Harold L Doherty, an autism advocate and parent of a child with autism, has commented on the limited amount of research conducted with kids with severe autism. Although this is an empirical question, and I have not seen data confirming this possible trend, Mr. Doherty is most likely right, in that it appears that children with severe autism are underrepresented in today’s published research. For example, while doing a less-than-scientific scan of the articles that I have covered during the past 3 months, it seems that most of them included kids with mild or high functioning autism. Thus, I decided to dedicate April to studies of low functioning autism.

The first study I want to review was done by Hsu-Min Chiang at Macquarie University in Australia. The author conducted a naturalistic observation of expressive communication among kids with severe autism. Specifically, the author was interested in examining what type of teacher instructions elicited the most expressive communication efforts in non-verbal children with autism.

The study included 32 children and adolescents with severe autism recruited in Taiwan and Australia (17 in Australia and 15 in Taiwan). These children were videotaped while participating in a variety of activities during a regular school day. The authors then observed the children’s communication behaviors in response to teacher prompts. Expressive behavior were considered expressive only when an action convayed information to a partner. Thus, responding to instructions or simple requests (write this down, sit, look up, etc) were not included as “expressive communication”. However, if the response to a request was deemed to be communicative (responding to the question “what do you want for lunch?”) then the response was coded as an expressive behavior.

The authors were very interested in “elicited” communication behaviors. That is, communication behaviors that were occasioned by the teacher. Three different teacher behaviors were observed for 2 hours:

“verbal prompt (e.g. question,direct instruction), modeling (i.e. demonstrating the correct response), and physical prompt (i.e. giving a body assistance)”

The results:

The children displayed an average of 20 elicited communication behaviors during the 2 hours (one communication event every 6 minutes). The author argues that this very low rate of expressive communication may be due to the limited number of prompts provided by the teachers. Specifically, the study showed that teachers provided a total of 709 instructions, or 1 instruction every 5.45 minutes per child, or 0.18 instructions per minute per child. The author indicates that this is severely below the recommended rate for teacher active instruction of 3.1 prompts per minute. The author states:

Further, it has been suggested that an appropriate rate of prompts is 3.5 prompts per minute during active instruction (Englert, 1983). Given that the rate of elicited expressive communication in the present study is much lower than the suggested rate of teacher prompt, it can be assumed that teachers of students with autism do not actively promote their students’ expressive communication.

The results also indicate that verbal prompts and a combination of verbal prompts and modeling were the most commonly used instruction. However, simple (non-combined) prompts were most effective in eliciting a communicative response with kids with the most severe autism. But most surprisingly, physical prompts did not seem to be as effective as verbal prompts, which may also explain why verbal prompts were use significantly more by these teachers.

In sum, the study has implications for the type of techniques that are effective in eliciting communicative responses in children with severe autism. In this study simple verbal prompts and modeling were the most effective strategy to elicit communicative responses in these children.

Chiang, H. (2009). Naturalistic observations of elicited expressive communication of children with autism: An analysis of teacher instructions Autism, 13 (2), 165-178 DOI: 10.1177/1362361308098513

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One Response to Expressive communication in children with severe autism

  1. hipso says:

    thank you for this post and the commitment to posting about low functioning autism this month. As a parent of 3 on the spectrum ranging in severity, I have also noticed the bias against “lower” functioning autism. One research said in her conference presentation, that it was just easier to work with “higher” functioning and more verbal participants. While I see her reasoning, it does perpetuate a cycle of ignorance and lack of information.

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