Skip to main content
SpringerLink
Log in

Assessing Communication in Children with Autism Spectrum Disorder Who Are Minimally Verbal

  • Communication Disorders (J Sigafoos, Section Editor)
  • Published:
Current Developmental Disorders Reports Aims and scope Submit manuscript

Abstract

Purpose of review

Children with autism spectrum disorder (ASD) who are minimally verbal may often require timely and tailored intervention to optimize their short- and long-term communication outcomes. Effective intervention relies on appropriate and accurate assessment. The purposes of this review are to summarize current and emerging issues and practices in the assessment of these children and to consider implications for research and clinical practice.

Recent findings

There is growing awareness of the need for improved assessment practices and emerging consensus regarding principles that should underpin the assessment process. Enhanced use of existing assessment tools, as well adoption of emerging tools, has the potential to improve practice. However, there remains a general lack of specific, sensitive, and clinically useful tools for this population.

Summary

Although the importance of appropriate assessment for children with ASD who are minimally verbal is well established, there remains a critical need for concerted effort to enhance approaches currently available.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Brady NC, Marquis J, Fleming K, McLean L. Prelinguistic predictors of language growth in children with developmental disabilities. J Speech Lang Hear Res. 2004;47:663–77. https://doi.org/10.1044/1092-4388(2004/051).

    Article  PubMed  Google Scholar 

  2. Dawson G, Rogers S, Munson J, Smith M, Winter J, Greenson J, et al. Randomized, controlled trial of an intervention for toddlers with autism: the early start Denver model. Pediatrics. 2010;125(1):e17–23. https://doi.org/10.1542/peds.2009-0958.

    Article  PubMed  Google Scholar 

  3. Green J, Charman T, McConachie H, Aldred C, Slonims V, Howlin P, et al. Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial. Lancet. 2010;375(9732):2152–60. https://doi.org/10.1016/S0140-6736(10)60587-9.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Rose V, Trembath D, Keen D, Paynter J. The proportion of minimally verbal children with autism spectrum disorder in a community-based early intervention programme. J Intellect Disabil Res. 2016;60(5):464–77. https://doi.org/10.1111/jir.12284.

    Article  CAS  PubMed  Google Scholar 

  5. Trembath D, Iacono T. Standardised assessment of prelinguistic communication. In: Keen D, Meadan H, Brady NC, Halle JW, editors. Prelinguistic and minimally verbal communicators on the autism spectrum. Singapore: Springer; 2016. p. 75–100.

    Chapter  Google Scholar 

  6. Keen D, Meadan H, Brady NC, Halle JW. Introduction to prelinguistic and minimally verbal communicators on the autism spectrum. In: Keen D, Meadan H, Brady NC, Halle JW, editors. Prelinguistic and minimally verbal communicators on the autism spectrum. Singapore: Springer; 2016. p. 3–8.

    Chapter  Google Scholar 

  7. • Tager-Flusberg H, Kasari C. Minimally verbal school-aged children with autism spectrum disorder: the neglected end of the spectrum. Autism Res. 2013;6(6):468–78. https://doi.org/10.1002/Aur.1329 This article was among the first to highlight the lack of research to inform evidence-based communication assessment and intervention for children with ASD who are minimally verbal.

    Article  PubMed  Google Scholar 

  8. • Kasari C, Brady N, Lord C, Tager-Flusberg H. Assessing the minimally verbal school-aged child with autism spectrum disorder. Autism Res. 2013;6(6):479–93. https://doi.org/10.1002/aur.1334 This article provides an excellent review of tools that may be relevant for assesing school-aged children with ASD who are minimmaly verbal.

    Article  PubMed  PubMed Central  Google Scholar 

  9. •• Trembath D, Westerveld M, Shellshear L. Assessing spoken language outcomes in children with asd: a systematic review. Curr Dev Disord Rep. 2016;3(1):33–45. https://doi.org/10.1007/s40474-016-0068-8 . This article provides a systematic review of communicaiton assessments commonly used with children with ASD in research.

    Article  Google Scholar 

  10. Tager-Flusberg H, Rogers S, Cooper J, Landa R, Lord C, Paul R, et al. Defining spoken language benchmarks and selecting measures of expressive language development for young children with autism spectrum disorders. J Speech Lang Hear Res. 2009;52(3):643–52. https://doi.org/10.1044/1092-4388(2009/08-0136).

    Article  PubMed  Google Scholar 

  11. •• Tager-Flusberg H, Plesa Skwerer D, Joseph RM, Brukilacchio B, Decker J, Eggleston B, et al. Conducting research with minimally verbal participants with autism spectrum disorder. Autism. 2017;21(7):852–61. https://doi.org/10.1177/1362361316654605 This article provides practical guidance for conducting assessments with minimally verbal children.

    Article  PubMed  Google Scholar 

  12. •• Keen D, Meadan H, Brady NC, Halle JW. Prelinguistic and minimally verbal communicators on the autism spectrum. Singapore: Springer; 2016. This book contains chapters examining assessment, as well as intervention practices, for children with ASD who are minimally verbal.

    Book  Google Scholar 

  13. Filipek PA, Accardo PJ, Baranek GT, Cook EH, Dawson G, Gordon B, et al. The screening and diagnosis of autistic spectrum disorders. J Autism Dev Disord. 1999;29(6):439–84. https://doi.org/10.1023/A:1021943802493.

    Article  CAS  PubMed  Google Scholar 

  14. •• Barokova M, Tager-Flusberg H. Commentary: measuring language change through natural language samples. J Autism Dev Disord. 2018. https://doi.org/10.1007/s10803-018-3628-4 This commentary provides a comprehensive summary and insight into research and clinical considerations in the use of naturalistic language samples for this population.

  15. Ozonoff S, Goodlin-Jones BL, Solomon M. Evidence-based assessment of autism spectrum disorders in children and adolescents. J Clin Child Adolesc. 2005;34(3):523–40. https://doi.org/10.1207/s15374424jccp3403_8.

    Article  Google Scholar 

  16. Kaplan RM, Saccuzzo DP. Psychological testing: Principles, applications, and issues. 4th ed. Pacific Grove: Brooks/Cole Publishing; 1997.

    Google Scholar 

  17. Matson JL, Rieske RD. Are outcome measures for early intensive treatment of autism improving? Res Autism Spectr Disord. 2014;8(3):178–85. https://doi.org/10.1016/j.rasd.2013.11.006.

    Article  Google Scholar 

  18. Lord C, Rutter M, Dilavore PC, Risi S, Gotham K, Bishop SL. Autism diagnostic observation schedule - second edition (ADOS-2). Torrance: WPS; 2012.

    Google Scholar 

  19. Lord C, Rutter M, Goode S, Heemsbergen J, Jordan H, Mawhood L, et al. Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. J Autism Dev Disord. 1989;19(2):185–212.

    Article  CAS  PubMed  Google Scholar 

  20. Wetherby AM, Prizant BM. Communication and symbolic behavior scales™ (CSBS). Baltimore: Paul H Brookes; 2001.

    Google Scholar 

  21. Mullen E. Mullen scales of early learning. Cicle Pines: American Guidance Service; 1995.

    Google Scholar 

  22. Norrelgen F, Fernell E, Eriksson M, Hedvall A, Persson C, Sjolin M, et al. Children with autism spectrum disorders who do not develop phrase speech in the preschool years. Autism. 2015;19(8):934–43. https://doi.org/10.1177/1362361314556782.

    Article  PubMed  Google Scholar 

  23. •• Plesa Skwerer D, Jordan SE, Brukilacchio BH, Tager-Flusberg H. Comparing methods for assessing receptive language skills in minimally verbal children and adolescents with autism spectrum disorders. Autism. 2016;20(5):591–604. https://doi.org/10.1177/1362361315600146 . This is one of the few studies to examine the comparative effectiveness of different approaches to assessment for minimally verbal children with ASD.

    Article  PubMed  Google Scholar 

  24. Jordan R. Multidisciplinary work for children with autism. Educ Child Psychol 2001;18(2):5–14.

  25. Brady NC, Keen D. Individualised assessement of prelinguistic communication. In: Keen D, Meadan H, Brady NC, Halle JW, editors. Prelinguistic communication in autism spectrum disorders. Singapore: Springer; 2016. p. 101–21.

    Google Scholar 

  26. Filipek PA, Accardo PJ, Ashwal S, Baranek GT, Cook EH, Dawson G, et al. Practice parameter: screening and diagnosis of autism - report of the quality standards Subcommittee of the American Academy of neurology and the child neurology society. Neurology. 2000;55(4):468–79.

    Article  CAS  PubMed  Google Scholar 

  27. Speech Pathology Australia. Clinical guideline: evidence-based speech pathology practice for individuals with autism spectrum disorder. Melbourne: Speech Pathology Australia; 2016.

    Google Scholar 

  28. Heilmann JJ, Miller JF, Nockerts A. Using language sample databases. Lang Speech Hear Serv Sch. 2010;41(1):84–95. https://doi.org/10.1044/0161-1461(2009/08-0075).

    Article  PubMed  Google Scholar 

  29. Miller JF, Andriacchi K, Nockerts A, Westerveld M, Gillon G. Assessing language production using SALT software. A clinician's guide to language sample analysis. New Zealand version. Middleton: SALT Software; 2012.

    Google Scholar 

  30. Sigafoos J, O'Reilly MF, Lancioni GE, Carnett A, Bravo A, Rojeski L, et al. Functional assessment of problematic forms of prelinguistic behavior. In: Keen D, Meadan H, Brady NC, Halle JW, editors. Prelinguistic communication in autism spectrum disorders. Singapore: Springer; 2016. p. 121–45.

    Google Scholar 

  31. Parish-Morris J, Cieri C, Liberman M, Bateman L, Ferguson E, Schultz RT. Building language resources for exploring autism spectrum disorders. LREC Int Conf Lang Resour Eval. 2016;2016:2100–7.

    PubMed  PubMed Central  Google Scholar 

  32. LENA Research Foundation. User Guide LENA Pro. 2015 [cited 2019 May 15]. Available from: https://cdn.shopify.com/s/files/1/0596/9601/files/LENA_Pro_User_Guide.pdf?6014727090441220586.

  33. Trembath D, Westerveld MF, Teppala S, Thirumanickam A, Sulek R, Rose V, et al. Profiles of vocalization change in children with autism receiving early intervention. Autism Res. 2019;12:830–42. https://doi.org/10.1002/aur.2075.

    Article  PubMed  Google Scholar 

  34. Jones RM, Plesa Skwerer D, Pawar R, Hamo A, Carberry C, Ajodan EL, et al. How effective is LENA in detecting speech vocalizations and language produced by children and adolescents with ASD in different contexts? Autism Res. 2019;12:628–35. https://doi.org/10.1002/aur.2071.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Rankine J, Li E, Lurie S, Rieger H, Fourie E, Siper PM, et al. Language environment analysis (LENA) in phelan-mcdermid syndrome: validity and suggestions for use in minimally verbal children with autism spectrum disorder. J Autism Dev Disord. 2017;47(6):1605–17. https://doi.org/10.1007/s10803-017-3082-8.

    Article  PubMed  PubMed Central  Google Scholar 

  36. McConachie H, Parr JR, Glod M, Hanratty J, Livingstone N, Oono IP, et al. Systematic review of tools to measure outcomes for young children with autism spectrum disorder. Health Technol Assess. 2015;19(41):1–506. https://doi.org/10.3310/hta19410.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Paynter JM. Assessment of school-aged children with autism spectrum disorder. J Psychol Counc Sch. 2015;25(1):104–15. https://doi.org/10.1017/jgc.2015.2.

    Article  Google Scholar 

  38. World Health Organisation. International classification of functioning, disability, and health (ICF). World Health Organisation. 2001 [cited 2019 May 15]. Available from:http://www.who.int/classifications/icf/en/.

  39. Schopler E, Lansing MD, Reichler RJ, Marcus LM. Examiner's manual of the psychoeducational profile. 3rd ed. Austin: Pro-ed; 2005.

    Google Scholar 

  40. Grzadzinski R, Carr T, Colombi C, McGuire K, Dufek S, Pickles A, et al. Measuring changes in social communication behaviors: preliminary development of the brief observation of social communication change (BOSCC). J Autism Dev Disord. 2016;46(7):2464–79. https://doi.org/10.1007/s10803-016-2782-9.

    Article  PubMed  Google Scholar 

  41. Wagner A, Lecavalier L, Arnold LE, Aman MG, Scahill L, Stigler KA, et al. Developmental disabilities modification of the children’s global assessment scale. Biol Psychiatry. 2007;61(4):504–11. https://doi.org/10.1016/j.biopsych.2007.01.001.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ruble LJM. Goal attainment scaling as an outcome measure in randomized controlled trials of psychosocial interventions in autism. J Autism Dev Disord. 2012;42(9):1974–83. https://doi.org/10.1007/s10803-012-1446-7.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Luyster RJ, Kadlec MB, Carter A, Tager-Flusberg H. Language assessment and development in toddlers with autism spectrum disorders. J Autism Dev Disord. 2008;38(8):1426–38. https://doi.org/10.1007/s10803-007-0510-1.

    Article  PubMed  Google Scholar 

  44. Mundy P, Delgado C, Block J, Venezia M, Hogan A, Seibert J. A manual for the abridged early social communication scales (ESCS). University of Miami, Florida. 2003 [cited 2019 May 15]. Available from:https://education.ucdavis.edu/sites/main/files/file-attachments/escs_manual_2003_2013.pdf.

  45. Rogers SJ, Hepburn SL, Stackhouse T, Wehner E. Imitation performance in toddlers with autism and those with other developmental disorders. J Child Psychol Psychiatry. 2003;44(5):763–81. https://doi.org/10.1111/1469-7610.00162.

    Article  PubMed  Google Scholar 

  46. Barokova M, Hassan S, Lee C, Xu M, Tager-Flusberg H. A new approach for eliciting expressive language samples: ELSA. San Francisco: International Society for Autism Research; 2017.

    Google Scholar 

Download references

Acknowledgment

The writing of this review was informed by research completed as part of a research project aimed at supporting best practice in the assessment and treatment of children with ASD who are minimally verbal, funded by the Australian Government Department of Social Services. We would like to acknowledge the children, parents, clinicians, educators, and researchers at the six Autism Specific Early Learning and Care Centres (ASELCCS) in Australia and researcher colleagues at Griffith University, La Trobe University, and the University of New South Wales.

Funding

David Trembath was supported by a National Health and Medical Research Council ECR Fellowship (GNT1071811). The paper was also supported by funding (to HTF) from the National Institutes of Health (P50 DC 13027) and the Simons Foundation Autism Research Initiative (Award # 624201).

Author information

Authors and Affiliations

  1. Menzies Health Institute Queensland, Griffith University, Parklands Dr, Southport, QLD, 4222, Australia

    David Trembath & Jessica Paynter

  2. Australian Capital Territory, University of Canberra, Canberra, Australia

    Rebecca Sutherland

  3. Children’s Hospital at Westmead, Westmead, Australia

    Rebecca Sutherland

  4. Boston University, Boston, MA, USA

    Helen Tager-Flusberg

Authors
  1. David Trembath
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jessica Paynter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rebecca Sutherland
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Helen Tager-Flusberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Trembath.

Ethics declarations

Conflict of Interest

David Trembath reports grants from National Health and Medical Research Council (GNT1071811) and grants from Australian Department of Social Services during the conduct of the study. Jessica Paynter and Rebecca Sutherland report grants from the Australian Department of Social Services. Helen Tager-Flusberg reports grants from the National Institutes of Health (P50 DC 13027) and the Simons Foundation Autism Research Initiative (Award # 624201).

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Communication Disorders

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Trembath, D., Paynter, J., Sutherland, R. et al. Assessing Communication in Children with Autism Spectrum Disorder Who Are Minimally Verbal. Curr Dev Disord Rep 6, 103–110 (2019). https://doi.org/10.1007/s40474-019-00171-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40474-019-00171-z

Keywords

Search

Navigation