Autism and Meta Analysis
submitted by Lisa Goldy, graduate student at the University of Utah
Autism is one of a group of developmental disorders known as Autism Spectrum Disorders (ASDs). Diagnostic impressions typically include delays in language development, delays in understanding social relationships, inconsistent patterns of sensory response, uneven patterns of cognitive functioning and marked restriction of activities and interests (American Psychiatric Association, 2001). According to the CDC (2007), the average prevalence for ASDs in the United States is currently one in every 150 children. “While the cause remains a mystery, most specialists now view autism as a brain disorder that makes it difficult for the person to process and respond to the world” (NIDCD, 2002, p.1). Although the knowledge regarding this disorder is increasing, there is no known cure for autism. There are, however, recommendations for effective treatment for children with autism as outlined by The National Research Council (2001). The committee found that, “Functional, spontaneous communication should be the primary focus of early education.”
Autism and Language
Language, or more specifically functional communication, allows individuals to get their needs met, to express themselves and to understand and respond to others. Language acquisition is developmental in nature; therefore, gains are anticipated over time. Being that autism is a developmental disorder, children’s skill acquisition does not mirror that of children with typical development. It has been estimated that 50% of all individuals diagnosed with autism will remain nonverbal (Prizant, 1983). Although there is a plethora of research regarding various teaching techniques, interventions and the ever-so-promising “cure” for autism, this information is not readily available for interpretation by service providers, caregivers or educators. As a graduate student in school psychology, the need to consolidate the outcomes found in such a large and diverse body of literature became apparent.
The goal of consolidating and analyzing the available research is that effective interventions may be identified which can help lead to better practices. Parents, teachers, clinicians and care providers, in addition to individuals with autism, stand to benefit from systematic evaluations of the treatment modalities available for increasing functional communication skills in children with autism. The results of this researcher’s meta-analysis affirm that total communication, combining sign language with speech, is a highly effective strategy for increasing functional communication skills in children and young adults with autism. In fact, individuals who received total communication interventions experienced larger treatment gains than individuals who received other interventions. Children classified as nonverbal at the commencement of an intervention ultimately made the most significant treatment gains as measured by mean effect size (a common metric which allows for comparison among treatment interventions). This should provide hope for individuals working with children with autism, being that nonverbal children do have the capacity to develop some functional communication skills in the form of sign language. Additionally, children with autism and moderate mental retardation have the ability to acquire sign language.
Practical Implications and Public Policy
First and foremost, regardless of personal preference, it is critical that practitioners understand that most children with autism benefit from total communication interventions. Sign language, or gesture, enhances language acquisition; and, although most parents and teachers ideally want speech for their children and students with autism, Capone and McGregor (2004) state, “Clinicians should keep in mind that gesture provides children a means of communicating when the spoken modality is not fully developed” (p183). Resources such as Signing Time are invaluable for families of individuals with autism. Unfortunately, not all practitioners are versed in American Sign Language (ASL), thus preventing the ability to communicate with individuals receiving sign instruction. As a matter of public policy, university special education programs should require at least minimal competence in sign language from both undergraduate and graduate students.
American Psychiatric Association. (2001). Diagnostic and statistical manual of mental disorders-4th edition-Text Revision. Washington, DC: American Psychiatric Association.
Capone, N.C. & McGregor, K.K. (2004). Gesture development: A review for clinical and research practices. Journal of Speech, Language and Hearing Research, 47, 1, 173-186.
Centers for Disease Control and Prevention (CDC). Autism Information Center. [cited Feb 2007]. Available at: http://www.cdc.gov/ncbddd/autism/faq_prevalence.htm.
National Institute on Deafness and Other Communication Disorders. (2002). Communication in Autism (NIH Pub. No. 99-4315). Retrieved November 27, 2002, from NIDCD Health Information . Autism Online Access: http//www.nidcd.nih.gov/health/pubs_vsl/autism.html
National Research Council (2001) Educating Children with Autism. Committee on Educational Interventions for Children with Autism. C Lord and JP McGee, eds. Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.
Prizant, B.M. (1983). Language acquisition and communicative behavior in children with autism: Toward an understanding of the whole of it. Journal of Speech and Hearing Disorders, 48, 296-307.
Most Recent Editorial Article: Effective Communication Interventions for Children and Young Adults with Autism , by Lisa Goldy.