Selecting and tailoring implementation interventions: a concept mapping approach.

BACKGROUND: To improve the uptake of research into practice, knowledge translation frameworks recommend tailoring implementation strategies to address practice barriers. This study reports our experience pairing the Theoretical Domains Framework with information from multiple stakeholder groups to co-develop practice-informed strategies for improving the implementation of an evidence-based outcome measurement tool across a large community health system for preschoolers with communication impairments. METHODS: Concept mapping was used to identify strategies for improving implementation of the Focus on the Outcomes of Communication Under Six (FOCUS) in Ontario Canada's Preschool Speech and Language Program. This work was done in five stages. First, we interviewed 37 speech-language pathologists (clinicians) who identified 90 unique strategies to resolve practice barriers to FOCUS implementation. Second, clinicians (n = 34), policy-makers (n = 3), and members of the FOCUS research team (n = 6) sorted and rated the strategies by importance and feasibility. Third, stakeholders' sorting data were analyzed to generate a two-dimensional concept map. Based on the rating data from stakeholders, we prioritized a list of strategies that were rated as highly important and highly feasible, and summarized the practice barriers addressed by each of the prioritized strategies. Fourth, we validated these findings with stakeholders via an online survey. Fifth, the mechanisms of action of the prioritized list of strategies were considered based on available evidence from the Theoretical Domains Framework and associated behavior change literature. RESULTS: Stakeholders categorized the 90 unique implementation strategies into a six-cluster concept map. Based on stakeholders' ratings, a list of 14 implementation strategies were prioritized. These implementation strategies were reported to resolve barriers within the environmental context and resources and beliefs about consequences domains of the Theoretical Domains Framework. All but one of the prioritized strategies have a demonstrated link in resolving existing barriers according to the behavioral change literature. CONCLUSIONS: Our study contributes to a growing literature that demonstrates the process of tailoring implementation strategies to specific barriers. Practical drawbacks and benefits of using concept mapping as a way to engage stakeholders in implementation research are discussed.

Maturation in auditory event-related potentials explains variation in language ability in children.

Processing of auditory information in the cortex continues to develop into later childhood and adolescence. Recent research has indicated that intraclass correlation (ICC) is the best method for capturing maturation in auditory event-related potentials (AEPs) of school-age children. However, the sensitivity of the ICC approach in discerning AEP changes in children has not been consistently demonstrated and positive results have not been replicated. We attempted this replication and further explored whether AEP maturation estimated using the ICC approach predicts cognitive and linguistic abilities in addition to chronological age. We measured AEPs in response to simple tones in groups of 7-, 8-, 9- and 10-year olds with typical development (N = 67) and used ICC to estimate the age equivalent of each child's AEP (AEP-age). Results indicated that ICC differentiated 7- to 8-year-old children from 9- to 10-year-old children and that AEP-age predicted both chronological age and significant, unique variance in language ability, but not in nonverbal IQ. Our findings support the view that auditory organization in children reflects both general developmental maturation and more specific development of language skills, and support the future use of AEP-age to identify and understand individual differences in brain maturation in typically developing and clinical populations.

Testing the accuracy of timing reports in visual timing tasks with a consumer-grade digital camera.

This study tested the accuracy of a visual timing task using a readily available and relatively inexpensive consumer grade digital camera. A visual inspection time task was recorded using short high-speed video clips and the timing as reported by the task's program was compared to the timing as recorded in the video clips. Discrepancies in these two timing reports were investigated further and based on display refresh rate, a decision was made whether the discrepancy was large enough to affect the results as reported by the task. In this particular study, the errors in timing were not large enough to impact the results of the study. The procedure presented in this article offers an alternative method for performing a timing test, which uses readily available hardware and can be used to test the timing in any software program on any operating system and display.

What do Speech-Language Pathologists want to know when assessing early vocal development in children who are deaf/hard-of-hearing?

PURPOSE: Delays in vocal development are an early predictor of ongoing language difficulty for children who are deaf/hard-of-hearing (CDHH). Despite the importance of monitoring early vocal development in clinical practice, there are few suitable tools. This study aimed to identify the clinical decisions that speech-language pathologists (SLPs) most want to make when assessing vocal development and their current barriers to doing so. METHOD: 58 SLPs who provide services to CDHH younger than 22 months completed a survey. The first section measured potential barriers to vocal development assessment. The second section asked SLPs to rate the importance of 15 clinical decisions they could make about vocal development. RESULTS: SLPs believed assessing vocal development was important for other stakeholders, and reported they had the necessary skills and knowledge to assess vocal development. Barriers primarily related to a lack of commercially available tests. SLPs rated all 15 clinical decisions as somewhat or very important. Their top 5 decisions included a variety of assessment purposes that tests are not typically designed to support, including measuring change, differential diagnosis, and goal setting. CONCLUSIONS: SLPs wish to make a number of clinical decisions when assessing vocal development in CDHH but lack access to appropriate tools to do so. Future work is needed to develop tools that are statistically equipped to fulfill these purposes. Understanding SLPs' assessment purposes will allow future tests to better map onto the clinical decisions that SLPs need to make to support CDHH and their families and facilitate implementation into clinical practice.

Current practices, supports, and challenges in speech-language pathology service provision for autistic preschoolers.

Background: Speech-language pathology services are among the most frequently accessed services for young autistic children. Therefore, understanding the nature of these services, what challenges these clinicians face, and what supports they value is critical for developing appropriate policies and practices that can maximize positive outcomes for children and families. This study had two primary aims. The first was to examine the self-reported assessment and intervention practices of community-based Speech Language Pathologists (SLPs) and communicative disorders assistants (CDAs; who provide services under the supervision of a SLP) in supporting preschool children with suspected and diagnosed autism. The second aim was to identify barriers and supports (facilitators) to providing services in the community using the Consolidated Framework for Implementation Research (CFIR) as a framework. Methods: A cross-sectional online survey was used to collect qualitative and quantitative data from clinicians in Ontario Canada who were providing speech and language services to preschool children with suspected or diagnosed autism. Quantitative data were used to describe clinicians" practices, and qualitative data captured their perspectives on barriers and supports to providing services. Results: A total of 258 clinicians participated in the survey. On average, clinicians reported almost half of the preschoolers on their caseload had either diagnosed or suspected autism. There was consistency across the skill development areas assessed by SLPs, and targeted during therapy sessions, with the top four areas targeted being: foundational social communication, language, play and pragmatics. However, there was wide variation in speech and language assessment and intervention practices reported by this sample of clinicians (i.e., service delivery models, tools or programs used, length and duration of therapy services, level of collaboration with other professionals). Clinicians identified several barriers to providing services: limited funding and time, lack of inter-professional collaboration, difficulty accessing services, community messaging about autism services, family readiness and clinician knowledge. Supports (facilitators) included: access to autism-focused professional development, inter- and intra-professional collaboration, and access to additional supports in the community.

Clinical feasibility, utility, and usability of the Profile of Preschool Communication: A pilot test in community settings.

AIM: . This study aimed to pilot test, assess usability and utility of, and identify barriers to implementation for the Profile of Preschool Communication (PPC) - a new data collection tool designed to support outcome monitoring in preschool speech-language programs and practice-based research. METHODS: . This pilot study was conducted with three sites in the Ontario Preschool Speech and Language (PSL) program. Twenty-three speech-language pathologists used the PPC for all outcome monitoring assessments for 2-3-months and provided feedback about their experience using it in practice. Then, 18 of the 23 speech-language pathologists completed online surveys to rate usability and utility, and report their perceived implementation barriers and facilitators. RESULTS: . Speech-language pathologists reported difficulties completing some sections of the PPC, most notably obtaining data related to maternal education and family history of mental health concerns. Usability and utility were generally rated favorably with some items rated as neutral. Barriers to implementation included the paper format, completion time, requirement to ask personal questions, and the perception by some that data were useful for outcome monitoring but not practice. Facilitators included ease of use, an improvement over the existing tool, and the collection of data to support service planning. CONCLUSIONS: . The PPC shows potential as an outcome monitoring data collection tool in preschool speech-language pathology programs. Findings will be of interest to researchers engaged in practice-based research and those interested in engaging end users to develop clinically meaningful tools.

Barriers and Facilitators to Implementation of a Preschool Outcome Measure: An Interview Study with Speech-Language Pathologists.

INTRODUCTION: The Preschool Speech and Language Program in Ontario, Canada implemented the Focus on the Outcomes of Communication Under Six (FOCUS), an outcome measure, in 2012. This study aimed to investigate commonly experienced facilitators of and barriers to implementing the FOCUS in clinical practice from the perspectives of speech-language pathologists (SLPs). METHODS: Thirty-seven SLPs participated in semi-structured interviews to share their experiences adopting the FOCUS in clinical practice. A deductive content analysis of interview transcripts was conducted using the Theoretical Domains Framework (TDF), followed by an inductive analysis to identify sub-themes within each domain. RESULTS: SLPs frequently encountered barriers within three TDF domains: Environmental Context and Resources (e.g., difficulties integrating the FOCUS into assessment sessions and intervention schedules), Beliefs about Consequences (e.g., beliefs that data collected using the FOCUS lack relevance to clinical practice), and Social Influences (e.g., administration of the FOCUS harmed rapport with families). Commonly reported facilitators were found in the Behavioural Regulation (e.g., reminder system) and Environmental Context and Resources (e.g., availability of administrative personnel and technology support) domains. CONCLUSIONS: SLPs identified barriers and facilitators to implementing an evidence-based outcome measure into practice. Insights drawn from SLPs' perspectives will support the design of new methods to improve the implementation of functional outcome measurement tools within programs.

Pediatric Responses to Fundamental and Formant Frequency Altered Auditory Feedback: A Scoping Review.

Purpose: The ability to hear ourselves speak has been shown to play an important role in the development and maintenance of fluent and coherent speech. Despite this, little is known about the developing speech motor control system throughout childhood, in particular if and how vocal and articulatory control may differ throughout development. A scoping review was undertaken to identify and describe the full range of studies investigating responses to frequency altered auditory feedback in pediatric populations and their contributions to our understanding of the development of auditory feedback control and sensorimotor learning in childhood and adolescence. Method: Relevant studies were identified through a comprehensive search strategy of six academic databases for studies that included (a) real-time perturbation of frequency in auditory input, (b) an analysis of immediate effects on speech, and (c) participants aged 18 years or younger. Results: Twenty-three articles met inclusion criteria. Across studies, there was a wide variety of designs, outcomes and measures used. Manipulations included fundamental frequency (9 studies), formant frequency (12), frequency centroid of fricatives (1), and both fundamental and formant frequencies (1). Study designs included contrasts across childhood, between children and adults, and between typical, pediatric clinical and adult populations. Measures primarily explored acoustic properties of speech responses (latency, magnitude, and variability). Some studies additionally examined the association of these acoustic responses with clinical measures (e.g., stuttering severity and reading ability), and neural measures using electrophysiology and magnetic resonance imaging. Conclusion: Findings indicated that children above 4 years generally compensated in the opposite direction of the manipulation, however, in several cases not as effectively as adults. Overall, results varied greatly due to the broad range of manipulations and designs used, making generalization challenging. Differences found between age groups in the features of the compensatory vocal responses, latency of responses, vocal variability and perceptual abilities, suggest that maturational changes may be occurring in the speech motor control system, affecting the extent to which auditory feedback is used to modify internal sensorimotor representations. Varied findings suggest vocal control develops prior to articulatory control. Future studies with multiple outcome measures, manipulations, and more expansive age ranges are needed to elucidate findings.

Reliability of Speech-Language Pathologists' Categorizations of Preschoolers' Communication Impairments in Practice.

Purpose An efficient and reliable way to categorize children's communication impairments based on routine clinical assessments is needed to inform research and clinical decisions. This preliminary study assessed interrater reliability of speech-language pathologists' categorization of preschoolers' speech, language, and communication impairments using a clinical consensus document. Method Six speech-language pathologists at three community sites worked in pairs to assess 38 children aged 1-5 years, then used the clinical consensus document to categorize children's communication impairments broadly. Identified language and speech sound impairments were further subcategorized. Results Speech-language pathologists had substantial to almost perfect agreement for three broadly focused impairment categories. Agreement for whether language difficulties/disorders were developmental or associated with a biomedical condition was almost perfect, but moderate for whether difficulties impacted receptive or expressive language, or social communication skills. Agreement was fair for rule-based speech delays/disorders, but low for motor-based and mixed speech impairments. Conclusions Results support use of the clinical consensus document to collect data for reliable categories. Additional work is needed to confirm reliability for some broadly focused impairment categories and for subcategorization of speech impairments.

Looking back and moving forward: A scoping review of research on preschool autism interventions in the field of speech-language pathology.

Background & Aims: Speech-language pathology services are frequently accessed by families of children who have suspected or diagnosed autism. This is expected given that social communication differences are a core feature of autism. This review looked broadly at the state of research in the field of speech-language pathology and preschool autism interventions in order to identify the types of studies that could be used to inform the practices of speech-language pathologists (SLPs), and to identify gaps in the field so they can be addressed in future research. Specifically, we examined the extent of research conducted on interventions delivered (at least in part) by SLPs to preschool children with suspected or diagnosed autism, identified the range of skill development areas targeted within the studies, and explored the characteristics of the interventions (i.e., theoretical models underlying the programs, service delivery models, treatment dosage). Methods: A scoping review of articles published between 1980 and 2019 was conducted using the five phases outlined by the Arksey and O'Malley framework: (a) articulating the research question; (b) identifying relevant studies; (c) selecting studies; (d) charting the data; and (e) collating, summarizing, and reporting the results. Main Contribution/Results: A total of 114 studies met inclusion criteria with most published since 2010 and conducted within North America. Case study or single-subject study designs were the most frequently used. Interventions delivered solely by SLPs and by multiprofessional teams that included SLPs were relatively equally represented. Across the included studies, nine skill development areas were targeted, but interventions targeting social communication, language, and augmentative communication skills made up the vast majority of studies. There was relatively even distribution of interventions informed by child-centered, clinician-directed, and hybrid models. Explicit information detailing intervention characteristics (e.g., treatment dosage, professional training of clinicians delivering the intervention) was poorly reported in many studies. For those studies providing details, there was a great deal of variability in the nature of interventions (e.g., service delivery models, SLPs' role, dosage). Conclusions: This review revealed that research in the area of autism interventions delivered, at least in part, by SLPs has markedly increased over the past 10 years. Still, there remains a need for more research, and greater transparency detailing the nature of the interventions being investigated. The research conducted to date captures the versatility of the SLP's role within preschool autism intervention. Improved reporting and studies with strong methodological rigor focused on capturing the complex and individualized nature of interventions are needed, as are intervention studies aligned with real-world community practice. Implications: This review provides a comprehensive examination of the status of research on preschool interventions delivered to children with suspected or diagnosed autism within the field of speech-language pathology. Several directions for future research are provided, as are suggestions for improving the clinical applicability of results to further the development of effective, evidence-informed policy and practice in speech-language pathology.

Closing the species gap: Translational approaches to studying sensory processing differences relevant for autism spectrum disorder.

The study of sensory phenotypes has great potential for increasing research translation between species, a necessity to decipher the neural mechanisms that contribute to higher-order differences in neurological conditions such as autism spectrum disorder (ASD). Over the past decade, despite separate advances in our understanding of the structural and functional differences within the brain of autistic and non-autistic individuals and in rodent models for ASD, researchers have had difficulty translating the findings in murine species to humans, mostly due to incompatibility in experimental methodologies used to screen for ASD phenotypes. Focusing on sensory phenotypes offers an avenue to close the species gap because sensory pathways are highly conserved across species and are affected by the same risk-factors as the higher-order brain areas mostly responsible for the diagnostic criteria for ASD. By first reviewing how sensory processing has been studied to date, we direct our focus to electrophysiological and behavioral techniques that can be used to study sensory phenotypes consistently across species. Using auditory sensory phenotypes as a template, we seek to improve the accessibility of translational methods by providing a framework for collecting cohesive data in both rodents and humans. Specifically, evoked-potentials, acoustic startle paradigms, and psychophysical detection/discrimination paradigms can be created and implemented in a coordinated and systematic fashion across species. Through careful protocol design and collaboration, sensory processing phenotypes can be harnessed to bridge the gap that exists between preclinical animal studies and human testing, so that mutually held questions in autism research can be answered. LAY SUMMARY: It has always been difficult to relate results from animal research to humans. We try to close this gap by studying changes in sensory processing using careful protocol design and collaboration between clinicians and researchers. Sensory pathways are comparable between animals and humans, and are affected in the same way as the rest of the brain in ASD. Using changes in hearing as a template, we point the field in an innovative direction by providing a framework for collecting cohesive data in rodents and humans.

Effectiveness of a parent-implemented language intervention for late-to-talk children: a real-world retrospective clinical chart review.

Purpose: This study aimed to: (1) evaluate the effectiveness of Target WordTM - The Hanen Program®for Parents of Children Who are Late Talkers for improving the real-world communicative participation skills of children who are late-to-talk, and (2) explore predictors of change in children's communicative participation skills.Method: We conducted a retrospective clinical chart review for 76 families who participated in the Target Word programme at a publicly-funded clinic. Families completed the Focus on the Outcomes of Communication Under Six (FOCUS) at pre-intervention, post-intervention, and after a 3-month consolidation period and scores were compared across the three assessment points. Regression analysis was then used to explore the relation between changes in children's communicative participation skills and potential predictors of change identified by 25 Target Word certified speech-language pathologists.Result: At the end of intervention, 75% of children had made a clinically significant change in communicative participation skills. Clinicians proposed verbal imitation, language development stagnation and parent interaction style as the top predictors of change in communicative participation skills. Of these, only verbal imitation at pre-intervention predicted change in communicative participation following the intervention.Conclusion: The Target Word programme can facilitate the development of communicative participation skills in late-to-talk children. Modifications to the intervention may be needed in order to maximise outcomes for children with limited verbal imitation.

Lessons learned in practice-based research: Studying language interventions for young children in the real world.

Background and aims: Practice-based research holds potential as a promising solution to closing the research-practice gap, because it addresses research questions based on problems that arise in clinical practice and tests whether systems and interventions are effective and sustainable in a clinical setting. One type of practice-based research involves capturing practice by collecting evidence within clinical settings to evaluate the effectiveness of current practices. Here, we describe our collaboration between researchers and clinicians that sought to answer clinician-driven questions about community-based language interventions for young children (Are our interventions effective? What predicts response to our interventions?) and to address questions about the characteristics, strengths, and challenges of engaging in practice-based research. Methods: We performed a retrospective chart review of 59 young children who had participated in three group language interventions at one publicly funded community clinic between 2012 and 2017. Change on the Focus on the Outcomes of Communication Under Six (FOCUS), a government mandated communicative participation measure, was extracted as the main outcome measure. Potential predictors of growth during intervention were also extracted from the charts, including type of intervention received, attendance, age at the start of intervention, functional communication ability pre-intervention, and time between pre- and post-intervention FOCUS scores. Results: Overall, 49% of children demonstrated meaningful clinical change on the FOCUS after their participation in the language groups. Only 3% of participants showed possibly meaningful clinical change, while the remaining 46% of participants demonstrated not likely meaningful clinical change. There were no significant predictors of communicative participation growth during intervention. Conclusions: Using a practice-based research approach aimed at capturing current practice, we were able to answer questions about the effectiveness of interventions delivered in real-world settings and learn about factors that do not appear to influence growth during these interventions. We also learned about benefits associated with engaging in practice-based research, including high clinical motivation, high external validity, and minimal time/cost investment. Challenges identified were helpful in informing our future efforts to examine other possible predictors through development of a new, clinically feasible checklist, and to pursue methods for improving collection of outcome data in the clinical setting.Implications: Clinicians and researchers can successfully collaborate to answer clinically informed research questions while considering realistic clinical practice and using research-informed methods and principles. Practice-based research partnerships between researchers and clinicians are both valuable and feasible.

Establishing consensus among community clinicians on how to categorize and define preschoolers' speech and language impairments at assessment.

PURPOSE: To achieve consensus amongst speech-language pathologists (SLPs) on the categories and definitions of preschoolers' communication impairments. METHODS: In Phase 1, impairments were identified, categorized, and defined based on an evidence review. In Phase 2, a four-round Modified Delphi study was completed with SLPs (N = 38). SLPs reviewed three documents that categorized and defined preschoolers': (1) broadly focused impairments, (2) language disorder sub-categories, and (3) speech sound disorder sub-categories; rated whether categories captured all preschoolers with communication impairments and definitions were clear (consensus = 90% agreement across all documents); and made suggestions for improvement. Documents were revised between rounds based on SLPs' responses, literature review, and consultation with experts. RESULTS: In Round 1, 90% agreement was reached only for the language disorder sub-categories document. In Round 2, no consensus was reached for the Speech Sound Disorder sub-categories document. In Round 3, consensus was reached for all three documents, but a fourth round was run to incorporate newly updated terminology. In Round 4, consensus was reached for updated terminology presented in the language disorders document. CONCLUSIONS: Clinical and research expertise are integrated throughout the final documents, resulting in consensus terminology for preschoolers' communication impairments. Findings can support consistent terminology for preschoolers with communication impairments amongst SLPs. In research, documents will be used in a developing data collection tool that will undergo reliability testing prior to use in large scale studies related to children's communication. This study demonstrates the value of engaging in practice-based research.

Auditory evoked fields predict language ability and impairment in children.

Recent evidence suggests that a subgroup of children with autism show similarities to children with Specific Language Impairment (SLI) in the pattern of their linguistic impairments, but the source of this overlap is unclear. We examined the ability of auditory evoked magnetic fields to predict language and other developmental abilities in children and adolescents. Following standardized assessment of language ability, nonverbal IQ, and autism-associated behaviors, 110 trails of a tone were binaurally presented to 45 7-18 year olds who had typical development, autism (with LI), Asperger Syndrome (i.e., without LI), or SLI. Using a 151-channel MEG system, latency of left hemisphere (LH) and right hemisphere (RH) auditory M50 and M100 peaks was recorded. RH M50 latency (and to a lesser extent, RH M100 latency) predicted overall oral language ability, accounting for 36% of the variance. Nonverbal IQ and autism behavior ratings were not predicted by any of the evoked fields. Latency of the RH M50 was the best predictor of clinical LI (i.e., irrespective of autism diagnosis), and demonstrated 82% accuracy in predicting Receptive LI; a cutoff of 84.6 ms achieved 92% specificity and 70% sensitivity in classifying children with and without Receptive LI. Auditory evoked responses appear to reflect language functioning and impairment rather than non-specific brain (dys)function (e.g., IQ, behavior). RH M50 latency proved to be a relatively useful indicator of impaired language comprehension, suggesting that delayed auditory perceptual processing in the RH may be a key neural dysfunction underlying the overlap between subgroups of children with autism and SLI.

MEG detects neural consequences of anomalous nasalization in vowel-consonant pairs.

This study identifies a delay in the neuromagnetic activity evoked by passive auditory presentation of anomalous speech sound combinations. Vowel-consonant-vowel (VCV) stimuli were constructed to manipulate vowel nasalization in violation of the patterns of English, in which vowel nasalization ordinarily arises as a predictable coarticulatory effect of anticipatory velum lowering for production of a following nasal consonant. For anomalous stimuli with V1 and C mismatched in nasalization, the neural response to C was delayed relative to congruent control stimuli with V1 and C matched for nasalization. As both anomalous and control stimuli represent linguistically possible speech sound sequences, the temporal disparity in evoked neuromagnetic activity in English speakers reflects a role for language-specific phonological knowledge at the earliest stages of auditory processing.

Magnetoencephalography identifies rapid temporal processing deficit in autism and language impairment.

Deficient rapid temporal processing may contribute to impaired language development by interfering with the processing of brief acoustic transitions crucial for speech perception. Using magnetoencephalography, evoked neural activity (M50, M100) to two 40 ms tones passively presented in rapid succession was recorded in 10 neurologically normal adults and 40 8-17-year-olds with autism, specific language impairment, Asperger syndrome or typical development. While 80% of study participants with intact language (Asperger syndrome, typical development, adults) showed identifiable responses to the second tone, which presented rapid temporal processing demands, 65% of study participants with impaired language (autism, specific language impairment) did not, despite having shown identifiable responses to the first tone. Rapid temporal processing impairments may be fundamentally associated with impairments in language rather than autism spectrum disorder.

Delayed mismatch field for speech and non-speech sounds in children with autism.

This study investigated the magnetic mismatch field elicited by changes in streams of vowels or spectrally matched tones in children with autism spectrum disorder (ASD) relative to children with typical development to explore whether impaired sound discrimination may contribute to language impairments in autism spectrum disorder. Using magnetoencephalography, we recorded evoked neural activity to 300-Hz and 700-Hz tones (and /u/ and /a/ vowels) presented in an oddball paradigm with deviant stimuli (15%) occurring within a train of standards (85%). The magnetic mismatch field was robustly observed in both groups, but children with autism spectrum disorder demonstrated a significantly delayed magnetic mismatch field compared with typically developing peers. Difficulty parsing transient differences in sounds may lead to impaired acoustic or phonological representations and subsequent language impairment in autism spectrum disorder.

Prominence of M50 auditory evoked response over M100 in childhood and autism.

This study investigated the 50 ms (M50) and 100 ms (M100) components of the auditory evoked field to explore their change during development. Using MEG, neuromagnetic fields elicited by a 1 kHz sinusoidal tone were recorded in adults and two groups of children and adolescents with typical development or autism spectrum disorder. M50 amplitude was larger in children than in adults, suggesting a developmental trajectory with M50 amplitude decreasing and M100 increasing with age. Child M50 and M100 latencies were prolonged relative to adults. Children with autism did not differ from control children with respect to these observations. The M50 in relation to the M100 is a robust index of early auditory system maturation suitable for future developmental investigations.

A meta-analysis of the reading comprehension skills of individuals on the autism spectrum.

This meta-analysis examined 36 studies comparing autism spectrum disorder (ASD) and control groups in reading comprehension. Three moderators (semantic knowledge, decoding skill, PIQ) and two text types (high vs. low social knowledge) were examined as predictors of reading comprehension in ASD. The overall standardized mean difference for reading comprehension was g = -0.7 SD. The strongest individual predictors of reading comprehension were semantic knowledge (explaining 57 % of variance) and decoding skill (explaining 55 % of variance). Individuals with ASD were significantly worse at comprehending highly social than less social texts. Having ASD alone does not predict reading comprehension deficits. Instead, individual skills, especially language ability, must be considered before one can accurately predict whether a given individual with ASD will experience difficulties in reading comprehension.