The Urgent Need for Neuroscience Research to Consider Culture when Assessing the Development of Gait in Autistic Children: A Scoping Review.

BACKGROUND: Over the last decade, there has been a steady increase in the number of children diagnosed with autism spectrum disorder (ASD) on a global scale, impacting all racial and cultural groups. This increase in the diagnostic rate has prompted investigation into a myriad of factors that may serve as early signs of ASD. One of these factors includes the biomechanics of gait, or the manner of walking. Although ASD is a spectrum, many autistic children experience differences in gross motor function, including gait. It has been documented that gait is also impacted by racial and cultural background. Given that ASD is equally prevalent across all cultural backgrounds, it is urgent that studies assessing gait in autistic children consider the impact of cultural factors on children's development of gait. The purpose of the present scoping review was to assess whether recent empirical research studies focusing on gait in autistic children have taken culture into account. METHODS: To do so, we conducted a scoping review following PRISMA guidelines using a keyword searching with the terms autism, OR autism spectrum disorder, OR ASD, OR autis, AND gait OR walking in the following databases: CINAHL, ERIC (EBSCO), Medline, ProQuest Nursing & Allied Health Source, PsychInfo, PubMed, and Scopus. Articles were considered for review if they met all six of the following inclusionary criteria: (1) included participants with a diagnosis of autism spectrum disorder (ASD), (2) directly measured gait or walking, (3) the article was a primary study, (4) the article was written in English, (5) participants included children up to age 18, and (6) the article was published between 2014 and 2022. RESULTS: A total of 43 articles met eligibility criteria but none of the articles took culture into account in the data analysis process. CONCLUSIONS: There is an urgent need for neuroscience research to consider cultural factors when assessing gait characteristics of autistic children. This would allow for more culturally responsive and equitable assessment and intervention planning for all autistic children.

Braille literacy as a human right: A challenge to the "inefficiency" argument against braille instruction.

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) affirms a right to education for disabled persons and aims to ensure braille instruction for blind individuals. However, there is evidence that braille instruction is often circumvented or abandoned early in CRPD nations because it is perceived as an inefficient learning medium for blind students. This perception persists despite insufficient empirical evidence and a lack of understanding of the efficiency of reading versus listening for learning in sighted individuals. We therefore investigated the efficiency of learning written versus spoken words in blind and sighted samples. Participants (23 blind, 20 sighted) studied the written definitions of 70 rare English words in successive rounds, presented in conjunction with written or spoken wordforms. Blind participants learned with equal efficiency across modalities, whereas sighted participants learned spoken words more efficiently. The findings indicate the inefficiency argument against teaching braille is groundless, both because braille word learning is not less efficient than auditory word learning for blind individuals, and because reading is valued in the education of sighted individuals despite its apparent inefficiency in that population.

Prevalence Versus Evidence: A Closer Look at the Research Available for Serving Children Exposed to Maltreatment and a Response to Hyter's Call for Trauma-Informed Care.

PURPOSE: In an October 2021 post of The ASHA LeaderLive, Dr. Yvette Hyter emphasized the need for trauma-informed services for children exposed to maltreatment in the wake of the COVID-19 pandemic. Inspired by her call, we discuss how the pandemic created a high-risk context for maltreatment, the speech-language pathologists' (SLPs') role in prevention and intervention, reflect on the gap in evidence for maltreatment within empirical journals aimed at the speech-language pathology audience, and reiterate Hyter's call for trauma-informed care as a guide for clinicians serving children exposed to maltreatment. METHOD: We searched for empirical evidence within journals aimed at SLPs focused on maltreatment to get an estimate of the available research. For comparison, we consulted the same journals for the number of publications covering other risk factors or conditions with similar impacts on communication skills but with lower prevalence rates. RESULTS: Compared to other risk factors or conditions with lower prevalence rates, the disparity between the evidence aimed at SLPs and the prevalence of childhood maltreatment was difficult to ignore. CONCLUSION: Given the current circumstances, we encourage clinicians to seek information about the communicative effects of exposure to maltreatment beyond journals aimed specifically at speech-language pathologists, stress the need for trauma-informed care instruction during graduate schooling, increase awareness of our role in preventative care, and call for more research on intervention services tailored specifically for children exposed to maltreatment.

Comprehensive motor skills assessment in children with autism spectrum disorder yields global deficits.

Purpose: Although children with autism spectrum disorder (ASD) often display motor deficits, the nature of these motor deficits remains unspecified. The purpose of this study was to establish a robust motor profile in children with ASD across a wider range of motor skills by using two professionally administered standardized motor assessments alongside a parent report measure to capture a comprehensive view of motor performance compared to a group of neurotypical peers. Methods: Complex motor skills, balance and global motor performance were compared in twenty-four children, between the ages of 5-12 years, split into two groups: ASD and typically developing. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) and the Movement Assessment Battery for Children, Second Edition (MABC-2) were used to examine skill performance. Motor proficiency was also collected using the parent/caregiver form of the Vineland Adaptive Behavior Scales, 3rd edition (Vineland-3). Results: Children with ASD presented with significant differences in complex motor skills, balance skills, and global motor performance when compared to their neurotypical peers across all three measures. Conclusion: This preliminary study indicated that the children with ASD had greater difficulty with global motor performance, including more difficulty performing complex motor tasks and balance tasks compared to their neurotypical peers. The parents of the children with ASD reported decreased proficiency of motor skills. Overall, the children with ASD demonstrated deficits performing tasks that targeted strength, speed, agility, coordination and both static and dynamic balance. While manifestations of motor skill deficits specific to the ASD population are variable, physical therapists should be included in the ongoing assessment and implementation of comprehensive therapeutic plans for children with ASD.

How Children with Autism Spectrum Disorder, Developmental Language Disorder, and Typical Language Learn to Produce Global and Local Semantic Features.

A local processing bias, often considered a cognitive style unique to autism spectrum disorder (ASD), may influence the types of semantic features acquired by children with ASD and could contribute to weaknesses in word learning. Children with developmental language disorder (DLD) also struggle to learn semantic aspects of words, but this cognitive style has not been ascribed to children with DLD. The purpose of this study was to explore whether global-local processing differences influence the type of semantic features children with ASD, DLD, and their neurotypical peers learn to produce when learning new words. Novel word definitions produced by 36 school-aged children (12 with ASD, 12 with DLD, and 12 with typical language) who participated in an extended word-learning paradigm were used to extract newly learned semantic features. These semantic features were then coded for global and local attributes and analyzed to detect whether there were differences between groups. Results indicated that the children with ASD and DLD produced more global, rather than local, semantic features in their definitions than the children with typical language. An over-reliance on global, rather than local, features in children with ASD and DLD may reflect deficits in depth of word knowledge.

The Influence of Language Context on Repetitive Speech Use in Children With Autism Spectrum Disorder.

Purpose Although repetitive speech is a hallmark characteristic of autism spectrum disorder (ASD), the contributing factors that influence repetitive speech use remain unknown. The purpose of this exploratory study was to determine if the language context impacts the amount and type of repetitive speech produced by children with ASD. Method As part of a broader word-learning study, 11 school-age children with ASD participated in two different language contexts: storytelling and play. Previously collected language samples were transcribed and coded for four types of repetitive speech: immediate echolalia, delayed echolalia, verbal stereotypy, and vocal stereotypy. The rates and proportions of repetitive speech were compared across the two language contexts using Wilcoxon signed-ranks tests. Individual characteristics were further explored using Spearman correlations. Results The children produced lower rates of repetitive speech during the storytelling context than the play-based context. Only immediate echolalia differed between the two contexts based on rate and approached significance based on proportion, with more immediate echolalia produced in the play-based context than in the storytelling context. There were no significant correlations between repetitive speech and measures of social responsiveness, expressive or receptive vocabulary, or nonverbal intelligence. Conclusions The children with ASD produced less immediate echolalia in the storytelling context than in the play-based context. Immediate echolalia use was not related to social skills, vocabulary, or nonverbal IQ scores. These findings offer valuable insights into better understanding repetitive speech use in children with ASD.

Visual and verbal semantic productions in children with ASD, DLD, and typical language.

PURPOSE: Associations between visual and verbal input allow children to form, augment, and refine their semantic representations within their mental lexicons. However, children with autism spectrum disorder (ASD) and with developmental language disorder (DLD; also known as specific language impairment) process visual and verbal information differently than their typically developing peers, which may impact how they incorporate visual and verbal features into their semantic representations. The purpose of this exploratory study was to investigate how children with ASD and DLD use visually and verbally presented input to produce semantic representations of newly learned words. METHOD: Semantic features produced by 36 school-aged children (12 with ASD, 12 with DLD, and 12 with typical language development) were extracted from previously collected novel word definitions and coded based on their initial presentation modality (either visual, verbal, or both in combination) during an extended novel word learning paradigm. These features were then analyzed to explore group differences in the use of visual and verbal input. RESULTS: The children with ASD and DLD produced significantly more visually-presented semantic features than their typical peers in their novel word definitions. There were no differences between groups in the proportion of semantic features presented verbally or via both modalities in combination. Also, the children increased their production of semantic features presented via both modalities combined across the sessions; this same increase in production was not observed for the semantic features taught in either the visual or verbal modality alone. CONCLUSION: Children with ASD and DLD benefit from visually presented semantic information, either in isolation or combined with verbal input, during tasks of word learning. Also, the reinforcement of combined visual-verbal input appears to enhance semantic learning over time.

Semantic richness and word learning in children with autism spectrum disorder.

Semantically rich learning contexts facilitate semantic, phonological, and articulatory aspects of word learning in children with typical development (TD). However, because children with autism spectrum disorder (ASD) show differences at each of these processing levels, it is unclear whether they will benefit from semantic cues in the same manner as their typical peers. The goal of this study was to track how the inclusion of rich, sparse, or no semantic cues influences semantic, phonological, and articulatory aspects of word learning in children with ASD and TD over time. Twenty-four school-aged children (12 in each group), matched on expressive vocabulary, participated in an extended word learning paradigm. Performance on five measures of learning (referent identification, confrontation naming, defining, phonetic accuracy, and speech motor stability) were tracked across three sessions approximately one week apart to assess the influence of semantic richness on extended learning. Results indicate that children with ASD benefit from semantically rich learning contexts similarly to their peers with TD; however, one key difference between the two groups emerged - the children with ASD showed heightened shifts in speech motor stability. These findings offer insights into common learning mechanisms in children with ASD and TD, as well as pointing to a potentially distinct speech motor learning trajectory in children with ASD, providing a window into the emergence of stereotypic vocalizations in these children.

The Influence of Prosodic Stress Patterns and Semantic Depth on Novel Word Learning in Typically Developing Children.

The goal of this study was to investigate the effects of prosodic stress patterns and semantic depth on word learning. Twelve preschool-aged children with typically developing speech and language skills participated in a word learning task. Novel words with either a trochaic or iambic prosodic pattern were embedded in one of two learning conditions, either in children's stories (semantically rich) or picture matching games (semantically sparse). Three main analyses were used to measure word learning: comprehension and production probes, phonetic accuracy, and speech motor stability. Results revealed that prosodic frequency and density influence the learnability of novel words, or that there are prosodic neighborhood density effects. The impact of semantic depth on word learning was minimal and likely depends on the amount of experience with the novel words.

Alternative tense and agreement morpheme measures for assessing grammatical deficits during the preschool period.

PURPOSE: P. A. Hadley and H. Short (2005) developed a set of measures designed to assess the emerging diversity and productivity of tense and agreement (T/A) morpheme use by 2-year-olds. The authors extended 2 of these measures to the preschool years to evaluate their utility in distinguishing children with specific language impairment (SLI) from their typically developing (TD) peers. METHOD: Spontaneous speech samples from 55 children (25 with SLI, 30 TD) at 2 different age levels (4;0-4;6 [years;months] and 5;0-5;6) were analyzed, using a traditional T/A morphology composite that assessed accuracy, and the Hadley and Short measures of Tense Marker Total (assessing diversity of T/A morpheme use) and Productivity Score (assessing productivity of major T/A categories). RESULTS: All 3 measures showed acceptable levels of sensitivity and specificity. In addition, similar differences in levels of productivity across T/A categories were seen in the TD and SLI groups. CONCLUSION: The Tense Marker Total and Productivity Score measures seem to have considerable utility for preschool-age children, in that they provide information about specific T/A morphemes and major T/A categories that are not distinguished using the traditional composite measure. The findings are discussed within the framework of the gradual morphosyntactic learning account.