The Efficacy of Joint Attention Interventions on Play Skills in Children with Autism Spectrum Disorder: A Systematic Review
Flinn Esselstyn, Emilie Hall, and Alexandra Winkel
Purpose:The aim of this study is to determine if joint attention interventions have an effect on general play skills in individuals with Autism Spectrum Disorder (ASD) aged birth to five years.
Method: The reviewers examined various databases and selected research based on predetermined inclusion/exclusion criteria. This included peer-reviewed research articles that assessed children with a formal diagnosis of ASD between the ages of birth to five years, examined joint attention interventions, included outcome measures related to play, and were published after the year 2000. The articles reviewed consisted of 581 participants. Research designs included primarily pre-post randomized clinical trials, one single subject multiple baseline design, and one case study design.
Results: The collective results suggest that joint attention interventions may be effective in increasing play skills in children with ASD. While some studies report no change to either functional or symbolic play skills, other studies report improvements in only one type. No study reports a decrease in play skills.
Conclusion: While there is evidence that joint attention interventions may improve play skills in children with ASD, overall, the results of this systematic review are inconclusive. Future research will help to clarify if joint attention interventions have a measurable impact on either symbolic or functional play skill development.
Erin Fifield, Morgan Bailey, and Lauren Burningham
Access to skilled speech and language intervention can be difficult for individuals residing in rural areas as well as for individuals with complex health and mobility issues. Telehealth (including therapy and rehabilitation) can provide effective services in the context of one’s home, allowing clinicians to reach a wider population of individuals.
Purpose: To determine whether tele-practice service delivery produces positive expressive language outcomes that are comparable to direct service delivery for adults with aphasia.
Method: A variety of databases were searched utilizing systematic inclusionary and exclusionary criteria. Research focused on adults over the age of 18 with a formal diagnosis of aphasia who engaged in telehealth intervention. Various research designs were identified and analyzed. Identified articles included a total of 235 participants.
Results: The identified studies supported the implementation of tele-practice as a means of providing individuals with aphasia access to services that produce positive expressive language outcomes. Several studies indicated that tele-practice produces similar outcomes when compared to traditional direct therapy. Several studies also included qualitative data regarding patient satisfaction and quality of life, much of which produced positive outcomes.
Conclusion: The chosen studies were found to largely support the inclusion of tele-practice as an effective option for producing positive expressive language outcomes for individuals with aphasia. Potential limitations include variability in treatment times and programs, assessment tools used, clinical training of individuals providing treatment, small sample sizes, and variable patient characteristics. Future research should focus on implementing research designs using larger numbers of individuals to increase generalizability.
Systematic Review: Comparative Efficacy of the Picture Exchange Communication System (PECS) to Other Augmentative Communication Systems in Increasing Social Communication Skills in Children with Autism Spectrum Disorder
Brittany Mahoney, Alyssa Johnson, Maggie McCarthy, and Cameron White
Purpose: This systematic review aims to compare the efficacy of the Picture Exchange Communication System (PECS) to other forms of Augmentative and Alternative Communication (AAC) in increasing social communication skills in children with Autism Spectrum Disorder (ASD).
Methods: A systematic review of the literature on PECS and other forms of AAC written between 2007 and 2018 was conducted. Studies were selected based on the established inclusionary and exclusionary criteria. The inclusionary criteria incorporated subjects with a formal diagnosis of ASD under the age of 18. Exclusionary criteria included individuals with severe sensory, motor, and/or other medical conditions that may have affected their use of PECS. 25 articles of varying study designs were critically appraised for validity and reliability to minimize bias.
Results: Results suggest that both PECS and other forms of AAC are conducive to improving social communication in children (<18>years) with ASD. Advancements in conversation initiation, requesting behaviors and joint attention were noted, resulting in a global increase in communication interactions. However, studies demonstrated mixed results with specific consideration of rate of acquisition, modality preference, and overall effectiveness of the system.
Conclusion: Synthesis of results from the 25 studies suggest that both PECS and other AAC systems show favorable outcomes for encouraging social-communicative behavior. The clinical implications of these results suggest the implementation of an AAC system may be client dependent. Single design designs were included in this review due to the lack of research in the areas of ASD and AAC. Further research of this comparison should be conducted on larger populations of children with ASD to improve clinical decision making to target social communication and increase generalizability.
Examining the Effects of AAC Intervention on Oral Language in Children with Autism Spectrum Disorders: A Systematic Review
Alexandra F G Patch, Emily V. Mortner, and Alison R. Joseph
This systematic review researched the efficacy of augmentative and alternative communication (AAC) in increasing oral communication in children with Autism Spectrum Disorder (ASD). It may be used to inform best practice when working with children with ASD. The search strategy reviewed medical, social science, and communication databases. Inclusionary criteria consisted of peer-reviewed, quantitative research published after 2007 regarding children with ASD under age 18. The included studies used AAC interventions and measured spoken language outcomes. After conducting an initial database search with these criteria, a manual search was performed using references from the found articles. Results varied across studies. Although the trend demonstrates increases in verbal language with AAC intervention, few studies show statistically significant outcomes. The studies indicate that additional factors, such as verbal communication at baseline, may affect outcomes. AAC use did not decrease verbal language. Limitations included few randomized control trial designs, few study replications, and varied outcome measures. Based on the studies analyzed, implementation of AAC may increase the number of communicative acts, but may not reliably increase verbal language. Further research is needed to understand the most effective implementation of AAC intervention to increase verbal language. Higher quality research in the form of randomized control trials, and the replication of studies to confirm results is necessary to inform evidence-based practice. The findings are consistent with those of previous systematic reviews and meta analyses. Future considerations should include type of AAC, communicative act being measured, longitudinal studies, and increased use of formal measures.
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