Auditory-Motor Mapping Training: Comparing the Effects of a Novel Speech Treatment to a Control Treatment for Minimally Verbal Children with Autism

Karen Chenausky, Andrea Norton, Helen Tager-Flusberg, Gottfried Schlaug, Karen Chenausky, Andrea Norton, Helen Tager-Flusberg, Gottfried Schlaug

Abstract

This study compared Auditory-Motor Mapping Training (AMMT), an intonation-based treatment for facilitating spoken language in minimally verbal children with autism spectrum disorder (ASD), to a matched control treatment, Speech Repetition Therapy (SRT). 23 minimally verbal children with ASD (20 male, mean age 6;5) received at least 25 sessions of AMMT. Seven (all male) were matched on age and verbal ability to seven participants (five male) who received SRT. Outcome measures were Percent Syllables Approximated, Percent Consonants Correct (of 86), and Percent Vowels Correct (of 61) produced on two sets of 15 bisyllabic stimuli. All subjects were assessed on these measures several times at baseline and after 10, 15, 20, and 25 sessions. The post-25 session assessment timepoint, common to all participants, was compared to Best Baseline performance. Overall, after 25 sessions, AMMT participants increased by 19.4% Syllables Approximated, 13.8% Consonants Correct, and19.1% Vowels Correct, compared to Best Baseline. In the matched AMMT-SRT group, after 25 sessions, AMMT participants produced 29.0% more Syllables Approximated (SRT 3.6%);17.9% more Consonants Correct (SRT 0.5); and 17.6% more Vowels Correct (SRT 0.8%). Chi-square tests showed that significantly more AMMT than SRT participants in both the overall and matched groups improved significantly in number of Syllables Approximated per stimulus and number of Consonants Correct per stimulus. Pre-treatment ability to imitate phonemes, but not chronological age or baseline performance on outcome measures, was significantly correlated with amount of improvement after 25 sessions. Intonation-based therapy may offer a promising new interventional approach for teaching spoken language to minimally verbal children with ASD.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Percent Syllables Approximated By Time…
Fig 1. Percent Syllables Approximated By Time and Stimulus Type (AMMT Group).
Lighter lines represent 95% confidence intervals.
Fig 2. Percent Consonants Correct by Time…
Fig 2. Percent Consonants Correct by Time and Stimulus Type (AMMT Group).
Lighter lines represent 95% confidence intervals.
Fig 3. Percent Vowels Correct by Time…
Fig 3. Percent Vowels Correct by Time and Stimulus Type (AMMT Group).
Lighter lines represent 95% confidence intervals.
Fig 4. Percent Syllables Approximated by Time…
Fig 4. Percent Syllables Approximated by Time and Treatment (Matched Group).
Lighter lines represent 95% confidence intervals.
Fig 5. Percent Consonants Correct By Time…
Fig 5. Percent Consonants Correct By Time and Treatment (Matched Group).
Lighter lines represent 95% confidence intervals.
Fig 6. Percent Vowels Correct by Time…
Fig 6. Percent Vowels Correct by Time and Treatment (Matched Group).
Lighter lines represent 95% confidence intervals.
Fig 7. Change Score in Percent Syllables…
Fig 7. Change Score in Percent Syllables Approximated vs Baseline Change Score.

References

    1. American Psychiatric Association & American Psychiatric Association. Task Force on DSM-5. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 2013. Washington, DC: American Psychiatric Association.
    1. Tager-Flusberg H, Paul R, Lord C. Language and communication in autism In: Volkmar F, Paul R, Klin A, Cohen D, editors. Handbook of autism and pervasive developmental disorder 3. Vol. 1 New York: Wiley; 2005. pp 335–364.
    1. Kasari C, Brady N, Lord C, Tager-Flusberg H. Assessing the minimally verbal school-aged child with autism spectrum disorder. Autism Research 2013: 6(6): 479–493. 10.1002/aur.1334
    1. Tager-Flusberg H, Kasari C. Minimally verbal school-aged children with autism spectrum disorder: the neglected end of the spectrum. Autism Research 2013; 6(6): 468–478. 10.1002/aur.1329
    1. Venter A, Lord C, Schopler E. A follow-up study of high-functioning autistic children. Journal of Child Psychology and Psychiatry 1992; 33: 489–507.
    1. Howlin P, Mawhood L, Rutter M. Autism and developmental receptive language disorder–a follow-up comparison in early adult life. II: social, behavioural, and psychiatric outcomes. Journal of Child Psychology and Psychiatry 2000; 41: 561–578.
    1. Dominick K, Davis N, Lainhart J, Tager-Flusberg H, Folstein S. Atypical behaviors in children with autism and children with a history of language impairment. Research in Developmental Disabilities 2007; 28: 145–162. 10.1016/j.ridd.2006.02.003
    1. Matson J, Boisjoli J, Mahan S. The relation of communication and challenging behaviors in infants and toddlers with autism spectrum disorders. Journal of Developmental and Physical Disabilities 2009; 21: 253–261.
    1. Wolf M, Risley T, Mees H. Application of operant conditioning procedures to the behaviour problems of an autistic child. Behaviour Research and Therapy 1963; 1: 305–312.
    1. Lovaas O. Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology 1987; 55(1): 3–9.
    1. Ross D, Greer R. Generalized imitation and the mand: Inducing first instances of speech in young children with autism. Research in Developmental Disabilities 2003; 24: 58–74.
    1. Koegel R, O’Dell M, Koegel L. A natural language teaching paradigm for nonverbal autistic children. Journal of Autism and Developmental Disorders 1987; 17(2): 187–200.
    1. Paul Campbell, Gilbert K, Tsiouri I. Comparing spoken language treatments for minimally verbal preschoolers with autism spectrum disorders. Journal of Autism and Developmental Disorders 2013; 43: 418–431. 10.1007/s10803-012-1583-z
    1. Rogers S, Hayden D, Hepburn S, Charlifue-Smith R, Hall T., Hayes A. Teaching young nonverbal children with autism useful speech: A pilot study of the Denver Model and PROMPT interventions. Journal of Autism and Developmental Disorders 2006; 36: 1007–1024. 10.1007/s10803-006-0142-x
    1. Prizant BM, Wetherby AM, Rydell P. Communication intervention issues for children with autism spectrum disorders In: Wetherby AM, Prizant BM, editors. Autism spectrum disorders: A transactional developmental perspective. Baltimore: Brookes Publishing Co.; 2000. pp. 193–224.
    1. Paul R. Interventions to improve communication in autism. Child and Adolescent Psychiatric Clinics of North America 2008; 17: 835–856. 10.1016/j.chc.2008.06.011
    1. Mullen E. Mullen Scales of Early Learning. Circle Pines, MN: American Guidance Service, Inc.; 1995.
    1. Fenson L., Marchman V. A., Thal D. J., Dale P. S., Reznick J. S., Bates E. MacArthur-Bates Communicative Development Inventories: User's guide and technical manual (2nd ed.). Baltimore, MD: Brookes; 2007.
    1. Koegel RL, Koegel LK, Carter CM. Pivotal teaching interactions for children with autism. School Psychology Review 1999; 28; 576–594.
    1. Yoder P, Stone W. Randomized comparison of two communication interventions for preschoolers with autism spectrum disorders. Journal of Consulting and Clinical Psychology 2006; 74(3): 426–435. 10.1037/0022-006X.74.3.426
    1. Wan C, Bazen L, Baars R, Libenson A, Zipse L, Zuk J, et al. Auditory-motor mapping training as an intervention to facilitate speech output in non-verbal children with autism: A proof of concept study. PLoS ONE 2011; 6(9): e25505 10.1371/journal.pone.0025505
    1. Meister I, Boroojerdi B, Foltys H, Sparing R, Huber W, Topper R. Motor cortex hand area and speech: implications for the development of language. Neuropsychologia 2003; 41: 401–406.
    1. Ozdemir E, Norton A, Schlaug G. Shared and distinct neural correlates of singing and speaking. Neuroimage 2006; 33: 628–635. 10.1016/j.neuroimage.2006.07.013
    1. Lahav A, Saltzman E, Schlaug G. Action representation of sound: audiomotor recognition network while listening to newly acquired actions. Journal of Neuroscience 2007; 27: 308–314. 10.1523/JNEUROSCI.4822-06.2007
    1. Binkofski F, Buccino G. Motor functions of the Broca’s region. Brain and Language 2004; 89(2): 362–369. 10.1016/S0093-934X(03)00358-4
    1. Iverson JM, Fagan MK . Infant vocal-motor coordination: precursor to the gesture-speech system? Child Dev. 2004;75(4):1053–66. 10.1111/j.1467-8624.2004.00725.x
    1. Iverson JM, Wozniak RH. Variation in Vocal-Motor Development in Infant Siblings of Children with Autism. J Autism Dev Disord. 2007; 37(1): 158–170. 10.1007/s10803-006-0339-z
    1. Gernsbacher M, Sauer E, Geye H, Schweigert E, Goldsmith H. Infant and toddler oral- and manual-motor skills predict later speech fluency in autism. Journal of Child Psychology and Psychiatry 2008: 49(1): 43–50. 10.1111/j.1469-7610.2007.01820.x
    1. Leonard H, Bedford R, Pickles A, Hill E. Predicting the rate of language development from early motor skills in at-risk infants who develop autism spectrum disorder. Research in Autism Spectrum Disorders 2015; 13–14: 15–24.
    1. Miller S, Toca J. Adapted melodic intonation therapy—Case-study of an experimental language program for an autistic child. Journal of Clinical Psychiatry 1979; 40: 201–203.
    1. Hoelzley P. Communication potentiating sounds: developing channels of communication with autistic children through psychobiological responses to novel sound stimuli. Canadian Journal of Music Therapy 1993; 1: 54–76.
    1. Heaton P, Williams K, Cummins O, Happé F. Beyond perception: Musical representation and on-line processing in autism. Journal of Autism and Developmental Disorders 2007; 37, 1355–1360. 10.1007/s10803-006-0283-y
    1. Norton A, Zipse L, Marchina S, Schlaug G. Melodic intonation therapy: how it is done and why it might work. Annals of the New York Academy of Science 2009; 1169: 431–436.
    1. Wan C, Schlaug G. Neural pathways for language in autism: the potential for music-based treatments. Future Neurology 2010; 5: 797–805.
    1. Kaufman N. The Kaufman Speech Praxis Test for Children. Detroit, MI: Wayne State University Press; 1995.
    1. Schopler E, Reichler R, Rochen Renner B . The Childhood Autism Rating Scale. Los Angeles, CA: Western Psychological Services; 1988.
    1. Lord C, Rutter M, DiLavore P, Risi S. Autism Diagnostic Observation Schedule. Los Angeles, CA: Western Psychological Services; 1999.
    1. Shriberg L. Four new speech and prosody-voice measures for genetics research and other studies in developmental phonological disorders. Journal of Speech and Hearing Research 1993; 36: 105–140.
    1. Heaton P, Allen R, Williams K, Cummins O, Happé F. Do social and cognitive deficits curtail musical understanding? Evidence from autism and Down syndrome. British Journal of Developmental Psychology 2008; 26: 171–182.
    1. Feinstein A, Cicchetti D. High agreement but low kappa: I. the problems of two paradoxes. Journal of Clinical Epidemiology 1990; 43(6): 543–549.
    1. Davis B, MacNeilage P. The articulatory basis of babbling. Journal of Speech and Hearing Research 1995; 38: 1199–1211.
    1. Wetherby A, Prizant B. (2002) Communication and Symbolic Behavior Scales Developmental Profile. Baltimore, Brookes Publishing Co.
    1. Shriberg L, Kwiatkowski J. Phonological disorders III: A procedure for assessing severity of involvement. Journal of Speech and Hearing Disorders 1982; 47: 242–256.
    1. Wing L. Autistic Children. London: Constable Publishers; 1985.
    1. Hairston M. Analyses of responses of mentally retarded autistic and mentally retarded nonautistic children to art therapy and music therapy. Journal of Music Therapy 1990; 27: 137–150.
    1. Trevarthen C, Aitken K, Paoudi D, Robarts J. Children with Autism. London: Jessica Kingsley Publishers; 1996.
    1. Sahin N, Pinker S, Cash S, Schomer D, Halgren E. Sequential processing of lexical, grammatical, and phonological information within Broca’s area. Science, 2009; 326, 445–449. 10.1126/science.1174481
    1. Rauschecker JP, Tian B. Mechanisms and streams for processing of “what” and “where” in auditory cortex. Proceedings of the National Academy of Science 2000; 97: 11800–11806.
    1. Rauschecker JP, Scott S. Maps and streams in the auditory cortex: nonhuman primates illuminate human speech processing. Nature Neuroscience 2009; 12: 718–724. 10.1038/nn.2331
    1. Fritz J, Poeppel D, Trainor L, Schlaug G, Patel A, Peretz I, et al. The Neurobiology of Language, Speech, and Music In: Lupp J. editor. Strüngmann Forum Reports, vol. 10 Cambridge, MA: MIT Press; 2013. pp 417–459.
    1. Fletcher P, Whitaker R, Tao R, DuBray M, Froelich A, Ravichandran C, et al. Microstructural connectivity of the arcuate fasciculus in adolescents with high functioning autism. Neuroimage 2010; 51: 1117–1125. 10.1016/j.neuroimage.2010.01.083
    1. Wan CY, Marchina S, Norton A, Schlaug G. Atypical hemispheric asymmetry in the arcuate fasciculus of completely nonverbal children with autism. Annals of the New York Academy of Science 2012; 1252: 332–337.
    1. Catani M, Dell’Acqua F, Budisavljevic S, Howells H, Thiebaut de Schotten M, Froudist-Walsh S, et al. Frontal networks in adults with autism spectrum disorder. Brain 2016; 139: 616–630. 10.1093/brain/awv351
    1. Herbert M, Harris G, Adrien K, Zeigler D, Makris N, Kennedy DN, et al. Abnormal asymmetry in language association cortex in autism. Annals of Neurology 2002; 52: 588–596. 10.1002/ana.10349
    1. DeFosse L, Hodge S, Makris N, Kennedy DN, Caviness VS, McGrath L et al. Language-association cortex asymmetry in autism and specific language impairment. Annals of Neurology 2004; 56: 757–766. 10.1002/ana.20275
    1. Tager-Flusberg H, Lindgren K, Mody M. Structural and functional imaging research on language disorders: Specific language impairment and autism spectrum disorders In Wolf L, Schreiber H, Wasserstein J, editors. Adult learning disorders: Contemporary issues. New York: Psychology Press; 2008. pp. 127–157.
    1. Kleinhans N, Muller R-A, Cohen D, Courchesne E. Atypical functional lateralization of language in autism spectrum disorders. Brain Research 2008; 1221: 115–125. 10.1016/j.brainres.2008.04.080
    1. Knaus T, Silver A, Kennedy M, Lindgren K, Dominick K, Siegel J, Tager-Flusberg H. Language laterality in autism spectrum disorder and typical controls: A functional, volumetric, and diffusion tensor MRI study. Brain and Language 2010; 112: 113–120. 10.1016/j.bandl.2009.11.005
    1. Floris D, Lai M, Auer T, Lombardo M, Ecker C, Chakrabarti B, et al. Atypically rightward cerebral asymmetry in male adults with autism stratifies individuals with and without language delay. Human Brain Mapping 2016; 37: 230–253. 10.1002/hbm.23023
    1. Lo Y-C, Soong W-T, Gau S, Wu Y-Y, Lai M-C, Yeh F-C, et al. The loss of asymmetry and reduced interhemispheric connectivity in adolescents with autism: A study using diffusion spectrum imaging tractography. Psychiatry Research Neuroimaging 2011; 192: 60–66. 10.1016/j.pscychresns.2010.09.008
    1. Tokimura H, Tokimura Y, Oliviero A, Asakura T, Rothwell J. Speech-induced changes in corticospinal excitability. Annals of Neurology 1996; 40(4): 628–634. 10.1002/ana.410400413
    1. Gentilucci M, Benuzzi F, Bertolani L, Daprati E, Gangitano, M. Language and motor control. Experimental Brain Research 2000; 133(4): 468–490.
    1. Uozumi T, Tamagawa A, Hashimoto T, Tsuji S. Motor hand representation in cortical area 44. Neurology 2004; 62(5): 757–761.
    1. Newmeyer A J, Grether S, Grasha C, White J, Akers R, Aylward C, et al. Fine motor function and oral-motor imitation skills in preschool-age children with speech-sound disorders. Clinical Pediatrics 2007; 46(7): 604–611. 10.1177/0009922807299545
    1. Square P. Treatment of developmental apraxia of speech: Tactile-kinesthetic, rhythmic, and gestural approaches In: Caruso A, Strand E, editors. Clinical Management of Motor Speech Disorders in Children. New York: Thieme Medical Publishers, Inc; 1999. pp 149–186.
    1. Caruso A, Strand E. Motor speech disorders in children: Definitions, background, and a theoretical framework In: Caruso A, Strand E, editors. Clinical Management of Motor Speech Disorders in Children. New York: Thieme Medical Publishers, Inc; 1999. pp 1–28.
    1. Saporta A, Kumar A, Govindan R, Sundaram S, Chugani H. (2011) Arcuate fasciculus and speech in congenital bilateral perisylvian syndrome. Pediatric Neurology 44: 270–274. 10.1016/j.pediatrneurol.2010.11.006
    1. Paldino M, Hedges K, Golriz F. (2015) The arcuate fasciculus and language development in a cohort of pediatric patients with malformations of cortical development. American Journal of Neuroradiology 37: 169–175. 10.3174/ajnr.A4461
    1. Marchina S, Zhu LL, Norton A, Zipse L, Wan CY, Schlaug G. (2011) Impairment of speech production predicted by lesion load of the left arcuate fasciculus. Stroke 42: 2251–2256. 10.1161/STROKEAHA.110.606103
    1. Yeatman J, Dougherty R, Rykhlevskaia E, Sherbondy A, Deutsch G, Wandell B, et al. (2012) Anatomical properties of the arcuate fasciculus predict phonological and reading skills in children. Journal of Cognitive Neuroscience 23: 3304–3317.
    1. Shriberg L, Kwiatkowski J, Gruber F. Developmental Phonological Disorders II: Short-Term Speech-Sound Normalization. Journal of Speech and Hearing Research 1994; 37: 1127–1150.
    1. Rvachew S, Brosseau-Lapré F. (2012) Developmental Phonological Disorders: Foundations of Clinical Practice. San Diego, CA: Plural Publishing.

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