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Expressive language development in minimally verbal autistic children: exploring the role of speech production

Saul, Joanne Elizabeth; (2020) Expressive language development in minimally verbal autistic children: exploring the role of speech production. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Trajectories of expressive language development are highly heterogeneous in autism. I examine the hypothesis that co-morbid speech production difficulties may be a contributing factor for some minimally verbal autistic individuals. Chapters 1 and 2 provide an overview of language variation within autism, and existing intervention approaches for minimally verbal autistic children. These chapters situate this thesis within the existing literature. Chapter 3 describes a longitudinal study of expressive language in minimally verbal 3-5 year olds (n=27), with four assessment points over 12 months. Contrary to expectations, initial communicative intent, parent responsiveness and response to joint attention did not predict expressive language growth or outcome. Speech skills were significant predictors. Chapter 4 describes the design, development and feasibility testing of the BabbleBooster app, a novel, parent-meditated speech skills intervention, in which 19 families participated for 16 weeks. Acceptability feedback was positive but adherence was variable. I discuss how this could be improved in future iterations of the app and intervention protocol. Chapter 5 details how BabbleBooster’s efficacy was evaluated. For interventions with complex or rare populations, a randomized case series design is a useful alternative to an under-powered group trial. There was no evidence that BabbleBooster improved speech production scores, likely due to limited dosage. Future research using this study design could determine optimal treatment intensity and duration with an improved version of the app. Taken together, these studies underscore the contribution of speech production abilities to expressive language development in minimally verbal autistic individuals. I argue that this reflects an additional condition, and is not a consequence of core autism features. The intervention piloted here represents a first step towards developing a scalable tool for parents to support speech development in minimally verbal children, and illustrates the utility of randomized single case series for testing treatment effects in small, heterogeneous cohorts.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Expressive language development in minimally verbal autistic children: exploring the role of speech production
Event: UCL
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
Keywords: autism, speech, minimal language, intervention, longitudinal
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10095738
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