RESUMO
Purpose Persons with autism spectrum disorder (ASD) may demonstrate abnormal prosodic patterns in conversational speech, which can negatively affect social interactions. The purpose of this systematic review was to identify interventions measuring the improvement of expressive speech prosody in persons with ASD in order to support clinician's evidence-based decision making. Method We used 13 electronic databases to search for relevant articles using terms related to autism, intervention, and speech prosody. The databases identified a total of nine articles for the title, abstract, and full-text reviews. Five more articles were included after performing descendant and reference searches. One peer-reviewed article was excluded due to insufficient data received from the authors. We coded the resulting 13 articles for report, setting, intervention, outcome, and results characteristics and methodological quality. Results Results showed that interventions specifically targeting speech prosody using established and emerging evidence-based practices across more than 1 treatment day resulted in moderate to large improvements in speech prosody in persons with ASD. Interventions that indirectly targeted prosody or were very short resulted in small or nonsignificant effects. Discussion The results of this literature review suggest that interventions that directly target speech prosody using established evidence-based practices for ASD may be most effective for increasing typical prosodic patterns during speech for persons with ASD. Further research is needed to establish which interventions are most effective for each age range and context. Supplemental Material https://doi.org/10.23641/asha.12735926.
Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Percepção da Fala , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/terapia , Comunicação , Humanos , FalaRESUMO
Purpose This systematic review synthesized a set of peer-reviewed studies published between 1985 and 2019 and addressed the effectiveness of existing narrative and expository discourse interventions for late elementary- and middle school-aged students with language-related learning disabilities. Method A methodical search of the literature for interventions targeting expository or narrative discourse structure for students aged 9-14 years with group experimental designs identified 33 studies, seven of which met specific criteria to be included in this review. Results An 8-point critical appraisal scale was applied to analyze the quality of the study design, and effect sizes were calculated for six of the seven studies; equivocal to small effects of far-transfer outcomes (i.e., generalizability to other settings) and equivocal to moderate near-transfer outcomes (i.e., within the treatment setting) were identified. The most effective intervention studies provided explicit instruction of expository texts with visual supports and student-generated learning materials (e.g., notes or graphic organizers) with moderate dosage (i.e., 180-300 min across 6-8 weeks) in a one-on-one or paired group setting. Greater intervention effects were also seen in children with reading and/or language disorders, compared to children with overall academic performance difficulties. Conclusions A number of expository discourse interventions showed promise for student use of learned skills within the treatment setting (i.e., near-transfer outcomes) but had limited generalization of skills (i.e., far-transfer outcomes). Supplemental Material https://doi.org/10.23641/asha.12449258.