Transitioning to Spoken Language in Preverbal Preschoolers with ASD

This text-based course is a written transcript of the course, "Transitioning to Spoken Language in Preverbal Preschoolers with ASD", presented by Rhea Paul, Ph.D. on January 19, 2011.

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>> Amy: Okay, everybody, good afternoon and welcome to the Nancy McKinley Lecture Series focusing on autism spectrum disorders and Asperger's Syndrome. So today's expert seminar's entitled Evidence based Practices for Improving Early Communication in Young Children with ASD. And it is presented by the highly esteemed Dr. Reah Paul. My name is Amy Hanson, and I will be your moderator for this online course.

At this time it is very much an honor to introduce Dr. Rhea Paul this afternoon. Rhea Paul is Professor and director of the communication disorder section at the Yale Child Study Center. She received her Ph.D. from the University of Wisconsin Madison in 1981 and has taught language development and disorders in children for over 25 years. She is author of over 70 articles and refereed journals, 30 book chapters and seven books. She has been principal investigator on research projects on child language disorders and autism funded by agencies of the National Institutes of Health, as well as several foundations. She received faculty scholar awards from the Portland State University and Southern Connecticut State University, and in 1996 received the editor's award from the American Journal of Speech Language Pathology. She has been a fellow of the American Speech Language Hearing Association since 1991 and is president of the Connecticut Speech Language Hearing Association. So we welcome you, Dr. Paul, and thank you so much for being here to share your expertise today.

(applause)

>> Rhea: Thank you for having me, Amy. You will have to excuse me. I did want to say that it is a special honor to do this lecture in honor of Nancy McKinley, who as Amy told you, is someone that has been a source of inspiration to all of us in the field and someone whom I certainly have admired for many years, and she is much missed.

Communication is a Primary Deficit in ASD

I'll go ahead and get started. And I'll do that by just reminding you that communication is one of the primary deficits that define autism spectrum disorders. Of the three symptoms that comprise the syndrome, two of them really involve communication. The first is communication itself, communication deficits are a primary means of identifying and diagnosing autism. Communication is also involved in the second diagnostic criteria for autism, and that is social difficulties, and of course, we communicate - rather we attain social interaction primarily through communication.

It is necessary to know that communication in autism involves both delay and deviance in terms of development so that children with autism aren't just slower in their development of language from other children. In fact, they show differences between their development and what's typically seen and sometimes children with autism do things that are hardly ever observed in normal development. When there is a deficit in communication, the primary area of difficulty is in pragmatics. There can also be difficulties in paralinguistics and prosody when talking about those whom verbal language has not been attained. So today, pragmatics and prosody aren't relevant to the point that I'm going to be discussing.

So in thinking about the role of language development in the unfolding of autism spectrum disorders, until very recently almost half of children with autism didn't develop spoken language at all. They were referred to as mute, and it wasn't just that they didn't talk. They also didn't use gestures or other forms of nonverbal communication, and they also didn't understand language, so it wasn't just that there was some sort of production impediment but the whole structure of communication was really absent in these individuals. Now, fortunately these estimates have changed recently so that now we think only about 20 to 40% of children still don't use verbal language by the time they get to school. Nonetheless, that's still a considerable proportion, and more importantly, the ability to use spoken language is very highly correlated with long term outcome.