Le numéro de décembre 2017 de Folia Phoniatrica et Logopaedica est consacré à l’autisme :

Supporting the Communication Development of Children and Adolescents with Autism Spectrum Disorder

1. Gillon G, Hyter Y, Fernandes FD, Ferman S, Hus Y, Petinou K, Segal O, Tumanova T, Vogindroukas I, Westby C, Westerveld M. International Survey of Speech-Language Pathologists’ Practices in Working with Children with Autism Spectrum Disorder. Folia Phoniatr Logop ;2017 ;69(1-2):8-19.

OBJECTIVE : Autism spectrum disorder (ASD) is a complex neurodevelopmental impairment. To better understand the role of speech-language pathologists (SLPs) in different countries in supporting children with ASD, the International Association of Logopedics and Phoniatrics (IALP) Child Language Committee developed a survey for SLPs working with children or adolescents with ASD. Method and Participants : The survey comprised 58 questions about background information of respondents, characteristics of children with ASD, and the role of SLPs in diagnosis, assessment, and intervention practices. The survey was available in English, French, Russian, and Portuguese, and distributed online. RESULTS : This paper provides a descriptive summary of the main findings from the quantitative data from the 1,114 SLPs (representing 35 countries) who were supporting children with ASD. Most of the respondents (91%) were experienced in working with children with ASD, and the majority (75%) worked in schools or early childhood settings. SLPs reported that the children’s typical age at diagnosis of ASD on their caseload was 3-4 years, completed mostly by a professional team. CONCLUSIONS : The results support positive global trends for SLPs using effective practices in assessment and intervention for children with ASD. Two areas where SLPs may need further support are involving parents in assessment practices, and supporting literacy development in children with ASD.

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2. Hyter Y, Vogindroukas I, Chelas EN, Paparizos K, Kivrakidou E, Kaloudi V. Differentiating Autism from Typical Development : Preliminary Findings of Greek Versions of a Pragmatic Language and Social Communication Questionnaire. Folia Phoniatr Logop ;2017 ;69(1-2):20-26.

OBJECTIVE : A social pragmatic communication disorder is one of the primary characteristics of children with autism. Although several measures of pragmatics and social communication exist, many are not comprehensive, do not examine the quality of interactions across contexts and interlocutors, and cannot be easily administered and interpreted. The aim of this article is to report on preliminary data collected using the Greek version of comprehensive social communication and pragmatic language questionnaires completed by parents and teachers interacting with young children in different contexts. METHODS : A Greek translation of the social communication and pragmatic language questionnaires was administered to parents and teachers of 31 children diagnosed with autism and of 51 typically developing children aged 3.0-6.0 years. Analysis and Results : The performance on the Greek versions of the social communication and pragmatic language questionnaires of typically developing children was compared with the performance of the children with autism using a series of independent t tests. Descriptive statistics were used to summarize participant characteristics and performances on the measure. Preliminary results showed that significant differences with moderate effect sizes were found between groups on 63% of the 30 test items. CONCLUSIONS : The performance of children on questionnaires may lead to the development of easily administered and interpretable assessments for differentiating children with pragmatics and social communication impairments, such as children with autism, from typically developing children.

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3. Hus Y. Issues in Identification and Assessment of Children with Autism and a Proposed Resource Toolkit for Speech-Language Pathologists. Folia Phoniatr Logop ;2017 ;69(1-2):27-37.

BACKGROUND : The prevalence of autism spectrum disorder (ASD) has increased significantly in the last decade as have treatment choices. Nonetheless, the vastly diverse autism topic includes issues related to naming, description, iden-tification, assessment, and differentiation from other neu-rodevelopmental conditions. ASD issues directly impact speech-language pathologists (SLPs) who often see these children as the second contact, after pediatric medical practitioners. Because of shared symptomology, differentiation among neurodevelopmental disorders is crucial as it impacts treatment, educational choices, and the performance trajectory of affected children. OBJECTIVES : To highlight issues in : identification and differentiation of ASD from other communication and language challenges, the prevalence differences between ASD gender phenotypes, and the insufficient consideration of cultural factors in evaluating ASD in children. A second objective was to propose a tool to assist SLPs in the management of autism in children. SUMMARY : A universal resource toolkit development project for SLP communities at large is proposed. The resource is comprised of research-based observation and screening tools for caregivers and educators, as well as parent questionnaires for portraying the children’s function in the family, cultural com-munity, and educational setting.

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4. Petinou K, Minaidou D. Neurobiological Bases of Autism Spectrum Disorders and Implications for Early Intervention : A Brief Overview. Folia Phoniatr Logop ;2017 ;69(1-2):38-42.

OBJECTIVES : To better understand the pathogenesis of autism spectrum disorder (ASD) and implications for intervention, the current paper reports on research related to the neurobiological underpinnings of ASD and the implication for early intervention with a focus on the importance of joint attention and eye gaze behaviors. PARTICIPANTS AND METHODS : An overview is provided on the available research findings from the fields of social neuroscience and experimental psychology specific to brain development, brain pathology, eye gaze, and joint attention behaviors. RESULTS : The results of the review converge towards the existence of aberrant brain connections and atypical brain morphology areas, which in complex and dynamic ways hinder the prioritization of social information. Consequently, the atypical social interaction skills exhibited by infants at risk for developing ASD are traced in the malformation of respective brain connections. CONCLUSIONS : Given the importance of neurobiological findings and their mapping onto early social pragmatic skills, early intervention goals need to focus on increasing appropriate eye gaze skills and joint attention. Such goals could potentially improve intervention outcomes in terms of improving social communication skills in youngsters with ASD.

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5. Westerveld M, van Bysterveldt AK. The Home Literacy Environment of Preschool-Age Children with Autism or Down Syndrome. Folia Phoniatr Logop ;2017 ;69(1-2):43-53.

AIMS : This exploratory study investigated if there were differences in the home literacy environment of preschool children on the autism spectrum and preschool children with Down syndrome to determine if the home literacy environment may potentially be associated with strengths or weaknesses in children’s social communication skills. METHODS : A total of 111 parents of preschoolers with identified disabilities completed a home literacy questionnaire. RESULTS : Results indicated that both groups of parents started reading to their children at an early age and owned at least 25 children’s books. However, parents of children with Down syndrome read to their child more often, reported higher child interest in reading, and more frequently played rhyming games with their child. No group differences were found in teaching of letter names, although parents of children with autism reported a higher frequency of pointing out signs/words in the environment and reported their children knew more letter names. Group differences were also found in the relationship between parent behaviours, child interest, and children’s print-related skills. CONCLUSION : This study highlights the influence both parent behaviours and child interest may have on shared book reading practices of parents with their preschool children with disabilities.

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6. Ferman S, Bar-On A. Morpho-Orthographic Processing in Children with Autism Spectrum Disorder : The Case of Hebrew Orthography. Folia Phoniatr Logop ;2017 ;69(1-2):54-66.

OBJECTIVE : Most studies on word reading in children with autism spectrum disorder (ASD) focus on graphemic-phonemic decoding and the direct orthographic route. To extend the scope, we investigated morpho-orthographic identification beyond graphemic-phonemic abilities. PATIENTS AND METHODS : The original study included 31 sixth-grade children with ASD and comparison groups of typically developing (TD) children : 23 age-matched children, 15 third-graders, and 17 second-graders. The groups were compared regarding reading of morphologically based Hebrew pointed pseudowords to examine graphemic-phonemic decoding, and unpointed pseudowords to test morpho-orthographic identification. To better focus on morpho-orthographic identification processes, we eventually included only children with a minimum threshold of >/=65% correct in reading pointed pseudowords, thereby excluding 11 children with ASD, 1 TD age-matched child, and 1 TD third-grader. RESULTS : About half of the children with ASD eventually included were as accurate as the TD second-graders in reading unpointed pseudowords, and slow in reading both pointed and unpointed pseudowords. The other half were as accurate as their typical peers in reading unpointed pseudowords, but slightly slower. CONCLUSION : The results highlight the difficulties many Hebrew-reading children with ASD experience in using morpho-orthographic processes beyond their difficulties in using graphemic-phonemic processes, demonstrating effortful (slow) reading. While this study can be considered a pilot investigation, further studies are needed.

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7. Segal O, Kaplan D, Patael S, Kishon-Rabin L. Comprehension of « Narrow Focus » by Adolescents in the Autism Spectrum. Folia Phoniatr Logop ;2017 ;69(1-2):67-77.

OBJECTIVE : The study compared the performance of adolescents with autistic spectrum disorder (ASD) to that of age-matched peers with typical development (TD) and cognitive language-matched peers with TD on measures of identification and comprehension of « narrow focus. » PARTICIPANTS : Forty-nine participants, 17 autistic, 17 TD peers matched for age and sex, and 15 TD children matched for expressive vocabulary participated in the study. METHOD : The Hebrew Narrow Focus Test (HNFT) was used. The HNFT includes 3 subtests. The first subtest (A) required identification of the stressed word in the sentence based on psychoacoustic abilities alone. The second (B) and third (C) subtests required understanding the meaning of focused stress in different contexts. In subtest B, the meaning of « narrow focus » was to contrast other possibilities related to the lexical-grammatical role of the stressed word in the sentence, whereas in subtest C, the meaning was to indicate a mistake. RESULTS : ASD participants showed reduced performance compared to peers across all the subtests of the HNFT, but similar performance compared to TD children in subtests A and B and better performance on subtest C. A significant correlation was found between the Raven test for assessing nonverbal intelligence and subtests B and C of the HNFT in the group of adolescents with ASD. CONCLUSIONS : Comprehension of narrow focus in adolescents with ASD who study in a special educational system is related to their cognitive-linguistic abilities and not to the autistic condition by itself or to its severity.

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8. Sun IYI, Varanda CA, Fernandes FD. Stimulation of Executive Functions as Part of the Language Intervention Process in Children with Autism Spectrum Disorder. Folia Phoniatr Logop ;2017 ;69(1-2):78-83.

AIMS : Identifying effective methods for stimulating language and communication of children with autism spectrum disorder (ASD) is fundamental to the effective use of available resources to support these children. This pilot study was designed to explore the potential benefits of a program of stimulation of executive functions (SEF) on the functional aspects of language and communication through the assessment of the functional communicative profile and social-cognitive performance. METHODS : Twenty children, aged 5-12 years, with a diagnosis of ASD participated in the study. Two stimulation programs were offered over a 10- to 12-week period as part of the regular services offered to these children through a University’s speech and language therapy outpatient clinic in Sao Paulo, Brazil. Children either received SEF intervention in their home implemented by their parent/s, with close monitoring by the speech-language pathologist (SLP) (group 1), or they received SEF by the SLP during regular speech-language therapy individual sessions (group 2). RESULTS : The findings suggested that there were differences between the children’s pre- and posttest performance. Significantly different performances were observed in the areas of occupation of communication space, proportion of communicative interactivity, and social-cognitive performance. CONCLUSION : The inclusion of activities to stimulate executive function abilities in language intervention for children with ASD warrants further investigation.

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