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Facilitating language development in children with specific language impairment (SLI) who are learning African American English (AAE) as their first dialect requires clinicians to consider grammatical, lexical, and cultural differences. The purpose of this article is to examine 2 intervention methods that have an extensive history of validation for general American English—imitation using discrete trials and conversational recast—for use with children who speak AAE. Participants in the preliminary study were 4 pre–school-aged AAE-speaking children, who were at-risk for language delays and who used AAE forms. A within-participants design was employed. Both interventions were associated with growth in contrastive and noncontrastive target structure use. All children increased production of specific language targets that were not observed in baseline samples in AAE or general American English forms, and language scores on posttreatment assessments increased in all participants. Considerations include individualizing interventions on the basis of level of support and understanding the relationship between language learning and culture.

Children with SLI (Specific Language Impairment) display language deficits in the absence of frank neurological lesions, global cognitive deficits or significant clinical hearing loss. Although these children can display disruptions in both receptive and expressive grammar, the intervention literature has been largely focused on expressive deficits. Thus, there are numerous reports in the literature suggesting that expressive language skills can be improved using focused presentation of grammatical targets (cf. conversational recast; Camarata, Nelson & Camarata, 1994), but there have been few investigations addressing the remediation of receptive language skills in SLI for those children with receptive language deficits. The purpose of this study was to examine whether focused grammatical intervention on expressive grammar is associated with growth in receptive language in 21 children with SLI who have receptive language deficits. These children displayed significant growth in receptive language scores as an incidental or secondary association with expressive language intervention and significantly higher gains than seen in a comparison-control group with SLI and receptive language deficits ( n = 6). The theoretical and clinical implications of these results are discussed.

The aim of this study was to uncover factors accounting for the ability of children with specific language impairment (SLI) to learn agreement morphemes in intervention. Twenty-five children with SLI who participated in a six-month intervention program focused on teaching third person singular -s or auxiliary is/are/was showed a wide range of use of the target morpheme after intervention. Regression analyses showed that age and two factors expected to be related to agreement – the use of noun plural -s and subject/verb constructions prior to intervention – significantly predicted progress in the acquisition of agreement morphemes. In contrast, the pretreatment use of morphemes hypothesized to be unrelated to agreement was not a significant predictor of progress. The results indicate that the ability of children with SLI to learn agreement morphemes relies on their prior ability to use noun plural and subject/verb constructions.

Objective: A common assumption in vocabulary training for Down syndrome (DS) is that learning in one modality will generalize incidentally to untreated modalities, but few studies evaluate the validity of this presumption. The purpose of this study was to examine cross modal generalization in children with DS. Method: Five preschool children with DS were taught three sets of receptive and expressive vocabulary within a multiple probe single subject design. Vocabulary knowledge for trained and untrained modalities was probed. Results: Cross modal generalization probes indicated moderate transfer from the treated expressive modality to the untreated receptive modality but relatively low receptive generalization to the untreated expressive modality in all participants. Conclusion: These results support delivering expressive vocabulary interventions in DS provided clinicians systematically test generalization to receptive knowledge. Conversely, receptive vocabulary training, although certainly a worthwhile goal for children with DS, is less likely to generalize across modality.

OBJECTIVES It has long been speculated that effortful listening places children with hearing loss at risk for fatigue. School-age children with hearing loss experiencing cumulative stress and listening fatigue on a daily basis might undergo dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity resulting in elevated or flattened cortisol profiles. The purpose of this study was to examine whether school-age children with hearing loss show different diurnal salivary cortisol patterns than children with normal hearing. DESIGN Participants included 32 children with mild to moderate hearing loss (14 males; 18 females) and 28 children with normal hearing (19 males; 9 females) ranging in age from 6 to 12 years. Saliva samples were obtained six times per day on two separate school days. Cortisol levels were measured by mass spectrometric detection after liquid-liquid extraction. Salivary cortisol levels between children with hearing loss and children with no hearing loss over the course of the day were examined with hierarchical linear modeling using mixed model statistical analysis. Between-group comparisons were also computed for the area under the curve, an analytical approach for calculating overall cortisol secretion throughout the day. RESULTS Significant differences in the cortisol awakening response (CAR) were observed between children with hearing loss and children with normal hearing; however, no differences were observed between the two groups subsequent to the cortisol awakening response (60-min postawakening, 10:00 A.M., 2:00 P.M., and 8:00 P.M.). Compared with children with normal hearing, children with hearing loss displayed elevated cortisol levels at awakening and a reduced growth in cortisol secretion from awakening to 30-min postawakening. No significant differences in overall cortisol secretion throughout the day were found between groups (area under the curve). Finally, cortisol levels increased with increasing age for children with hearing loss but not for children with normal hearing. CONCLUSIONS Results of this preliminary study indicate a possible dysregulation in HPA axis activity in children with hearing loss characterized by elevated salivary cortisol levels at awakening and a diminished increase in cortisol from awakening to 30-min postawakening. The pattern of elevated cortisol levels at awakening is consistent with some studies on adults with burnout, a condition characterized by fatigue, loss of energy, and poor coping skills. These findings support the idea that children with hearing loss may experience increased vigilance and need to mobilize energy promptly in preparation for the new day.

A growing area of interest and relevance in the study of autism spectrum disorder (ASD) focuses on the relationship between multisensory temporal function and the behavioral, perceptual, and cognitive impairments observed in ASD. Atypical sensory processing is becoming increasingly recognized as a core component of autism, with evidence of atypical processing across a number of sensory modalities. These deviations from typical processing underscore the value of interpreting ASD within a multisensory framework. Furthermore, converging evidence illustrates that these differences in audiovisual processing may be specifically related to temporal processing. This review seeks to bridge the connection between temporal processing and audiovisual perception, and to elaborate on emerging data showing differences in audiovisual temporal function in autism. We also discuss the consequence of such changes, the specific impact on the processing of different classes of audiovisual stimuli (e.g. speech vs. nonspeech, etc.), and the presumptive brain processes and networks underlying audiovisual temporal integration. Finally, possible downstream behavioral implications, and possible remediation strategies are outlined. Autism Res 2016, 9: 720-738. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Purpose The goals of this investigation were to determine whether treatment assists children with specific language impairment (SLI) in the use of grammatical morphemes that mark tense and agreement and whether treatment gains influence the children’s use of other, untreated morphemes. Method Twenty-five children with SLI participated in 96 intervention sessions designed to facilitate the children’s use of third-person singular - s or auxiliary is/are/was . Results The children showed significantly larger gains on the target forms than on control forms (e.g., past tense - ed ) that were monitored but not included in intervention. Along with possible treatment-related generalization across morpheme types, there was also evidence of one morpheme type influencing another when neither was the target of intervention. Conclusions Although the results provide clear evidence for intervention effects, it appeared as if maturational factors also played a role. The findings are discussed in terms of their implications for treatment and for characterizing development in SLI.

The purpose of this study was to compare the cognitive abilities and selected achievement performance of females and males across the lifespan on standardization samples of broad cognitive abilities in 1987 participants (1102 females, 885 males) from the WJ III, 4253 participants (2014 males, 2239 females) from the WJ-R, and 4225 participants (1964 males and 2261 females) from the WJ-77. Preschool through adult cohorts were included in the analyses. The results indicated that males scored significantly lower on estimates of Gs (processing speed) in all three normative samples, with the largest difference evident in adolescent subgroups. A secondary finding was significantly higher scores for males on estimates of comprehension knowledge (Gc) in all three samples. Follow-up analyses of the achievement tests also indicated lower performance for males on speeded tests such as reading fluency and writing fluency. There was a high degree of concordance across tests and no sex difference was observed in overall estimates of general intellectual ability (GIA) on the WJ III. The educational implications of these findings are discussed with an emphasis on the adolescent (high school) cohort.

Children with Down syndrome often display speech-comprehensibility and grammatical deficits beyond what would be predicted based upon general mental age. Historically, speech-comprehensibility has often been treated using traditional articulation therapy and oral-motor training so there may be little or no coordination of grammatical and speech-comprehensibility treatment. The purpose of this paper is to provide the rationale for and preliminary evidence in support of integrating speech and grammatical intervention using a type of recast treatment in six children with Down syndrome. Speech-comprehensibility and MLU growth in generalisation sessions occurred in 4/6 and 5/6 participants, respectively. Using multiple baseline design logic, two of these participants showed evidence of treatment effects on speech-comprehensibility and two in MLU in generalisation sessions, respectively. The study constitutes a conservative test of the intervention effects for reasons that are discussed. The theoretical and applied significance of these findings are discussed.

This purpose of this randomized group experiment was (a) to test the post-treatment (i.e., immediately after treatment) and follow-up (i.e., 8 months after the end of treatment) efficacy of a treatment designed to facilitate both sentence length and speech intelligibility (i.e., broad target recast), and (b) to explore whether pretreatment speech accuracy predicted response to treatment in children with severe phonological and expressive language impairment. The results support the conclusion that broad target recast facilitated follow-up speech intelligibility in children whose speech accuracy was relatively low prior to treatment.

An accurate differential diagnosis of children adopted from foreign language situations that include challenging conditions (e.g., neglect) often rests upon accurate measurement of cognitive abilities in the context of low English proficiency, specifically, and may also include generally poor linguistic skills in the native language. In addition, because the goal of any adoption program is ultimately to generate effective intervention supports when needed and measurable progress in function as the child assimilates into his/her new home, it is essential that these programs be designed within the context of valid measurement. Given the particular confluence of low language ability and entrée into a culture that may have differing social interactive norms than the previous culture, one can imagine that identifying disabilities generally, but social-interactive based disabilities such as autism spectrum disorders specifically, could be problematic. Thus, assessment and treatment in these children is difficult and fraught with potential pitfalls. Moreover, recent advances in the measurement of cognitive abilities have out-paced changes in diagnostic classification and treatment methods, and it appears that applications to international adoption cases have lagged even further. This suggests that diagnosis should not be guided solely by available subtests on an intelligence battery or on clinical ascertainment instruments, because these could be confounded by language ability and cultural background. The purpose of this paper is to review measurement of cognitive abilities and diagnosis in international adoption situations and discuss methods for ensuring that diagnosis and treatment include consideration of potential pitfalls. In addition, potential confounds on clinical instruments are discussed.

The purpose of this review is to discuss the importance of treatment efficacy research in language comprehension in MR/DD populations. Although receptive language deficit is an integral part of most MR/DD typologies, there have been relatively few studies evaluating the effectiveness or efficacy of treatment for this condition. Recently, there has been increased attention placed on auditory processing in children with disabilities, an aspect of cognition related to receptive language, but there have also been few studies investigating the effectiveness or efficacy of training designed to improve auditory processing. In addition to arguing that additional studies in this area are needed, the review includes several theoretical frameworks for addressing the treatment of receptive language deficits in MR/DD. © 2004 Wiley-Liss, Inc. MRDD Research Reviews 2004;10:201–207.

The participants in this study were 4 children diagnosed with Expressive Language Disorder who displayed poor imitation skills, with scores significantly below typical levels on the Sentence Imitation subtest of the Test of Language Development-2: Primary (Newcomer & Hammill, 1988). The purpose of this study was to compare the treatment effects of both naturalistic (conversational recast) treatment and analog treatment in these participants. The results indicate that children with poor preintervention imitation skills required higher numbers of analog presentations to establish production of the language structures than was observed under the naturalistic treatment. Clinical implications of these results are discussed.

The accurate diagnosis of clinical conditions that include language disorders (e.g., developmental disabilities, autism, and specific language impairment) rests squarely on the accurate measurement of language and related abilities. In addition, because the goal of any treatment program is to generate measurable progress in language function, it is essential that treatment programs be designed within the context of state-of-the-art measurement. Therefore, both diagnosis and treatment of language disorders in children are founded on measurement. However, recent advances in the measurement of language abilities have outpaced changes in diagnostic classification and treatment methods. This should not imply that diagnosis be solely guided by available subtests on an intelligence battery or that treatment be designed primarily to teach the items used in measurement. Rather the goal should be to diagnose with an eye on the results of measurement and develop treatments that result in advances in the underlying s...

Abstract: This study examined the feasibility of an intervention using naturalistic language teaching procedures for communication problems of individuals with autism conducted by the child's general education teacher in collaboration with the child's language clinician. The results of a multiple baseline study across children indicate successful implementation of naturalistic language teaching procedures in the school settings by all general education teachers and improved intelligibility of the language skills of all the children with autism in generalized spontaneous language use. These results are discussed in terms of previous research demonstrating the effectiveness and benefits of naturalistic teaching procedures and in terms of the implications for educational practices involving children with autism.

Is there a significant difference in expressive and receptive language ability or auditory processing after treatment with Fast ForWord®, when it is compared with three other treatments: (1) comput...

The nature of Attention Deficit-Hyperactivity Disorder (ADHD) as described in the Fourth Edition of the Diagnostic and Statistical Manual [DSM-IV, American Psychiatric Association, 1994] indicates a potential association with language disorder, particularly in the area of social language skills (pragmatics). However, to date there have been relatively few studies examining this language-behavior relationship in children with ADHD. The purpose of this paper is to provide a description of social/pragmatic language deficits and to present a theoretical model of potential associations between pragmatic language deficits and ADHD. Previous studies of language skills in children with ADHD are examined within this theoretical framework and the clinical implications of the proposed association are discussed. MRDD Research Reviews 1999;5:207–214. © 1999 Wiley-Liss, Inc.

Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, reliably influence the effectiveness of language teaching interactions for children with autism. However, the effectiveness of this approach has not yet been assessed with respect to improving speech intelligibility. The purpose of this study was to systematically compare two intervention conditions, a Naturalistic approach (which incorporated motivational variables) vs. an Analog (more traditional, structured) approach, with developmentally similar speech sounds equated within and across conditions for each child. Data indicate that although both methods effectively increased correct production of the target sounds under some conditions, functional use of the target sounds in conversation occurred only when the naturalistic procedures were used during intervention. Results are discussed in terms of pivotal variables that may produce improvements in speech sounds during conversational speech.

Purpose In this study, the authors examined the effect of hearing loss on subjective reports of fatigue in school-age children using a standardized measure. Methods As part of a larger ongoing study, the authors obtained subjective ratings of fatigue using the Pediatric Quality of Life Inventory (PedsQL) Multidimensional Fatigue Scale (Varni, Burwinkle, Katz, Meeske, & Dickinson, 2002). This standardized scale provides a measure of general fatigue, sleep/rest fatigue, cognitive fatigue, and an overall composite measure of fatigue. To date, data from 10 children with hearing loss (CHL) and 10 age-matched children with normal hearing (CNH) have been analyzed. Results These preliminary results show that subjective fatigue is increased in school-age children with hearing loss (Cohen's d = 0.78–1.90). In addition, the impact of hearing loss on fatigue in school-age children appears pervasive across multiple domains (general, sleep/rest, and cognitive fatigue). Conclusion School-age CHL reported significantly more fatigue than did CNH. These preliminary data are important given the negative academic and psychosocial consequences associated with fatigue. Further research is needed to determine the underlying mechanisms responsible for this increased fatigue in school-age children with hearing loss, and to identify factors that may modulate (e.g., degree of loss) and mediate (e.g., hearing aid or cochlear implant use) its impact.

Over the past decade, there has been increased interest in identifying autism and autism spectrum disorder (ASD) in toddlers. Although there is a strong rationale for identifying ASD early and delivering effective intervention, a recent report in the journal Pediatrics raises important questions about the scientific evidence currently available supporting early intervention. In addition, the British National Health Service (NHS) has not adopted universal screening for autism, even though the American (US) Academy of Pediatrics endorsed a recommendation that all toddlers be screened for ASD by the age of 24 months (in 2007). The goal of this initiative is to identify and, where indicated, provide early intervention for autism and ASD. Although it is inarguable that this is a worthwhile and laudable goal, the systematic study of this goal is confounded by the inherent difficulty in reliably identifying autism in 24-month-old toddlers. It is challenging to demonstrate intervention effects in the absence of randomly assigned control groups in an increasingly heterogeneous ASD population. The purpose of this paper is to examine the current literature on early identification and early intervention in autism and ASD and to provide a framework for examining these issues.

Atypical communicative abilities are a core marker of Autism Spectrum Disorders (ASD). A number of studies have shown that, in addition to auditory comprehension differences, individuals with autism frequently show atypical responses to audiovisual speech, suggesting a multisensory contribution to these communicative differences from their typically developing peers. To shed light on possible differences in the maturation of audiovisual speech integration, we tested younger (ages 6–12) and older (ages 13–18) children with and without ASD on a task indexing such multisensory integration. To do this, we used the McGurk effect, in which the pairing of incongruent auditory and visual speech tokens typically results in the perception of a fused percept distinct from the auditory and visual signals, indicative of active integration of the two channels conveying speech information. Whereas little difference was seen in audiovisual speech processing (i.e., reports of McGurk fusion) between the younger ASD and TD groups, there was a significant difference at the older ages. While TD controls exhibited an increased rate of fusion (i.e., integration) with age, children with ASD failed to show this increase. These data suggest arrested development of audiovisual speech integration in ASD. The results are discussed in light of the extant literature and necessary next steps in research.

The purpose of the study was to compare the relative effectiveness of imitative treatment and conversational recast treatment in children with language impairment and in a group of children with normal language skills. Language treatment outcomes were compared between a group of older (4.7 to 6.7) specifically-language-impaired (SLI) children and a group of younger (2.2 to 4.2) language-normal (LN) children matched on language levels and on intervention targets. The results indicated: (a) Target acquisition was more rapid under conversational recast treatment for both groups. (b) This outcome held for targets absent initially (in pretreatment sampling and probing) as well as for initially partially mastered targets. (c) SLI children sometimes can learn grammatical structures as efficiently as language-normal children if similar language input is tailored to their specific developmental language levels. Implications of these findings for language treatment strategies with SLI children are discussed. Theoretical models compatible with the data also are considered.

This issue of MRDD research reviews is dedicated to treatment efficacy research. The treatment of MRDD conditions has long been a central question, but the clinical science of treatment efficacy has not yet been systematically applied to many MRDD typologies. The purpose of this paper is to provide an overview of this special issue and to provide a rationale for including treatment efficacy research as a tool for studying selected neurological development and genetic correlates of MRDD. Existing treatment efficacy paradigms should be applied systematically to relevant populations (and theoretical questions) and new, objectively tested paradigms should be developed in order to integrate ongoing discovery in MRDD. © 2004 Wiley-Liss, Inc. MRDD Research Reviews 2004;10:159–161.

The recent literature on language intervention has become increasingly focused upon developing treatments that more closely parallel normal language acquisition. However, there have been relatively few reports that directly compare imitative procedures to conversational-interactive interventions. The purpose of the present study was to compare the relative effectiveness of imitative intervention and conversational recast language intervention applied to a wide range of grammatical morpheme and complex sentence targets in 21 children with specific language impairment. The results indicated that although both kinds of treatments were effective in triggering acquisition of most targets, consistently fewer presentations to first spontaneous use were required in the conversational procedure. In addition, the transition from elicited production to generalized spontaneous production was more rapid under conversationinteractive treatment. Finally, although imitation treatment was more effective in generating elicited production, a significantly greater number of spontaneous productions occurred under the conversational training procedures. The theoretical and applied ramifications of these findings are discussed.

This study investigated the level of social valence and type of social behaviors expressed in 15 children with specific language impairment as they engaged in typical language intervention activities during conversation-based and imitation-based language programs. These programs were both applied to each child over a period of several weeks. Videotapes of treatment sessions were analyzed for the presence of five verbal and 11 nonverbal behaviors selected to measure social valence. In addition, the child’s level of social valence was scored on a three-point rating scale. The results showed that although both types of treatments were predominantly associated with positive social valence ratings and a high frequency of smiling, laughing, and engagement in the activities, a significantly higher number of these positive ratings and behaviors were noted within conversation-based treatment. In contrast, although negative social valence ratings and expressions of boredom or dislike were very rare, these were observed more frequently under imitation-based treatment. There was a significantly higher rate of verbal initiations in the conversation-based treatment, and a significantly higher rate of quiet, passive participation in the imitation-based treatment. The findings are discussed in relation to treatment selection and viable strategies for assessing treatment acceptability in children.

The purpose of this experiment was to test the effectiveness of including speech production into naturalistic conversation training for 2 children with speech production disabilities. A multiple baseline design across behaviors (target phonemes) and across subjects (for the same phoneme) indicated that naturalistic conversation training resulted in improved spontaneous speech production. The implications of these findings are discussed relative to existing models of speech production training and other aspects of communication disorders.

Until the past few years, language characteristics of students receiving services for mild/moderate behavior disorders (BD) have been neglected for research on the language of the more severely disturbed population. However, recent investigations of the language characteristics of mild/moderately BD students have produced sufficient evidence to warrant further study. The purpose of the present study was to examine the language skills (i.e., morphology, syntax, and semantics) of a group of 30 mild/moderately BD students served in public school, resource classrooms. Overall results from the Test of Language Development-Intermediate (TOLD-I) (Hammill & Newcomer, 1982), the Test for Auditory Comprehension of Language-Revised (TACL-R) (Carrow-Woolfolk, 1985), the Peabody Picture Vocabulary Test-Revised (PPVT-R) (Dunn & Dunn, 1982), and the Expressive One Word Vocabulary Test (EOWVT) (Gardner, 1979) revealed that the BD students fell a minimum of one standard deviation below the normative mean on all but one (i.e., Word Classes and Relations subtest of the TACL-R) of the measures. Further within subject analyses indicated the students were having difficulty with both receptive and expressive language. These findings substantiate the fact that mild/moderate BD students should be considered at risk for language disorders.

A number of studies appearing in the recent literature examined the effectiveness of treating language impairments using indirect, conversationally based interventions. However, such studies have been difficult to interpret, due, in part, to a lack of direct comparisons of treatment types. The present study was designed to compare directly elicited imitation treatment and conversational treatment using linguistic targets matched for structural stage and assigned randomly to treatment condition. These treatments were applied to four specifically language-impaired children (age range 4;9 to 5;11) during a 16-week training period. Spontaneous productions occurred following significantly fewer presentations within the conversational treatment. Additionally, the results indicated that both kinds of treatments were effective and that certain individual targets were acquired more rapidly within the elicited imitation treatment. These findings are discussed in terms of the differing approaches to treatment and in terms of more general theories of language learning.

We examined the conversational skills of 2 adult males with severe motor and speech deficits resulting from cerebral palsy. A multiple baseline design across subjects was used to determine the effectiveness of an intervention strategy designed to teach them to use an augmentative communication system (Touch Talker) independently. The dependent measure was the number of conversation initiations relative to conversation reactions during spontaneous communication across baseline and treatment. The treatment included specific training on using the augmentative system to participate in communication. Once the intervention began, the production of conversation initiations accelerated at a rapid rate. The treatment program was effective in training the subjects to use the augmentative system to increase conversation participation. These results demonstrate that training on the operation of the device alone is not sufficient to ensure improvement in conversation performance, and that it is important to incorporate direct conversational treatment when providing instruction on the use of augmentative communication systems for severely speech-impaired individuals.

Suprasegmental marking of plural has been noted in language- and phonologically-impaired children. Additionally, such marking has been interpreted within the iconicity model of language acquisition. The purpose of this paper is to extend this model of iconic influences on plural acquisition to the normal population. An analysis of the convergence of phonological, morphological and semantic factors within plural acquisition reveals that normal children are confronted with the identical factors that resulted in suprasegmental plural marking in phonologically impaired children. The above arguments are augmented by a case study of a linguistically normal female child (age 2 years 7 months) who used an increase in fundamental frequency (F0) and duration to signal plural.

A rare event transactional model of tricky mix conditions contributing to language acquisition and varied communicative delays

The purpose of this review is to provide a model for studying genetic association of response to intervention in child language disorders. In addition to a theoretical overview and review of different approaches to studying candidate genes, a specific methodology for completing this type of analysis is presented. The goal of the analysis is to provide detail beyond simple broad phenotyping for affected and nonaffected individuals and to take advantage of data yielded from concise behavioral phenotyping often available in treatment studies.

Recent modeling of language development and intervention for children with disabilities has increasingly focused on the interactions between adults and children. These models have resulted in a number of recent advances in the behavioral treatment of language abilities in children with disabilities. Because these interventions are associated with substantial growth in a number of skills including speech, grammar and vocabulary, these paradigms may provide a useful model for studying neurological development of these aspects of language. The purpose of this paper is to discuss the potential neurodevelopmental ramifications of this type of theoretical model for facilitating language growth in children with and without disabilities. Indeed, because intervention can sometimes trigger rapid advances in language skills and presumably, associated neurological organization, this may prove to be a very useful paradigm for understanding the neurological correlates of language growth.

Dear Editor: We write this letter because we feel the article by Odom et al. (2010a) as well as the erratum by Odom et al. (2010b) would have benefited from the following considerations. An important obstacle for attempts to identify an intervention is the difficulty in distinguishing prepackaged interventions from evolving scientific approaches. An important methodological weakness in such reviews is that they often imply static intervention packages are superior to individualized adaptive approaches, when, in fact, the data supporting the latter are much more plentiful and persuasive. We suggest that such reviews should evaluate the empirical bases for approaches so that relevant supporting evidence is not excluded from the review. For example, Pivotal Response Treatment (PRT) is an example of a scientifically based approach that has evolved steadily over the years, and is supported by hundreds of programmatic studies (cf. Koegel et al. 2010). However, when one attempts to look at PRT as a static intervention (as if it were complete and final), one is limited to only a select portion of the available research, which could inadvertently mislead the reader with regard to the depth and breadth of the evidence supporting this approach. When one examines the evolving scientific research related to PRT, a different picture emerges. Originally based upon early discrete trial research, primarily the Applied Behavior Analysis work of Ivar Lovaas and colleagues (cf., Lovaas et al. 1973), a major advance was made in the late 1980s when specific motivational variables, identified through a great many experimental studies, were integrated into an advanced discrete trial approach called the Natural Language Paradigm (Koegel et al. 1987), which was an early forerunner of PRT. The approach continued to be founded upon principles of applied behavior analysis, but incorporated specific motivational variables, that were behaviorally defined, to produce a more rapid, more generalized treatment effect that distinguish PRT from the earlier approach. Because the approach was implemented in natural environments, rather than in segregated settings, some of the research focused on the naturalistic versus analog dimension of the approach, related studies have been conducted on the rubric of Naturalistic Interventions that extend across goals and settings (e.g. Koegel et al. 1998). Similar research studies found that the approach was producing effects far beyond speech and language, and resulted in direct or collateral improvements in areas such as symbolic play, joint attention, disruptive behavior, social behavior, etc. These research studies, focusing on the broader impact of the approach, called the newest evolution of the approach by the name, Pivotal Response Treatment. By expanding the approach, additional pivotal areas were discovered, extending the Pivotal Response Treatment approach into areas such as responsivity to multiple stimulus input, and child-initiated social interactions. The effect of child-initiated social communication had such a major impact on long term treatment effectiveness, that virtually all recent studies are focusing on, and include child initiations as a key foundational component of Pivotal Response Treatment. Again, for this reason, Pivotal Response Treatment is a scientifically based approach that is continually evolving and individualized, not a static intervention, so that these studies supporting evolution of implementation variables should be included in a scientific review. If one adopts this view for evaluating PRT, more than two hundred scientifically sound articles (according to the guidelines of the American Psychological Association) provide empirical evidence supporting the evolving Pivotal Response Treatment that can be effectively individualized to meet the needs of various family, cultural, child variables along with an adaptation for different settings and target behaviors. Each advance in the PRT approach has produced major improvements in the lives of the children and their families. Yet, we expect that each evolution has the implicit assumption that it will become refined by improved procedures as science produces yet another major advance forward, until 1 day, optimal intervention will be provided to all individuals with autism. Unfortunately, well intentioned articles, could inadvertently favor static “one size fits all” intervention packages over dynamic, individualized, scientifically developing intervention approaches such as PRT. Although it certainly is important to note that some static interventions do not have any empirical support whatsoever, and thus may not meet even minimal scientific standards, it is potentially misleading to limit the parameters of review so that an approach that has its roots in long-standing scientific findings with hundreds of articles to support it is represented only in a single article. There is no doubt that PRT has its roots in ABA, however, the large data base that has evolved into producing more child-friendly, naturalistic procedures, has significantly advanced the field while continuing to meet the rigorous standards of ABA and scientific, peer reviewed studies. This is not only true for children with autism, but for a range of disabilities and typical children.

The purpose of this paper is to review the procedures, reported in three journals, that researchers have adopted to evaluate the intelligence of children with specific language impairment. The results indicated that researchers used one of the following procedures: no mention of intelligence, statements of negative history for mental retardation (without further documentation), reporting cut-off scores on one or more standardized assessment instruments, reporting means on one or more standardized assessment instruments, or reporting individual test scores from such instruments. A majority of researchers adopted the procedures in the first three categories. Implications of such reporting procedures are discussed.

Our purpose in this exploratory investigation was to examine the relationship between degree of impairment in grammatical morpheme comprehension and event-related potential measures of differentiated processing of speech syllables in 10 children with Down syndrome. Results strongly support the hypothesized association. Graphs of the association indicate that children with less impaired grammatical comprehension had greater amplitude differences in event-related potentials to contrast of syllables within preselected poststimulus latency ranges. The theoretical and clinical ramifications of these results are discussed.

We examined whether motivational procedures incorporated into teaching question-asking to children with autism, who lack verbal initiations, would result in generalization without additional teaching, prompting, or reinforcement in other settings. Specifically, we assessed whether such children could learn to use questions and whether the spontaneous use of question-asking would generalize across stimuli, settings, and people. All children learned to use questions in relation to items they had previously been unable to label and demonstrated generalization of spontaneous question-asking to new items and to their home environments with their mothers, with concomitant gains in expressive vocabulary. Results were discussed in terms of teaching response strategies, such as question-asking, to promote spontaneous child-initiated social interactions and expressive language development.

Young children's productions of novel words serving as names of objects and actions were compared. Although the object and action names were matched according to consonant and syllable structure, accurate production of newly emerging consonants was greater for the object words for each of the measures used: spontaneous production and unsolicited imitation during the word exposure sessions, and responses to production probes administered during and following the exposure sessions. These findings are attributed to the fact that action words have greater semantic complexity than object words, and that the increased processing requirements involved in referring to actions reduce the capacity to use newly developing sounds in these words.

A case of final consonant repetition in the speech of a normal child is presented. It is argued that this production pattern is the result of a convergence of phonological factors, including phonetic constraints and cognitively based rule generation, rather than a pathologic process. Final consonant repetition is discussed relative to natural languages and other cases of rule generation in normal children and relative to earlier cases examining this pattern in terms of models of dysfluency. Additionally, the clinical ramifications of the findings are discussed.

This study examines the communicative functions served by the lexical usage of normal and language impaired children whose speech was limited to single-word utterances. The two groups were similar in the frequency with which they produced utterances serving most of the functions. However, naming was more frequent in the normal children's speech, while answering was more frequent in the speech of the language impaired children. The two groups were indistinguishable in terms of the number of different lexical items they used in the service of each of the communicative functions.

The classification assessment procedure developed by Denney (1972) was administered to 30 subjects: 10 language impaired children, 10 normal children matched to the language impaired children on the basis of chronological age, and 10 normal children matched to the language impaired children on the basis of MLU. The results indicated that the age-matched subjects performed the task significantly belter than either the language-impaired or the MLU-matched subjects. The performance of the language impaired children was not different from that of the MLU matched children. Correlational analysis revealed that classification performance was significantly correlated with language production. These findings are discussed in terms of the various cognitive hypotheses of language development and also in terms of previous findings regarding the cognitive skills of language impaired children.

With various descriptions of adults' speech to children in hand, investigators have turned their attention to questions concerning the specific nature and extent of relationships between aspects of input and language development. Answering such questions requires some conceptualization of the potential relationships that may exist. Equally important, though, are the statistical and design issues surrounding the inference of these relationships. An exhaustive discussion of these issues is beyond the scope of this Note. Consequently, we will focus on three specific topics: (1) the use of gain scores; (2) aspects of correlation and alternative procedures that have an impact on the validity and interpretability of statistical findings; and (3) passive observation versus experimental manipulation.

The purpose of the present investigation was to examine the language skills of a group of 38 mildly to moderately behavior-disordered students. At issue was whether such students suffer from language disorders as has been reported for Children with more severe behavior disorders such as autism. The results from the Test of Language Development-Intermediate (TOLD-I) (Hammill & Newcomer, 1982) revealed that 37 of the children (97%) fell a minimum of one standard deviation below the normative mean on one or more of the TOLD-I subtests. These findings are offered in support of the notion that the mildly to moderately behavior-disordered child is at risk for language disorders.