Articulation in early childhood autism

Differences in speech articulatory timing and associations with pragmatic language ability in autism

Background

Speech articulation difficulties have not traditionally been considered to be a feature of Autism Spectrum Disorder (ASD). In contrast, speech prosodic differences have been widely reported in ASD, and may even be expressed in subtle form among clinically unaffected first-degree relatives, representing the expression of underlying genetic liability. Some evidence has challenged this traditional dichotomy, suggesting that differences in speech articulatory mechanisms may be evident in ASD, and potentially related to perceived prosodic differences. Clinical measurement of articulatory skills has traditionally been phoneme-based, rather than by acoustic measurement of motor control. Subtle differences in articulatory/motor control, prosodic characteristics (acoustic), and pragmatic language ability (linguistic) may each be contributors to differences perceived by listeners, but the interrelationship is unclear. In this study, we examined the articulatory aspects of this relationship, in speech samples from individuals with ASD and their parents during narration.

Method

Using Speechmark® analysis, we examined articulatory landmarks, fine-grained representations of articulatory timing as series of laryngeal and vocal-tract gestures pertaining to prosodic elements crucial for conveying pragmatic information.

Results

Results revealed articulatory timing differences in individuals with ASD but not their parents, suggesting that although potentially not influenced by broader genetic liability to ASD, subtle articulatory differences may indeed be evident in ASD as the recent literature indicates. A follow-up path analysis detected associations between articulatory timing differences and prosody, and subsequently, pragmatic language ability.

Conclusion

Together, results suggest a complex relationship where subtle differences in articulatory timing may result in atypical acoustic signals, and serve as a distal mechanistic contributor to pragmatic language ability ASD.

Neural coding of formant-exaggerated speech and nonspeech in children with and without autism spectrum disorders

The presence of vowel exaggeration in infant-directed speech (IDS) may adapt to the age-appropriate demands in speech and language acquisition. Previous studies have provided behavioral evidence of atypical auditory processing towards IDS in children with autism spectrum disorders (ASD), while the underlying neurophysiological mechanisms remain unknown. This event-related potential (ERP) study investigated the neural coding of formant-exaggerated speech and nonspeech in 24 4- to 11-year-old children with ASD and 24 typically-developing (TD) peers. The EEG data were recorded using an alternating block design, in which each stimulus type (exaggerated/non-exaggerated sound) was presented with equal probability. ERP waveform analysis revealed an enhanced P1 for vowel formant exaggeration in the TD group but not in the ASD group. This speech-specific atypical processing in ASD was not found for the nonspeech stimuli which showed similar P1 enhancement in both ASD and TD groups. Moreover, the time-frequency analysis indicated that children with ASD showed differences in neural synchronization in the delta-theta bands for processing acoustic formant changes embedded in nonspeech. Collectively, the results add substantiating neurophysiological evidence (i.e., a lack of neural enhancement effect of vowel exaggeration) for atypical auditory processing of IDS in children with ASD, which may exert a negative effect on phonetic encoding and language learning. LAY SUMMARY: Atypical responses to motherese might act as a potential early marker of risk for children with ASD. This study investigated the neural responses to such socially relevant stimuli in the ASD brain, and the results suggested a lack of neural enhancement responding to the motherese even in individuals without intellectual disability.

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

OBJECTIVES

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. Participant and Methods: 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.

RESULTS

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.

CONCLUSIONS

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.

Development and evaluation of a 3-D virtual pronunciation tutor for children with autism spectrum disorders

The deficit in speech sound production in some children with autism spectrum disorder (ASD) adds to their communication barriers. The 3-D virtual environments have been implemented to improve their communication abilities. However, there were no previous studies on the use of a 3-D virtual pronunciation tutor designed specifically to train pronunciation for children with ASD. To fill this research gap, the current study developed and evaluated a 3-D virtual tutor which served as a multimodal and real-data-driven speech production tutor to present both places and manners of Mandarin articulation. Using an eye-tracking technique (RED 5 Eye Tracker), Experiment 1 objectively investigated children’s gauged attention distribution online while learning with our computer-assisted 3-D virtual tutor in comparison to a real human face (HF) tutor. Eye-tracking results indicated most participants showed more interests in the visual speech cues of the 3-D tutor, and paid some degree of absolute attention to the additional visual speech information of both articulatory movements and airflow changes. To further compare treatment outcomes, training performance was evaluated in Experiment 2 with the ASD learners divided into two groups, with one group learning from the HF tutor and the other from the 3-D tutor (HF group vs. 3-D group). Both groups showed improvement with the help of computer-based training in the post-intervention test based on the calculation of a 5-point Likert scale. However, the 3-D group showed much higher gains in producing Mandarin stop and affricate consonants, and apical vowels. We conclude that our 3-D virtual imitation intervention system provides an effective approach of audiovisual pronunciation training for children with ASD.

Acquisition of voice onset time in toddlers at high and low risk for autism spectrum disorder

Although language delay is common in autism spectrum disorder (ASD), research is equivocal on whether speech development is affected. We used acoustic methods to investigate the existence of sub-perceptual differences in the speech of toddlers who developed ASD. Development of the distinction between b and p was prospectively tracked in 22 toddlers at low risk for ASD (LRC), 22 at high risk for ASD without ASD (HRA-), and 11 at high risk for ASD who were diagnosed with ASD at 36 months (HRA+). Voice onset time (VOT), the main acoustic difference between b and p, was measured from spontaneously produced words at 18, 24, and 36 months. Number of words, number of tokens (instances) of syllable-initial b and p produced, error rates, language scores, and motor ability were also assessed. All groups' mean language scores were within the average range or slightly higher. No between-group differences were found in number of words, b's, p's, or errors produced; or in mean or standard deviation of VOT. Binary logistic regression showed that only diagnostic status, not language score, motor ability, number of words, number of b's and p's, or number of errors significantly predicted whether a toddler produced acoustically distinct b and p populations at 36 months. HRA+ toddlers were significantly less likely to produce acoustically distinct b's and p's at 36 months, which may indicate that the HRA+ group may be using different strategies to produce this distinction. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1269-1279. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Language Profiles in Children with Autism

The profile of language abilities in autism was examined by giving a number of standardized language assessments to a group of 1 20 children with autism. These assessments included measures of comprehension and of production of both vocabulary and grammar. Contrary to initial predictions, the group performed at a similar level across the range of tests, showing a relatively uniform profile of language attainment. In addition, there was no evidence of different language profiles in any diagnostic subgroup of children, such as children diagnosed as having Asperger syndrome. The theoretical implications of these findings, and their practical implications for research methodology, are discussed.

Research review: structural language in autistic spectrum disorder - characteristics and causes

BACKGROUND

Structural language anomalies or impairments in autistic spectrum disorder (ASD) are theoretically and practically important, although underrecognised as such. This review aims to highlight the ubiquitousness of structural language anomalies and impairments in ASD, and to stimulate investigation of their immediate causes and implications for intervention.

METHOD

Studies of structural language in ASD are reviewed (based on a search of the literature and selected as meeting defined inclusion criteria), and explanatory hypotheses are discussed.

RESULTS

Some individuals with ASD never acquire language. Amongst those who do, language abilities range from clinically normal (ALN) to various degrees of impairment (ALI). Developmental trajectories and individual profiles are diverse, and minority subgroups have been identified. Specifically: language is commonly but not always delayed and delayed early language is always characterised by impaired comprehension and odd utterances, and sometimes by deviant articulation and grammar. Nevertheless, by school age an 'ASD-typical' language profile emerges from group studies, with articulation and syntax least affected, and comprehension, semantics and certain facets of morphology most affected. Thus, even individuals with ALN have poor comprehension relative to expressive language; also semantic-processing anomalies and idiosyncratic word usage. It is argued that impaired socio-emotional-communicative relating, atypical sensory-perceptual processing, and uneven memory/learning abilities may underlie shared language anomalies across the spectrum; and that varying combinations of low nonverbal intelligence, semantic memory impairment and comorbidities including specific language impairment (SLI), hearing impairment, and certain medical syndromes underlie ALI and variation in individual profiles.

CONCLUSIONS

Structural language is universally affected in ASD, due to a complex of shared and unshared causal factors. There is an urgent need for more research especially into the characteristics and causes of clinically significant language impairments.

The hypothesis of apraxia of speech in children with autism spectrum disorder

In a sample of 46 children aged 4-7 years with Autism Spectrum Disorder (ASD) and intelligible speech, there was no statistical support for the hypothesis of concomitant Childhood Apraxia of Speech (CAS). Perceptual and acoustic measures of participants' speech, prosody, and voice were compared with data from 40 typically-developing children, 13 preschool children with Speech Delay, and 15 participants aged 5-49 years with CAS in neurogenetic disorders. Speech Delay and Speech Errors, respectively, were modestly and substantially more prevalent in participants with ASD than reported population estimates. Double dissociations in speech, prosody, and voice impairments in ASD were interpreted as consistent with a speech attunement framework, rather than with the motor speech impairments that define CAS.

An Investigation of Language Impairment in Autism: Implications for Genetic Subgroups

Autism involves primary impairments in both language and communication, yet in recent years the main focus of research has been on the communicative deficits that define the population. The study reported in this paper investigated language functioning in a group of 89 children diagnosed with autism using the ADI-R, and meeting DSM-IV criteria. The children, who were between 4- and 14- years-old were administered a battery of standardized language tests tapping phonological, lexical, and higher-order language abilities. The main findings were that among the children with autism there was significant heterogeneity in their language skills, although across all the children, articulation skills were spared. Different subgroups of children with autism were identified on the basis on their performance on the language measures. Some children with autism have normal language skills; for other children, their language skills are significantly below age expectations. The profile of performance across the standardized measures for the language-impaired children with autism was similar to the profile that defines the disorder specific language impairment (or SLI). The implications of this language impaired subgroup in autism for understanding the genetics and definition of both autism and SLI are discussed.

Phonetic and phonological errors in children with high functioning autism and Asperger syndrome

This study involved a qualitative analysis of speech errors in children with autism spectrum disorders (ASDs). Participants were 69 children aged 5-13 years; 30 had high functioning autism and 39 had Asperger syndrome. On a standardized test of articulation, the minority (12%) of participants presented with standard scores below the normal range, indicating a speech delay/disorder. Although all the other children had standard scores within the normal range, a sizeable proportion (33% of those with normal standard scores) presented with a small number of errors. Overall 41% of the group produced at least some speech errors. The speech of children with ASD was characterized by mainly developmental phonological processes (gliding, cluster reduction and final consonant deletion most frequently), but non-developmental error types (such as phoneme specific nasal emission and initial consonant deletion) were found both in children identified as performing below the normal range in the standardized speech test and in those who performed within the normal range. Non-developmental distortions occurred relatively frequently in the children with ASD and previous studies of adolescents and adults with ASDs shows similar errors, suggesting that they do not resolve over time. Whether or not speech disorders are related specifically to ASD, their presence adds an additional communication and social barrier and should be diagnosed and treated as early as possible in individual children.

A longitudinal study of language acquisition in autistic and Down syndrome children

Findings from a longitudinal study of language acquisition in a group of autistic children are presented. Six autistic subjects and six children with Down syndrome, matched on age and MLU at the start of the study, were followed over a period of between 12 and 26 months. Language samples were collected in the children's homes while they interacted with their mothers. Samples of 100 spontaneous child utterances from the transcripts were analyzed using the following measures: MLU, Index of Productive Syntax, lexical diversity, and form class distribution. The results indicate that the majority of these autistic children followed the same general developmental path as the Down syndrome children in this study, and normal children reported in the literature, in the acquisition of grammatical and lexical aspects of language, and confirm previous findings suggesting that autism does not involve a fundamental impairment in formal aspects of language.

Infantile autism: a syndrome of multiple primary deficits?

Attempts to explain infantile autism in terms of just one underlying neurological or psychological deficit may be misguided. As in the case of many neurological syndromes, autism may involve multiple functional deficits due to multiple coexistent neurological deficits. Comparison with Asperger's syndrome and the developmental dysphasias suggests that the autistic syndrome results from the coexistence of at least two distinct constellations of functional impairments: deficits in mechanical language skills, as in the developmental dysphasias; and deficits in social relatedness, play, and nonverbal communication, as in Asperger's syndrome. Possible neurological underpinnings are considered, including the relative contribution of the two cerebral hemispheres. Implications for etiology and research are discussed.

Autism and Piaget's theory: are the two compatible?

Autism is interpreted in Piagetian terms with particular reference to the question of whether the atypical cognitive development represents an exception to the similar sequence hypothesis. Findings from relevant research applying Piaget's theory to mental retardation, psychosis, and autism are reviewed. The apparent exceptions to the hypothesis presented in autistic individuals are explained by Piaget's two-factor theory of figurative versus operative functions. Many autistic individuals show an arrest in operative functions at the sensorimotor level while continuing to progress in figurative functions. The early arrest interferes with subsequent development of higher-level conceptual, symbolic, and social skills. Questions for research are offered.

Childhood autism: deficits of communication and symbolic development. I. Distinctions from language disorders

The present paper reviews, outlines, and explores the literature concerned with the speech-language disorder of childhood autism. The problems of communication of the autistic child are compared and contrasted with those of children with a variety of other language disorders (e.g. receptive developmental dysphasia). Based upon the review of normal preverbal communicatory and symbolic development, it is concluded that childhood autism involves a pervasive language disorder encompassing communication in general, as well as certain symbolic-representational abilities necessary for language. An overview of the attempts to teach speech to autistic children in then undertaken with special emphasis on the possible implications of developmental knowledge for these training pursuits. Finally, the role of neurologic substrates in the language and communication disorder of autism is presented.

Objectively defined linguistic parameters in children with autism and other developmental disabilities

The language of children with autism and other developmental disabilities was examined systematically according to a set of objectively defined linguistic parameters. These criteria were drawn from clinical observations reported in the literature and from developmental norms of language acquisition. Data analysis identified sets of parameters that were correlated with psychiatrists' clinical diagnoses but failed to isolate individual parameters (such as echolalia or noncommunicativeness) that have been suggested to be pathonomic.