The persistence of fad interventions in the face of negative scientific evidence: Facilitated communication for autism as a case example
Evidence-based Communication Assessment and Intervention, Apr 3, 2014
Abstract Communication disorder and mental health professionals may assume that once novel clinic... more Abstract Communication disorder and mental health professionals may assume that once novel clinical techniques have been refuted by research, they will be promptly abandoned. Using facilitated communication (FC) for autism as a recent case example, we provide evidence to the contrary. Although FC was scientifically discredited by the mid-to-late 1990s, data we review demonstrate that it is still frequently administered in clinical and educational settings. We examine evidence for FC’s (a) continued use as an intervention for autism, (b) persistence in academic and institutional settings, (c) popularity in online and print sources, (d) promotion in the media, and (e) ongoing risk to caregivers accused of sexual abuse. We analyze the sources of these troubling developments, explore their ethical implications, and offer recommendations for addressing the spread of FC and other fad interventions.
Miniature Linguistic Systems for Individuals With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis
Journal of Speech Language and Hearing Research, May 9, 2023
Purpose: Miniature linguistic systems (also known as matrix training) is a method of organizing l... more Purpose: Miniature linguistic systems (also known as matrix training) is a method of organizing learning targets to achieve generative learning or recombinative generalization. This systematic review is aimed at determining whether matrix training is effective for individuals with autism spectrum disorder (ASD) in terms of improving recombinative generalization for instruction-following, expressive language, play skills, and literacy skills. Method: A systematic review methodology was employed to limit bias in the various review stages. A multifaceted search was conducted. Potential primary studies were imported into Covidence, a systematic review software, and inclusion criteria were applied. Data were extracted regarding (a) participant characteristics, (b) matrix designs, (c) intervention methods, and (d) dependent variable. A quality appraisal using the What Works Clearinghouse (WWC) Single-Case Design Standards (Version 1.0, Pilot) was carried out. In addition to the visual analysis of the data, an effect size estimate, non-overlap of all pairs (NAP), was generated for each participant. Independent t tests and between-subjects analyses of variance were conducted to identify moderators of effectiveness. Results: Twenty-six studies including 65 participants met criteria for inclusion. All included studies were single-case experimental designs. Eighteen studies received a rating of Meets Standards Without Reservations or Meets Standards With Reservations . The aggregated combined NAP scores for acquisition, recombinative generalization, and maintenance of a range of outcomes were in the high range. Conclusions: Findings suggested that matrix training is an effective teaching method for individuals with ASD for acquisition, recombinative generalization, and maintenance of a range of outcomes. Statistical analyses to identify moderators of effectiveness were insignificant. Based on the WWC Single-Case Design Standards matrix training meets criteria to be considered an evidence-based practice for individuals with ASD.
Augmentative and alternative communication (AAC) is an area of research and clinical specializati... more Augmentative and alternative communication (AAC) is an area of research and clinical specialization within the broader field of speech-language pathology. The American Speech-Language Hearing Association (ASHA) described AAC as the effort "to study and when necessary compensate for temporary or permanent impairments, activity limitations, and participation restrictions of persons with severe disorders of speechlanguage production and/or comprehension, including spoken and written modes of communication" (ASHA 2005 1). noted that AAC should be described as "a system with four primary components: symbols, aids, strategies, and techniques." (4). Thus AAC not only refers to several various types of non-speech modes or systems of communication, but also to a range of strategies and intervention techniques for enabling effective communication with AAC symbols and aids.
Advances in neurodevelopmental disorders, Nov 4, 2017
Everyday, consumer-level technologies such as mobile technologies may lend themselves to be repur... more Everyday, consumer-level technologies such as mobile technologies may lend themselves to be repurposed for special needs of the populations. In this three-part study, we aimed to investigate whether the Amazon Echo™, a popular personal assistant general consumer product, can function as a speaker-independent device that permits the hands-free retrieval of visual supports for children with autism. Phase 1 investigated whether the Echo's speaker-independent speech recognition system, linked to a proprietary Amazon BSkill,ĉ ould retrieve visual supports in order to facilitate direction following (e.g., Bput the girl under the bowl^). The accuracy with which the Echo retrieved and delivered visual supports to the iPad was found to be low, suggesting that the Echo cannot function as a speaker-independent speech recognition system. Subsequently, we customized the vocabulary that was delivered to the Echo with the relevant vocabulary and repeated the protocol in phase 2. A significant increase in accuracy was noted. Finally, in phase 3, the experimenter asked the Echo to retrieve visual supports in the presence of a child with autism while monitoring correct implementation of directives based on successful retrieval by the Echo. Results will be discussed in terms of implications for future research.
The Evaluation of Children with an Autism Spectrum Disorder: Adaptations to Accommodate a Telepractice Model of Clinical Care
Perspectives on telepractice, Sep 1, 2014
Telepractice is increasingly applied to assessment and intervention for persons with autism spect... more Telepractice is increasingly applied to assessment and intervention for persons with autism spectrum disorders (ASD), and the use of telepractice for delivering augmentative and alternative communication (AAC) services is expanding. To date, no studies have focused on the assessment of communication in children with ASD who are minimally verbal. This case exploration represents a first attempt to apply the clinical assessment approach (also known as Visual Immersion System) developed in the Autism Language Program in the Center for Communication Enhancement (CCE) at Boston Children's Hospital (BCH) through a telepractice service delivery model. In this paper we detail an on-site evaluation, and then describe the application of the various evaluation components to telepractice delivery. Our findings provide preliminary evidence that communication assessment information can be successfully obtained for this population via telepractice. The results demonstrated that the telepractice evaluation took greater time to complete than the on-site evaluation, likely due to both technical and cultural factors. Further study is warranted particularly in the delivery of family instruction materials prior to the evaluation and to quality assurance measures.
Dysarthric speakers' intelligibility and speech characteristics in relation to computer speech recognition
Augmentative and Alternative Communication, 1995
... Linda J. Ferrier, Howard C. Shane, Holly F. Ballard, Tyler Carpenter, and Anne Benoit Departm... more ... Linda J. Ferrier, Howard C. Shane, Holly F. Ballard, Tyler Carpenter, and Anne Benoit Department of Speech-Language Pathology and Audiology ... Sentence intelligibility and word intelligi-bility as judged in a transcription format were both lower, with means of 51.40% and 43.4 ...
Perspectives on Augmentative and Alternative Communication, Apr 1, 2011
Abstract The speed with which apps for the iOS platform have become available has caused many cli... more Abstract The speed with which apps for the iOS platform have become available has caused many clinicians, educators, and potential consumers of AAC to search for a “quick fix.” While this platform may indeed be a good match to the strengths and needs of some individuals, it is not a match to the communication needs of many with complex communication needs. This paper highlights the need to use the clinical feature matching process when considering all options for AAC. Apps are poised to have a dramatic impact in a wide range of fields, from education to health care to retail and financial services…[Apps] represent something large and important: the advent of a mobile technology paradigm that may just be as significant as the birth of the web…[Apps] are just the beginning of a social and technological transformation that will have major implications for years to come. (Gravitytank, 2009).
Delivery of Augmentative Communication Services
Language Speech and Hearing Services in Schools, Oct 1, 1981
Computer-Based Commmunication Aids for the Nonspeaking Child with Cerebral Palsy
Seminars in Speech and Language, Feb 1, 1987
Use of a Visual Graphic Language System to Support Communication for Persons on the Autism Spectrum
Perspectives on Augmentative and Alternative Communication, Dec 1, 2009
This paper addresses use of visual graphic language to promote learning and communication for ind... more This paper addresses use of visual graphic language to promote learning and communication for individuals on the autism spectrum via a comprehensive framework. Specifically, visuals are used expressively (Visual Expressive Mode), receptively (Visual Instructional Mode), and to provide organization and structure (Visual Organizational Mode). Seven key communicative functions are defined and discussed, including protesting and refusal, organization and transitions, requests, directives, comments, questions, and social pragmatics. The nature of visual supports for each communicative function is described in detail.
Access to AAC: Present, past, and future
Augmentative and Alternative Communication, 2007
Historically, access in augmentative and alternative communication (AAC) has been conceptualized ... more Historically, access in augmentative and alternative communication (AAC) has been conceptualized as the physical operation of AAC technologies; more recently, research and development in the cognitive and social sciences has helped to broaden the concept to include a range of human factors involved in the successful use of AAC technologies in social interactions. The goal of this article is to expand the current understanding of communication access by providing a conceptual framework for examining AAC access, evaluating recent scientific and technical advances in the areas of AAC, and discussing the challenges to accessing AAC technologies for a range of communication activities.
Visual language in autism
Communication Boards: Help for the Child Unable to Talk
Exceptional Parent, 1978
Communication Enhancement: Principles and Practices
Apraxia of speech is a neurogenic articulatory disorder characterized by impaired ability to prog... more Apraxia of speech is a neurogenic articulatory disorder characterized by impaired ability to program the successive articulatory events necessary for motor speech production. Apraxia occurs despite the absence of weakness, paralysis, incoordination, or altered tone of the speech musculature. The articulatory error patterns of individuals with apraxia of speech have been documented by several researchers (Shankweiler and Harris, 1966; Johns and Darley, 1970; Trost and Canter, 1974). How these errors vary as a function of some systematic manipulation, however, has been studied less extensively (Johns and Darley, 1970; Larimore, 1970; Deal and Darley, 1972). Several observers have suggested that rhythmic stimulation may facilitate the articulation of apraxic subjects. Rosenbek, Hansen, Baughman and Lemme (197 4) have observed that rhythmic speech production during singing facilities articulatory precision with apraxic children. They recommended "the systematic use of rhythm" (p. 16) as a therapeutic procedure. Singing might be considered analogous to what Barber (1940) classified as a speech rhythm (rhythmic patterns generated by the act of speaking). Yoss and Darley (1974), reporting clinical observations during treatment of a group of apraxic children, noted improvement in consonant production during periods of activity that Barber (1940) considered bodily rhythm-"clapping, swinging the arms, body English, and even whole body movement" (p. 29) seemed to improve articulatory performance. The effects of rhythmic stimulation on the performance of adult apraxic speakers are discussed by Schuell, Jenkins and Jimenez-Pab6n (1964). They report that "strong rhythmic drill on consonants and consonant blends" (p. 210) is the best strategy for improving the phonemic accuracy of patients who evidence the speech characteristics considered by the current authors to be apraxia of speech. In brief, subjective impressions of several experienced clinicians indicate that rhythmic stimulation (provided by bodily or speech rhythm) improves the articulatory performance of apraxic speakers. Because the observed improvement occurs under different conditions of patterned activity, the essential element effecting these articulatory changes may be the underlying rhythm. To date no study has systematically investigated whether an externally imposed rhythmic pattern can improve apraxic articulation. The purpose of this study was to determine the effects of different rates of imposed auditory rhythmic stimulation on the articulatory accuracy of individuals who have apraxia of speech.
Facilitated communication : the clinical and social phenomenon
Electronic Screen Media for Persons with Autism Spectrum Disorders: Results of a Survey
Journal of Autism and Developmental Disorders, Feb 22, 2008
Social and anecdotal reports suggest a predilection for visual media among individuals on the aut... more Social and anecdotal reports suggest a predilection for visual media among individuals on the autism spectrum, yet no formal investigation has explored the extent of that use. Using a distributed questionnaire design, parents and caregivers report on time allotted toward media, including observable behaviors and communicative responses. More time was spent engaged with electronic screen media (ESM) than any other leisure activity. Television and movie viewing was more popular than computer usage. Across media platforms, animated programs were more highly preferred. Prevalent verbal and physical imitation was reported to occur during and following exposure to ESM. Clinical implications to strategically incorporate ESM into learning approaches for children with autism spectrum disorders (ASD) are provided.
Autism Spectrum Disorder, AAC, and the Feature-Matching Process
Routledge eBooks, Jan 26, 2023
Using AAC Principles to Guide Language Instruction for Autistic Individuals
Uploads
Papers by Howard Shane