Prosody and its relationship to language in school-aged children with high-functioning autism.

BACKGROUND: Disordered expressive prosody is a widely reported characteristic of individuals with autism. Despite this, it has received little attention in the literature and the few studies that have addressed it have not described its relationship to other aspects of communication. AIMS: To determine the nature and relationship of expressive and receptive language, phonology, pragmatics, and non-verbal ability in school-aged children with high-functioning autism and to determine how prosody relates to these abilities and which aspects of prosody are most affected. METHODS & PROCEDURES: A total of 31 children with high-functioning autism and 72 typically developing children matched for verbal mental age completed a battery of speech, language, and non-verbal assessments and a procedure for assessing receptive and expressive prosody. OUTCOMES & RESULTS: Language skills varied, but the majority of children with high-functioning autism had deficits in at least one aspect of language with expressive language most severely impaired. All of the children with high-functioning autism had difficulty with at least one aspect of prosody and prosodic ability correlated highly with expressive and receptive language. The children with high-functioning autism showed significantly poorer prosodic skills than the control group, even after adjusting for verbal mental age. CONCLUSIONS: Investigating prosody and its relationship to language in autism is clinically important because expressive prosodic disorders add an additional social and communication barrier for these children and problems are often life-long even when other areas of language improve. Furthermore, a receptive prosodic impairment may have implications not only for understanding the many functions of prosody but also for general language comprehension.

Receptive and expressive prosodic ability in children with high-functioning autism.

PURPOSE: This study aimed to identify the nature and extent of receptive and expressive prosodic deficits in children with high-functioning autism (HFA). METHOD: Thirty-one children with HFA, 72 typically developing controls matched on verbal mental age, and 33 adults with normal speech completed the prosody assessment procedure, Profiling Elements of Prosodic Systems in Children. RESULTS: Children with HFA performed significantly less well than controls on 11 of 12 prosody tasks (p < .005). Receptive prosodic skills showed a strong correlation (p < .01) with verbal mental age in both groups, and to a lesser extent with expressive prosodic skills. Receptive prosodic scores also correlated with expressive prosody scores, particularly in grammatical prosodic functions. Prosodic development in the HFA group appeared to be delayed in many aspects of prosody and deviant in some. Adults showed near-ceiling scores in all tasks. CONCLUSIONS: The study demonstrates that receptive and expressive prosodic skills are closely associated in HFA. Receptive prosodic skills would be an appropriate focus for clinical intervention, and further investigation of prosody and the relationship between prosody and social skills is warranted.

Taking aim at infusion confusion.

A comprehensive multidisciplinary approach was used to improve drug infusion safety in an acute care hospital in Melbourne, Australia. This project aimed to reduce the potential for drug infusion-related error, improve drug infusion safety for patients, and encourage incident reporting to inform and guide continuous quality improvement projects. The project applied a systems approach to medication safety, using redesign strategies such as continuous quality improvement (plan, do, study, and act) and re-engineering. Key safety design concepts such as standardization, simplification, and forcing functions were also used.

Prosody in autism spectrum disorders: a critical review.

BACKGROUND: Many individuals with autism spectrum disorders present with unusual or odd-sounding prosody. Despite this widely noted observation, prosodic ability in autism spectrum disorders is often perceived as an under-researched area. AIMS: This review seeks to establish whether there is a prosodic disorder in autism, what generalizations can be made about its various manifestations and whether these manifestations vary according to the diagnosis. A literature review was carried out to establish what areas of prosody in autism spectrum disorders have been researched to date, what the findings have been and to determine what areas are yet to be researched. MAIN CONTRIBUTION: It is shown that prosody in autism spectrum disorders is an under-researched area and that where research has been undertaken, findings often conflict. The findings of these conflicting studies are compared and recommendations are made for areas of future research. CONCLUSIONS: Research in this area has covered mostly prosodic expression, although some more recent studies cover comprehension, processing and the relationship of receptive prosodic ability to theory of mind. Findings conflict and methodology varies greatly.

Assessing intonation and prosody in children with atypical language development: the PEPS-C test and the revised version.

A procedure for assessing prosody and intonation in children (PEPS-C: Profiling Elements of Prosodic Systems--Children), suitable for use by clinicians with both children and adults, is described. The procedure includes testing of four communication areas in which intonation/prosody has a crucial role: interaction, affect, boundary (chunking) and focus. Each area has parallel tasks for assessing understanding and expression of the functions and ability to discriminate and articulate the prosodic forms involved. The original and revised forms of the test are compared, with some discussion of procedural considerations. Past and present uses of the test and future applications are considered.