Input and language development in children with autism.

Input and Language Development in Children with Autism

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Letitia R. Naigles, Ph.D.1

ABSTRACT

The social deficits associated with autism spectrum disorders (ASD) have been implicated in the language delays and deficits of children with ASD. Consequently, the extent to which children with ASD utilize their language-related interactions and input in the same ways as typically developing children is only just beginning to be investigated. The current article summarizes the role of input for typically developing children learning language, and then reviews in some detail recent studies demonstrating influential effects of maternal responsivity (e.g., following in on children’s focus of attention) and aspects of maternal speech (e.g., word frequency, word diversity, structural complexity) on the language production and comprehension of young children with ASD. Maternal responsivity appears to play a particularly influential role with children who are minimally verbal whereas the content and structure of maternal speech facilitate language in children who are already verbal. KEYWORDS: Language, maternal effects, autism

Learning Outcomes: As a result of this activity, the reader will be able to (1) evaluate whether a child with an autism spectrum disorder is minimally verbal versus already verbal; (2) determine whether a child with an autism spectrum disorder should receive more responsive versus more linguistically complex input;(3) discuss strategies with caregivers for providing more responsive versus more complex input to their children.

L

anguage impairment is a clinical feature of the diagnosis of autism spectrum disorders (ASD) in children. Children with ASD are usually delayed in the onset of their language develop-

ment and frequently demonstrate impairments of specific subcomponents of language.1–3 These impairments are likely attributable, at least in part, to the well-attested difficulties with social

1 Department of Psychology, University of Connecticut, Storrs, Connecticut. Address for correspondence: Letitia R. Naigles, Ph.D., 406 Babbidge Road U-20, Department of Psychology, University of Connecticut, Storrs, CT 06269-1020 (e-mail: [email protected]). Child Language Input and Interaction: Key Concepts for the Speech-Language Pathologist; Guest Editor, Meredith L. Rowe, Ed.D.

Semin Speech Lang 2013;34:237–248. Copyright # 2013 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 584-4662. DOI: http://dx.doi.org/10.1055/s-0033-1353446. ISSN 0734-0478.

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SEMINARS IN SPEECH AND LANGUAGE/VOLUME 34, NUMBER 4

attention and interaction of children with ASD; if children do not pay attention to the people in their environment, they are unlikely to pay attention to the language those people are using, and so will not profit from the language data those people are providing. Intervention thus frequently focuses on directing children with ASD toward attention to language input—that of their therapists—and progress in language development is often seen once children begin such therapy.4,5 However, it is very likely that children showing the most language gains will be those who also begin to learn language incidentally, that is, from listening to regular social discourse.6 The current article summarizes recent research demonstrating that children with ASD are able to learn language from social discourse, more specifically from maternal input, and explores the extent to which input features found to be influential for typically developing (TD) children are also utilized by children with ASD. HOW DO TD CHILDREN LEARN FROM MATERNAL LANGUAGE? For TD children, language input plays a role whenever they are in the presence of a speaking adult. TD children use adult speech as a dataset of information about how the adult language works. Virtually all TD children are exposed to natural language in some form; however, mothers/caregivers vary in how talkative they are, how often they ask their children questions compared with making declarative statements, their usage of nouns compared with verbs, sentence length, and so on. It is this variability in maternal input that has allowed researchers to examine which aspects of maternal input are most influential in facilitating the development of children’s language. In the most conclusive studies, variables in the input at a baseline point are regressed against children’s language at a later time, with controls included for potentially confounding factors. Numerous studies have illuminated how the lexical, grammatical, and pragmatic aspects of adult speech impact a TD child’s subsequent language acquisition.7 For example, in the lexical domain, the relative frequency of different words in maternal speech predicts the order in which those words are acquired by their

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children8: More frequent words in parents’ speech (especially those referring to objects) are produced earlier by their children. Moreover, the diversity of lexical input (number of word types), as well as its syntactic complexity (i.e., mean length of utterance [MLU]) are also positive predictors of children’s subsequent vocabulary size.9,10 Thus, children who hear more different words within longer sentences are likely to have bigger vocabularies. In the grammatical domain, effects of frequency are less direct. For example, hearing more auxiliary verbs in parents’ speech does not appear to promote children’s acquisition of auxiliaries; however, mothers who used more yes or no questions, which highlight auxiliary verbs both prosodically and syntactically (e.g., “Do you want more juice?”), had children who subsequently used more auxiliary verbs (e.g., do, can).11,12 Moreover, mothers who expanded on their children’s utterances more frequently (e.g., child: “More juice”; mother: “Yes, you want more orange juice”) had children whose noun phrases were more complex,12 and children who hear discourse contrasting the I/you pronouns more frequently acquire these pronouns earlier.13 Finally, hearing more complex sentences has been shown to facilitate children’s production and comprehension of long and complex sentences.14,15 Thus, a plethora of evidence demonstrates that TD children use their input to learn specific facts about their language, and that semantically richer and syntactically more complex input facilitates acquisition. One of the abilities that enables TD children to learn from their caregivers’ input is the ability to attend to both the language and the surroundings more or less simultaneously.9,16 This ability is often operationalized as joint attention; that is, engagement in sustained attention with another individual concerning an object or event.17 Children who engage in joint attention have the opportunity to observe the objects and events that the accompanying linguistic utterances are (presumably) describing, and so map the objects’ names onto the nouns in the utterances, and the events onto the verbs and verb phrases.18,19 The temporal contiguity of the child’s attention on specific objects and events, and the linguistic description,


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facilitates the formulation of mappings between the two. TD toddlers who engage in more and/or longer bouts of joint attention with their mothers have been shown to have larger vocabularies 6 to 12 months later.20 Moreover, because joint attention is fragile in children younger than 18 months,18,19 researchers have also investigated the extent to which mothers might do more of the work in creating and sustaining joint attention bouts, by following in or supporting the child’s focus of attention. That is, rather than require children to shift their attention to what the mother is looking at (respond to joint attention [RJA]) or provide the attention cues (points, gaze shifts from object to mother) to indicate an initiation of a joint attention episode (IJA), mothers could look at what the child is attending to, and talk about that. Mothers who exhibit such responsivity tend to have children who demonstrate earlier onset of their first word and earlier achievement of their first 50 words,21,22 and more advanced grammatical usage as well.23 INPUT EFFECTS FOR CHILDREN WITH ASD: MATERNAL RESPONSIVITY An important element of the impairment in autism is the diminished degree to which children with ASD engage in monitoring of the attention of other people in relation to their surroundings; they exhibit joint attention abilities well below their chronological age level.18,24,25 These documented difficulties with both RJA and IJA have led researchers to investigate effects of parental responsivity in this population as well.26 Several recent studies have demonstrated that mothers who engage in this strategy more, or for longer periods of time, have children with ASD who display higher language scores 1 to 3 years later. For example, Adamson and colleagues recorded mother–child play sessions over the course of a year with children with ASD who were 30 months of age at the study onset.27 Joint engagements during the sessions were coded for whether they were supported (i.e., mother attending to child’s activity but child not acknowledging mother’s attention) or

coordinated (child acknowledging mother’s attention), and whether they were symbol infused (i.e., child shows comprehension of mother’s words or gestures) or not (child shows no obvious comprehension of mother’s words or gestures). At the end of the year, the children were administered standardized expressive and receptive vocabulary tests. Controlling for the children’s initial vocabulary levels, Adamson et al found that the children who had engaged in more supported symbol-infused engagements had higher scores on the language tests. Similarly, Siller and Sigman coded parent– child play sessions for parent synchronicity with their child’s attention and activity, including talking about what the child was pointing to and acting on.28 Standardized tests were used to assess the children’s language at time 1, when they had “language ages” under 36 months, and also used to assess their gains over the ensuing 3 years. The percent of time in which parents engaged in synchronous interactions was found to contribute unique variance to the children’s subsequent language gains, over and above nonverbal mental age and the children’s joint attention abilities. McDuffie and Yoder compared different types of parental responsivity on their children’s vocabulary increases over the course of 6 months.6 At time 1, the children averaged 40 months of age and were minimally verbal, producing fewer than 10 nonimitative spoken words across several public communication sampling contexts, and fewer than 50 words on a vocabulary checklist.29 Within engagement episodes during play sessions, parents’ follow-in utterances were coded as comments (wherein something about the focus of attention is described) or directives (requests for action). Following children’s overt communicative acts, parents’ utterances were also coded as linguistic mappings, repeats, or expansions. Significant predictors of the children’s vocabulary production at time 2 included parental follow-in comments and directives, as well as parental expansions. Haebig, McDuffie, and Ellis Weismer further distinguished directives for action (e.g., “Push the pig”) from directives for language (e.g., “What does the pig say?”) in parents’ play interactions with 40 children

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MATERNAL INPUT AND AUTISM/NAIGLES


with ASD averaging 2.5 years.30,31 At time 1, approximately half of the children were minimally verbal whereas the other half were verbally fluent, producing on average over 100 words on a vocabulary checklist. At time 2 (12 months later) and time 3 (36 months later), the children were administered a standardized language assessment. Predictors of language at times 2 and 3 included directives for language for the overall group, and follow-in comments for the minimally verbal subgroup only. Parental responsiveness to children’s communicative acts was not a significant predictor of when child language at time 1 was controlled, indicating that initial level of language exerted a stronger influence than parental expansions, repeats, or linguistic mappings. Perryman and colleagues recorded the parent–child play sessions of 26-month-old toddlers who were at high risk for ASD (most of whom received an ASD diagnosis by 30 months).32 At 21 months, their age-equivalent language levels had averaged 7 to 8 months. Play sessions were coded for parental follow-in comments; children’s ability to initiate and respond to joint attention bids was assessed separately. Significant correlates of the children’s Mullen receptive language scores at 30 months included their RJA levels and parental follow-in comments; however, when both were included in a regression model, only parental follow-in commenting accounted for significant variance. Finally, Rollins and Snow tracked the morphosyntactic growth of six boys with ASD, whose MLUs at time 1 varied from 1.2 to 3.74, and who were observed regularly for between 15 and 26 months.23 Maternal speech was assessed during three 20-minute play samples, and coded for talkativeness and for communicative acts. Mothers who engaged in more communicative acts that followed the child’s attention had children whose growth curves for spoken grammatical complexity increased more steeply over the time period studied. In sum, parent’s comments that follow in on their child’s focus of attention, and describe or elicit language presumably matching the children’s thoughts, show significant facilitative effects on the subsequent language of children with ASD. Most of the children in these studies

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were minimally verbal at the point when the maternal input was measured; thus, it is unknown how important such follow-in responding remains for children with ASD who are already verbal or become verbal. Moreover, none of the above studies investigated more content-oriented aspects of the parental input; that is, what exactly the parents were saying when they were following in on and/or being responsive to their child’s focus of attention. Do children with ASD show sensitivity to maternal word frequency, for example? Moreover, as described above, TD children’s language development is facilitated by hearing more complex input, including a more diverse set of words and more complex sentence structures. Do children with ASD show similar facilitative effects? Or might their language delay, social attention difficulties, and/or working memory deficits yield influences only of simpler types of input?18 INPUT EFFECTS FOR CHILDREN WITH ASD: MATERNAL SPEECH My research group has conducted several longitudinal studies addressing these questions. We have investigated whether children with ASD whose mothers use more (or fewer) word types, utterance types, and/or sentence types subsequently show different rates or levels of language use. Studies from two different cohorts of children are discussed here. With cohort 1, which includes 10 children with ASD (and 12 TD controls), we investigated relationships between several maternal speech measures, both lexical and grammatical, and subsequent child language measures that included both spontaneous speech and standardized tests.33–36 With cohort 2, which includes 15 children with ASD (and 18 TD controls), we have investigated relationships between maternal use of wh questions and subsequent child production and comprehension of wh questions.37–39 The children with ASD in both cohorts lived in the Northeastern United States, were receiving between 5 and 30 hours of applied behavior analysis (ABA) therapy a week,4 and had been diagnosed with autism or pervasive developmental disorder not otherwise specified by clinicians; at the beginning of the study, the


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diagnoses were confirmed via the Autism Diagnostic Observation Schedule.40 Table 1 presents relevant information above the language levels of the children in each cohort. Children were visited at home every 4 months for 4 to 6 visits; at each visit, interactions between the children and their mothers were video and audio recorded. For cohort 1 dyads at visits 1 through 4, these interactions lasted 15 minutes and consisted entirely of free play. At visit 5, the interactions were recorded for 30 minutes, with 15 minutes of free play and 15 minutes of more structured tasks that included book reading, pretend play, and “an activity that will best elicit speech for their child.” Cohort 2 dyads engaged in a 30minute play session at each visit. Half of the session was semistructured and the other half of the session was free play. Both parent and child speech was transcribed at each visit; the specific linguistic elements coded for are described below.

Table 1 Visit

Overall Analysis Strategy Our purpose was to search for evidence of the influence of maternal language on subsequent child language. Therefore, pairwise correlations were first performed between maternal speech at the early visits (1 through 3, depending on the cohort) and child speech or comprehension at the later visits (3 through 6, again depending on the cohort). These were followed by partial correlations or regressions to address concerns that the obtained relationships could be attributed to the general factors of maternal input complexity and child language level. For both cohorts, we controlled for child language at the same visit that the input data were collected, because it is likely that (1) parental language at a given visit is influenced by child language at that same visit, and (2) children with better language at earlier visits will have better language at later visits. For cohort 1 analyses, we also controlled for parental language at the outcome visits, again because of the likelihood that child

Participant Information Chronological Age (months)

CDI

Mullen RL

Scales EL

MLU

Word-Spontaneous Types

Speech Tokens

2.01

40.70

162.80

(.80)

(35.02)

(147.11)

2.21 (.80)

44.00 (24.55)

176.60 (112.23)

Cohort 1

(n¼10)

1

33

94.9†

25.0

26.7

(2.96) 308.00‡

(6.07)

(6.88)

3

(4.06) 42 (4.36)

(197.23)

4

47 (4.21)

385.11‡ (223.00)

5§

74

39.25

36.88

2.76

83.36

370.25

(17.91)

(16.45)

(1.23)

(68.46)

(278.25)

Cohort 2

(8.34) (n¼15)

1.95

88.46

361.73

(1.13)

(80.39)

(384.00)

1.97 (1.40)

92.6 (85.05)

380.06 (372.18)

38.4 (15.12)

33.10 (9.59)

1

32.86

106.7†

39.53

34.73

(112.89) 303.29‡

(18.84)

(14.95)

3

(3.61) 41.06 (3.77)

(233.98)

5 6

49.59 (4.33) 53.89

35.8

33.4

2.09

111.73

420.33

(4.68)

(19.67)

(16.67)

(1.12)

(94.24)

(378.29)

CDI, communicative development inventory; EL, expressive language subscale; MLU, mean length of utterance; RL, receptive language subscale. Mullen Scales of Early Learning Standard Scores. † CDI Infant version. ‡ CDI Toddler version. § n ¼ 8.

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language at a given visit is influenced by/may be primed by parent language at that same visit. Finally, we controlled for maternal IQ (collected at visit 5), because parents with higher IQs are likely to have children with higher IQs, and IQ is itself correlated with language skills.18 For cohort 2 analyses, our goal was to ascertain the extent to which maternal input specifically related to wh-questions predicted their children’s later production or comprehension of whquestions. Because previous research has demonstrated that mothers with more complex speech overall have TD children with better language abilities overall,9,14,41 we controlled for mothers’ MLU at the same visit as their input measures.

Cohort 1: Which Aspects of Maternal Speech Predict Subsequent Child Language? Maternal speech at visits 2 and 3 provided the input measures for this cohort; correlations were performed with child language at visits 3 through 5. The lexical and grammatical measures coded for are listed in Table 2. Children’s scores on the communicative development inventory (CDI) at visits 3 through 4, and on the Table 2

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Mullen at visits 4 through 5 were also included as dependent variables. Because of the small sample size of this cohort, partial correlations were conducted as opposed to regressions. Furthermore, correlations were considered significant at a p value of less than 0.01, and marginally significant at a p value of less than 0.05. Only relationships of moderate to high confidence, indicated by scatterplots and leverage calculations,42 are reported. Maternal noun frequency at visit 2 was found to correlate positively with children’s word types at visit 3, and with their CDI scores at visit 4. Thus, mothers who used more nouns at early visits had children who subsequently produced a more diverse vocabulary. Moreover, maternal yes-or-no question frequency at visit 3 was found to correlate positively with child auxiliary use at visit 4. Thus, mothers who used more yes-or-no questions had children who subsequently used more auxiliary verbs. The number of maternal expansions at visit 3 was positively related to children’s receptive language scores at visit 536; thus, mothers who expanded their child’s utterances more at early visits had children who subsequently performed better on standardized language tests.

Linguistic Elements Coded in Maternal and Child Speech

Coded Element

Description

Cohort 1 Word types, noun types

No. of different word types and noun types

Auxiliary verbs Determiners

No. of auxiliary verbs: do, can, could, will, should, shall No. of determiners used: the, a, that

Past tense

No. of uses of past tense: I went there

Plurals Yes-or-no questions

No. of plurals: books No. of yes-or-no questions: “Are you hungry?”

Expansions

Language elements added to previous utterance: “I throw”; mom: “You are throwing it”; mothers only

Cohort 2 Wh word types

Number of different wh words: What's in there? Where did it go?

Auxiliaries Subject questions

Tokens: What do you have? Which one would you like?) Who ___ chases a toy mouse? Who___’s gonna live in the castle?

Object questions

What does he have ___? What are they drinking ___?

Where questions Predicate nominatives

Where did it go? Where’s the washcloth? What is this? What’s that one? Who is that little bear?

Content verbs

Noncopular: Which one do you like? Who didn’t clean up?

Different verbs

Types: Who eats grass? What do you want? What do we say?


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These findings replicate those from the literature of TD children,9,11,12 suggesting that the language acquisition processes previously found in TD children may also be observed in children with ASD. For example, the finding that children with ASD hearing more nouns later produced more words suggests sensitivity to sheer frequency of occurrence in the language development of children with ASD.43,44 Moreover, the observation that children with ASD hearing more yes-or-no questions subsequently produced more auxiliaries suggests an ability to segment speech preferentially on the basis of initial position in the utterance. And the finding that maternal expansions are advantageous for grammatical as well as lexical development extends McDuffie and Yoder’s findings and suggests that children with ASD may be able to use these sentences as models of the adult grammar, gathering information about specific elements and their desired uses.6

Cohort 2: Do Features of Maternal Speech Predict Children’s Comprehension and Production of Wh Questions? Maternal speech at visits 1 and 2 provided the input measures for this cohort; correlations were performed with child wh question production at visits 3 and 4, and with child wh question comprehension at visits 3 through 6. The relevant features of maternal and child speech are listed in Table 2. Outcome: Wh- Question Production at Visits 3 and 4 The different aspects of maternal wh-question use might themselves be intercorrelated, and children’s overall language levels are expected to be related to their wh-question production; therefore, for these hierarchical regressions we first entered the children’s vocabulary scores, followed by the set of maternal wh-question features at visits 1 or 2. Indeed, children’s number of wh-questions, and number of different wh words produced at visit 3 were both significantly correlated with their concurrent vocabulary scores. Con-

trolling for vocabulary, children’s number of different wh words produced at visit 4 was predicted by their mothers’ use of different wh words at visit 1. Moreover, children’s number of different wh words at visit 3, and number of wh questions at visit 4, were predicted by their mothers’ use of wh-questions with a variety of different verbs at visit 2. Thus, we observed two kinds of effects. Mothers who produced more different wh words had children who did the same; this is a finding similar to the word frequency effects for cohort 1. Children with ASD who hear a wider range of wh words subsequently produce a wider range of wh words. The second finding suggests that children with ASD benefit from complex rather than simple input: hearing whquestions with a larger variety of verbs, rather than just one or two, enables them to use more wh-questions, themselves. Outcome: Wh-Question Comprehension at Visits 3 through 6 The outcomes of child wh-question comprehension were derived from their eye movement scores while viewing the wh-question intermodal preferential looking video (see Table 3). This video assessed wh-question comprehension by comparing children’s looking preferences when they heard subject and object whquestions (“What hit the flower?”; “What did the apple hit?”; see rows 4 and 8 in Table 3) with their preferences for the same pictures when they heard where questions (“Where is the apple/flower?”; see row 9 in Table 3) or baseline statements (“They are on both screens”; see row 1 in Table 3). During baseline, children should show no preferences; when they heard “Where is the apple?” they should look longer at the screen showing the apple; and when they heard “What did the apple hit?” they should look relatively more at the screen showing the flower. Although TD children show reliable wh-question comprehension as a group by visits 3 and 4, the children with ASD showed less consistency overall, and no group comprehension until visit 6. For the purpose of investigations of effects of maternal input, the absence of consistent group wh-question comprehension exhibited by the ASD group was an asset, because this indicated

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Table 3

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Abbreviated Layout of the Wh Question IPL Video

Trial Type

Audio

Video 1

Video 2

1

Control

They’re on both screens!

Apple

Flower

2

Familiarization

Look at this!

Apple hits flower

Black

3 4

Familiarization Test

See this? What did the apple hit __?

Black Apple

Apple hits flower Flower

5 6

Control Familiarization

They’re on both screens! See this?

Apple Apple hits flower

Flower Black

7

Familiarization

Look at this!

Black

Apple hits flower

8

Test†

What __ hit the flower? (Block repeats with keys/book)

Apple

Flower

9

Where

Where is the flower?

Apple

Flower

(Block repeats with keys/book)

(Block repeats with flower/keys/book)‡ IPL, intermodal preferential looking. Object wh questions ¼ What did the apple hit? What did the keys hit? † Subject wh questions ¼ What hit the flower? What hit the book? ‡ Where is the apple? Where is the flower? Where are the keys?; Where is the book?

considerable variability in the children’s levels of wh-question understanding. The question we addressed was, to what extent is this variability in child wh-question understanding (at each of visits 3 through 6) predicted by earlier variability in maternal wh-question production? In a series of stepwise regressions, mothers’ MLU at visit 1 (i.e., the same visit at which the predictor variables were obtained) and children’s number of word types from the same visit as the comprehension scores were entered in the first step of the hierarchical regression. In the ensuing steps, all input measures that had yielded significant pairwise correlations were entered into the regression one at a time (i.e., one variable per step), to allow us to determine if each variable accounted for a significant amount of additional variance. The most interesting finding, across all regressions, was that the significant maternal speech predictors of child wh-question comprehension were all negative. For example, the number of where questions and predicate nominative questions produced by mothers at visit 1 were each negatively related to children’s whquestion comprehension scores at visits 3 and 4, respectively. Thus, mothers who asked more of each of these types of questions at visit 1 had children with lower wh-question comprehension scores at visits 3 and 4. Similar negative

effects were observed with maternal speech at visit 2 as the predictor: The number of auxiliary verb tokens, wh-questions with content verbs, and subject wh-questions produced by mothers at visit 2 was each negatively related to children’s wh-question comprehension visits 3 and 5. At first glance, these relationships appear quite puzzling, and one might almost say, random. Possibly, they emerged as significant just because of our relatively small sample size, or might even suggest that children with ASD are not yet really learning from their input. However, we have several reasons to believe that these relationships are, in fact, both real and sensible, revealing key aspects in the ability of children with ASD to learn from their maternal input. First, many of these same negative relationships were also observed with our TD sample; thus, they are not simply a property of input–outcome comparisons with children with ASD. Second, hearing an overabundance of predicate nominative wh-questions and where questions may indeed mask the fact that wh movement is involved in whquestions (i.e., that the wh word stands for a missing noun phrase (NP) later in the sentence). This masking may occur in a couple of (nonexclusive) ways. For example, predicate nominatives, especially in the current corpus, were quite homogeneous in form (i.e., what


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þ [be] þ pronoun), which makes them rather amenable to rote memorization. That is, “What’s that?,” “What’s in there?,” and “Where’s the bear?” do not necessarily need to be parsed correctly before a child can begin using these questions and understanding their intent. The more such rote questions recur, the more they may be treated by children as unanalyzed routines. Thus, predicate nominatives may not encourage internal analysis of whquestion structure. Moreover, in predicate nominatives, the wh word does not actually stand for a referent that is missing in the utterance. Instead, in questions such as “What is that?” and “Who is the little bear?” the wh word serves as a cue to name or further specify whatever item is indicated later in the sentence. Thus, hearing a large number of questions such as “What’s that?” might lead a child to an (initial) incorrect assumption about the grammar of wh-questions, namely that wh words are simply cues to name the item in question. And children who do not understand the requisite wh-movement might then have difficulties comprehending subject and object wh-questions, especially in our time-dependent task. To explore the negative relationships involving maternal wh-question usage at visit 2, we scrutinized the input of the mothers whose children performed at the higher and lower ends of comprehension at visits 3 and 5. What we found was that children who performed more poorly had mothers who repeated specific wh-questions a lot. That is, children who performed more poorly at visit 3 had mothers who produced primarily (over 80% of instances) repetitions of “What do you want?” or “What do you see/think/say?” Children who performed more poorly at visit 5 had mothers who seemed similarly repetitive with their subject wh-questions, asking multiple times “What happened?” or “Who drinks the bottle?” or “And who eats the [noun]?” In contrast, children who performed at higher levels at visit 3 heard a wider variety of auxiliaries (e.g., “Who’s going to go first?”; “What are you making?”; “What do you wanna put?”; “What else can we do here?”). And children who performed at higher levels at visit 5 heard fewer overall subject wh-questions (n ¼ 0 to 3 per child), but almost no repetitions—each ques-

tion was spoken once (e.g., “Who’s going to go first?”; “Which one has the cookie?”; “Who takes a bath now?”; “Who wears a collar?”). We conjecture that the repetitive input did not benefit the children because it enabled them to memorize these questions as stylized routines, rather than to analyze them further as varied instances of a more abstract construction. Overall, these findings suggest that hearing a large quantity of wh-questions is not informative for learning about wh-movement in whquestions, if the questions lack variety and do not exemplify wh-movement. Instead, children with ASD may benefit more from wh-questions that vary in lexical and grammatical word use. CONCLUSIONS AND IMPLICATIONS FOR SPEECHLANGUAGE PATHOLOGISTS TD children acquire language via situations in which parents follow in on and talk about their focus of attention, as well as when the children are more active participants in joint attention episodes. Moreover, TD children acquire language from the actual content and structure of parent speech, showing facilitative effects of word frequency, diversity of word use, and complexity of sentence structures.7 Research on the roles of input and interaction in the language acquisition of children with ASD is still in its infancy. What is most remarkable about the extant research, as reviewed here, is how similar the role of input seems to be for children with ASD, demonstrating effects of maternal responsiveness, effects of the child’s role in establishing and maintaining joint attention, and effects of specific components of maternal speech on subsequent language development. It is important to emphasize that the effects described here were the ones that were consistently seen even when children’s initial language levels and mothers’ concurrent language were controlled; hence, the correlations cannot be attributed simply to the fact that children who initially excel in language (or not) continue to do so, nor in the fact that mothers who are generally more verbal tend to have children who are more verbal. Instead, the relationships found are more likely attributed

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to specific aspects of maternal input. Perhaps most intriguing are our findings showing that simple, highly repetitive input is not as facilitative for children with ASD as is input that presents a wide variety of lexical and grammatical items. The optimal developmental course of input to children with ASD has yet to be determined. That is, research with TD children suggests that attentional variables are most important at the earliest periods of language development, with structural features playing a stronger role during the latter half of the second year and beyond.9 Thus far, the studies demonstrating effects of responsivity have primarily involved minimally verbal children and studies demonstrating effects of word frequency, diversity, and structural complexity have primarily involved children who are already verbal. What are needed are direct comparisons of the roles of attentional and structural input variables in children with ASD. From a clinical perspective, the findings reviewed here suggest that advising parents about verbal responsivity during their interactions with their children could help promote those children’s language development.45 Moreover, parents could be advised to pay more attention to the formats of the questions they ask their children. Rather than asking only “What’s this?” types of questions, parents could be encouraged to diversify their question formats, using a wider range of verbs and providing multiple models of both subject and object whquestions. Including complex sentences in the input of children with ASD appears to be beneficial for their language development. ACKNOWLEDGMENTS

The research described in this article was supported by the National Institutes of Health (NIH-DCD, R01 DC07428) and the National Alliance for Autism Research. I am happy to acknowledge my collaborators Deborah Fein, Lauren Swensen Meade, and Anthony Goodwin. Gratitude goes to our parent and child participants, and to Rose Jaffery, Janina Piotroski, and the many undergraduate students of the UConn Child Language Laboratory for their assistance in data collection, coding, and

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analysis. I would also like to thank James Dixon, Inge-Marie Eigsti, James Green, Andrea McDuffie, and Manuela Wagner for their helpful suggestions and commentary on this research. This chapter was written while the author was on sabbatical leave; she thanks the University of Connecticut for providing the leave and the MIND Institute at UC Davis for providing such a stimulating place to spend the sabbatical. REFERENCES 1. Tager-Flusberg H. Defining language phenotypes in autism. Clin Neurosci Res 2006;6:219–224 2. Tager-Flusberg H, Calkins S, Nolin T, Baumberger T, Anderson M, Chadwick-Dias A. A longitudinal study of language acquisition in autistic and Down syndrome children. J Autism Dev Disord 1990;20:1–21 3. Eigsti IM, Bennetto L, Dadlani MB. Beyond pragmatics: morphosyntactic development in autism. J Autism Dev Disord 2007;37:1007–1023 4. Lovaas OI. Behavioral treatment and normal educational and intellectual functioning in young autistic children. J Consult Clin Psychol 1987; 55:3–9 5. Stone WL, Yoder PJ. Predicting spoken language level in children with autism spectrum disorders. Autism 2001;5:341–361 6. McDuffie A, Yoder P. Types of parent responsiveness that predict language in young children with ASD. J Speech Lang Hear Res 2010;53:1026–1039 7. Gathercole VC, Hoff E. Input and the acquisition of language: three questions. In: Hoff E, Shatz M, eds. Blackwell Handbook of Language Development. New York, NY: Blackwell; 2007:105–127 8. Huttenlocher J, Haight W, Bryk A, Seltzer M, Lyons T. Early vocabulary growth: relations to language input and gender. Dev Psychol 1991;27:236–248 9. Hoff E, Naigles L. How children use input to acquire a lexicon. Child Dev 2002;37:418–433 10. Naigles LR, Hoff-Ginsberg E. Why are some verbs learned before other verbs? Effects of input frequency and structure on children’s early verb use. J Child Lang 1998;25:95–120 11. Newport EL, Gleitman H, Gleitman LR. “Mother I’d rather do it myself”: some effects and noneffects of maternal speech style. In: Snow C, Ferguson C, eds. Talking to Children: Language Input and Acquisition. London, UK: Cambridge University Press; 1977:109–150 12. Hoff-Ginsberg E. Some contributions of mothers’ speech to their children’s syntactic growth. J Child Lang 1985;12:367–385


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13. Oshima-Takane Y, Goodz E, Derevensky JL. Birth order effects on early language development: do secondborn children learn from overheard speech? Child Dev 1996;67:621–634 14. Huttenlocher J, Vasilyeva M, Cymerman E, Levine S. Language input and child syntax. Cognit Psychol 2002;45:337–374 15. Huttenlocher J, Waterfall H, Vasilyeva M, Vevea J, Hedges LV. Sources of variability in children’s language growth. Cognit Psychol 2010;61: 343–365 16. Medina TN, Snedeker J, Trueswell JC, Gleitman LR. How words can and cannot be learned by observation. Proc Natl Acad Sci U S A 2011; 108:9014–9019 17. Bruner JS. From communication to language: a psychological perspective. Cognition 1974/1975; 3:255–287 18. Mundy P. Lessons learned from autism: an information-processing model of joint attention and social-cognition. In: Cicchetti D, Gunnar M, eds. Minnesota Symposia on Child Psychology: Meeting the Challenge of Translational Research in Child Psychology. Hoboken, NJ: John Wiley & Sons, Inc.; 2009:59–114 19. Akhtar N, Tomasello M. The social nature of words and word learning. In: Golinkoff R, Hirsh-Pasek K, eds. Becoming a Word Learner: A Debate on Lexical Acquisition. Oxford, UK: Oxford University Press; 2001:115–135 20. Mundy P, Gomes A. Individual differences in joint attention skill development in the second year. Inf Beh Dev 1998;21:469–482 21. Akhtar N, Dunham F, Dunham PJ. Directive interactions and early vocabulary development: the role of joint attentional focus. J Child Lang 1991;18:41–49 22. Tamis-LeMonda CS, Bornstein MH, Baumwell L. Maternal responsiveness and children’s achievement of language milestones. ChDev 2001;72: 748–767 23. Rollins PR, Snow CE. Shared attention and grammatical development in typical children and children with autism. J Child Lang 1998; 25:653–673 24. Charman T. Specifying the nature and course of the joint attention impairment in autism in the preschool years: implications for diagnosis and treatments. Autism 1998;2:61–79 25. Mundy P, Sigman M, Kasari C. Joint attention, developmental level, and symptom presentation in autism. Dev Psychol 1994;31:851–865 26. Adamson LB, Deckner DF, Bakeman R. Early interests and joint engagement in typical development, autism, and Down syndrome. J Autism Dev Disord 2010;40:665–676 27. Adamson LB, Bakeman R, Deckner DF, Romski M. Joint engagement and the emergence of lan-

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

guage in children with autism and Down syndrome. J Autism Dev Disord 2009;39:84–96 Siller M, Sigman M. Modeling longitudinal change in the language abilities of children with autism: parent behaviors and child characteristics as predictors of change. Dev Psychol 2008;44: 1691–1704 Fenson L, Dale P, Reznick J, Bates E, Thal D, Pethick S. Variability in early communicative development. Monogr Soc Res Child Dev 1994;59:14–24 Haebig E, McDuffie A, Ellis Weismer S. The contribution of two categories of parent verbal responsiveness to later language for toddlers and preschoolers on the autism spectrum. Am J Speech Lang Pathol 2013;22:57–70 Haebig E, McDuffie A, Ellis Weismer S. Parent verbal responsiveness and language development in toddlers on the autism spectrum. J Aut Dev Disorders 2013 (Epub ahead of print) Perryman TY, Carter AS, Messinger DS, Stone WL, Ivanescu AE, Yoder PJ. Brief report: parental child-directed speech as a predictor of receptive language in children with autism symptomatology. J Autism Dev Disord 2012; 43:1983–1987 Swensen LD, Fein D, Naigles L. Properties of discourse and the language of children with autism. Poster presented at: International Meetings for Autism Research; May 2007; Seattle, WA Swensen LD, Fein D, Naigles L. Do lexical elements of maternal input affect the language of children with autism? Poster presented at: International Conference on Infant Studies; March 2008; Vancouver, Canada Swensen LD, Naigles LR, Fein D. Does maternal input affect the language of children with autism? In: Caunt-Nulton H, Kulatilake S, Woo I, eds. Proceedings of the 31st annual Boston University Conference on Language Development. Somerville, MACascadilla Press2007:609–619 Mullen EM. Mullen Scales of Early Learning. Circle Pines, MN: American Guidance Service; 1995 Goodwin A, Fein D, Naigles LR. Comprehension of wh-questions precedes their production in typical development and autism spectrum disorders. Autism Res 2012;5:109–123 Goodwin A, Fein D, Naigles L. Production of whquestions in young children with autism. Poster presented at: International Meeting for Autism Research; May 2009; Chicago, IL. Goodwin A, Jaffery G, Fein D, Naigles LR. Whquestions in toddlerhood: comprehension precedes production and input predicts comprehension. Poster presented at: Society for Research in Child Development; April 2009; Denver, CO Lord C, Risi S, Lambrecht L, et al. The autism diagnostic observation schedule-generic: a standard

247




measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord 2000;30:205–223 41. Gleitman LR, Newport EL, Gleitman H. The current status of the motherese hypothesis. J Child Lang 1984;11:43–79 42. Cohen J, Cohen P, West SG, Aiken LS. Applied Multiple Regression/Correlational Analysis For The Behavioral Sciences. 3rd ed. Mahwah, NJ: Lawrence Erlbaum Associates; 2003 43. Warren SF, Gilkerson J, Richards JA, et al. What automated vocal analysis reveals about the vocal

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production and language learning environment of young children with autism. J Autism Dev Disord 2010;40:555–569 44. Venuti P, de Falco S, Esposito G, Zaninelli M, Bornstein MH. Maternal functional speech to children: a comparison of autism spectrum disorder, Down syndrome, and typical development. Res Dev Disabil 2012;33:506–517 45. Venker CE, McDuffie A, Ellis Weismer S, Abbeduto L. Increasing verbal responsiveness in parents of children with autism: a pilot study. Autism 2012;16:568–585


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