Promoting Speech Intelligibility in Autism Spectrum Disorder through the Implementation of Phonologically Similar Stimuli

Abstract

<b><i>Objectives:</i></b> The study focused on promoting expressive phonological skills in 1 Greek-speaking child with autism spectrum disorder (ASD) and comorbid speech sound disorder (SSD). Based on the phonological neighborhood density framework, it was hypothesized that the experimental manipulation through clinical implementation of phonologically overlapping stimuli would yield positive expressive phonology gains relevant to ASD. <b><i>Participant and Methods:</i></b> A multiple-baseline single-subject design was implemented. Three baseline sessions measured expressive phonology variables. Sixteen biweekly 30-min intervention sessions were carried out for a period of 2 months. Dependent variables included phonetic inventory size, proportion of consonants correct, occurrences of phonological processes, and percentage of whole word matches elicited via specific word probe stimuli. The Intelligibility in Context Scale was completed by the child’s teacher prior to the initiation of intervention and at a follow-up session. Experimental stimuli were grouped together in phonologically dense cohorts. <b><i>Results:</i></b> Comparison between pre-test and post-test measures revealed expressive phonology gains across all measured variables. Follow-up session results showed generalization of expressive phonology gains on untreated targets. <b><i>Conclusions:</i></b> Significant expressive phonology gains were achieved through the implementation of phonologically similar word stimuli within a systematic intervention protocol with the implementation of specific word-level variables. The findings supported this treatment approach for a child with ASD and SSD, while providing evidence for the phonological density advantage from a cross-linguistic perspective.

Language and Speech Characteristics in Autism

“… 39 However the existence, characteristics, and severity of SSD remain unclear within children with ASD. Although older reports on development of phonetics, phonological awareness and prosody reported age-appropriate speech profiles, 40 recent reports on younger children with autism revealed atypical speech patterns. The immature structure of syllables, restricted variety of phonetics, speech sound deformations, inconsistent production of words, inconsistent use of phonological process, late development of meaningful expressive vocabulary, and restricted use of phonological contrasts were the characteristics of these atypical speech patterns.…”

Oromotor skills in autism spectrum disorder: A scoping review

“…Fourteen (21%) measured phonetic inventory either in imitation or from a spontaneous speech sample (Biller et al, 2022; Broome et al, 2021; Chenausky et al, 2016, 2018, 2021; Chenausky, Nelson, & Tager‐Flusberg, 2017; Chenausky, Norton, et al, 2022; Chenausky, Norton, & Schlaug, 2017; Chenausky & Schlaug, 2018; Kim & Seung, 2015; Landa et al, 2013; Petinou, 2021; Schoen et al, 2011; Yoder et al, 2015), 11 (17%) examined speech rate or diadochokinetic rate (DDK; rapidly produced sequences of syllables) (Chenausky et al, 2019, 2020, 2021; Deshmukh, 2012; Mahler, 2012; Mandelbaum et al, 2006; Nadig & Shaw, 2011; Patel et al, 2020; Shriberg et al, 2001, 2011; Velleman et al, 2010), seven (11%) examined the consistency or stability of speech production (Chenausky et al, 2019, 2020, 2021; Deshmukh, 2012; Gladfelter & Goffman, 2018; Mahler, 2012; Shriberg et al, 2011), six (9%) examined motor‐related feeding/eating behaviors (Amato & Slavin, 1998; Brisson et al, 2012; McDaniel et al, 2018; Peterson et al, 2016, 2019; Yoder et al, 2015), five (8%) examined speech intelligibility (Gabig, 2008; Koegel et al, 1998; Lyakso et al, 2017; Petinou, 2021; Shriberg et al, 2001), five (8%) examined vocalization quality (Chenausky, Nelson, & Tager‐Flusberg, 2017; Plumb & Wetherby, 2013; Schoen et al, 2011; Sheinkopf et al, 2000; Trembath et al, 2019), four (6%) examined resonance quality (Chenausky et al, 2019, 2020, 2021; Shriberg et al, 2011), and th...…”

“…Four studies (4%) examined the intelligibility (i.e., the amount of speech that is understood by a listener) of autistic individuals, all using perceptual methods. Three of these studies (75%) reported low intelligibility among autistic speakers (Koegel et al, 1998;Lyakso et al, 2017;Petinou, 2021), although it should be noted that Petinou (2021) was a case study of one child and Lyakso et al (2017) did not report the statistical significance of the reduced intelligibility in autistic children compared to their control group.…”

“…Fourteen (21%) measured phonetic inventory either in imitation or from a spontaneous speech sample (Biller et al, 2022;Broome et al, 2021;Chenausky et al, 2016Chenausky et al, , 2021Chenausky, Nelson, & Tager-Flusberg, 2017;Chenausky, Norton, et al, 2022;Kim & Seung, 2015;Landa et al, 2013;Petinou, 2021;Schoen et al, 2011;Yoder et al, 2015), 11 (17%) examined speech rate or diadochokinetic rate (DDK; rapidly produced sequences of syllables) (Chenausky et al, 2019(Chenausky et al, , 2020(Chenausky et al, , 2021Deshmukh, 2012;Mahler, 2012;Mandelbaum et al, 2006;Nadig & Shaw, 2011;Patel et al, 2020;Shriberg et al, 2001Shriberg et al, , 2011Velleman et al, 2010), seven (11%) examined the consistency or stability of speech production (Chenausky et al, 2019(Chenausky et al, , 2020(Chenausky et al, , 2021Deshmukh, 2012;Gladfelter & Goffman, 2018;Mahler, 2012;Shriberg et al, 2011), six (9%) examined motor-related feeding/eating behaviors (Amato & Slavin, 1998;Brisson et al, 2012;McDaniel et al, 2018;Peterson et al, 2016Peterson et al, , 2019Yoder et al, 2015), five (8%) examined speech intelligibility (Gabig, 2008;Koegel et al, 1998;…”

The Many Facets of ASD in Children, Youth, and Young Adults

“…Evidence-based treatment options are sparse for youngsters with autism comorbid with atypical speech profiles and speech intelligibility issues. Petinou's article [8], "Promoting Speech Intelligibility in ASD through the Implementation of Phonologically Similar Stimuli," highlights the successful theoretically driven approach in treating speech sound disorders in a child with autism from a Greek-Cypriot linguistic milieu. This is an important contribution to treatment options for children with autism and atypical speech profiles.…”