Auditory-Motor Mapping Training: Comparing the Effects of a Novel Speech Treatment to a Control Treatment for Minimally Verbal Children with Autism

Abstract

This study compared Auditory-Motor Mapping Training (AMMT), an intonation-based treatment for facilitating spoken language in minimally verbal children with autism spectrum disorder (ASD), to a matched control treatment, Speech Repetition Therapy (SRT). 23 minimally verbal children with ASD (20 male, mean age 6;5) received at least 25 sessions of AMMT. Seven (all male) were matched on age and verbal ability to seven participants (five male) who received SRT. Outcome measures were Percent Syllables Approximated, Percent Consonants Correct (of 86), and Percent Vowels Correct (of 61) produced on two sets of 15 bisyllabic stimuli. All subjects were assessed on these measures several times at baseline and after 10, 15, 20, and 25 sessions. The post-25 session assessment timepoint, common to all participants, was compared to Best Baseline performance. Overall, after 25 sessions, AMMT participants increased by 19.4% Syllables Approximated, 13.8% Consonants Correct, and19.1% Vowels Correct, compared to Best Baseline. In the matched AMMT-SRT group, after 25 sessions, AMMT participants produced 29.0% more Syllables Approximated (SRT 3.6%);17.9% more Consonants Correct (SRT 0.5); and 17.6% more Vowels Correct (SRT 0.8%). Chi-square tests showed that significantly more AMMT than SRT participants in both the overall and matched groups improved significantly in number of Syllables Approximated per stimulus and number of Consonants Correct per stimulus. Pre-treatment ability to imitate phonemes, but not chronological age or baseline performance on outcome measures, was significantly correlated with amount of improvement after 25 sessions. Intonation-based therapy may offer a promising new interventional approach for teaching spoken language to minimally verbal children with ASD.

White Matter Integrity and Treatment-Based Change in Speech Performance in Minimally Verbal Children with Autism Spectrum Disorder

“…In addition, some children began producing a high rate of extra syllables in addition to the two in the stimuli. These findings motivated the current study, which includes 10 children from Chenausky et al (2016) who were able to participate in an MRI study at baseline.…”

“…Participants in this study included 23 children with MV ASD (20 male), between the ages (year;months) of 3;5 and 9;8, who participated in at least 25 sessions of AMMT; other outcomes from this participant group were reported in Chenausky et al (2016). Ten of the 23 children (eight male, mean age 6;10 ± 1;4 SD), had successful MR imaging studies at baseline.…”

“…However, a wide range of improvement in speech fluency was found among the children in the two studies. Specifically, in Chenausky et al (2016), while 19 of the 23 AMMT participants showed a statistically significant improvement in number of syllables approximately correct per stimulus after treatment, the remaining four did not experience such an improvement. In addition, some children began producing a high rate of extra syllables in addition to the two in the stimuli.…”

“…In addition to improvement in the outcome measures discussed above, both Wan et al (2011) and Chenausky et al (2016) noted other positive changes in the AMMT participants after treatment, such as increased ability to vocalize and an improvement in the range and complexity of their speech output. However, a wide range of improvement in speech fluency was found among the children in the two studies.…”

“…Building on this work, Chenausky et al (2016) compared AMMT to a non-intonation-based control intervention, Speech Repetition Therapy (SRT), in 23 children receiving AMMT and seven receiving SRT. After 25 sessions of treatment, the AMMT group improved by 19.4% syllables approximately correct, significantly higher than the SRT group’s improvement of 3.6%.…”