Enhancing the communication development of toddlers with autism spectrum disorders

Following the child’s attentional focus has been highlighted in several intervention methods as critical to enhancing prelinguistic communication of children with autism, including the incidental teaching approach used by McGee et al. (1999) and described above, the relationship-based intervention of Mahoney and Morales (2003) described above, and the prelinguistic milieu teaching approach of Yoder and Warren (1998), which uses a variety of strategies to elicit nonverbal communication from and give contingent responses to toddlers in a natural preschool group setting. As noted above, Siller and Sigman (2002) found that parents’ ability to follow in on their child’s focus of attention and add contingent, undemanding language input was predictive of gains in language skills as the 1, 10, and 16 year follow-ups for children with ASD.
Although not specific to toddlers with ASD, research on intervening to help parents become more responsive to their children’s communication suggests that promoting such responsive interaction strategies in parents promotes the growth of social-communicative development in children (Girolametto, Verbey & Tannock, 1994; Kaiser et al., 1996; Tannock, Girolametto, & Siegel, 1992). Recent research by Yoder and Warren (2002), however, indicates that the effects of teaching caregivers to be more responsive is mediated by the initial child characteristics, and that this type of intervention model may be most successful in facilitating language development in toddlers who demonstrate low levels of initiating and requesting at the onset of the study. Interestingly, this profile of low levels of initiating and requesting is characteristic of most toddlers with ASD. In addition to talking about what the child is focusing on, some specific strategies for responsive interactions with preverbal children with disabilities, based on the work of Yoder and Warren are (1) linguistic mapping, or putting into words the child’s nonverbally expressed communicative intentions, (2) complying with the child’s communication intent, and (3) imitating the child’s prespeech vocalizations.
Following the attentional focus of a child with autism may be beneficial due to evidence that suggests that children with autism have difficulty following the directional gaze of others and therefore have the potential for increased linguistic mapping errors (Baron-Cohen & Baldwin, 1997). By following the child with autism’s lead, the child is more likely to correctly map linguistic input with the correct referent. In addition, following the lead of a child with autism increases the likelihood that the child is interested and motivated in a particular activity and thus more likely to benefit from accompanying linguistic input. Lack of motivation and internal rewards have been hypothesized as contributing to the difficulties observed in children with autism (Dawson et al., 2004).
Engaging in motivating, child-selected activities within the child’s current abilities has also been highlighted in the literature as beneficial to language and communication development. Prizant and colleagues (2000) suggest that activities should also fall within the child’s current range of developmental functioning. This notion is consistent with Vygotsky’s theory of a zone of proximal development. According to Vygotsky, children are able to demonstrate skill levels that they are unable to demonstrate independently with the support of an expert partner (Vygotsky, 1978). Vygotsky’s theory proposes that optimal learning occurs when input is provided within this zone of proximal development. Therefore, the caregivers’ ability to accurately estimate their child’s current abilities and provide scaffolding that is slightly above this current skill level is believed to facilitate language and literacy development.