Social communication intervention effects vary by dependent variable type in preschoolers with autism spectrum disorders

Abstract

Individuals with autism spectrum disorders (ASDs) have difficulty communicating in ways that are primarily for initiating and maintaining social relatedness (i.e., social communication). We hypothesized that the way researchers measured social communication would affect whether treatment effects were found. Using a best evidence review method, we found that treatments were shown to improve social communication outcomes approximately 54% of the time. The probability that a treatment affected social communication varied greatly depending on whether social communication was directly targeted (63%) or not (39%). Finally, the probability that a treatment affected social communication also varied greatly depending on whether social communication as measured in (a) contexts very similar to treatment sessions (82%) or (b) contexts that differed from treatment on at least setting, materials, and communication partner (33%). This paper also provides several methodological contributions.

Value-Added Predictors of Expressive and Receptive Language Growth in Initially Nonverbal Preschoolers with Autism Spectrum Disorders

“…For both of these potential treatment targets, we have replicated evidence that intervention can affect generalized outcomes in dyads with children with ASD (Kasari et al 2006; Mahoney and Perales 2005; Siller et al 2013). For intentional communication, there is evidence that treatments can facilitate highly generalized use of intentional communication in initially nonverbal or minimally verbal children with ASD, even for the most socially-motivated pragmatic functions (Ingersoll and Wainer 2013; Yoder et al 2014). For early receptive language, there is replicated evidence that treatments can influence highly generalized changes in children with ASD (Dawson et al 2010; Fava et al 2011).…”

How to Study the Influence of Intensity of Treatment on Generalized Skill and Knowledge Acquisition in Students with Disabilities

“…In other words, we expect that whether or not boosts in treatment intensity will translate to better outcomes will often depend on child profiles (Warren et al, 2007). We have, in fact, observed conditional or “moderated” effects of treatment intensity for some highly generalized outcomes in a recent randomized controlled trial of an early communication intervention in young children with intellectual disabilities (Fey, Yoder, Warren, & Bredin-Oja, 2013; Yoder, Woynaroski, Fey, & Warren, 2014). Therefore, finding that more intensive treatment is better for a specific subgroup of students cannot be taken as evidence that more is better for all students.…”

“…By “optimal” effects, we specifically mean those effects on student skill and knowledge that are demonstrated across settings, activities, persons, materials, and interaction contexts. We have previously referred to these effects as highly generalized (Yoder, Bottema-Beutel, Woynaroski, and Sandbank, 2014). Educators universally hope to achieve these types of effects in their students, versus effects that do not generalize outside of intervention.…”

“…Educators universally hope to achieve these types of effects in their students, versus effects that do not generalize outside of intervention. We have previously referred to these effects, which we suspect may be dependent upon the features of the treatment context based on the way that they were measured in the study, as possibly context-bound (Yoder, et al, 2014). …”

“…In contrast, when there is not functional independence between conditions or when dependent variables readily reverse when the treatment is withdrawn, the change is potentially context-bound. More information about the important distinction between context-bound behavior change and highly generalized skill acquisition can be found in Yoder, Bottema-Beutel, Woynaroski, and Sandbank (2014).…”