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Introduction: Augmentative and alternative communication (AAC) intervention research is rarely focused on school-age beginning communicators, despite the urgent need to ensure individuals in this population have access to the fundamental human right of communication. Methods: Four school-age children with multiple disabilities who were primarily prelinguistic communicators participated in the current study. The study used a single-subject research design to explore the effects of two interaction approaches – a social routine approach and a directive approach – on prelinguistic communication, compared to independent play and to one another. This study then evaluated the added effects of high-tech AAC within the most effective interaction approach for each participant. Results: All participants demonstrated prelinguistic communication indicating positive affect most frequently when interacting within a social routine. Furthermore, all participants increased linguistic communication while either maintaining or increasing prelinguistic communication when high-tech AAC was added to the social routine interaction. Conclusions: Clinicians should consider building accessible, predictable, engaging, and age-respectful social routines into leisure contexts to promote prelinguistic communication from school-age beginning communicators. Clinicians should also provide access to linguistic communication through high-tech AAC while continuing to honor and promote prelinguistic communication. [ABSTRACT FROM AUTHOR]

Purpose: Augmentative and alternative communication (AAC) technology innovation is urgently needed to improve outcomes for children on the autism spectrum who are minimally verbal. One potential technology innovation is applying artificial intelligence (AI) to automate strategies such as augmented input to increase language learning opportunities while mitigating communication partner time and learning barriers. Innovation in AAC research and design methodology is also needed to empirically explore this and other applications of AI to AAC. The purpose of this report was to describe (a) the development of an AAC prototype using a design methodology new to AAC research and (b) a preliminary investigation of the efficacy of this potential new AAC capability. Method: The prototype was developed using a Wizard-of-Oz prototyping approach that allows for initial exploration of a new technology capability without the time and effort required for full-scale development. The preliminary investigation with three children on the autism spectrum who were minimally verbal used an adapted alternating treatment design to compare the effects of a Wizard-of-Oz prototype that provided automated augmented input (i.e., pairing color photos with speech) to a standard topic display (i.e., a grid display with line drawings) on visual attention, linguistic participation, and (for one participant) word learning during a circle activity. Results: Preliminary investigation results were variable, but overall participants increased visual attention and linguistic participation when using the prototype. Conclusions: Wizard-of-Oz prototyping could be a valuable approach to spur much needed innovation in AAC. Further research into efficacy, reliability, validity, and attitudes is required to more comprehensively evaluate the use of AI to automate augmented input in AAC. [ABSTRACT FROM AUTHOR]

We conducted a multi-pronged investigation of different types of reporting bias in autism early childhood intervention research. First, we investigated the prevalence of reporting failures of completed trials registered on clinicaltrials.gov, and found that only 7% of registered trials were updated with results on the registration platform and only 64% had associated published reports. Next, we investigated the extent to which inadequate reporting prevents inclusion in meta-analytic summary estimates by identifying reports of studies that were eligible for inclusion in a prior meta-analysis, and found that 25% were excluded due to inadequate reporting. Finally, we investigated selective reporting practices by analyzing the protocols of the studies included in the meta-analysis which had been registered on any trial registry and coding their timing, completeness, and consistency. We found that 23% of studies were pre-registered, 71% were late-registered, and 5% were registered at an unclear date. Only 8% of registrations specified all of the necessary components. Evidence of selective reporting was common; 36% failed to report a registered outcome, 61% reported unregistered outcomes, 23% switched primary and secondary outcomes, and 43% had assessment timepoints that differed from registration specification. Given the inadequacy of registration and reporting practices, we offer practical recommendations to facilitate improvement for the field of autism research.When researchers fail to report their findings or only report some of their findings, it can make it difficult for clinicians to provide effective intervention recommendations. However, no one has examined whether this is a problem in studies of early childhood autism interventions. We studied how researchers that study early childhood autism interventions report their findings. We found that most researchers did not register their studies when they were supposed to (before the start of the study), and that many researchers did not provide all of the needed information in the registration. We also found that researchers frequently did not publish their findings when their studies were complete. When we looked at published reports, we found that many of the studies did not report enough information, and that many studies were reported differently from their registrations, suggesting that researchers were selectively reporting positive outcomes and ignoring or misrepresenting less positive outcomes. Because we found so much evidence that researchers are failing to report their findings quickly and correctly, we suggested some practical changes to make it better. [ABSTRACT FROM AUTHOR]

Importance: Health professionals routinely recommend intensive interventions (ie, 20-40 hours per week) for autistic children. However, primary research backing this recommendation is sparse and plagued by methodological flaws., Objective: To examine whether different metrics of intervention amount are associated with intervention effects on any developmental domain for young autistic children., Data Sources: A large corpus of studies taken from a recent meta-analysis (with a search date of November 2021) of early interventions for autistic children., Study Selection: Studies were eligible if they reported a quasi-experimental or randomized clinical trial testing the effects of a nonpharmacological intervention on any outcome in participant samples comprising more than 50% autistic children 8 years or younger., Data Extraction and Synthesis: Data were independently extracted by multiple coders. Meta-regression models were constructed to determine whether each index of intervention amount was associated with effect sizes for each intervention type, while controlling for outcome domain, outcome proximity, age of participants, study design, and risk of detection bias. Data were analyzed from June 2023 to February 2024. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines., Main Outcomes and Measures: The primary predictor of interest was intervention amount, quantified using 3 different metrics (daily intensity, duration, and cumulative intensity). The primary outcomes of interest were gains in any developmental domain, quantified by Hedges g effect sizes., Results: A total of 144 studies including 9038 children (mean [SD] age, 49.3 [17.2] months; mean [SD] percent males, 82.6% [12.7%]) were included in this analysis. None of the meta-regression models evidenced a significant, positive association between any index of intervention amount and intervention effect size when considered within intervention type., Conclusions and Relevance: Findings of this meta-analysis do not support the assertion that intervention effects increase with increasing amounts of intervention. Health professionals recommending interventions should be advised that there is little robust evidence supporting the provision of intensive intervention.