Association for Behavior Analysis International

Prevalence of speech errors in the autism population is placed between 24 and 33% ( Rapin, Dunn, Allen, Stevens and Fein, 2009; Cleland, Gibbon, Pepp, OHare, and Rutherford, 2010; Shriberg, Paul, et al., 2001). While several Behavior Analytic studies address early vocalizations and communication in the autism population, very few such studies address the profound articulation problems faced by children in the spectrum. Speech Sound Disorders present a formidable barrier to further speech development. This Symposium presents successes in this clinically important area with 3 experimental papers on specific behavioral technologies covering Sufficient Response Exemplar Training, Phonetic hand prompting methods and Precision Teaching procedures. A conceptual paper introduces a behavioral perspective to interpretation of speech sound disorders, their classification and assessment challenges.

Children with autism spectrum disorder (ASD) are at a higher risk of being affected by speech disorders and often require remedial intervention. SufficientResponse-Exemplar Training of vocal imitation was used to successfully teach two typically developing children to articulate several Norwegian words with blends (Eikeseth and Nesset, 2003). The present study extends and adapts these procedures to children with Autism. Participants were a 11-year-old boy and a 15-year-old girl, both with ASD and speech sound disorders. For each participant 3 sets of 10 words, with specific blends they had difficulties with in the initial position were targeted for training. Within stimulus prompts, shaping, chaining and supplementary prompts were added to the intervention. A multiple baseline across behaviors (word sets with target blends) demonstrated improvement in articulation of trained words and generalization of correct articulation to untrained words in both participants. This study provides support for the value of sufficient response exemplar training in addressing speech sound disorders in children with ASD.

Improving speech intelligibility in children with autism with limited vocal repertoires is the focus of many early intensive behavior programs. Phonetic hand cueing systems are commonly promoted in commercially available speech-language products (Carahaly, 2012; Kaufman, 2007; Strode, 1994), however; research on effectiveness is limited (Hall and Jordan, 1992, Jordan 1988, Klick, 1985, Stelton & Graves 1985). This study examines the effectiveness of phonetic hand cues as a stimulus control transfer procedure to improve articulatory precision in a six year old with autism and limited vocal behavior. Results revealed rapid acquisition of 20 hand cues, steady acquisition of 248 single word echoics when hand cues were used as an antecedent prompt, and an increase in words and phrases improved when hand cues were used as error correction during natural environment training. Results of formal assessment of speech production skills by an independent speech-language pathologist revealed a reduction in errors on the Hodson Assessment of Phonological Targets Third Edition from 194 to 57 errors over a 10 month period. Results confirm previous case study findings that phonetic hand cues may be an effective intervention in promoting speech production skills in children with autism with limited vocal repertoires.

Fluency Training emphasizes rate as a preferred response dimension (Binder,1996) with evidence that learning to perform a component skill accurately at high rates could lead to faster acquisition of composite skills (Binder 1996; Johnson and Layng,1994). KS a 17 year old girl with autism and profound speech sound disorder participated in this delayed multiple baseline across behaviors study. Single consonant- vowel sounds tu, and fu were targeted and trained using Precision Teaching procedures (Lindsley,1964) and Standard Celeration charting. Rate of correct responses accelerated from low levels in baseline to over 40 per minute with intervention. Errors decelerated to zero for tu and 8 per minute for fu. Non-timed assessments of articulation at the composite levels of words demonstrated improvement from 30% to 100% for words with tu and 0% to 47% for fu sounds. Intervention is scheduled to begin on ku sound with low baseline rates correct. Additional participants have been identified for replication. The role of cues within precision teaching sessions, setting a realistic aim, generalization to composite level or other untrained words will be discussed.

Articulation for better intelligibility in children with autism is a socially significant outcome for Behavior Analysts to target but has only a limited body of behavioral research. 24 to 33% of persons with ASD are likely to be affected by speech sound disorders (Rapin, Dunn, Allen, Stevens & Fein, 2009; Shriberg, Paul, Black and Santen, 2011). There have been clarion calls for Behavior Analysts to collaborate with Speech and Language pathologists given the unique expertise and insights each can bring to address the problem of profound articulation disorders in children with autism (Sundberg,2011; Hegde, 2010; Esch, B.E., La Londe and Esch, J. W, 2010). This paper will discuss the challenges Behavior Analysts face and offers insights from SLP literature on areas such as assessment of articulation disorders, transcription, data recording and development of task analyses to progress from sounds to words to intelligible phrase speech to sentence speech. A further examination of existing approaches to articulation problems and how they can be shaped for better client outcomes using behavioral principles and evidence based methods such as treating to optimal intensity, prompting, stimulus salience, shaping and chaining.