Elizabeth Choi-Tucci PhD, CCC-SLP(she/her)

Purpose. Intentional communication acts, or purposefully directed vocalizations and gestures, are particularly difficult for infants at elevated likelihood for eventual diagnosis of autism. The ability to measure and track intentional communication in infancy thus has the potential to aid early identification and intervention efforts. This study assesses the validity of a novel measure of intentional communication intended for use within semistructured caregiver–infant interactions.

Method. The Intentional Communication Coding Scale (IC Coding Scale) captures infants' Vocalizations, Gestures, and Combined (vocalizations paired with gestures) acts. Using data from 36 infants at elevated likelihood for autism, we tested the convergent and discriminant validity of the IC Coding Scale with established language measures using Spearman's rho. We tested interrater reliability using intraclass correlation coefficient (ICC) calculations. Finally, we tested responsiveness (i.e., sensitivity to change) using Wilcoxon signed-ranks tests and Spearman's rho.

Results. Our initial psychometric tests suggested adequate levels of convergent and discriminant validity. ICCs ranged from .77 to .92, while confidence intervals were wide, suggesting that Gestures and Combined acts were coded more variably than Vocalizations were among raters. Tests of the scale's responsiveness suggested adequate sensitivity to change across a 12-week period.

Conclusions. This study is an important first step toward validating the IC Coding Scale for use in measuring and tracking intentional communication behaviors in infants at elevated likelihood for autism within more naturalistic, semistructured activities. Additional studies are needed to disentangle the effects of intervention from maturation and to examine types of intentional communication acts in more detail.

Purpose. The purposes of this article were (a) to compare the developmental skills of toddlers whose scores on the First Years Inventory–Lite (FYI-Lite), an early screening tool, indicated an elevated likelihood of a later diagnosis of autism (ELA) to the developmental skills of toddlers at a lower likelihood of a later diagnosis of autism (LLA) and (b) to examine how autism characteristics are correlated with communication measures in toddlers at an ELA.

Method. We assessed the language, social communication (SC) skills, and characteristics of autism demonstrated by 45 toddlers at an ELA and 37 toddlers at an LLA between the ages of 11 and 18 months and compared group scores on these measures. We also examined the correlations between the characteristics of autism and language measures within the ELA group.

Results. Toddlers at an ELA demonstrated lower scores on measures of global expressive and receptive language, receptive vocabulary, gestures, and response to joint attention bids as well as SC characteristics of autism when compared to those demonstrated by toddlers at an LLA. There were no significant differences between groups on expressive vocabulary, language profiles (i.e., the relationship between receptive and expressive scores), or restrictive and repetitive behaviors. Within the ELA group, the SC characteristics of autism were significantly associated with their global receptive and expressive language skills.

Conclusions. On the basis of the FYI-Lite screening tool, toddlers at an ELA are demonstrating delays in language and SC skills when compared to toddlers identified with an LLA. For toddlers at an ELA, the SC characteristics of autism are significantly associated with early language skills.

Parental language input influences child language outcomes but may vary based on certain characteristics. This research examined how parental language differs during two contexts for toddlers at varying likelihood of autism based on their developmental skills. Parental language (quantity, quality, and pragmatic functions) was analyzed during dyadic play and mealtime interactions as a secondary data analysis of observational data from a study of toddlers at elevated and lower likelihood of autism. Child developmental skills and sensory processing were also assessed. Parents used more words per minute, directives, and verbs during play and more adjectives, descriptions, and questions during mealtime. Parental language differed based on child fine motor skills, receptive language, and levels of sensory hyporesponsiveness but not autism likelihood. Overall, this study found that parental language varies based on context and child developmental skills. Future research examining parental language should include pragmatic functions and context across developmental trajectories.

Keywords. autism; parental language; early intervention; play; mealtime

Infants at elevated likelihood of developing autism display differences in sensory reactivity, especially hyporeactivity, as early as 7 months of age, potentially contributing to a developmental cascade of autism symptoms. Caregiver responsiveness, which has been linked to positive social communication outcomes, has not been adequately examined with regard to infant sensory reactivity. This study examined the multiplicative impact of infant sensory hypo- and hyperreactivity on caregiver responsiveness to sensory reactivity and regulation cues in 43 infants at elevated likelihood of autism. Sensory hyperreactivity was found to moderate the association between sensory hyporeactivity and caregiver responsiveness, such that caregivers of infants with moderately high sensory hypo- and hyperreactivity demonstrated higher responsiveness.

Keywords. Early risk signs; Sensory reactivity; Caregiver responsiveness; Community sample

Purpose. The purpose of this study was to conduct a scoping review of literature focused on the effects of developmental language disorder (DLD) on writing skills across the life span to highlight gaps in our knowledge of how to support writing for this population.

Method. We adopted the five-step framework for conducting scoping reviews outlined by Arksey and O'Malley (2005) to identify literature focused on writing outcomes for individuals with DLD in childhood, adolescence, and adulthood.

Results. Seventy-two studies from 1991 to 2022 met review criteria. Results indicated that spelling may be an area of relative weakness for individuals with DLD across the life span. Children and adolescents with DLD also may have relative difficulty with grammar, organization, cohesion, and length of written output. Research on the writing skills of adults with DLD is too sparse to draw broad conclusions about the writing skills of this subset of the population with DLD.

Conclusions. Overall, research into the writing skills of individuals with DLD is limited, and more information is needed to inform functional evidence-based approaches to assessment and intervention of writing for those with DLD from childhood through adulthood. Additionally, more focus on electronic writing in research is needed, as only two studies included in this review examined typed writing in any form. Results of this review also indicate a need for systematic, uniform approaches to defining and measuring writing skills for those who experience language difficulties.