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Background and aims Practice-based research holds potential as a promising solution to closing the research-practice gap, because it addresses research questions based on problems that arise in clinical practice and tests whether systems and interventions are effective and sustainable in a clinical setting. One type of practice-based research involves capturing practice by collecting evidence within clinical settings to evaluate the effectiveness of current practices. Here, we describe our collaboration between researchers and clinicians that sought to answer clinician-driven questions about community-based language interventions for young children (Are our interventions effective? What predicts response to our interventions?) and to address questions about the characteristics, strengths, and challenges of engaging in practice-based research. Methods We performed a retrospective chart review of 59 young children who had participated in three group language interventions at one publicly funded community clinic between 2012 and 2017. Change on the Focus on the Outcomes of Communication Under Six (FOCUS), a government mandated communicative participation measure, was extracted as the main outcome measure. Potential predictors of growth during intervention were also extracted from the charts, including type of intervention received, attendance, age at the start of intervention, functional communication ability pre-intervention, and time between pre- and post-intervention FOCUS scores. Results Overall, 49% of children demonstrated meaningful clinical change on the FOCUS after their participation in the language groups. Only 3% of participants showed possibly meaningful clinical change, while the remaining 46% of participants demonstrated not likely meaningful clinical change. There were no significant predictors of communicative participation growth during intervention. Conclusions Using a practice-based research approach aimed at capturing current practice, we were able to answer questions about the effectiveness of interventions delivered in real-world settings and learn about factors that do not appear to influence growth during these interventions. We also learned about benefits associated with engaging in practice-based research, including high clinical motivation, high external validity, and minimal time/cost investment. Challenges identified were helpful in informing our future efforts to examine other possible predictors through development of a new, clinically feasible checklist, and to pursue methods for improving collection of outcome data in the clinical setting. Implications: Clinicians and researchers can successfully collaborate to answer clinically informed research questions while considering realistic clinical practice and using research-informed methods and principles. Practice-based research partnerships between researchers and clinicians are both valuable and feasible. more...

Background & Aims Speech-language pathology services are frequently accessed by families of children who have suspected or diagnosed autism. This is expected given that social communication differences are a core feature of autism. This review looked broadly at the state of research in the field of speech-language pathology and preschool autism interventions in order to identify the types of studies that could be used to inform the practices of speech-language pathologists (SLPs), and to identify gaps in the field so they can be addressed in future research. Specifically, we examined the extent of research conducted on interventions delivered (at least in part) by SLPs to preschool children with suspected or diagnosed autism, identified the range of skill development areas targeted within the studies, and explored the characteristics of the interventions (i.e., theoretical models underlying the programs, service delivery models, treatment dosage). Methods A scoping review of articles published between 1980 and 2019 was conducted using the five phases outlined by the Arksey and O’Malley framework: (a) articulating the research question; (b) identifying relevant studies; (c) selecting studies; (d) charting the data; and (e) collating, summarizing, and reporting the results. Main Contribution/Results A total of 114 studies met inclusion criteria with most published since 2010 and conducted within North America. Case study or single-subject study designs were the most frequently used. Interventions delivered solely by SLPs and by multiprofessional teams that included SLPs were relatively equally represented. Across the included studies, nine skill development areas were targeted, but interventions targeting social communication, language, and augmentative communication skills made up the vast majority of studies. There was relatively even distribution of interventions informed by child-centered, clinician-directed, and hybrid models. Explicit information detailing intervention characteristics (e.g., treatment dosage, professional training of clinicians delivering the intervention) was poorly reported in many studies. For those studies providing details, there was a great deal of variability in the nature of interventions (e.g., service delivery models, SLPs’ role, dosage). Conclusions This review revealed that research in the area of autism interventions delivered, at least in part, by SLPs has markedly increased over the past 10 years. Still, there remains a need for more research, and greater transparency detailing the nature of the interventions being investigated. The research conducted to date captures the versatility of the SLP's role within preschool autism intervention. Improved reporting and studies with strong methodological rigor focused on capturing the complex and individualized nature of interventions are needed, as are intervention studies aligned with real-world community practice. Implications This review provides a comprehensive examination of the status of research on preschool interventions delivered to children with suspected or diagnosed autism within the field of speech-language pathology. Several directions for future research are provided, as are suggestions for improving the clinical applicability of results to further the development of effective, evidence-informed policy and practice in speech-language pathology. more...

© 2014 Elsevier Ltd. All rights reserved. Clinical anecdotes suggest that children with autism spectrum disorder (ASD) often show an atypical language profile in which expressive language exceeds receptive language competency. However, the few studies to directly explore this language profile have yielded inconsistent findings. This meta-analysis examined 74 studies that reported the receptive and expressive language performances of children and youth with ASD. Four potential predictors (age, language domain, source of language data, method of ASD diagnosis) were separately analyzed for their contribution to the relative receptive and expressive language impairment in ASD. Contrary to popular belief, the current meta-analyses found no evidence that an expressive advantage is common in ASD. Overall, children and youth with ASD showed equally impaired receptive and expressive language skills, both falling roughly 1.5 SD below peers with typical development. No discrepancies were found in receptive and expressive language across developmental stages, cognitive abilities, vocabulary, global language skills, caregiver report measures, clinician-administered measures, mixed method measures, or method of ASD diagnosis. Although some individual children with ASD may have an expressive-better-than-receptive language profile, this profile is not common enough to be a useful marker of ASD. more...

Previous studies of students with high-functioning autism spectrum disorder (HFASD) have shown great variability in their writing abilities. Most previous studies of students with HFASD have combined individuals with linguistic impairments (HF-ALI) and individuals without linguistic impairments (HF-ALN) into a single group. The current study was the first to compare the persuasive writing of students with HF-ALN with controls, without confounding the effects of language ability and autism on writing achievement, and while considering possible cognitive underpinnings of their writing skills. Twenty-five students with HF-ALN and 22 typically developing controls completed measures of oral language, nonverbal IQ, social responsiveness, theory of mind, integrative processing and persuasive writing. The persuasive texts were coded on 19 variables across six categories: productivity, grammatical complexity, lexical diversity, cohesiveness, writing conventions, and overall quality. The texts were reliably different between groups across measures of productivity, syntactic complexity, lexical complexity and persuasive quality. Specifically, the texts of students with HF-ALN scored lower on overall quality (d = −0.6 SD), contained shorter and simpler sentences (d = −1.0), and had less repetition of content words (d = −0.8 SD). For the HF-ALN group, integrative processing, language ability and age predicted 77% of the variance in persuasive quality. more...