to identical spoken words that were either strongly predicted by the preceding context or violated lexical-semantic expectations. Context was given by a cue word (Experiment 1) or sentence frame (Experiment 2), and participants either made an overall judgment on word relatedness or counted lexical-semantic violations. We measured EEG concurrently from a research-grade system, Neuroscan's SynAmps2, and an adapted gaming system, Emotiv's EPOC+. Results We found substantial interindividual variability in the timing and topology of N400-like effects. For both paradigms and EEG systems, traditional N400 effects at the expected sensors and time points were statistically significant in around 50% of individuals. Using multivariate analyses, detection rate increased to 88% of individuals for the research-grade system in the sentences paradigm, illustrating the robustness of this method in the face of interindividual variations in topography. Conclusions There was large interindividual variability in neural responses, suggesting interindividual variation in either the cognitive response to lexical-semantic violations and/or the neural substrate of that response. Around half of our neurotypical participants showed the expected N400 effect at the expected location and time points. A low-cost, accessible EEG system provided comparable data for univariate analysis but was not well suited to multivariate decoding. However, multivariate analyses with a research-grade EEG system increased our detection rate to 88% of individuals. This approach provides a strong foundation to establish a neural index of language comprehension in children with limited communication. Supplemental Material https://doi.org/10.23641/asha.12606311.

Eye-tracking w diagnozie, terapii i edukacji dzieci z niepełnosprawnością sprzężoną. Zarys problematyki

Celem artykułu jest przedstawienie możliwości wykorzystania eye-trackingu w szeroko pojmowanej edukacji dziecka niemówiącego ze sprzężoną niepełnosprawnością. Autorka posłużyła się analizą danych zastanych dokonaną z perspektywy własnego doświadczenia terapeutycznego w stosowaniu eye-trackingu w pracy z dziećmi w wieku przedszkolnym z niepełnosprawnością sprzężoną. W tekście przedstawiła najpierw zasadę działania eye-trackingu, a następnie ukazała jego wykorzystanie w badaniach z zakresu marketingu, kartografii, informatyki, jak również technik uczenia się. Następnie wskazała na eye-tracking jako potencjalne narzędzie do komunikacji z dziećmi niemówiącymi oraz do ich edukacji. W dalszej części zaprezentowała polskie urządzenia wykorzystujące technologię eye-trackingu w działaniach diagnostycznych, terapeutycznych i edukacyjnych. Z badań wynika, iż eye-tracking może odmienić życie dzieci, dla których jedynym kanałem komunikacyjnym jest wzrok, ponieważ oferuje im nowe formy spędzania wolnego czasu, uczenia się i komunikowania z otoczeniem. Ponadto technologię eye-trackingową można i trzeba wykorzystać do ponownej diagnozy dzieci ze sprzężoną niepełnosprawnością, u których poradnie psychologiczno-pedagogiczne posługujące się tradycyjnymi metodami rozpoznały głęboki stopień niepełnosprawności intelektualnej.

Augmentative and Alternative Communication for Speaking Autistic Adults: Overview and Recommendations.

What is augmentative and alternative communication?: Augmentative and alternative communication (AAC) describes the ways people communicate without, or in addition to, speech.What do we know about AAC for autistic adults who can speak?: Research on AAC and autism has focused on nonspeaking children. However, autistic adults who use AAC sometimes tell each other about AAC. This community knowledge includes reasons AAC is important, useful AAC strategies, and barriers to AAC use. This article talks about autistic community knowledge about AAC and then makes suggestions.Why is AAC important for autistic adults who can speak?: Autistic adults, including those who talk, may not always be able to meet all their communication needs with speech alone. Autistic people who use speech may experience intermittent, unreliable, and/or insufficient speech.What AAC strategies do speaking autistic adults use?: The three main ways that autistic adults report on using AAC include: (1)Free or low-cost tools that are not specific to AAC (e.g., online chat rooms, text messaging applications, or handwriting).(2)Mobile applications designed for communication support.(3)Signed languages such as American Sign Language.What are some common barriers to AAC use for speaking autistic adults?: Several barriers may prevent AAC use. These include the following: Knowledge of AAC optionsAttitudes about who AAC is useful forBeliefs that the use of AAC should be decreased if a person can speakCost of AAC devices and applications.What are our recommendations to autistic adults who might use AAC and their supporters?: Support autistics in defining their own communication needs, regardless of speech.Evaluate communication goals and match them with system features when making decisions about AAC.Prioritize all communication, not just speech.Explore a variety of options to support communication.Explore low- and no-cost options to support communication. What are some research questions that still need to be answered?: What communication strategies do autistic adults see as effective?What AAC strategies are being used, in what environments, and by whom?What prevents effective AAC use?How can AAC specialists and autistic adults best collaborate to promote and evaluate AAC use?How can communication supports be designed to better meet the needs of autistic adults?

Modern Recognized Methods of Working with Non-Speaking Children of Early Age Internationally

This article deals with issues of organization and implementation of correctional care for young children with delayed speech development; we explore the key aspects of brain mechanisms which are fundamental to the child’s speech acquisition. Here we describe modern internationally recognized methods (Tomatis, Floortime, Theraplay) which can significantly increase the effectiveness of correctional and pedagogical work with non-speaking children. Substantial attention is paid to issues of parent-child relations.

Longitudinal growth of receptive language in children with cerebral palsy between 18 months and 54 months of age.

We examined receptive language developmental trajectories between 18 months and 54 months for three clinical speech-language profile groups of children with cerebral palsy (those with speech motor involvement, without speech motor involvement, and with anarthria) and quantified differences from age-level expectations. We identified latent classes of comprehension development, related these classes to clinical profile groups, and examined how well early receptive language predicted outcomes. We used a prospective longitudinal design. Eighty-five children with cerebral palsy (43 females, 42 males) were followed longitudinally from 18 to 54 months of age. Children were seen two to eight times (322 data points). Children were classified into clinical profile groups. Language comprehension age-equivalent scores were the primary measures of interest. Children with anarthria had significant language delays, limited developmental change over time, and comprised their own latent class. Children with speech motor impairment had slight receptive language delays over time. Children with no speech motor impairment had age-appropriate receptive language over time. Early language comprehension scores were highly predictive of later latent profile group membership. Early language comprehension abilities are highly predictive of language comprehension growth trajectory and suggest that children with early language delay, particularly those who are non-speaking, should receive language intervention to support development. There are two growth trajectories for language comprehension among children with cerebral palsy. Children with speech motor impairment had a constant 6-month receptive language delay. Children without speech motor impairment had age-appropriate receptive language. Non-speaking children had significant receptive language delay. Early language comprehension change was highly predictive of later trajectory group.

Применение метода Facilitated Communication при обучении детей с РАС письменной коммуникации с использованием компьютера

Facilitated Communication method aims at forming the skill of voluntary communication and is often used as one of the ways to communicate and interact with the development of writing in nonverbal children. The author’s experience of 10 years of applying of Facilitated Communication with the use of computer in classes with non-speaking children with ASD and other disorders gives grounds to draw conclusions about the usefulness of the method for the development of a self-contained writing. Examples of working with children and youth in the Autonomous Non-Profit Organization «Our Sunny World» using the Facilitated Communication method are given. Practical recommendations for working with children, which are often easier to master the skill of computer typing than more labor-intensive writing on paper are also provided. Present article is addressed to teachers and to parents of non-speaking children.