Clinical discourse and engagement during shared storybook reading in preschool groups.

This study investigated the impact of discourse on engagement in shared storybook reading in children who are language impaired and hard to engage. Although active participation in shared storybook reading in children who are typically developing is well defined, research has shown that the engagement of children with language disorders differ as a result of adult reading styles. To investigate the influence of reading style on children who were hard to engage, four shared storybook-reading sessions were analyzed. Within the highly engaged sessions studied, several discourse features were identified that were supportive of the engagement of children with language impairment who were difficult to engage. These features were a balance of requests and responses between clinician and child, use of various scaffolding measures, and a focus on content through the use of pausing, inflection, and volume. The discourse patterns identified were additional to the strategies associated with dialogic book-reading literature focused on active participation.

Evidence-based systematic review: effects of different service delivery models on communication outcomes for elementary school-age children.

PURPOSE: The purpose of this investigation was to conduct an evidence-based systematic review (EBSR) of peer-reviewed articles from the last 30 years about the effect of different service delivery models on speech-language intervention outcomes for elementary school-age students. METHOD: A computer search of electronic databases was conducted to identify studies that addressed any of 16 research questions. Structured review procedures were used to select and evaluate data-based studies that used experimental designs of the following types: randomized clinical trial, nonrandomized comparison study, and single-subject design study. RESULTS: The EBSR revealed a total of 5 studies that met the review criteria and addressed questions of the effectiveness of pullout, classroom-based, and indirect-consultative service delivery models with elementary school-age children. Some evidence suggests that classroom-based direct services are at least as effective as pullout intervention for some intervention goals, and that highly trained speech-language pathology assistants, using manuals prepared by speech-language pathologists to guide intervention, can provide effective services for some children with language problems. CONCLUSION: Lacking adequate research-based evidence, clinicians must rely on reason-based practice and their own data until more data become available concerning which service delivery models are most effective. Recommendations are made for an expanded research agenda.

Prologue: Autism Spectrum Disorder: The Context of Speech-Language Pathologist Intervention.

As the need for services for children with autism and related disorders has increased, so has the need for information about communication assessment and intervention for these children. Each of the articles in this forum considers essential knowledge for meeting the social, behavioral, and communication challenges presented by this population, as well as considerations for the individual variation noted within this population. It is hoped that the knowledge contained in this forum will provide interdisciplinary insight into the challenges of autism and related disorders and a research-based framework for making assessment and intervention decisions.

A New Look at Performance on Theory-of-Mind Tasks by Adolescents With Autism Spectrum Disorder.

PURPOSE: A hallmark of autistic spectrum disorder (ASD) is disruption in theory-of-mind development, including the understanding of false beliefs. Previous studies have typically assessed the development of first- and second-order false belief concepts in ASD, with tasks primarily emphasizing physical causality and logical inferencing. The present study investigated how preadolescents and adolescents with ASD performed on false belief tasks that included social inferencing of psychological states as well as logical inferencing of physical states. METHOD: Two categories of tasks were administered: four traditional logical inferencing tasks and four social inferencing tasks specifically developed for this study. In addition, a prompt hierarchy was included to ascertain if performance on both task types improved. Participants were 45 children and adolescents primarily selected from three urban school districts: 15 adolescents with a previous diagnosis of ASD (ASD group); 15 typically developing children matched for age, gender, and ethnicity (CA group); and 15 typically developing children matched for language age, gender, and ethnicity (LA group). RESULTS: Three findings were pertinent. First, the CA group performed at higher levels than did the LA group and the ASD group on both task sets. Second, although the CA and the LA groups performed equally well on both the logical and the social inferencing tasks, the ASD group performed better on the social inferencing tasks. Finally, the prompt hierarchy significantly improved overall task performance for the ASD and LA groups. CLINICAL IMPLICATIONS: These findings indicate that task type, variations in vocabulary ability, and the provision of support influenced performance on the false belief tasks.