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Autism Spectrum Disorder01:19

Autism Spectrum Disorder

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Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by persistent deficits in social communication and interaction alongside restrictive and repetitive behaviors or interests. ASD is sometimes accompanied by intellectual impairment.
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Learning disabilities are cognitive disorders caused by neurological impairments that affect cognitive functions like language and reading, without indicating overall intellectual or developmental challenges. These disabilities differ from global intellectual or developmental disabilities as they are limited to distinct cognitive functions. Common learning disabilities include dysgraphia, dyslexia, and dyscalculia, each of which impacts unique aspects of learning.
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Related Experiment Video

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A Randomized Trial of Direct Instruction Language for Learning in Children With Autism Spectrum Disorder.

Lawrence Scahill1, M Alice Shillingsburg2, Opal Ousley1

  • 1Emory University School of Medicine and the Marcus Autism Center, Atlanta, Georgia.

Journal of the American Academy of Child and Adolescent Psychiatry
|January 30, 2022
PubMed
Summary

Direct Instruction Language for Learning (DI) plus treatment as usual (TAU) improved language outcomes in children with autism spectrum disorder (ASD). Post hoc analysis showed DI+TAU was superior to TAU alone for language development in ASD.

Keywords:
autismchildrenclinical triallanguage delay

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Area of Science:

  • Pediatric Speech-Language Pathology
  • Neurodevelopmental Disorders Research
  • Clinical Trial Methodology

Background:

  • Children with autism spectrum disorder (ASD) often experience moderate language delays, impacting communication and social development.
  • Early language intervention is crucial for improving outcomes in children with ASD.
  • Treatment as usual (TAU) provides a baseline for comparison in intervention studies.

Purpose of the Study:

  • To compare the efficacy of Direct Instruction Language for Learning (DI) combined with treatment as usual (TAU) against TAU alone in children with ASD and moderate language delay.
  • To evaluate the impact of DI+TAU on standardized language assessments and clinical global improvement ratings.

Main Methods:

  • Eighty-three children (4-7 years) with ASD and moderate language delay were randomized to DI+TAU (n=42) or TAU (n=41) for 6 months.
  • DI was delivered by trained therapists in twice-weekly, 90-minute sessions.
  • Primary outcome: Clinical Evaluation of Language Fundamentals (CELF) standard score. Secondary outcome: Clinical Global Impressions-Improvement (CGI-I) scale.

Main Results:

  • DI+TAU did not meet the primary outcome on CELF in the initial analysis (p=.14).
  • Post hoc analysis adjusting for IQ showed DI+TAU superior to TAU on CELF (p=.04).
  • Significantly more children in the DI+TAU group were rated "much improved" or "very much improved" on CGI-I (54.8% vs 21.9%, p=.002).

Conclusions:

  • Direct Instruction Language for Learning (DI) combined with treatment as usual (TAU) demonstrated significant improvements in language skills and overall clinical improvement in children with autism spectrum disorder.
  • While the primary outcome on the CELF was not met in the main analysis, adjusted analyses and secondary outcomes suggest a beneficial effect of DI+TAU.
  • DI+TAU represents a promising intervention for enhancing language development in children with ASD and moderate language delays.