Developmental Profiles of Infants and Toddlers with Autism Spectrum Disorders Identified Prospectively in a Community-Based Setting The Social Communication Intervention Project: a randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder. Using the preschool language scale, fourth edition to characterize language in preschoolers with autism spectrum disorders. Longitudinal Effects of Adaptive Interventions With a Speech-Generating Device in Minimally Verbal Children With ASD Randomized comparative trial of a social cognitive skills group for children with autism spectrum disorder. ‘Everyday Memory’ Impairments in Autism Spectrum Disorders Early Language and Communication Development of Infants Later Diagnosed with Autism Spectrum Disorder The effects of music therapy incorporated with applied behavior analysis verbal behavior approach for children with autism spectrum disorders. Diminished Time-Based, but Undiminished Event-Based, Prospective Memory Among Intellectually High-Functioning Adults With Autism Spectrum Disorder: Relation to Working Memory Ability Incorporating a Peer-Mediated Approach Into Speech-Generating Device Intervention: Effects on Communication of Preschoolers With Autism Spectrum Disorder. A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. Effect of "developmental speech and language training through music" on speech production in children with autism spectrum disorders. Reducing Specific Phobia/Fear in Young People with Autism Spectrum Disorders (ASDs) through a Virtual Reality Environment Intervention A Virtual Week study of prospective memory function in autism spectrum disorders. Managing Repetitive Behaviours in Young Children with Autism Spectrum Disorder (ASD): Pilot Randomised Controlled Trial of a New Parent Group Intervention Effect of Omega-3 and -6 Supplementation on Language in Preterm Toddlers Exhibiting Autism Spectrum Disorder Symptoms Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism. Clinical assessment of autism in high-risk 18-month-olds Two to Ten Years: Developmental Trajectories of Joint Attention in Children With ASD Who Received Targeted Social Communication Interventions Epidemiology of autism spectrum disorders in adults in the community in England. A prospective study of autistic-like traits in unaffected siblings of probands with autism spectrum disorder. A Parent-Mediated Intervention to Increase Responsive Parental Behaviors and Child Communication in Children with ASD: A Randomized Clinical Trial
This prospect i ve , longitudinal , study charted the developmental profiles of young children with Autism Spectrum Disorders ( ASD ) identified through routine developmental surveillance . 109 children with Autistic Disorder ( AD ) , ‘ broader ’ ASD , and developmental and /or language delays ( DD/LD ) were assessed using the Mullen Scales of Early Learning ( MSEL ) at 12-months ( n = 10 assessment s ) , 18-months ( n = 45 assessment s ) , and 24-months ( n = 99 assessment s ) . The children with AD performed most poorly , overall , than the ASD and DD/LD groups on the MSEL . Furthermore , the children with AD/ASD displayed an uneven cognitive profile , with poorer performance on verbal ( particularly receptive language ) relative to nonverbal skills . There was also evidence of developmental slowing in verbal skills from 18- to 24-months for children on the spectrum , especially those with AD . Given that the poor receptive , relative to expressive , language profile emerges very early in life for children with AD/ASD , this cognitive profile may serve as an additional red flag to social attention and communication deficits . Receptive language should therefore be stringently monitored in any developmental surveillance program for autism spectrum disorders in the second year of life BACKGROUND Children who show disproportionate difficulty with the pragmatic as compared with the structural aspects of language are described as having pragmatic language impairment ( PLI ) or social communication disorder ( SCD ) . Some children who have PLI also show mild social impairments associated with high-functioning autism or autism spectrum disorder ( ASD ) . There is little robust evidence of effectiveness of speech- language interventions which target the language , pragmatic or social communication needs of these children . AIMS To evaluate the effectiveness of an intensive manualized social communication intervention ( SCIP ) for children who have PLI with or without features of ASD . METHODS & PROCEDURES In a single-blind RCT design , 88 children with pragmatic and social communication needs aged 5;11 - 10;8 , recruited from UK speech and language therapy services , were r and omly assigned in a 2:1 ratio to SCIP or to treatment-as-usual . Children in the  SCIP  condition received up to 20 sessions of direct intervention from a specialist research speech and language therapist working with supervised assistants . All therapy content and methodology was derived from an intervention manual . A primary outcome measure of structural language and secondary outcome measures of narrative , parent-reported pragmatic functioning and social communication , blind-rated perceptions of conversational competence and teacher-reported ratings of classroom learning skills were taken pre-intervention , immediately post-intervention and at 6-month follow-up . Analysis was by intention to treat . OUTCOMES & RESULTS No significant treatment effect was found for the primary outcome measure of structural language ability or for a measure of narrative ability . Significant treatment effects were found for blind-rated perceptions of conversational competence , for parent-reported measures of pragmatic functioning and social communication , and for teacher-reported ratings of classroom learning skills . CONCLUSIONS & IMPLICATION S There is some evidence of an intervention effect on blind and parent/teacher-reported communication outcomes , but not st and ardized language assessment outcomes , for 6 - 11-year-old children who have pragmatic and social communication needs . These findings are discussed in the context of the increasingly central role of service user outcomes in providing evidence for an intervention . The substantial overlap between the presence of PLI and ASD ( 75 % ) across the whole cohort suggests that the intervention may also be applicable to some verbally able children with ASD who have pragmatic communication needs PURPOSE The Preschool Language Scale , Fourth Edition ( PLS-4 ; Zimmerman , Steiner , & Pond , 2002 ) was used to examine syntactic and semantic language skills in preschool children with autism spectrum disorders ( ASD ) to determine its suitability for use with this population . We expected that PLS-4 performance would be better in more intellectually able children and that receptive skills would be relatively more impaired than expressive abilities , consistent with previous findings in the area of vocabulary . METHOD Our sample consisted of 294 newly diagnosed preschool children with ASD . Children were assessed via a battery of developmental measures , including the PLS-4 . RESULTS As expected , PLS-4 scores were higher in more intellectually able children with ASD , and overall , expressive communication was higher than auditory comprehension . However , this overall advantage was not stable across nonverbal developmental levels . Expressive skills were significantly better than receptive skills at the youngest developmental levels , whereas the converse applied in children with more advanced development . CONCLUSIONS The PLS-4 can be used to obtain a general index of early syntax and semantic skill in young children with ASD . Longitudinal data will be necessary to determine how the developmental relationship between receptive and expressive language skills unfolds in children with ASD There are limited data on the effects of adaptive social communication interventions with a speech-generating device in autism . This study is the first to compare growth in communications outcomes among three adaptive interventions in school-age children with autism spectrum disorder ( ASD ) who are minimally verbal . Sixty-one children , ages 5–8 years , participated in a sequential , multiple-assignment r and omized trial ( SMART ) . All children received a developmental behavioral communication intervention : joint attention , symbolic play , engagement and regulation ( JASP ) with enhanced milieu teaching ( EMT ) . The SMART included three 2-stage , 24-week adaptive interventions with different provisions of a speech-generating device ( SGD ) in the context of JASP+EMT . The first adaptive intervention , with no SGD , initially assigned JASP+EMT alone , then intensified JASP+EMT for slow responders . In the second adaptive intervention , slow responders to JASP+EMT were assigned JASP+EMT+SGD . The third adaptive intervention initially assigned JASP+EMT+SGD ; then intensified JASP+EMT+SGD for slow responders . Analyses examined between-group differences in change in outcomes from baseline to Week 36 . Verbal outcomes included spontaneous communicative utterances and novel words . Nonlinguistic communication outcomes included initiating joint attention and behavior regulation , and play . The adaptive intervention beginning with JASP+EMT+SGD was estimated as superior . There were significant ( p < .05 ) between-group differences in change in spontaneous communicative utterances and initiating joint attention .  School-age children with ASD who are minimally verbal make significant gains in communication outcomes with an adaptive intervention beginning with JASP+EMT+SGD . Future research should explore mediators and moderators of the adaptive intervention effects and second-stage intervention options that further capitalize on early gains in treatment OBJECTIVE This study evaluated the efficacy of a targeted social skills training group in school-aged children with autism spectrum disorder ( ASD ) . The intervention , Seaver-NETT ( Nonverbal communication , Emotion recognition , and Theory of mind Training ) , is a 12-session cognitive-behavioral intervention ( CBI ) for verbal , school-aged children targeting ASD-specific social behavioral impairments . METHOD Sixty-nine children with ASD , 8 to 11 years of age , with verbal IQs greater than 70 , participated in a r and omized comparative trial to examine the efficacy of NETT relative to a facilitated play group . Treatment outcomes included caregiver reports of social behavior and neuropsychological assessment s of social cognition conducted by blinded raters . Outcomes were collected at baseline , endpoint , and 3 months posttreatment . RESULTS Significant improvements were found on social behavior outcomes such as nonverbal communication , empathic responding , and social relations in the NETT condition relative to the active control at endpoint . Verbal IQ moderated the interaction effect on social behavior , with higher verbal IQ associated with improvements in the CBI condition . No significant improvements were found on social cognitive outcomes . No significant group differences were found at 3-month follow-up conducted with approximately half the sample ( n = 34 ) . CONCLUSION These data indicate that targeted CBI social skills groups such as NETT improve social communication deficits in verbal , school-aged children with ASD . The moderating effects of high verbal IQ suggest a need to consider participant and treatment characteristics associated with outcomes in future studies . Clinical trial registration information-Neural and Behavioral Outcomes of Social Skills Groups in Children With Autism Spectrum Disorder ; https:// clinical trials.gov ; NCT01190917 Abstract ‘ Everyday memory ’ is conceptualised as memory within the context of day-to-day life and , despite its functional relevance , has been little studied in individuals with autism spectrum disorders ( ASDs ) . In the first study of its kind , 94 adolescents with an ASD and 55 without an ASD completed measures of everyday memory  from the Rivermead Behavioural Memory Test ( RBMT ) and a st and ard word recall task ( Children ’s Auditory Verbal Learning Test-2 : CAVLT-2 ) . The ASD group showed significant impairments on the RBMT  , including in prospect i ve memory , alongside impaired performance on the CAVLT-2 . Social and communication ability was significantly associated with prospect i ve remembering in an everyday memory context but not with the CAVLT-2 . The complex nature of everyday memory and its relevance to ASD is discussed ABSTRACT . It is well recognized that delayed " first words " is among the most common presenting symptoms of autistic spectrum disorders ( ASD ) . However , data on earlier language and communication development in children with ASD are limited to retrospective reports from parents and from home videos . In this study , we prospect ively collected parent report data on early communication and language development in 97 infant siblings of children with ASD and 49 low-risk controls . Parents completed the  MacArthur Communicative Development Inventory-Infant Form  at 12 and 18 months . Analysis compared 3 groups defined on the basis of diagnostic assessment at 24 months : ( 1 ) siblings with ASD ( n = 15 ) , ( 2 ) siblings not meeting diagnostic criteria for ASD ( n = 82 ) , and ( 3 ) low-risk controls , none of whom had ASD ( n = 49 ) . Children with ASD showed delays in early language and communication compared with non-ASD siblings and controls . At 12 months , the ASD group was reported to underst and significantly fewer phrases and to produce fewer gestures . At 18 months , they showed delays in their underst and ing of phrases , comprehension and production of single words , and use of gestures . Siblings not diagnosed with ASD also used fewer play-related gestures at 18 months than low-risk controls , even when children with identified language delays were excluded . Overall , this prospect i ve study confirms that delays in communication and language development are apparent early in life in children with ASD , and emphasizes that developmental surveillance should include monitoring for delays in gesture , which may be among the earliest signs of ASD This study compared a common form of Applied Behavior Analysis Verbal Behavior ( ABA VB ) approach and music incorporated with ABA VB method as part of developmental speech- language training in the speech production of children with Autism Spectrum Disorders ( ASD ) . This study explored how the perception of musical patterns incorporated in ABA VB operants impacted the production of speech in children with ASD . Participants were 22 children with ASD , age range 3 to 5 years , who were verbal or pre verbal with presence of immediate echolalia . They were r and omly assigned a set of target words for each of the 3 training conditions : ( a ) music incorporated ABA VB , ( b ) speech ( ABA VB ) and ( c ) no-training . Results showed both music and speech trainings were effective for production of the four ABA verbal operants ; however , the difference between music and speech training was not statistically different . Results also indicated that music incorporated ABA VB training was most effective in echoic production , and speech training was most effective in tact production . Music can be incorporated into the ABA VB training method , and musical stimuli can be used as successfully as ABA VB speech training to enhance the functional verbal production in children with ASD Objective : Prospect i ve memory ( PM ) is the ability to remember to carry out an intended action . Working memory is the ability to store information in mind while processing potentially distracting information . The few previous studies of PM in autism spectrum disorder ( ASD ) have yielded inconsistent findings . Studies of working memory ability in ASD have suggested a selective impairment of “ visual working memory . ” However , it remains unclear whether any such impairment is the result of diminished ( domain-specific ; visual/verbal ) storage capacity or diminished ( domain-general ) processing capacity . We aim to clarify these issues and explore the relation between PM and working memory in ASD . Method : Seventeen adults with ASD and 17 age- and IQ-matched comparison participants completed experimental measures of both event-based ( perform action x when event y occurs ) and time-based ( perform action a at time b ) PM , plus a self-report measure of PM skills  . Participants also completed a working memory test battery . Results : Participants with ASD self-reported diminished PM skill , and showed diminished performance on the time-based , but not event-based , PM task . On the working memory test battery , visual but not verbal storage capacity was diminished among participants with ASD , as was processing ability . Whereas visual storage was associated with event-based PM task performance among comparison participants , verbal storage was associated among ASD participants . Conclusions : ASD appears to involve a selective deficit in time-based PM and a selective difficulty with aspects of working memory that depend on the storage of visual information . However , event-based PM may be achieved through compensatory strategies in ASD Purpose This study examined the effects of incorporating a peer-mediated approach into a speech-generating device ( SGD ) intervention on communication of 45 nonverbal and minimally verbal preschoolers with autism spectrum disorder ( ASD ) and 95 peers without disabilities . The SGD was an iPad 2 ( Apple ) with voice output app . Method Effects were evaluated using a multivariate r and omized control trial design with repeated measures for 4 cohorts across baseline , intervention , generalization , and maintenance phases . Children were r and omly assigned to an experimental treatment that trained peers on use of the SGD or a business-as-usual comparison condition with untrained peers .  Communication outcomes were measured for both children with ASD and peers . Results Children receiving the treatment demonstrated significant increases in rates of communication and more balanced responses and initiations ( a measure of reciprocity ) than children in the comparison group . They were able to generalize improvements and maintain communication gains . Treatment fidelity was high for school staff and peer implementation . Conclusions Results support positive effects on communication of teaching young children with ASD and peers without disabilities to use the same SGD system in typical preschool activities . SGD interventions that utilize peer-mediated approaches may improve core deficits in communication and reciprocity and allow for greater classroom social participation and interactions with peers BACKGROUND This prospect i ve study compared outcome for pre-school children with autism spectrum disorders ( ASD ) receiving autism-specific nursery provision or home-based Early Intensive Behavioural Interventions ( EIBI ) in a community setting . METHODS Forty-four 23- to 53-month-old children with ASD participated ( 28 in EIBI home-based programmes ; 16 in autism-specific nurseries ) . Cognitive , language , play , adaptive behaviour skills and severity of autism were assessed at intake and 2 years later . RESULTS Both groups showed improvements in age equivalent scores but st and ard scores changed little over time . At follow-up , there were no significant group differences in cognitive ability , language , play or severity of autism . The only difference approaching significance ( p = .06 ) , in favour of the EIBI group , was for Vinel and Daily Living Skills st and ard scores . However , there were large individual differences in progress , with intake IQ and language level best predicting overall progress . CONCLUSIONS Home-based EIBI , as implemented in the community , and autism-specific nursery provision produced comparable outcomes after two years of intervention The study compared the effect of music training , speech training and no-training on the verbal production of children with Autism Spectrum Disorders ( ASD ) . Participants were 50 children with ASD , age range 3 to 5 years , who had previously been evaluated on st and ard tests of language and level of functioning . They were r and omly assigned to one of three 3-day conditions . Participants in music training ( n = 18 ) watched a music video containing 6 songs and pictures of the 36 target words ; those in speech training ( n = 18 ) watched a speech video containing 6 stories and pictures , and those in the control condition ( n = 14 ) received no treatment . Participants ' verbal production including semantics , phonology , pragmatics , and prosody was measured by an experimenter design ed verbal production evaluation scale . Results showed that participants in both music and speech training significantly increased their pre to posttest verbal production . Results also indicated that both high and low functioning participants improved their speech production after receiving either music or speech training ; however , low functioning participants showed a greater improvement after the music training than the speech training .  Children with ASD perceive important linguistic information embedded in music stimuli organized by principles of pattern perception , and produce the functional speech Anxiety is common in children with autism spectrum disorders ( ASD ) , with specific fears and phobias one of the most frequent subtypes . Specific fears and phobias can have a serious impact on young people with ASD and their families . In this study we developed and evaluated a unique treatment combining cognitive behaviour therapy ( CBT ) with graduated exposure in a virtual reality environment ( VRE ) .  Nine verbally fluent boys with an ASD diagnosis and no reported learning disability , aged 7 to 13 years old , were recruited . Each had anxiety around a specific situation ( e.g. crowded buses ) or stimulus ( e.g. pigeons ) . An individualised scene was recreated in our ‘ wrap-around ’ VRE . In the VRE participants were coached by a psychologist in cognitive and behavioural techniques ( e.g. relaxation and breathing exercises ) while the exposure to the phobia/fear stimulus was gradually increased as the child felt ready . Each child received four 20–30 minute sessions . After participating in the study , eight of the nine children were able to tackle their phobia situation . Four of the participants completely overcame their phobia . Treatment effects were maintained at 12 months . These results provide evidence that CBT with VRE can be a highly effective treatment for specific phobia/fear for some young people with ASD . Trial Registration Controlled-Trials.com IS RCT N58483069 Prospect i ve memory ( PM ) refers to the implementation of delayed intentions , a cognitive ability that plays a critical role in daily life because of its involvement in goal -directed behavior and consequently the development and maintenance of independence . Emerging evidence indicates that PM may be disrupted in autism spectrum disorders ( ASDs ) , potentially contributing to the functional difficulties that characterize this group . However , the degree , nature , and specificity of ASD-related impairment remains poorly understood . In the current study , children between 8 and 12 years of age who were diagnosed with ASDs ( n=30 ) were compared with typically developing children ( n=30 ) on a child-appropriate version of the Virtual Week board game . This measure provides an opportunity to investigate the different sorts of PM failures that occur . The ASD group showed significant PM impairment on measures of time-based ( but not event-based ) prospect i ve remembering . However , only a subtle difference emerged between regular and irregular PM tasks , and group differences were consistent across these tasks . Because regular and irregular tasks differentially load retrospective memory , these data imply that the PM difficulties seen in ASDs may primarily reflect a monitoring deficit and not an encoding and memory storage deficit . PM performance was poorer under conditions of high ongoing task absorption , but the magnitude of this effect did not vary as a function of group . In both groups , time-based ( but not event-based ) PM difficulties were associated with functional outcomes in daily life , but only an inconsistent association with executive control emerged Early intervention for autism spectrum disorder ( ASD ) tends to focus on enhancing social-communication skills . We report the acceptability , feasibility and impact on child functioning of a new 8 weeks parent-group intervention to manage restricted and repetitive behaviours ( RRB ) in young children with ASD aged 3–7 years . Forty-five families took part in the pilot RCT . A range of primary and secondary outcome measures were collected on four occasions ( baseline , 10 , 18 and 24 weeks ) to capture both independent ratings and parent-reported changes in RRB . This pilot established that parents were willing to be recruited and r and omised , and the format and content of the intervention was feasible . Fidelity of delivery was high , and attendance was 90 % . A fully powered trial is now planned Delayed language development may be an early indicator of autism spectrum disorder ( ASD ) . Early intervention is critical for children with ASD , and the present study presents pilot data on a clinical trial of omega-3 and -6 fatty acid supplementation and language development , a secondary trial outcome , in children at risk for ASD . We r and omized 31 children to receive an omega-3 and -6 supplement or a placebo for 3 months , and measured their language abilities at baseline and after supplementation . Gesture use , but not word production , increased for children in the treatment group more than children in the placebo group . These results suggest possible effectiveness of omega-3 and -6 supplementation for language development in children at risk for ASD BACKGROUND Autism spectrum disorder ( ASD ) is a frequent developmental disorder characterized by pervasive deficits in social interaction , impairment in verbal and nonverbal communication , and stereotyped patterns of interests and activities . It has been previously reported that there is vitamin D deficiency in autistic children ; however , there is a lack of r and omized controlled trials of vitamin D supplementation in ASD children . METHODS This study is a double-blinded , r and omized clinical trial ( RCT ) that was conducted on 109 children with ASD ( 85 boys and 24 girls ; aged 3 - 10 years ) . The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children . ASD patients were r and omized to receive vitamin D3 or placebo for 4 months . The serum levels of 25-hydroxycholecalciferol ( 25 (OH)D ) were measured at the beginning and at the end of the study . The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale ( CARS ) , Aberrant Behavior Checklist ( ABC ) , Social Responsiveness Scale ( SRS ) , and the Autism Treatment Evaluation Checklist ( ATEC ) . TRIAL REGISTRATION NUMBER UMIN-CTR Study Design : trial number : UMIN000020281 . RESULTS Supplementation of vitamin D was well tolerated by the ASD children . The daily doses used in the therapy group was 300 IU vitamin D3/kg/day , not to exceed 5,000 IU/day . The autism symptoms of the children improved significantly , following 4-month vitamin D3 supplementation , but not in the placebo group . This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD . CONCLUSIONS This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients . Depending on the parameters measured in the study , oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD . At this stage , this study is a single RCT with a small number of patients , and a great deal of additional wide-scale studies are needed to critically vali date the efficacy of vitamin D in ASD BACKGROUND With rates of autism diagnosis continuing to rise , there is an urgent need for effective and efficient service delivery models . Pivotal Response Treatment ( PRT ) is considered an established treatment for autism spectrum disorder ( ASD ) ; however , there have been few well-controlled studies with adequate sample size . The aim of this study was to conduct a r and omized controlled trial to evaluate PRT parent training group ( PRTG ) for targeting language deficits in young children with ASD . METHODS Fifty-three children with autism and significant language delay between 2 and 6 years old were r and omized to PRTG ( N = 27 ) or psychoeducation group ( PEG ; N = 26 ) for 12 weeks . The PRTG taught parents behavioral techniques to facilitate language development . The PEG taught general information about ASD ( clinical trial NCT01881750 ; http://www . clinical trials.gov ) . RESULTS Analysis of child utterances during the structured laboratory observation ( primary outcome ) indicated that , compared with children in the PEG , children in the PRTG demonstrated greater improvement in frequency of utterances ( F(2 , 43 ) = 3.53 , p = .038 , d = 0.42 ) . Results indicated that parents were able to learn PRT in a group format , as the majority of parents in the PRTG ( 84 % ) met fidelity of implementation criteria after 12 weeks . Children also demonstrated greater improvement in adaptive communication skills ( Vinel and -II ) following PRTG and baseline Mullen visual reception scores predicted treatment response to PRTG . CONCLUSIONS This is the first r and omized controlled trial of group-delivered PRT and one of the largest experimental investigations of the PRT model to date . The findings suggest that specific instruction in PRT  results in greater skill acquisition for both parents and children , especially in functional and adaptive communication skills .  Further research in PRT is warranted to replicate the observed results and address other core ASD symptoms Earlier intervention improves outcomes for children with autism spectrum disorders ( ASDs ) , but existing identification tools are at the limits of st and ardization with 18-month-olds . We assessed potential behavioural markers of ASD at 18 months in a high-risk cohort of infant siblings of children with ASD . Prospect i ve data were collected using the Autism Diagnostic Observation Schedule ( ADOS ) and Autism Observation Scale for Infants ( AOSI ) on 155 infant siblings and 73 low-risk controls at 18 months . Infants were classified into three groups ( ASD sibs , non-ASD sibs , controls ) based on blind best-estimate diagnosis at age 3 . Fisher 's exact tests , followed by discriminant function analyses , revealed that the majority of informative ADOS items came from the social and behavioural domains , and AOSI items measuring behavioural reactivity and motor control contributed additional information . Findings highlight the importance of considering not only social-communication deficits , but also basic dimensions of temperament including state regulation and motor control when assessing toddlers with suspected ASD This study follows 40 children who were participants in a r and omized controlled early intervention trial ( Kasari et al. ) from early childhood ( 2–5 years of age ) to elementary school age ( 8–10 years ) . To fully utilize the available longitudinal data , the general linear mixed model was the primary analytical approach . The growth trajectories of joint attention skills ( pointing , coordinated joint looking , and showing ) and expressive language outcomes in these children were estimated based on five time points during the measurement period . The children were grouped by diagnosis at the last follow‐up ( autism , autism spectrum disorder ( ASD ) , no diagnosis ) and by their original treatment group assignment ( joint attention , symbolic play , control ) , and differences between these groups were evaluated . Results showed that joint attention skills of coordinated joint looking and showing increased over time , and pointing to share interest increased over the first year measured and decreased thereafter . These trajectories were influenced by both original treatment assignment and diagnostic status at follow‐up . In addition , a cross‐lagged panel analysis revealed a causal relationship between early pointing and later language development . This study highlights the longitudinal and developmental importance of measures of early core deficits in autism , and suggests that both treatment and ASD symptomatology may influence growth in these skills over time . Autism Res 2014 , 7 : 207–215 . © 2014 International Society for Autism Research , Wiley Periodicals , CONTEXT To our knowledge , there is no published information on the epidemiology of autism spectrum disorders ( ASDs ) in adults . If the prevalence of autism is increasing , rates in older adults would be expected to be lower than rates among younger adults . OBJECTIVE To estimate the prevalence and characteristics of adults with ASD living in the community in Engl and . DESIGN A stratified , multiphase r and om sample was used in the third national survey of psychiatric morbidity in adults in Engl and in 2007 . Survey data were weighted to take account of study design and nonresponse so that the results were representative of the household population . SETTING General community ( ie , private households ) in Engl and . PARTICIPANTS Adults ( people 16 years or older ) . MAIN OUTCOME MEASURES Autism Diagnostic Observation Schedule , Module 4 in phase 2 vali date d against the Autism Diagnostic Interview-Revised and Diagnostic Interview for Social and Communication Disorders in phase 3 . A 20-item subset of the Autism-Spectrum Quotient self-completion question naire was used in phase 1 to select respondents for phase 2 . Respondents also provided information on sociodemographics and their use of mental health services . RESULTS Of 7461 adult participants who provided a complete phase 1 interview , 618 completed phase 2 diagnostic assessment s. The weighted prevalence of ASD in adults was estimated to be 9.8 per 1000 ( 95 % confidence interval , 3.0 - 16.5 ) . Prevalence was not related to the respondent 's age . Rates were higher in men , those without educational qualifications , and those living in rented social ( government-financed ) housing . There was no evidence of increased use of services for mental health problems . CONCLUSIONS Conducting epidemiologic research on ASD in adults is feasible . The prevalence of ASD in this population is similar to that found in children . The lack of an association with age is consistent with there having been no increase in prevalence and with its causes being temporally constant . Adults with ASD living in the community are socially disadvantaged and tend to be unrecognized CONTEXT The presence of autistic-like traits in relatives of individuals with autism spectrum disorder ( ASD ) is well recognized , but , to our knowledge , the emergence of these traits early in development has not been studied . OBJECTIVE To prospect ively investigate the emergence of autistic-like traits in unaffected ( no ASD diagnosis ) infant siblings of prob and s diagnosed as having ASD . DESIGN Two groups of children unaffected with ASD were assessed prospect ively-siblings of prob and s diagnosed as having ASD ( high risk [ HR ] ) and control subjects with no family history of ASD ( low risk [ LR ] ) . Scores on a measure of autistic-like traits at 12 months of age were used in a cluster analysis of the entire sample . SETTING A prospect i ve study of infant siblings of prob and s with ASD from 3 diagnostic centers in Canada . PARTICIPANTS The study included 170 HR and 90 LR children , none of whom was diagnosed as having ASD at age 3 years . MAIN OUTCOME MEASURES The Autism Observation Scale for Infants was used to measure autistic-like traits and derive clusters at 12 months of age . Clusters were compared on ASD symptoms , cognitive abilities , and social-emotional difficulties at age 3 years . RESULTS Two clusters were identified . Cluster 1 ( n = 37 ; 14.2 % of total sample ) had significantly higher levels of autistic-like traits compared with cluster 2 . Within cluster 1 , 33 children came from the siblings ( 19.4 % of HR group ) and only 4 came from the control subjects ( 4.5 % of LR group ) . At age 3 years , children from cluster 1 had more social-communication impairment ( effect size > 0.70 ; P < .001 ) , lower cognitive abilities ( effect size = -0.59 ; P < .005 ) , and more internalizing problems ( effect size = 0.55 ; P = .01 ) . Compared with control subjects , HR siblings had a relative risk of 4.3 ( 95 % CI,1.6 - 11.9 ) for membership in cluster 1 . CONCLUSIONS Study findings suggest the emergence of autistic-like traits resembling a broader autism phenotype by 12 months of age in approximately 19 % of HR siblings who did not meet ASD diagnostic criteria at age 3 years Longitudinal research has demonstrated that responsive parental behaviors reliably predict subsequent language gains in children with autism spectrum disorder . To investigate the underlying causal mechanisms , we conducted a r and omized clinical trial of an experimental intervention ( Focused Playtime Intervention , FPI ) that aims to enhance responsive parental communication ( N = 70 ) . Results showed a significant treatment effect of FPI on responsive parental behaviors . Findings also revealed a conditional effect of FPI on children ’s expressive language outcomes at 12-month follow up , suggesting that children with baseline language skills below 12 months ( n = 24 ) are most likely to benefit from FPI .  Parents of children with more advanced language skills may require intervention strategies that go beyond FPI ’s focus on responsive communication
There was no evidence that AAC improved frequency of speech , verbal expressive vocabulary or children 's social communication or pragmatic language immediately postintervention .
Overall , neither of the interventions ( PECS or FPI ) result ed in maintained improvements in spoken or non-verbal communication in most children .
AUTHORS ' CONCLUSIONS There is limited evidence that verbally based and ACC interventions improve spoken and non-verbal communication in minimally verbal children with ASD .
In the study that used an AAC intervention , there were significant gains in frequency of PECS use and verbal and non-verbal initiations , but not in expressive vocabulary or social communication immediately postintervention .
In the study that investigated a verbally based intervention , there were no significant gains in expressive language postintervention , but children with lower expressive language at the beginning of the study improved more than those with better expressive language at baseline .
Neither study investigated adverse events , other communication skills , quality of life or behavioural outcomes .
BACKGROUND Autism spectrum disorder ( ASD ) has an estimated prevalence of around 1.7 % of the population .
People with ASD often also have language difficulties , and about 25 % to 30 % of children with ASD either fail to develop functional language or are minimally verbal .
The ability to communicate effectively is an essential life skill , and difficulties with communication can have a range of adverse outcomes , including poorer academic achievement , behavioural difficulties and reduced quality of life .
Historically , most studies have investigated communication interventions for ASD in verbal children .
We can not assume the same interventions will work for minimally verbal children with ASD .
OBJECTIVES To assess the effects of communication interventions  for ASD in minimally verbal children .