Eliciting Language Samples for Analysis (ELSA): A New Protocol for Assessing Expressive Language and Communication in Autism.

Expressive language and communication are among the key targets of interventions for individuals with autism spectrum disorder (ASD), and natural language samples provide an optimal approach for their assessment. Currently, there are no protocols for collecting such samples that cover a wide range of ages or language abilities, particularly for children/adolescents who have very limited spoken language. We introduce a new protocol for collecting language samples, eliciting language samples for analysis (ELSA), and a novel approach for deriving basic measures of verbal communicative competence from it that bypasses the need for time-consuming transcription. Study 1 presents ELSA-adolescents (ELSA-A), designed for minimally and low-verbal older children/adolescents with ASD. The protocol successfully engaged and elicited speech from 46 participants across a wide range of ages (6;6-19;7) with samples averaging 20-25 min. The collected samples were segmented into speaker utterances (examiner and participant) using real-time coding as one is listening to the audio recording and two measures were derived: frequency of utterances and conversational turns per minute. These measures were shown to be reliable and valid. For Study 2, ELSA was adapted for younger children (ELSA-Toddler [ELSA-T]) with samples averaging 29 min from 19 toddlers (2;8-4;10 years) with ASD. Again, measures of frequency of utterances and conversational turns derived from ELSA-T were shown to have strong psychometric properties. In Study 3, we found that ELSA-A and ELSA-T were equivalent in eliciting language from 17 children with ASD (ages: 4;0-6;8), demonstrating their suitability for deriving robust objective assessments of expressive language that could be used to track change in ability over time. We introduce a new protocol for collecting expressive language samples, ELSA, that can be used with a wide age range, from toddlers (ELSA-T) to older adolescents (ELSA-A) with ASD who have minimal or low-verbal abilities. The measures of language and communication derived from them, frequency of utterances, and conversational turns per minute, using real-time coding methods, can be used to characterize ability and chart change in intervention research. LAY SUMMARY: We introduce a new protocol for collecting expressive language samples, ELSA, that can be used with a wide age range, from toddlers (ELSA-T) to older adolescents (ELSA-A) with autism spectrum disorder who have minimal or low-verbal abilities. The measures of language and communication derived from them, frequency of utterances and conversational turns per minute, using real-time coding methods, can be used to characterize ability and chart change in intervention research.

The Byl-Cheney-Boczai Sensory Discriminator: reliability, validity, and responsiveness for testing stereognosis.

This study evaluated reliability, validity, and responsiveness of a new test of stereognosis (Byl-Cheney-Boczai Sensory Discriminator Test [BCBI]). Participants included 38 controls, 29 subjects with hand problems, and 3 raters. With eyes closed, after sweeping the digit over a design (10 mm x 10 mm) embedded in a plastic cube (13 mm x 13 mm), subjects matched the design palpated with a design on an answer sheet (10 trials/digits 2 and 4). The intra-class correlation coefficients were 0.997 and 0.994 for intra-rater and inter-rater reliability. No significant performance differences were found by gender or side. Accuracy was significantly higher for digit 2 versus digit 4, younger subjects versus older subjects, and controls versus subjects with pathology. There were significant (1) positive correlations (+0.41 to +0.53) between the BCBI and tests of stereognosis and graphesthesia; (2) negative correlations (-0.44 to -0.51) between the BCBI and the Purdue and digital reaction time; and (3) gains on the BCBI and function with therapy. The BCBI seems to be a reliable, valid, and responsive test of stereognosis that can be administered in 15 minutes in the cinic.