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Speech and language therapy in autism spectrum disorder

Children with pragmatic language impairment (PLI) or social communication disorder (SCD) can show mild social impairments associated with high-functioning autism or autism spectrum disorder (ASD). There lacks robust evidence of the effectiveness of speech-language interventions that target their language, pragmatic, or social communication needs.

A study at the University of Manchester (Adams C, et al., Int J Lang Commun Disord. 2012 May-Jun;47(3):233-44. doi: 10.1111/j.1460-6984.2011.00146.x) has evaluated intensive manualized social communication intervention (SCIP) for these children.

In this single-blind, randomly-controlled trial, 88 children with pragmatic and social communication needs aged 5;11-10;8, recruited from UK speech and language therapy services, were assigned in a 2:1 ratio to SCIP or to treatment as usual. Children in the SCIP condition received up to 20 sessions of direct intervention from a specialist research speech and language therapist working with supervised assistants. A primary outcome measure of structural language and secondary outcome measures of narrative, parent-reported pragmatic functioning and social communication, blind-rated perceptions of conversational competence and teacher-reported ratings of classroom learning skills were taken pre-intervention, immediately post-intervention and at 6-month follow-up. Analysis was by intention to treat.

No significant treatment effect was found for the primary outcome measure of structural language ability or for a measure of narrative ability. But significant treatment effects were found for blind-rated perceptions of conversational competence, for parent-reported measures of pragmatic functioning and social communication, and for teacher-reported ratings of classroom learning skills.

Thus there is some evidence of an intervention effect on blind and parent/teacher-reported communication outcomes, if not standardized language assessment outcomes, for 6-11-year-old children with pragmatic and social communication needs. The substantial overlap between the presence of PLI and ASD (75%) across the whole cohort suggests that the intervention may also be applicable to some verbally able children with ASD who have pragmatic communication needs.

MyoNews from BreatheWorksTM is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure or prevention of any disease or syndrome.

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