The Feasibility and Data Quality for a Listening Comprehension Task in an Unmoderated Remote Study With Children.

PURPOSE: The purpose of this research note was to examine the sample representation, feasibility and completion, and data quality when using an unmoderated remote study (i.e., conducted without direct contact with a researcher) for a listening comprehension task with 4- to 11-year-old children. METHOD: Thirty-five participants met inclusionary criteria for this study. Sample representation was examined descriptively. Feasibility and completion (i.e., submission of parent questionnaires and more than 50% of task with no missing data) were examined descriptively and compared with differences of proportions tests. Data quality (i.e., missing data for items with interference or not codable) was examined descriptively with multilevel logistic regression models, as well as one-sample proportions tests by listening comprehension task and participant characteristics. RESULTS: Our sample skewed toward predominantly White and toward families with highly educated parents. Overall, most participants completed the task and had quality data (i.e., audibly clear responses that could be coded, few missing responses, and task completion) in this unmoderated format. There were not any statistically significant effects across participant characteristics in terms of rates of completion. Data quality only significantly differed by response type with mouse selection having the least amount of missing data followed by prompted audio-recorded questions and then open-ended audio-recorded questions. CONCLUSIONS: The unmoderated remote study approach seems feasible for a listening comprehension task for most children ages 4-11 years old. Future work is needed to determine if these results apply to samples with broader representation. Overall, we found good data quality despite the less controlled environment in remote studies. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23114924.

Story Comprehension Monitoring Across Visual, Listening, and Written Modalities in Children with and Without Autism Spectrum Disorder.

Visual, as compared to verbal, tasks are often assumed to be easier for individuals with autism spectrum disorder (ASD), but is this true for story comprehension? This study evaluated story comprehension monitoring across visual, listening, and written modalities and assessed predictors in two closely matched groups (age, socioeconomic status, language, nonverbal cognition, and word reading) of children and adolescents (8-14 years) with ASD (n = 20) and typical development (typically developing [TD]; n = 20). The results of mixed-effects models indicated that story comprehension monitoring was low overall, and performance was comparable across visual, listening, and written modalities for participants with ASD. Age, vocabulary, nonverbal working memory, response and distractor inhibition, and social communication significantly predicted comprehension monitoring.

Access to Speech and Language Services and Service Providers for Children With Speech and Language Disorders.

OBJECTIVES: The purposes of this study were to (a) examine children's access to services for their speech and language disorders during their lifetimes; (b) identify any child, disorder, and family characteristics associated with access to services; and (c) describe the speech and language service providers among children who received care. STUDY DESIGN: Data from the 2012 National Health Interview Survey were used for this retrospective cohort study. Our sample included 491 children (ages 3;0-17;11 [years;months]) with speech disorders and 333 children with language disorders. We measured the receipt of services for speech or language difficulties (main outcome) and the type of professional providing services (secondary outcome). We examined associations between services and child, disorder, and family characteristics. RESULTS: Approximately 75% of children with speech and language disorders had ever received services for their difficulties. Privately insured children and children with co-occurring conditions were more likely to receive services than their peers who were uninsured (speech: 6.1 [1.7,21.3]; language: 6.6 [1.3,32.9]) and had no co-occurring conditions (speech: 2.1 [1.2,3.9]; language: 2.9 [1.5,5.5]). Speech-language pathologists (SLPs) were the most commonly reported provider of services (speech: 68%, language: 60%) followed by early interventionists. CONCLUSIONS: Most children with speech and language disorders received services. However, disparities existed by race/ethnicity, health insurance type, co-occurring diagnoses, and disorder duration (speech only). Most children who received services were being provided with care by the experts of speech and language: SLPs. Updated population-based data and implementation studies are needed to document speech and language screening, referral, and access to services. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19799389.

Prologue: Implementation Science in CSD and Starting Where You Are.

In this prologue, we introduce readers to the Forum: Clinicians and Researchers Navigating Implementation Science in CSD. Implementation science (IS), or the study of the adoption of evidence-based practice in real-world settings, is a key area of development in communication sciences and disorders (CSD). The goal of this forum was to show by example how researchers and clinicians are collaborating to begin to apply IS in CSD. This goal culminated in a scoping review of IS in CSD, a tutorial on incorporating IS into clinical practice research, three articles on stakeholder engagement, and three examples of IS studies in CSD included in this forum. We hope this forum helps clinicians and researchers to begin wherever they are in their knowledge and understanding of IS in CSD.

Epilogue: Implementation Science in CSD and Starting Where You Are.

In this epilogue for the Clinicians and Researchers Navigating Implementation Science in CSD forum, we begin by summarizing the eight articles in this forum that describe where the field is in terms of published implementation science (IS) articles in communication sciences and disorders (CSD) and how numerous teams have begun incorporating IS into their research programs. We then situate these articles across three themes: (1) levels of analysis and support; (2) research methods, frameworks, and models; and (3) underserved populations. Next, we consider the challenges and opportunities for conducting IS in CSD. Finally, we conclude by offering tangible steps for researchers, department heads, clinicians, patients, organizations/administrators, and funders in doing and supporting IS research in CSD.

Reading Comprehension in School-Age Children With Autism Spectrum Disorder: Examining the Many Components That May Contribute.

Purpose Reading comprehension is consistently poor in many school-age children with autism spectrum disorder (ASD). The purpose of this tutorial is to provide an overview from a multicomponent view on the many predictors that may contribute to reading comprehension difficulties in ASD. Method This tutorial reviews current literature on profiles and predictors of reading comprehension in ASD. The review is situated from a multicomponent theoretical view based on the "direct and indirect effects of reading" model that builds on the familiar "simple view of reading." Each component, including word reading, listening comprehension, morphosyntax, vocabulary, working memory, comprehension monitoring, inferencing, and theory of mind, is separately reviewed, with consideration of the current evidence for their contribution to reading comprehension in ASD. At the end of each section, key takeaways are provided. To conclude, a summary with general clinical implications, case examples, and recommendations for future research across all components is offered. Conclusions Reading comprehension in ASD may be affected by any one or several components in any given individual. Speech-language pathologists have expertise and play a critical role in assessing and intervening on these components. The age and language status (language impaired or not) of a child are emerging as important factors for what to assess and consider for intervention. However, more research is needed that intentionally examines language status, evaluates reading comprehension at targeted ages or narrower age ranges, and/or examines language and reading development longitudinally.

Reading Comprehension in Children With and Without ASD: The Role of Word Reading, Oral Language, and Working Memory.

Word reading and oral language predict reading comprehension, which is generally poor, in individuals with autism spectrum disorder (ASD). However, working memory (WM), despite documented weaknesses, has not been thoroughly investigated as a predictor of reading comprehension in ASD. This study examined the role of three parallel WM N-back tasks using abstract shapes, familiar objects, and written words in children (8-14 years) with ASD (n = 19) and their typically developing peers (n = 24). All three types of WM were significant predictors of reading comprehension when considered alone. However, these relationships were rendered non-significant with the addition of age, word reading, vocabulary, and group entered into the models. Oral vocabulary emerged as the strongest predictor of reading comprehension.

A Preliminary Investigation of Parent-reported Fiction versus Non-fiction Book Preferences of School-Age Children with Autism Spectrum Disorder.

BACKGROUND & AIMS: Anecdotal evidence suggests that individuals with autism spectrum disorder (ASD) prefer non-fiction books over fiction books. The current study was the first to investigate parent-reports of children with ASD's fiction and non-fiction book preferences and whether these relate to individual differences in social communication, oral language, and/or reading abilities. METHOD: Children (ages 8-14 years, M = 10.89, SD = 1.17) with ASD diagnoses (n = 19) and typically developing (TD) peers (n = 21) participated. Children completed standardized measures of social communication, oral language, and reading abilities. Parents reported children's current favorite book, and from these responses, we coded children's fiction versus non-fiction book preferences. MAIN CONTRIBUTION: Contrary to anecdotal evidence, children with ASD preferred fiction similar to their TD peers. Fiction versus non-fiction book preference was significantly related to social communication abilities across both groups. Children's oral language and reading abilities were related, as expected, but the evidence for a relationship between social communication and reading comprehension was mixed. CONCLUSIONS: This study provides preliminary evidence supporting the association of social communication in fiction versus non-fiction book preference, which may be related to children's comprehension and support the theoretical role of social communication knowledge in narrative/fiction. IMPLICATIONS: It should not be assumed that all children with ASD prefer expository/non-fiction or do not read narrative/fiction. Children who prefer non-fiction may need additional social communication knowledge support to improve their understanding of narrative fiction.

Reading comprehension of ambiguous sentences by school-age children with autism spectrum disorder.

Weak central coherence (processing details over gist), poor oral language abilities, poor suppression, semantic interference, and poor comprehension monitoring have all been implicated to affect reading comprehension in individuals with autism spectrum disorder (ASD). This study viewed the contributions of different supporting skills as a collective set of skills necessary for context integration-a multi-component view-to examine individual differences in reading comprehension in school-age children (8-14 years) with ASD (n = 23) and typically developing control peers (n = 23). Participants completed a written ambiguous sentence comprehension task in which participants had to integrate context to determine the correct homonym meaning via picture selection. Both comprehension products (i.e., offline representations after reading) and processes (i.e., online processing during reading) were evaluated. Results indicated that children with ASD, similar to their TD peers, integrated the context to access the correct homonym meanings while reading. However, after reading the sentences, when participants were asked to select the meanings, both groups experienced semantic interference between the two meanings. This semantic interference hindered the children with ASD's sentence representation to a greater degree than their peers. Individual differences in age/development, word recognition, vocabulary breadth (i.e., number of words in the lexicon), and vocabulary depth (i.e., knowledge of the homonym meanings) contributed to sentence comprehension in both children with ASD and their peers. Together, this evidence supports a multi-component view, and that helping children with ASD develop vocabulary depth may have cascading effects on their reading comprehension. Autism Res 2017, 10: 2002-2022. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Like their peers, children with ASD were able to integrate context, or link words while reading sentences with ambiguous words (words with two meanings). After reading the sentences, both groups found it hard to pick the correct meaning of the ambiguous sentence and this decision was more difficult for the participants with ASD. Older children, children with better word reading abilities, and children with higher vocabularies were better at understanding ambiguous sentences. Helping children with ASD to develop richer vocabularies could be important for improving their reading comprehension.

The role of nonverbal working memory in morphosyntactic processing by children with specific language impairment and autism spectrum disorders.

BACKGROUND: Both children with autism spectrum disorders (ASD) and children with specific language impairment (SLI) have been shown to have difficulties with grammatical processing. A comparison of these two populations with neurodevelopmental disorders was undertaken to examine similarities and differences in the mechanisms that may underlie grammatical processing. Research has shown that working memory (WM) is recruited during grammatical processing. The goal of this study was to examine morphosyntactic processing on a grammatical judgment task in children who varied in clinical diagnosis and language abilities and to assess the extent to which performance is predicted by nonverbal working memory (WM). Two theoretical perspectives were evaluated relative to performance on the grammatical judgment task-the "working memory" account and the "wrap-up" account. These accounts make contrasting predictions about the detection of grammatical errors occurring early versus late in the sentence. METHODS: Participants were 84 school-age children with SLI (n = 21), ASD (n = 27), and typical development (TD, n = 36). Performance was analyzed based on diagnostic group as well as language status (normal language, NL, n = 54, and language impairment, LI, n = 30). A grammatical judgment task was used in which the position of the error in the sentence (early versus late) was manipulated. A visual WM task (N-back) was administered and the ability of WM to predict morphosyntactic processing was assessed. RESULTS: Groups differed significantly in their sensitivity to grammatical errors (TD > SLI and NL > LI) but did not differ in nonverbal WM. Overall, children in all groups were more sensitive and quicker at detecting errors occurring late in the sentence than early in the sentence. Nonverbal WM predicted morphosyntactic processing across groups, but the specific profile of association between WM and early versus late error detection was reversed for children with and without language impairment. CONCLUSIONS: Findings primarily support a "wrap up" account whereby the accumulating sentence context for errors positioned late in the sentence (rather than early) appeared to facilitate morphosyntactic processing. Although none of the groups displayed deficits in visual WM, individual differences in these nonverbal WM resources predicted proficiency in morphosyntactic processing.

A Discrepancy in Comprehension and Production in Early Language Development in ASD: Is it Clinically Relevant?

This study examined the extent to which a discrepant comprehension-production profile (i.e., relatively more delayed comprehension than production) is characteristic of the early language phenotype in autism spectrum disorders (ASD) and tracked the developmental progression of the profile. Our findings indicated that a discrepant comprehension-production profile distinguished toddlers (30 months) with ASD from late talkers without ASD (91% sensitivity, 100% specificity) in groups that were comparable on expressive language, age, and socioeconomic status. Longitudinal data for children with ASD revealed that the discrepant profile steadily decreased from 30 to 44 months until there was no significant comprehension-production difference at 66 months. In conclusion, results suggest that lower comprehension than production may be an age-specific marker of toddlers with ASD.

The Relationship Between Executive Functions and Language Abilities in Children: A Latent Variables Approach.

Purpose: We aimed to outline the latent variables approach for measuring nonverbal executive function (EF) skills in school-age children, and to examine the relationship between nonverbal EF skills and language performance in this age group. Method: Seventy-one typically developing children, ages 8 through 11, participated in the study. Three EF components, inhibition, updating, and task-shifting, were each indexed using 2 nonverbal tasks. A latent variables approach was used to extract latent scores that represented each EF construct. Children were also administered common standardized language measures. Multiple regression analyses were conducted to examine the relationship between EF and language skills. Results: Nonverbal updating was associated with the Receptive Language Index on the Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4). When composites denoting lexical-semantic and syntactic abilities were derived, nonverbal inhibition (but not shifting or updating) was found to predict children's syntactic abilities. These relationships held when the effects of age, IQ, and socioeconomic status were controlled. Conclusions: The study makes a methodological contribution by explicating a method by which researchers can use the latent variables approach when measuring EF performance in school-age children. The study makes a theoretical and a clinical contribution by suggesting that language performance may be related to domain-general EFs.

The role of nonverbal working memory in morphosyntactic processing by school-aged monolingual and bilingual children.

The current study examined the relationship between nonverbal working memory and morphosyntactic processing in monolingual native speakers of English and bilingual speakers of English and Spanish. We tested 42 monolingual children and 42 bilingual children between the ages of 8 and 10years matched on age and nonverbal IQ. Children were administered an auditory Grammaticality Judgment task in English to measure morphosyntactic processing and a visual N-Back task and Corsi Blocks task to measure nonverbal working memory capacity. Analyses revealed that monolinguals were more sensitive to English morphosyntactic information than bilinguals, but the groups did not differ in reaction times or response bias. Furthermore, higher nonverbal working memory capacity was associated with greater sensitivity to morphosyntactic violations in bilinguals but not in monolinguals. The findings suggest that nonverbal working memory skills link more tightly to syntactic processing in populations with lower levels of language knowledge.

Use of the ADOS for assessing spontaneous expressive language in young children with ASD: a comparison of sampling contexts.

PURPOSE: The current study compared the spontaneous expressive language of children with autism spectrum disorder (ASD) across multiple language sampling contexts: the Autism Diagnostic Observation Schedule (ADOS; Lord, Rutter, DiLavore, & Risi, 1999) and play with an examiner or parent. METHOD: Participants were children with ASD (n = 63; 55 boys) with a mean age of 45 months (SD = 3.94, range = 37-53). The number of utterances produced; percentage of intelligible utterances; number of different words; mean length of utterance; and the number of requests, comments, and instances of turn-taking were calculated for the ADOS, examiner-child play, and parent-child play. Children were categorized into Tager-Flusberg et al.'s (2009) developmental language phases for each context. RESULTS: Effects of sampling context were identified for all variables examined. The ADOS resulted in fewer utterances and lower structural and pragmatic language performance than examiner-child play and/or parent-child play. Categorization of children into language phases differed across contexts. CONCLUSIONS: Use of the ADOS as a language sampling context may lead to underestimating the abilities of young children with ASD relative to play with an examiner or parent. Researchers and clinicians should be aware of context effects, particularly for assessments designed to observe autism symptoms.

Characterization and prediction of early reading abilities in children on the autism spectrum.

Many children with autism spectrum disorder (ASD) have reading profiles characterized by higher decoding skills and lower reading comprehension. This study assessed whether this profile was apparent in young children with ASD and examined concurrent and longitudinal predictors of early reading. A discrepant profile of reading (higher alphabet and lower meaning) was found in 62% of this sample. Concurrent analyses revealed that reading proficiency was associated with higher nonverbal cognition and expressive language, and that social ability was negatively related to alphabet knowledge. Nonverbal cognition and expressive language at mean age 2½ years predicted later reading performance at mean age 5½ years. These results support the importance of early language skills as a foundation for reading in children with ASD.

Identity salience model: A paradigm for integrating multiple identities in clinical practice.

The manuscript presents an identity salience model for clinical practice and psychotherapy research. The model seeks to incorporate contemporary social identity theory and ecological theory, as well as an appreciation of individuals' multiple identities without necessitating a hierarchy of oppression. A clinical case example utilizing the identity salience model is presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved).